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The Centers for Disease Control and Prevention approved Thursday booster vaccines for millions of older or otherwise vulnerable Americans, ushering in a major new phase in the U.S. vaccination campaign against covid-19.
CDC director Dr Rochelle Walensky on Thursday evening approved a set of recommendations from a panel of advisers.
The advisers said boosters should be offered to people 65 and older, residents of nursing homes, and people aged 50 to 64 who have underlying health conditions at risk. The extra dose will be given once they are at least six months after their last shot of Pfizer.
However, Walensky decided to make a recommendation that the panel rejected.
On Thursday, the panel voted against the claim that people can get a booster if they are between the ages of 18 and 64 and are healthcare workers or have other employment that puts them at increased risk of exposure to the virus.
But Walensky disagreed and postponed the recommendation, noting that such a decision aligns with an FDA booster authorization decision at the beginning of the week. The category she included covers people who live in institutional settings that increase their risk of exposure, such as prisons or homeless shelters, as well as healthcare workers.
The panel had offered the option of a booster for 18 to 49 year olds who have chronic health conditions and want one. But counselors have refused to go any further and open reminders to otherwise healthy frontline health workers who are not at risk of serious illness but want to avoid even a mild infection.
The panel voted by 9 votes to 6 to reject this proposal. But Walensky decided to ignore the advice of the advisory committee on this issue. In a decision several hours after the panel adjourned, Walensky released a statement saying she had reinstated the recommendation.
“As director of the CDC, it’s my job to recognize where our actions can have the most impact,” Walensky said in a statement Thursday evening. “At the CDC, we’re tasked with analyzing complex, often imperfect, data to formulate actionable recommendations that optimize health. In a pandemic, even in the face of uncertainty, we must take actions that we believe will do the greatest good. ”
Experts say the top priority remains to vaccinate the unvaccinated, and the panel wondered whether the booster the debate diverted from this objective.
The three covid-19 vaccines used in the United States are still very protective against serious illness, hospitalization, and death, even with the spread of the extra-contagious delta variant. But only about 182 million Americans are fully immunized, or just 55% of the population.
“We can give people reminders, but that’s not really the answer to this pandemic,” said Dr Helen Keipp Talbot of Vanderbilt University. “The hospitals are full because people are not vaccinated. We refuse care to people who deserve care because we are full of unvaccinated covid-positive patients. ”
Thursday’s decision represented a dramatic cut in the Biden admin plan announced last month to hand out boosters to almost everyone to boost their protection. Late Wednesday, the Food and Drug Administration, like the CDC panel, approved Pfizer boosters for a much narrower segment of the population than envisioned by the White House.
The booster The plan marks a significant change in the country’s vaccination campaign. Britain and Israel are already giving a third round of gunfire despite strong objections from the World Health Organization that poor countries do not have enough for their initial doses.
Walensky opened Thursday’s meeting by stressing that immunizing the unvaccinated remains the primary focus “here in America and around the world.”
Walensky acknowledged that the data on who really needs a booster immediately “are not perfect”. “Yet collectively they form a picture for us,” she said, “and they are what we have right now to make a decision about the next stage of this pandemic. ”
The CDC panel stressed that its recommendations will be changed if new evidence shows more people need a booster.
CDC advisers have expressed concern over the millions of Americans who received injections of Moderna or Johnson & Johnson early in the vaccine rollout. The government has still not considered boosters for these brands and has no data as to whether it is safe or effective to mix and match and give these people a Pfizer injection.
“I just don’t understand how later this afternoon we can say to people 65 and over, ‘You are at risk of serious illness and death, but only half of you can protect yourself. right now, “” said Dr. Sarah Long of Drexel University.
About 26 million Americans received their last dose of Pfizer at least six months ago, of which about half are 65 or older. It’s unclear how many more would meet the expectations of the CDC panel booster qualifications.
Data from the CDC shows that vaccines still offer strong protection against serious illness for all ages, but there is a slight decline in older adults. And immunity to a milder infection seems to wane months after people are first vaccinated.
For most people, if you are not in a group recommended for a booster, “It’s really because we think you’re well protected,” said Dr. Matthew Daley of Kaiser Permanente Colorado.
Public health experts not involved in Thursday’s decision said people seeking a third dose at a pharmacy or other site were unlikely to be required to prove they qualify.
Even with the introduction of the boosters, a person who received only the first two doses would still be considered fully vaccinated, according to CDC’s Dr. Kathleen Dooling. This is an important question for people in parts of the country where you need to show proof of vaccination to eat in a restaurant or enter other workplaces.
Among those likely to benefit from booster, there is little risk, the CDC concluded. Serious side effects from the first two doses of Pfizer are extremely rare, including inflammation of the heart which sometimes occurs in younger men. Data from Israel, which gave nearly 3 million people – most of them 60 years and older – a third dose of Pfizer, revealed no red flags.
The United States has already authorized third doses of Pfizer and Moderna vaccines for certain people with weakened immune systems, such as cancer patients and transplant recipients. Other Americans, healthy or not, have been successful in getting reminders, in some cases just by asking.
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