The US Centers for Disease Control and Prevention on Thursday endorsed booster shots for millions of older or otherwise vulnerable Americans, starting a major new phase in the US vaccination campaign against COVID-19.
CDC Director Dr. Rochelle Valensky signed a series of recommendations from a panel of advisors late Thursday. The advisors said the booster should be offered to people aged 65 and over, nursing home residents and those aged 50 to 64 who have risky underlying health problems. Additional doses will be given when they are at least six months after their last Pfizer shot.
However, Valensky decided to make a recommendation which was rejected by the panel.
The panel on Thursday voted against saying people can get a booster if they are between the ages of 18 and 64 and are health care workers or have any other work that puts them at increased risk of exposure to the virus. Is.
But Valensky disagreed and held back that recommendation, noting that such a move aligns with an FDA booster authorization decision earlier this week. The category she covered includes people who live in institutional settings that increase their risk of exposure, such as prisons or homeless shelters, as well as health care workers.
The panel had offered the option of a booster for those aged 18 to 49 who have chronic health problems and want one. But advisers refused to go any further and open up boosters to otherwise healthy front-line health care workers who are not at risk of serious illness but want to avoid even a mild infection.
The panel voted 9 to 6 to reject that proposal. But Valensky decided to disregard the advisory committee’s counsel on that issue. In a decision several hours after the panel was adjourned, Valensky issued a statement saying he had reinstated the recommendation.
“As CDC director, it is my job to identify where our actions can have the most impact,” Valensky said in a statement late Thursday. “At the CDC, we are tasked with analyzing complex, often incomplete data to make concrete recommendations that optimize health. In a pandemic, even with uncertainty, we must take the steps we hope will be the biggest will be good. “
Experts say getting your first shots without vaccination is a top priority, and the panel wrestled whether the booster debate was deviating from that goal.
All three COVID-19 vaccines used in the US are still highly protective against serious illness, hospitalization, and death, even with the spread of the extra-infectious delta variant. But only 182 million Americans are fully vaccinated, or only 55% of the population.
“We can give people boosters, but it’s not really the answer to this pandemic,” said Dr Helen Keep Talbot from Vanderbilt University. “Hospitals are full because people are not vaccinated. We are stopping caring for people who deserve care because we have an influx of unvaccinated COVID positive patients.”
Thursday’s decision represented a dramatic scaling up of the Biden administration plan announced last month to give nearly everyone a booster for their own safety. Late Wednesday, a CDC panel like the Food and Drug Administration signed off on a Pfizer booster to a much narrower slice of the population than the White House imagined.
The booster scheme marks a significant change in the country’s vaccination campaign. Britain and Israel are already offering third-round shots over strong objections from the World Health Organization that poor countries do not have enough for their initial doses.
Valensky began Thursday’s meeting by emphasizing that unvaccinated vaccination remains the top goal “here in the US and around the world.”
Valensky acknowledged that the data on people who really need boosters is “not accurate.” “Yet collectively they form a picture for us,” she said, “and they are the ones we have at this point in time to make decisions about the next steps in this pandemic.”
The CDC panel insisted that its recommendations be changed if new evidence shows more people need boosters.
CDC advisors expressed concern over the millions of Americans who received either Moderna or Johnson & Johnson shots early in the vaccine rollout. The government still hasn’t considered boosters for those brands and there’s no data on whether it’s safe or effective to mix and match and give those people the Pfizer shot.
“I don’t understand how later this afternoon we can say to people 65 and older, ‘You’re at risk of serious illness and death, but only half of you can protect yourself,’” Dr. . Sarah Long of Drexel University.
About 26 million Americans got their last Pfizer dose at least six months ago, about half of whom are 65 or older. It’s not clear how many more will meet the CDC panel’s booster qualifications.
CDC data shows that vaccines still provide strong protection against serious disease for all ages, but there has been a slight decline in the oldest adults. And it appears that people’s immunity to minor infections begins to decline months after their initial vaccination.
For most people, if you’re not in the recommended group for boosters, “it’s really because we think you’re well protected,” said Dr. Matthew Daly of Kaiser Permanente Colorado.
Public health experts not involved in Thursday’s decision said it was unlikely that people taking a third dose at a drugstore or other site would need to prove they qualify.
According to the CDC’s Dr. Kathleen Dooling, even with the introduction of a booster, someone who has received only the first two doses will still be considered fully vaccinated. This is an important question for people in parts of the country where you are required to show proof of vaccination to eat in a restaurant or enter other places of business.
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