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A panel of experts that advises the Centers for Disease Control and Prevention (CDC) on the use of vaccines in the United States has voted to approve third booster doses of the Pfizer-BioNTech vaccine in line with the US Food and Drug Administration’s (FDA) authorization Wednesday — with some notable exceptions. 

Those groups included among the recommendations:

• Adults ages 65 and older and residents of long-term care facilities

• Adults ages 50 to 64 who have an underlying medical condition that may increase their risk from a COVID infection

• Adults ages 18 to 49 who may be at increased risk from a COVID-19 infection because of an underlying medical condition, if that person feels like they need one based on a consideration of their individual benefit and risks.

The committee considered, but narrowly rejected, boosters for a fourth group — adults ages 18 to 64 who live or work in a place where the burden of COVID-19 and risk of transmission are high.  

That would have included healthcare or other frontline workers and people who live in group settings like homeless shelters and prisons.

The committee left out healthcare workers, a group many expected would be first in line for third doses because of their risk. 

That is a departure from the FDA’s authorization, which included boosters for those 65 and over and for those aged 18-64 who are at high risk for severe illness from the coronavirus, including essential workers — such as those in healthcare — whose jobs increase their risk for infection.

The decision will likely cause some controversy, and confusion.

More in Store

One of the panel members tried to propose revised wording for a fifth vote, but the meeting was concluded because of time.

Grace Lee, MD, chair of the Advisory Committee on Immunization Practices, closed the meeting by reminding the public that the recommendations were temporary and that the committee would be back to reconsider the issue of third doses again soon.

The recommendations now go to CDC Director Rochelle Walensky, MD, to decide whether or not to sign off on them. 

For now, people who were initially vaccinated with either Moderna or Johnson & Johnson vaccines are excluded from booster recommendations, something many on the committee were uncomfortable with.

The FDA is still considering Moderna’s application to market booster doses. Johnson & Johnson hasn’t yet applied to the FDA for permission to offer second doses in the US.

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