CDC panel endorses Pfizer booster shot for elderly, high-risk people

The Centers for Disease Control and Prevention’s vaccine advisory committee on Thursday endorsed the use of Pfizer and BioNTech’s Covid-19 booster shot for elderly people, nursing home residents and those who may be at risk of developing severe disease, a move that could allow broad latitude for people to access additional doses.

But the panel rejected the notion of offering boosters to health care workers and others who may encounter the virus in the course of their jobs or “institutional” settings, such as prisons or homeless shelters.

The independent committee said the booster dose should be given at least six months after the initial two-dose vaccination series.

It unanimously voted for boosters for people 65 and older and those who live in long-term care homes, and backed — with some limits — shots for people between 18 and 64 with underlying medical conditions that raise their risk of severe Covid-19. People between 18 and 49 in the latter category would be directed to weigh the benefits and risks in consultation with their doctors or pharmacists, but they wouldn’t have to provide documentation to support their reasons for seeking a booster.

The CDC panel’s votes Thursday afternoon came less than a day after the Food and Drug Administration authorized the Pfizer-BioNTech booster for people 65 and older and those ages 18 to 64 with underlying health conditions. FDA also allowed the booster for people 18 to 64 who may be at risk of contracting or transmitting Covid-19 at work, such as doctors or nurses, or in congregate settings.

The final step in the process will come when CDC Director Rochelle Walensky approves the CDC advisory panel’s recommendations, clearing the way for a slightly narrower booster rollout than the FDA envisioned in its authorization. That does not mean that the two health agencies will not decide at some point to formally broaden the groups eligible for boosters.

CDC advisory panel members couched its decisions as “interim recommendations” in an effort to emphasize the evolving data and on-the-ground realities influencing their decision-making.

But it’s unclear to what extent the committee’s recommendations could prevent Americans who aren’t technically eligible under the new parameters from accessing boosters. Federal health officials have already allowed moderately to severely immunocompromised Americans to receive additional doses of either Pfizer’s or Moderna’s vaccines by attesting to their conditions, with 2.3 million having gotten them as of Wednesday.

“We might as well say, ‘Just give it to anyone 18 and older,'” said Pablo Sanchez of Ohio State University’s Nationwide Children’s Hospital.

Walensky applauded the committee’s work at the beginning of Thursday’s meeting, touting the importance of discussing different opinions to reach consensus on how to use the vaccine in real-world settings.

“This is a tremendous amount of work, a tremendous amount of data to review and, in truth, a tremendous service,” she said.

There was little debate on the benefits of boosting seniors, whose protection against severe disease and hospitalization has been shown to wane over time — and possibly due to the prevalence of the highly contagious Delta variant.

But committee members diverged on whether any adult who was initially immunized with the Pfizer product who either has an underlying medical condition or whose work or living situation put them at high risk for severe disease should get a booster now.

Members also fretted over the implications of approving one brand’s booster without allowing recipients of others authorized for use in the U.S. — Moderna and Johnson & Johnson’s — to access it, since mixing vaccine brands has yet to be sanctioned by the FDA.

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The Centers for Disease Control and Prevention’s vaccine advisory committee on Thursday endorsed the use of Pfizer and BioNTech’s Covid-19 booster shot for elderly people, nursing home residents and those who may be at risk of developing severe disease, a move that could allow broad latitude for people to access additional doses.

But the panel rejected the notion of offering boosters to health care workers and others who may encounter the virus in the course of their jobs or “institutional” settings, such as prisons or homeless shelters.

The independent committee said the booster dose should be given at least six months after the initial two-dose vaccination series.

It unanimously voted for boosters for people 65 and older and those who live in long-term care homes, and backed — with some limits — shots for people between 18 and 64 with underlying medical conditions that raise their risk of severe Covid-19. People between 18 and 49 in the latter category would be directed to weigh the benefits and risks in consultation with their doctors or pharmacists, but they wouldn’t have to provide documentation to support their reasons for seeking a booster.

The CDC panel’s votes Thursday afternoon came less than a day after the Food and Drug Administration authorized the Pfizer-BioNTech booster for people 65 and older and those ages 18 to 64 with underlying health conditions. FDA also allowed the booster for people 18 to 64 who may be at risk of contracting or transmitting Covid-19 at work, such as doctors or nurses, or in congregate settings.

The final step in the process will come when CDC Director Rochelle Walensky approves the CDC advisory panel’s recommendations, clearing the way for a slightly narrower booster rollout than the FDA envisioned in its authorization. That does not mean that the two health agencies will not decide at some point to formally broaden the groups eligible for boosters.

CDC advisory panel members couched its decisions as “interim recommendations” in an effort to emphasize the evolving data and on-the-ground realities influencing their decision-making.

But it’s unclear to what extent the committee’s recommendations could prevent Americans who aren’t technically eligible under the new parameters from accessing boosters. Federal health officials have already allowed moderately to severely immunocompromised Americans to receive additional doses of either Pfizer’s or Moderna’s vaccines by attesting to their conditions, with 2.3 million having gotten them as of Wednesday.

“We might as well say, ‘Just give it to anyone 18 and older,'” said Pablo Sanchez of Ohio State University’s Nationwide Children’s Hospital.

Walensky applauded the committee’s work at the beginning of Thursday’s meeting, touting the importance of discussing different opinions to reach consensus on how to use the vaccine in real-world settings.

“This is a tremendous amount of work, a tremendous amount of data to review and, in truth, a tremendous service,” she said.

There was little debate on the benefits of boosting seniors, whose protection against severe disease and hospitalization has been shown to wane over time — and possibly due to the prevalence of the highly contagious Delta variant.

But committee members diverged on whether any adult who was initially immunized with the Pfizer product who either has an underlying medical condition or whose work or living situation put them at high risk for severe disease should get a booster now.

Members also fretted over the implications of approving one brand’s booster without allowing recipients of others authorized for use in the U.S. — Moderna and Johnson & Johnson’s — to access it, since mixing vaccine brands has yet to be sanctioned by the FDA.

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