CDC Approves COVID Boosters for Almost All Adults, Mixing Vaccines

October 21, 2021 – Millions of U.S. adults are now eligible for a COVID-19 vaccine booster following approval Thursday by the CDC, which also gave the go-ahead for mixing the vaccines for the first time.

An expert panel advising the CDC weighed in earlier Thursday on who should receive boosters after their Moderna or Johnson & Johnson vaccines. The two recommendations were unanimous, 15-0.

The Advisory Committee on Immunization Practices (ACIP) says anyone over 18 who is at least 2 months after their Johnson & Johnson vaccine should be given a booster, a recommendation that affects about 13 million Americans. This booster may be one of the available COVID-19 vaccines.

CDC Director Rochelle Walneksy, MD then gave final approval to the panel’s recommendations to make the boosters available immediately.

People eligible for a booster at least 6 months after their last Moderna shot are the same groups who can get a Pfizer booster. They are:

  • Anyone over 65.
  • Those over 18 with an underlying health condition that puts them at risk of severe COVID-19.
  • People over the age of 18 who may be at higher risk of COVID-19 infection because they live or work in a risky environment.

An estimated 47 million people have received Pfizer vaccines and 39 million people vaccinated with Moderna who are now eligible for a booster dose, according to data presented by the CDC.

Before voting, some committee members expressed unease with generally recommending boosters, noting that there is very little evidence supporting the need for boosters in people under the age of 50. They feared that being so permissive with boosters could send the wrong message to Americans and undermine confidence in vaccines.

Ultimately, however, they felt it was more important to be permissive in allowing recalls so that individuals and their doctors could be free to make their own decisions.

“I cannot say that I am comfortable with the fact that a person under the age of 50 needs – an otherwise healthy person – a booster vaccine at this time with Moderna or Pfizer.” said Sarah Long, MD, ACIP member, professor of pediatrics at Drexel. University of Philadelphia.

During deliberations, she said she hoped the committee could try to mitigate the potential damage by imposing some sort of age restriction on those otherwise worried.

“We usually don’t have the vaccines because we are worried. We are giving it because we have a need that is worth the risk, and there is a serious illness burden, ”Long said.

Evidence to date shows that all vaccines authorized for use in the United States continue to protect people well from the serious consequences of COVID-19, including hospitalization and death. But breakthrough infections are on the rise, especially in people who initially received the single-dose Johnson and Johnson vaccine.

On Thursday, Pfizer released data from a study of more than 10,000 fully vaccinated people. Half were randomized to receive a booster of their Cominarty vaccine, the other half received a placebo. Over the next 2.5 months, there were 5 cases of COVID-19 in the boosted group and 109 in the group that received a placebo. The data was published in a press release and has yet to be peer reviewed, but it is the first to show the clinical effectiveness of boosters in preventing COVID-19 infections.

The data recently considered by the FDA and CDC for COVID-19 booster doses comes from studies that were mostly increasingly shorter. These studies looked at biomarkers of immunity like the concentration of antibodies in a person’s blood and the percentage of study participants who saw an increase in those antibodies. Studies have shown that the boosters do indeed restore high levels of antibodies, but they have not been able to show that these antibodies prevent COVID-19. These studies were also not designed to detect less common safety issues that might arise. After another dose of shots.

Ultimately, however, ACIP felt it was more important to be permissive in allowing recalls so that individuals and their physicians could be free to make their own decisions.

“The decision by the FDA and the ACIP recommendations, I think, reflect the real world. The public will do what they feel compelled to do. This adds at least a scientific review of the data currently available, ”said Jay Varkey, MD, infectious disease physician and associate professor at Emory University in Atlanta who was not involved in the ACIP deliberations.

Varkey said he would recommend anyone under the age of 65 who has no underlying medical conditions such as diabetes or obesity to speak with their doctor about their individual benefits and risks before receiving a treatment. reminder.

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