Dr. Rochelle Walensky has approved Pfizer booster shots for millions of people in high-risk jobs Email not displaying correctly?
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** UPDATE: CDC director overrules advisers and approves Pfizer booster shots for millions of people in high-risk jobs
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The head of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky, overruled her own board of experts and approved COVID-19 booster shots for people who work in places that might put them at high risk of getting infected. The highly unusual move comes after the advisory board on vaccines voted nine to six against giving booster shots to teachers, health care workers and others who come in close contact with people in their jobs.
On Thursday, after two intensive days of hearings, the CDC’s Advisory Committee on Immunization Practices had voted against providing boosters to people in high-risk jobs. They argued that such a recommendation would open the gates to virtually any adult who wanted a booster shot because a “high-risk” position is undefined.
Walensky’s ruling came shortly after midnight Friday morning. It may be the first time a CDC director has ever overruled an ACIP committee’s recommendations. Dr. Amanda Cohn, who oversaw the meetings, notified ACIP members by email that they had been overruled. “I am hoping to share this news with you before you see it in the press,” she said.
Walensky’s ruling means the CDC’s guidelines for how to administer booster shots fall in line with what the Food and Drug Administration recommended earlier this week. The FDA envisioned prison employees, police officers, emergency medical technicians, health care workers and teachers all being given booster shots to increase their immune protection. Before the ACIP vote, Walensky outlined who she hoped might be eligible for booster shots in addition to seniors and immunocompromised people. She mentioned, for example, a 35-year-old pregnant emergency room doctor — a high-risk individual in a high-risk job.
She did not hint when she gave that example that she felt so strongly about it that she would overrule the panel if it disagreed.
The ACIP experts did approve booster vaccines for senior citizens (age 65 and older) who got their vaccinations at least six months ago. The CDC’s best estimate is that around 11 million Americans fall into that category.
The committee also said adults age 18 and older who have underlying health conditions and who were vaccinated at least six months ago would also be eligible for boosters.
So, to be clear, the FDA and the CDC recommend that those that should get boosters are:
* People ages 65 and older, six months after vaccination
* Long term care residents, six months after vaccination
* People ages 50 to 64 withunderlying health conditions ([link removed]) , six months after vaccination
* People ages 18 to 49 with underlying conditions should weigh their individual benefits with risks
* People working in high exposure occupations (such as prisons and jails, health care workers, teachers, first responders), six months after vaccination. The list could also include store clerks and anybody who interacts with the public.
This head of the CDC overruling her own advisory panel adds yet another layer of confusion to the nation’s vaccination program. The news that people in “high-risk” jobs and living conditions may get booster shots comes after an entire network news cycle and morning newspapers reported that the panel had rejected that notion. The Biden administration will have to explain the change and the new strategy. All of this follows a month of confusion about boosters that began with the president saying they would be available to everyone this month.
Without a doubt, doctors’ phones will be ringing today as people try to get clarity on whether they should take booster shots.
The FDA and CDC’s votes only affect people who got the Pfizer vaccine. The Moderna vaccine data will soon also come before both the FDA and CDC to consider whether patients who got that vacine should get booster protection. Patients who got the Johnson & Johnson vaccine will wait even longer to get word on whether a booster is needed. The Pfizer booster is authorized by the FDA under an emergency use authorization (not fully approved), so clinicians cannot prescribe it off-label to those who got the Moderna or Johnson & Johnson vaccine.
The CDC panel made it clear that booster shots will not end the pandemic. But they have the potential to prevent more than 2,000 hospitalizations for every million doses given by preventing serious illness among vulnerable populations. Committee members insisted that the most important prevention, by far, is convincing unvaccinated people to get vaccinated.
The FDA approves vaccines as safe and effective while the CDC establishes policies for how a drug should be administered.
While state health departments can make their own rules, most follow the CDC’s guidelines.
And while both the FDA and CDC committees said they will certainly consider updates to their ruling in the months ahead, both said they did not have nearly enough safety data to approve booster shots for young people.
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