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Dubai, United Arab Emirates (CNN) – Vaccine advisers from the US Centers for Disease Control and Prevention (CDC) argued at length on Thursday before agreeing to give booster doses of the “Pfizer” vaccine against Covid -19 to people 65 years of age and over Residents of long-term care facilities, as well as some people with underlying health problems.
However, councilors voted against recommending a booster dose for people whose work puts them at high risk of penetrating vaccine infection, i.e. they refused some of the US Food and Drug Administration emergency use authorization.
The United States Food and Drug Administration on Wednesday authorized the administration of the recalls to people 65 years of age and older, those at high risk of serious illness and death, and people such as healthcare workers. who are at risk of infection as a result of their work. .
But the broad nature of the emergency use authorization did not fit with several members of the Centers for Disease Control and Prevention’s advisory committee on immunization practices, who met Thursday to determine how best to implement. implement FDA clearance.
CDC advisers voted unanimously to recommend a booster dose of the Pfizer-Biontech vaccine for people 65 years of age or older who live in long-term care facilities for at least 6 months after their full vaccination.
They also voted to recommend booster doses for people 50 and older, as well as people with underlying health conditions that may put them at increased risk for serious illness.
During the meeting, Dr Kathleen Dowling of the Centers for Disease Control explained that cases include cancer, stroke, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, heart disease and obesity. , as well as pregnant women and smokers.
However, advisers were divided on whether to recommend such recalls for people under the age of 50.
In a separate question, they voted 9-6 to recommend booster doses for people aged 18 to 49 with underlying health conditions.
After much debate, they voted against recommending booster doses for people whose working conditions put them at risk of infection.
The chair of the Advisory Committee on Immunization Practices, Dr. Grace Lee, a pediatrician at Stanford University, said her personal experience had made her aware of the need to make boosters widely available.
“I took care of the children who died from COVID-19, and their families wanted extra protection for their children,” she explained.
Risk-benefit analysis
Analysis from the United States Centers for Disease Control and Prevention found that giving a booster dose to people 65 and older was more beneficial than giving it to people in younger age groups.
Dr Megan Wallace of the Centers for Disease Control told the meeting that vaccinating one million people aged 65 or older would prevent 8,000 cases of COVID-19 and 2,080 hospitalizations over six months.
She noted that the greatest risk of being vaccinated with Pfizer is a rare heart disease called myocarditis – and a single case of myocarditis can be expected in a million people vaccinated in this age group.
“Even if the risk of myocarditis doubled, we would still see more hospitalizations refused than expected,” she added.
For every million booster doses, the model predicted four cases of myocarditis in women and 48 cases in men aged 18 to 29.
Wallace told the meeting that the booster dose would prevent 9,500 cases and 114 hospitalizations in one million people aged 18 to 29 over six months.
And while they voted unhesitatingly to recommend booster doses for older groups, committee members feared sending the wrong message.
“I am concerned that we will be distracted by the question of boosters and Pfizer when we have bigger and more important topics to do during the pandemic,” said Dr Helen Kip Talbot, associate professor of medicine at Vanderbilt University. , during a meeting.
Dr James Lauer of Cayuga Medical Center in Ithaca, New York, doesn’t think the addition of the boosters will save many lives. we are making progress, “he said. Too much for ourselves and to have a lot of hope with these boosters.”
And he continued, “Even if we provide booster doses to the 13 million people over the age of 65 who have received the Pfizer vaccine in the past, the number of hospitalizations could be reduced by about 200 people per day, which is a significant number “. but the biggest goal should be to keep the unvaccinated, especially children, out of the hospital.
“However, we shouldn’t let perfection get in the way of good. And if we can do a little more by giving reminders to people over 65, I’m all for it.”
After the Director of the Centers for Disease Control, Dr. Rochelle Walinsky, signs off on the recommendations of the Advisory Committee on Immunization Practices, the booster doses can be given immediately to those recommended.
Dr Amanda Cohn, executive secretary of the CDC’s advisory committee on immunization practices, said the committee could come back at any time in the future to change its recommendations.
The third dose has already been approved and recommended for some immunocompromised people at risk of developing serious illness from COVID-19.
The US Food and Drug Administration’s emergency use clearance only covered Pfizer vaccine, with boosters reaching recipients of the first two doses of Pfizer vaccine at least six months in advance. The United States Food and Drug Administration has not acted on Moderna’s request for clearance for its booster doses, while Johnson & Johnson has yet to file a request.
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