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US CDC advisers back COVID-19 booster shots for those 65 and older, not for high-risk workers

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A US Centers for Disease Control and Prevention (CDC) advisory panel on Thursday recommended a booster shot of the Pfizer (PFE.N) and BioNTech COVID-19 vaccine for Americans aged 65 and older and some adults with underlying medical conditions that put them at risk of severe disease.

The panel by a vote of 9-6 declined to recommend boosters for adults ages 18 to 64 who live or work in institutions with high risk of contracting COVID-19, based on individual risk, such as healthcare workers, teachers and residents of homeless shelters and prisons. Some panel members cited the difficulty of implementing such a proposal.

Panel member Lynn Bahta, who works with the Minnesota Department of Health, voted against that measure, which would have broadly increased availability. “I don’t think we have the data,” to support boosters in that group yet, she said. The guidelines voted on by the CDC’s Advisory Committee on Immunization Practices still need to be signed off on by agency Director Rochelle Walensky. The recommendations are not binding, and states and other jurisdictions could disregard them and use other approaches to administering the booster shots.

The recommendations also are considered interim and the committee has plans to meet to consider other issues twice in the next month. Still, the vote by the group, following US Food and Drug Administration authorization,  clears the way for a booster rollout to begin as soon as this week for millions of people who had their second dose of the Pfizer shot at least six months ago.

The CDC said that some 26 million people in the United States received the second Pfizer/BioNTech shot at least six months ago, including 13 million age 65 or older. Last month, US President Joe Biden and eight top health officials said they hoped to start booster shots the week of Sept. 10 for all people eight months after they had been vaccinated, saying that emerging data showed immunity wanes over time.

A group of independent FDA advisers last week overwhelmingly rejected recommending a broader approval  of booster doses and instead recommended a narrower authorization. Dr. Paul Offit, a member of the FDA advisory panel, said he believed the CDC advisers were worried that recommending boosters based on employment would make it difficult to limit who got them at a time where there was not enough data, especially about the effects of a third shot on younger people.

“My sense was that the committee felt that that was a hole that you could drive a truck through, that essentially what we were doing was basically what the (Biden) administration initially asked – to just have a vaccine for the general population, because obviously the pharmacists aren’t going to figure out whether you’re working in a grocery store or hospital,” he said. More than 180 million people in the United States are fully vaccinated, or about 64% of the eligible population.

Pfizer – and some top U.S. health officials like Dr. Anthony Fauci – have argued that the extra round of shots are needed to address waning immunity. Fauci and others have also said they could help contain surging hospitalisations and deaths caused by the highly transmissible Delta variant of the coronavirus by cutting breakthrough infections of fully vaccinated people. The United States is averaging about 128,000 new COVID-19 cases per day, off an August high of about 160,000. The recent wave of US COVID-19 hospitalizations, primarily among the unvaccinated, may also have peaked, although the nation was still recording some 1,500 COVID-19 deaths a day over the last week, according to CDC data.

Some countries, including Israel and the United Kingdom, have already begun COVID-19 booster campaigns. The United States authorized extra shots for people with compromised immune systems last month and around 2.3 million people have already received a third shot, according to the CDC.

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