Dr. Rochelle Walensky, Director of the CDC, signed off late Thursday on a number of recommendations made by a panel.
Advisors recommended that boosters be given to seniors 65 years and over, residents of nursing homes, and people 50-64 who have serious underlying health conditions. They would receive the extra dose if they have not received their last Pfizer shot in six months.
Walensky, however, decided to make a recommendation that the panel rejected.
On Thursday, the panel voted against allowing people to get a booster if their ages are between 18 and 64 and if they work in health-care or another occupation that increases their risk of contracting the virus.
Walensky disagreed with her recommendation and resubmitted it, noting that this move is in line with an FDA booster approval decision made earlier this week. She included people who are exposed in institutions such as homeless shelters and prisons.
The panel offered the option to a booster for people aged 18-49 who have chronic health issues and wish one. The panel refused to offer a booster to anyone over 50 who isn't at high risk for severe illness, but wants to prevent even mild infections.
This proposal was rejected by the panel 9 to 6. Walensky chose to ignore the advice of the advisory committee on this issue. Walensky made a statement stating that she had returned the recommendation, several hours after the panel adjourned.
Walensky stated that as CDC Director, "It is my job to recognize the areas where our actions can make the most impact." He made this statement late Thursday night. "We at CDC are tasked to analyze complex, sometimes imperfect data in order to make concrete recommendations that optimize our health. We must act in a situation like a pandemic. Even with uncertainty, this is what we do best.
Experts agree that getting unvaccinated children their first shot is the most important goal. The panel debated whether booster debates were distracting from this goal.
The three COVID-19 vaccines are still highly effective in protecting against severe illness, hospitalization, and death. This is even after the introduction of the delta variant. Only 182 million Americans have been fully vaccinated. This is 55% of the total population.
"We can give boosters, but that is not really the solution to this pandemic," Dr. Helen Keipp Talbot from Vanderbilt University said. "Hospitals have a high number of unvaccinated patients, which is why they are overcrowded. Because we have a lot of COVID-positive unvaccinated patients, we are unable to provide care to the people who need it.
Thursday's decision was a drastic reversal of the Biden administration's plan to distribute boosters to almost everyone in order to strengthen their protection. The Food and Drug Administration approved Pfizer boosters late Wednesday night, just like the CDC panel.
This booster plan represents a significant shift in the nation’s vaccination drive. Over strong objections by the World Health Organization, Israel and Britain are now giving a third round to counter claims that countries with low incomes don't have enough vaccines.
Walensky opened the meeting on Thursday by stressing that the goal of vaccinating unvaccinated people remains the highest priority "here in America" and "around the world."
Walensky admitted that there are not enough data to determine who needs a boost right away.
If new evidence suggests that more people require a booster, the CDC panel will change its recommendations.
The CDC advisors expressed concern about the millions of Americans who were given Moderna or Johnson & Johnson shots during the early stages of the vaccine rollout. The government hasn't yet considered boosters for these brands and doesn't have any data to show whether mixing-and-matching and giving those people a Pfizer shot is safe or effective.
Dr. Sarah Long, of Drexel University, stated that "I don't know how late this afternoon we can tell people 65 years and older, 'You are at risk for severe illness, and death, but only half can protect themselves right now.'
26 million Americans received their last Pfizer dose within six months. About half of them are 65 years old or older. It is not known how many additional people would be eligible for the CDC panel's booster qualification.
The CDC data shows that vaccines offer strong protection against serious illnesses for all ages. However, there is a slight decline in elderly people. The immunity to milder infections appears to be decreasing months after the initial vaccination.
Most people don't need boosters if they aren't in a group that is recommended. Dr. Matthew Daley from Kaiser Permanente Colorado said, "It's because we think you're protected."
Experts in public health who were not involved in Thursday’s decision stated that it is unlikely that people seeking third doses at a pharmacy or another site will need to prove their eligibility.
According to Dr. Kathleen Dooling, even with the introduction boosters, a person who has received only the first two doses of vaccine would still be considered fully vaccinated. This is a crucial question for people living in areas where proof of vaccination is required to enter restaurants or other businesses.
The CDC found that there are very few risks for people who could benefit from a booster. Side effects of the first two Pfizer doses have been extremely rare. This includes heart inflammation, which can sometimes occur in younger men. The data from Israel has not revealed any warning signs after nearly 3 million people, mostly aged 60 or older, received a third dose of Pfizer.
For certain individuals with compromised immune systems such as transplant recipients and cancer patients, the U.S. has approved third doses of Pfizer and Moderna vaccinations. Others, whether they are healthy or not have been able to receive boosters. In some cases, it was as simple as asking.