Experts say giving the unvaccinated their first shots remains the top priority, and the panel wrestled with whether the booster debate was distracting from that goal.
All three of the COVID-19 vaccines used in the US – Pfizer, Moderna and Johnson & Johnson’s Jensen – are still highly protective against severe illness, hospitalisation and death, even with the spread of the extra-contagious Delta variant. But only about 182 million Americans are fully vaccinated, or just 55 per cent of the population.
“We can give boosters to people, but that’s not really the answer to this pandemic,” said Dr Helen Keipp Talbot of Vanderbilt University. “Hospitals are full because people are not vaccinated. We are declining care to people who deserve care because we are full of unvaccinated COVID-positive patients.”
The decision represented a dramatic scaling back of the Biden administration plan announced last month to dispense boosters to nearly everyone to shore up their protection. Late on Wednesday, the Food and Drug Administration, like the CDC panel, signed off on Pfizer boosters for a much narrower slice of the population than the White House envisioned.
The booster plan marks an important shift in the nation’s vaccination drive. Britain and Israel are already giving a third round of shots over strong objections from the World Health Organisation that poor countries don’t have enough for their initial doses.
Walensky opened Thursday’s meeting by stressing that vaccinating the unvaccinated remains the top goal “here in America and around the world.”
Walensky acknowledged that the data on who really needs a booster right away “are not perfect.” “Yet collectively they form a picture for us,” she said, “and they are what we have in this moment to make a decision about the next stage in this pandemic.”
The CDC panel stressed that its recommendations will be changed if new evidence shows more people need a booster.
The CDC advisers expressed concern over the millions of Americans who received Moderna or Johnson & Johnson shots early in the vaccine rollout. The government still hasn’t considered boosters for those brands and has no data on whether it is safe or effective to mix-and-match and give those people a Pfizer shot.
“I just don’t understand how later this afternoon we can say to people 65 and older, ‘You’re at risk for severe illness and death, but only half of you can protect yourselves right now,’” said Dr. Sarah Long of Drexel University.
About 26 million Americans got their last Pfizer dose at least six months ago, about half of whom are 65 or older. It’s not clear how many more would meet the CDC panel’s booster qualifications.
CDC data show the vaccines still offer strong protection against serious illness for all ages, but there is a slight drop among the oldest adults. And immunity against milder infection appears to be waning months after people’s initial immunisation.
For most people, if you’re not in a group recommended for a booster, “it’s really because we think you’re well-protected,” said Dr Matthew Daley of Kaiser Permanente Colorado.
Public health experts not involved in Thursday’s decision said it is unlikely people seeking third doses at a drugstore or other site will be required to prove they qualify.
Even with the introduction of boosters, someone who has gotten just the first two doses would still be considered fully vaccinated, according to the CDC’s Dr Kathleen Dooling. That is an important question to people in parts of the country where you need to show proof of vaccination to eat in a restaurant or enter other places of business.
Among people who stand to benefit from a booster, there are few risks, the CDC concluded. Serious side effects from the first two Pfizer doses are exceedingly rare, including heart inflammation that sometimes occurs in younger men. Data from Israel, which has given nearly 3 million people — mostly 60 and older — a third Pfizer dose, has uncovered no red flags.