CDC vaccine advisers endorse Pfizer, Moderna COVID boosters for all adults

A CDC committee of vaccine advisers signed off on allowing adults 18 and older to receive a COVID-19 booster dose from either the Pfizer or Moderna vaccines. After hours of discussion, the committee said people 50 and older "should" get a booster, while people 18 to 49 "may" get an additional coronavirus vaccine dose.

The Advisory Committee on Immunization Practices (ACIP) endorsed boosters for all adults by a unanimous vote Friday afternoon. The recommendations advance to CDC director Rochelle Walensky for final approval.

Earlier in the day, the FDA granted emergency use authorizations simultaneously to Pfizer and Moderna for booster doses in all adults. In September, Pfizer received a go-ahead for booster vaccinations for those 65 and older and others at elevated risks. Moderna received its nod in the same population four weeks later.

The CDC action means that boosters could be provided the general population as soon as this weekend.

There is some urgency for administering shots. CDC advisers heard evidence at the meeting that COVID-19 cases have risen in the United States over the last three weeks.

Amid the discussion, ACIP tweaked its language surrounding the endorsement, concluding that those 50 and older “should” receive a booster while those 18 to 49 “may” get a booster.

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The endorsement will help clear some confusion about eligibility. The previous booster approvals covered adults of all ages who had underlying conditions or occupations that put them at a higher risk to be exposed to the virus, leaving some gray area for U.S. residents and providers.

For example, some of the underlying conditions include those who are overweight or who have smoked at any time in their lives.

“As a clinician, deep in the clinical trenches, I am really glad that we have clarity and streamlining of the recommendations so that all Americans can understand the vaccines that are recommended for them at this time,” Camille Kotton, M.D., of Massachusetts General Hospital said.

When ACIP met in September and signed off on booster doses for those 65 and older, it rejected providing boosters for the general adult population. At the time, several committee members said there wasn’t sufficient data to recommend a sweeping nod. Similar concerns were raised a month ago, when the ACIP met to discuss Moderna’s application.

Earlier this week, the White House’s chief medical adviser Anthony Fauci urged U.S. residents to get vaccinated and those who are eligible to receive booster doses.

“The Israelis have shown that when you boost, you multifold diminish the likelihood of getting infected, getting sick or dying,” Fauci said during a White House press briefing.

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During Friday’s meeting, there was little dissent to recommending boosters for all adults. The primary area of discussion surrounded whether to attach the “should” recommendation to people aged 50 and older. Ultimately, all 11 voting members agreed to do so.

“During a pandemic, both speed and process are incredibly important and ensuring that the public can understand the rationale behind any recommendation is critical for ongoing public trust,” said ACIP chair Grace Lee.