LAURAN NEERGAARD and MIKE STOBBE, AP Medical Writer
The U.S. vaccination campaign against COVID-19 was on the verge of a major new phase when government advisers on Thursday recommended booster doses of the Pfizer vaccine to millions of elderly or otherwise at risk Americans – despite doubts, the extra vaccinations will go a long way in slowing the pandemic.
Advisors to the Centers for Disease Control and Prevention said boosters should be offered to people 65 and over, nursing home residents, and those ages 50 to 64 with high-risk health problems. The extra dose would be given to them once they were at least six months after their last Pfizer shot.
Deciding who else could get one was much more difficult. While there is little evidence that younger people are at risk of losing immunity, the panel offered the option of a refresher for those ages 18 to 49 who have and want chronic health problems.
Consultants refused to go any further and offer boosters to otherwise healthy frontline health workers who are not at risk of serious illness but want to avoid even a mild infection.
“We might as well say give it to everyone aged 18 and over. We have a very effective vaccine and it’s like saying, ‘It doesn’t work’. It works, ”said Dr. Ohio State University’s Pablo Sanchez for helping block the widest booster option.
Still, giving the unvaccinated their first shots remains a top priority, and the panel debated whether the booster debate distracted from that goal.
All three COVID-19 vaccines used in the United States still offer high levels of protection against serious illness, hospitalization, and death, despite the spread of the extra-contagious Delta variant. But only about 182 million Americans are fully vaccinated, or only 55% of the population.
“We can give people a boost, but that’s not really the answer to this pandemic,” said Dr. Helen Keipp Talbot from Vanderbilt University. “The hospitals are full because the people aren’t vaccinated. We refuse to care for people who deserve care because we are full of unvaccinated COVID positive patients. “
Thursday’s decision represented a dramatic reduction in the Biden administration’s announced plan last month to distribute boosters to almost everyone to bolster their protection. Late Wednesday, the Food and Drug Administration, like the CDC panel, signed Pfizer boosters for a much narrower segment of the population than the White House had imagined.
It is up to the CDC to determine final US policy on who will qualify for the extra shot. A decision from the agency was expected later Thursday, but the CDC usually follows recommendations from its advisors.
The booster plan marks an important change in the country’s vaccination campaign. The UK and Israel are already giving a third round of syringes amid strong objections from the World Health Organization that poor countries do not have enough for their starting doses.
CDC director Dr. Rochelle Walensky opened the meeting on Thursday by emphasizing that vaccination of the unvaccinated remains the ultimate goal “here in America and around the world”.
Walensky admitted that the data on who really needs a booster right away is “not perfect”. “But together they form a picture for us,” she said, “and they are what we have right now to make a decision about the next phase of this pandemic.”
The CDC Panel stressed that its recommendations will be changed when new evidence shows that more people need a refresher.
CDC advisors expressed concern about the millions of Americans who received Moderna or Johnson & Johnson shots when the vaccine launch began. The government still hasn’t considered boosters for these brands and has no data on whether it’s safe or effective to combine these people and give them a Pfizer shot.
“I just don’t see how we can tell people 65 and over this afternoon, ‘You are at risk of getting seriously ill and dying, but only half of you can protect yourself right now,'” said Dr. Sarah Long of Drexel University.
About 26 million Americans received their last dose of Pfizer at least six months ago, of whom about half are 65 years of age or older. It is not clear how many more would meet the CDC panel’s booster qualifications.
CDC data shows that vaccines still offer strong protection against serious illness for all ages, but there is a slight decrease in the oldest adults. And immunity to lighter infections appears to decline months after people are first vaccinated.
For most people, if you don’t belong to a group recommended for a refresher, “it really is because we think you are well protected,” said Dr. Matthew Daley of Kaiser Permanente Colorado.
Public health experts who were not involved in Thursday’s decision said it was unlikely that people looking for a third dose at a drugstore or elsewhere would need to demonstrate they qualify for it.
Even with the introduction of boosters, someone who received only the first two doses would, according to Dr. Kathleen Dooling of the CDC is still considered fully vaccinated. This is an important question for people in parts of the country where you need to show a vaccination card to eat in a restaurant or to enter other stores.
Risks are few among people who could benefit from a booster, according to the CDC. Serious side effects with the first two doses of Pfizer are extremely rare, including heart inflammation, which sometimes occurs in younger men. Data from Israel, which has given a third dose of Pfizer to nearly 3 million people – mostly 60 and older – has uncovered any warning signs.
The US has already approved third doses of the Pfizer and Moderna vaccines for certain people with compromised 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.
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