With booster doses of Pfizer’s COVID-19 vaccine now authorized in the U.S., an influential panel of advisers to the Centers for Disease Control and Prevention reconvened on Thursday to tackle the most contentious question yet: Exactly who should roll up their sleeves right away?
The CDC sets final U.S. policy on who qualifies for the extra shot. And the CDC’s advisers voted Thursday on how many of the roughly 26 million Americans who had their last Pfizer shot at least six months ago should go ahead and get that third dose. The CDC advisory panel backed the decision for Pfizer COVID-19 booster shots for millions of older or otherwise vulnerable Americans.
The U.S. vaccination drive against COVID-19 stands on the verge of a major new phase: Government advisers on Thursday recommended booster doses of Pfizer’s vaccine for millions of Americans.
The advisory panel to the Centers for Disease Control and Prevention recommended the extra doses for people 65 and older, nursing home residents, and people who are 50 to 64 with underlying medical conditions. It also said boosters can be offered to people 18 to 49 with underlying conditions.
The shots would be given at least six months after the second dose of the Pfizer vaccine.
The CDC panel stressed its recommendations will be changed if new evidence shows more people need a booster.
The CDC advisers expressed concern over the millions more Americans who received Moderna or Johnson & Johnson shots early in the vaccine rollout. The government still hasn’t considered boosters for those brands and has no data on whether it’s safe or effective to mix-and-match and give those people a Pfizer shot.
“I just don’t understand how later this afternoon we can say to people 65 and older you’re at risk for severe illness and death but only half of you can protect yourselves right now,” said Dr. Sarah Long of Drexel University.
But for most people, if you’re 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. “This isn’t about who deserves a booster, but who needs a booster."
The CDC presented data showing the vaccines still offer strong protection for all ages, but there is a slight drop among the oldest adults. And immunity against milder infection appears to be waning months after people's initial immunization.
Late Wednesday, the Food and Drug Administration signed off on extra shots of the Pfizer formula for a broad swath of Americans: those 65 and older, people at high risk of severe illness, and health care workers and others in danger of becoming infected on the job.
They also wrestled with how to tell when a booster is needed. While an extra dose revs up numbers of virus-fighting antibodies, those naturally wane over time and no one knows how long the antibody boost from a third Pfizer dose will last -- or how much protection it really adds since the immune system also forms additional defenses after vaccination.
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The U.S. has already authorized third doses of the Pfizer and Moderna vaccines for certain people with weakened immune systems, such as cancer patients and transplant recipients. Other Americans, healthy or not, have managed to get boosters, in some cases simply by asking.
The widespread dispensing of the boosters would represent an important new phase in the nation's vaccination drive. Britain and Israel are already rolling out a third round of shots over strong objections from the World Health Organization that poor countries don't have enough for their initial doses.
The priority still is to vaccinate the unvaccinated. About 182 million Americans, or 55% of the population, are fully vaccinated.
The COVID-19 vaccines used in the U.S. still offer strong protection against severe illness, hospitalization and death, but immunity against milder infection appears to be waning months after people’s initial vaccination.
The FDA rejected a sweeping Biden administration plan announced a month ago to offer boosters to the general population, instead embracing a more targeted approach for now. Acting FDA Commissioner Dr. Janet Woodcock cautioned that booster decisions could very well change as real-world data come in.
“As we learn more about the safety and effectiveness of COVID-19 vaccines, including the use of a booster dose, we will continue to evaluate the rapidly changing science and keep the public informed,” Woodcock said.
The World Health Organization and other global health advocates are opposed to wealthy nations dispensing a third round of shots when poor countries don’t have enough vaccine for their first doses. And many independent scientists say that the vaccines continue to perform well against the worst effects of COVID-19 and that their ability to curb the overall trajectory of the epidemic is uncertain.
The U.S. is dispensing around 760,000 vaccinations per day on average, down from a high of 3.4 million a day in mid-April. About 182 million Americans are fully vaccinated, or 64% of those who are eligible.