COVID vaccine in hands of caregiver

Update, 11/19/21: Subsequent to the publication of this article, the CDC director endorsed the recommendation of the CDC’s Advisory Committee on Immunization Practices.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices unanimously voted Friday afternoon to open up COVID-19 booster vaccination to all adults age 18 and older who already have been fully vaccinated with the Pfizer-BioNTech or Moderna vaccine.

The CDC director now will make a decision on the recommendation.

Anyone 50 or older, and anyone 18 or older living in a long-term care facility, who already has been fully vaccinated with the Pfizer-BioNTech or Moderna vaccine should receive a COVID-19 booster dose, the committee determined. Additionally, anyone 18 or older who already has been fully vaccinated with the Pfizer-BioNTech or Moderna vaccine may receive a COVID-19 booster dose.

Any vaccine that has been approved or authorized by the Food and Drug Administration — a list that currently includes the Pfizer-BioNTech, Moderna and Janssen (Johnson & Johnson) vaccines — can be used for the booster, regardless of the vaccine someone initially received as part of his or her primary series (first two shots). Individuals should wait at least six months before getting a booster, the committee recommended.

Two votes were taken — one for the 18-and-older recommendation and one for the 50-and-older recommendation, and for both, the vote was 11 in favor, with nobody voting against either measure.

Committee members said they hoped that the recommendations would increase uptake of the booster, noting that they should make it easier for the public to understand who is eligible.

Previously, a single booster dose of the Pfizer-BioNTech or Moderna COVID-19 vaccines was recommended only for adults aged 65 or more years, those aged 18 to 64 at high risk of severe COVID-19, and those aged 18 to 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2, such as workers in senior living communities.

CDC committee members noted that 75% of adults aged 50 to 64 already were eligible under previous criteria that authorized vaccination for anyone with an underlying medical condition that put them at greater risk of a severe case of COVID-19. Even those 50 to 64 without underlying medical conditions may be at increased risk of severe COVID, members noted.

Nirav Shah, M.D., J.D., director of the Maine Center for Disease Control and Prevention and president of the Association of State and Territorial Health Officials, told committee members that during a call with other state health officials on Thursday, “there was not one single state” that opposed the move to open up COVID-19 vaccination boosters to all adults. State health officials were concerned that, already, many eligible individuals were not taking the booster shot because they were confused as to whether they were eligible, he said.

The ACIP vote followed a Friday morning authorization by the Food and Drug Administration of a single booster dose of the Pfizer-BioNTech and Moderna COVID-19 vaccines for everyone 18 or older after they have completed primary vaccination with any FDA-authorized or approved COVID-19 vaccine.

This is a developing story.