CDC Panel Recommends COVID-19 Boosters for Some, But Not for Those at Risk in the Workplace

A Centers for Disease Control and Prevention (CDC) expert panel yesterday voted 9 to 6 that people aged 18-49 with underlying health conditions should be eligible to receive a booster vaccine, but voted down, 6 to 9, recommending a booster shot for people in that age group at risk of contracting the coronavirus based on their workplace.

The rest of the advisory committee’s voting recommendations fit somewhat within the FDA’s newly revised Emergency Use Authorization (EUA) for the Pfizer-BioNTech booster issued 24 hours earlier that said those over the age of 65, those at risk of severe COVID-19 disease because of existing comorbidities and essential healthcare workers are eligible for the booster (DID, Sept. 23).

The CDC’s 15-member Advisory Committee on Immunization Practices (ACIP) recommended unanimously that adults age 65 and older should be offered booster shots. It also voted, 13-2, that a booster dose should be offered to individuals age 50-64 with underlying health conditions.

Regarding individuals age 18 to 49 years with underlying health conditions, several panel members worried a recommendation would give too much latitude to boost or not, without sufficient safety data for that population. Some pointed out that the risk of heart inflammation has been linked with vaccinations in younger males especially.

For now, the CDC panel’s recommendation may shut the door on frontline healthcare workers under age 65 despite the FDA’s EUA allowing boosters for those aged 18-64 at increased likelihood of contracting SARS-CoV-2 because their workplace puts them at high risk of serious complications of COVID-19, including severe disease.

Keipp Talbot, associate professor of medicine at Vanderbilt University who chaired the CDC’s vaccine safety technical work group, requested an additional fifth vote in an apparent attempt to include frontline workers. But the ACIP chair, Grace Lee, who is professor of pediatrics at Stanford University, said the panel would meet again at a later date to review additional considerations.

Most panelists expressed frustration that those who received a Moderna or Johnson & Johnson vaccine had no current boosting options. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said he understood their frustration but that the agency was awaiting further data from drugmakers which would enable the authorizations of other boosters.

The panel’s recommendations aren’t official CDC policy until CDC Director Rochelle Walensky formally approves them, enabling the Biden administration to launch its booster campaign originally set to begin Sept. 20. ― Jason Scott