- A CDC committee is meeting Wednesday to decide who should be eligible for a booster dose of Pfizer-BioNTech’s COVID-19 vaccine.
- However, the FDA hasn’t yet authorized a third dose. So the CDC group will only vote if the FDA acts in the meantime.
- Any decision isn’t necessarily the final one. As new data emerges, more people may be recommended for a booster.
A committee of experts spent more than five hours Wednesday reviewing data on the safety and effectiveness of a third shot of the Pfizer-BioNTech COVID-19 vaccine.
The committee, which advises the Centers for Disease Control and Prevention, is likely to vote Thursday on who should be eligible for a third shot. People who are severely immunocompromised and might not have gotten protection from the first two doses, have been able to get a third dose for the past six weeks or so.
Among the more than 20,000 people who were tracked after receiving a third dose, no major safety concerns popped up, CDC officials said Wednesday. If anything, their side effects were milder than those reported after first and second doses, though their experiences might not be representative.
Because the immune system’s effectiveness declines with age, people older than 65 are likely to get the biggest benefit from a booster dose.
Last week, a different advisory panel recommended that the Food and Drug Administration allow third doses of the Pfizer-BioNTech vaccine six months after a second shot for people over 65 and those at high risk for severe COVID-19.
The CDC panel, called the Advisory Committee on Immunization Practices, can’t decide the details of who should be eligible for a booster until the FDA authorizes a broader use of third shots.
That FDA decision is expected before the CDC committee reconvenes Thursday at noon EDT.
If the FDA makes a decision, the ACIP committee will vote on eligibility near the end of its scheduled three-hour meeting. The CDC director has to sign off on its recommendation before boosters could become more widely available.
The decision would affect only the Pfizer-BioNTech vaccine, because there is much less data on the long-term effectiveness of the other two authorized shots, from Moderna and Johnson & Johnson.
Several ACIP members expressed concern Wednesday that limiting boosters to one company’s vaccine would cause confusion and make it more likely for people to switch vaccines – though there’s limited evidence that this is safe.
Data from Israel, which authorized booster shots for its entire population, and from lab studies by the companies, suggests that protection against any infection with COVID-19 begins to fade after about six months. It’s not clear whether protection against severe disease will decline after that, but Israeli data suggests it might.
People over 65 saw the biggest decline in protection in the face of the delta variant of the coronavirus that dominates the USA.
Other groups did not show heightened risk for severe disease, according to data presented by the CDC. People with heart disease showed only a slight decline in vaccine protection, and people who are obese saw almost no drop-off. There was no clear difference by race or ethnicity.
A CDC model of nursing home patients showed clear benefit from a third shot, but they benefited even more when their caregivers were vaccinated and when infection rates were low in the surrounding communities.
No number of boosters will prevent all infections with COVID-19, several committee members said, but Pfizer and BioNTech’s data suggest they will improve the immune response, preventing some serious cases and deaths.
Health care workers, who tend to be younger and healthier than the general population, also fared well.
Some areas are so desperate for health care workers because of COVID-19 outbreaks that they can’t afford to have people out sick, said committee member Helen Keipp Talbot, a doctor at Vanderbilt University Medical Center in Nashville, Tennessee.
A booster might not save health care workers from severe disease, but it might prevent absenteeism, she said. “The idea would be to maintain necessary and needed staffing levels, because we have such large populations that are unvaccinated (and falling ill).”
The CDC presented updated information showing that COVID-19 vaccination protects pregnant people and their babies against a dangerous infection and is safe for both.
The committee must make its decision on boosters in the face of many questions that have no answers, including whether people who have caught COVID-19 and are vaccinated will benefit from a third shot.
Whatever the committee decides, it isn’t likely to be the last word on boosters, several members said. The situation with COVID-19 evolves as data regularly becomes available, saidDr. Julie Morita, a former committee member and executive vice president of the Robert Wood Johnson Foundation, a health-focused nonprofit group.
“If the pandemic has done nothing else,” she said, “it’s made clear that recommendations like this for a vaccination or other preventative measures evolve and change based on the data as it becomes available.
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