(CN) — Less than a week out from Thanksgiving with yet more family gatherings on the horizon, the vaccine advisory panel for the Center for Disease Control and Prevention agreed unanimously on Friday to back booster shots of the Pfizer and Moderna Covid-19 vaccines for all adults.
New guidelines will say that those ages 50 and older “should” get a booster shot six months after getting vaccinated, while those 18 and older “may” get one. They still require signature from the CDC’s director. Experts discussed the benefits and risks of changing the recommendations now, taking into account the holidays and winter season.
The Advisory Committee on Immunization Practices advanced a decision earlier on Friday by the Food and Drug Administration, which authorized booster shots of the two RNA-based vaccines for emergency use in everyone ages 18 and older.
Booster shots restored vaccine efficacy to 95 percent, according to Pfizer’s clinical trial of 10,000 people ages 16 and older. Pfizer and Moderna are each studying the risk of myocarditis, or heart inflammation, associated with the vaccines, and more prominent in younger males.
Previously, booster shots were authorized for those over age 65 or at high risk of severe disease, due to their occupation, a compromised immune system, or other underlying health issues.
Experts on the CDC’s vaccine panel said the old guidelines have created some confusion both in the public and among clinicians administering vaccines, and agreed that simplifying the recommendation could help with getting booster shots to more people who want them.
For instance, the list of health conditions that qualified someone for a booster shot is lengthy and broad — it includes conditions like those who are overweight, have a history of mood disorders or depression, and have ever smoked.
Three-quarters of people ages 50 to 64 would fall into the at-risk categories anyway, noted Dr. Sara Oliver, a medical officer at the National Center for Immunizations and Respiratory Diseases and the advisory committee's CDC lead.
“Age-based recommendations are easier to communicate,” she said — and “easy-to-communicate recommendations can facilitate equitable distribution.”
With such a broad list of categories, the need for a booster shot may seem more exclusive than it really is, said Dr. Matthew Daley of Kaiser Permanente Colorado’s Institute for Health Research.
“Because the list of medical conditions is long and expansive,” he said, it “creates a barrier when there was no barrier intended.”
In reality, those ages 50 to 64 without health conditions would “likely benefit from a booster” anyway, Daley said.
Dr. Nirav D. Shah, director of the Maine Center for Disease Control and Prevention, said that other state health officials agreed that broadening booster recommendations would cut down on confusion. In fact, during a recent call, “there was not a single state that voiced opposition to this move.”
The CDC committee was similarly unanimous. It took two separate votes at Friday’s virtual meeting: one to broaden the recommendation for those who “may” get a vaccine to all adults, and the second to say those 50 and older “should” get another shot. Both resulted in 11 yeses and zero no votes.
Multiple panelists mentioned that with the holidays approaching, the timing is right for shifting recommendations.
“It’ll be especially important going into the holiday season and the winter season,” said Dr. Jamie Loehr, owner of Cayuga Family Medicine in Ithaca, New York. “I look forward to having more information in the future about whether this sis actually a booster dose, or whether it’s a third dose of the primary series, but that will take months if not years to figure out.”
The meeting’s chair, Dr. Grace Lee, closed by addressing, though not directly by name, the “elephant in the room:” vaccine misinformation.
“There are many voices that the public hears regarding the best ways to use vaccines to handle this pandemic,” Lee said. “We recognize that this pandemic has created a situation where absolutely nothing is normal. Everything moved quickly, and data are constantly evolving, and local context can drive differences in the urgency and the need for these boosters, and vaccines in general.
“Diverse opinions at every level are always valued,” she continued, “however, it does create communication challenges and can also lead to more confusion, not only for the public, but we’re recognizing even amongst our provider community.”
Holding public vaccine panel meetings is key to transparency, Lee said. “During a pandemic, both speed and process are incredibly important.”
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