CDC recommends a booster dose for recipients of a Pfizer-BioNTech COVID-19 Vaccine primary series who are age 65 years or older, who reside in long-term care facilities, who are age 18 through 64 with underlying health conditions, or who are at high risk of occupational or institutional exposure to COVID-19

On September 22, the FDA updated its Emergency Use Authorization (EUA) for Pfizer-BioNTech COVID-19 Vaccine (also known as Comirnaty) to authorize administration of a third (booster) dose in certain individuals. The next day, CDC’s Advisory Committee on Immunization Practices (ACIP) made interim recommendations for certain populations to receive a booster dose of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech vaccine primary series. In addition, the CDC Director recommended a booster dose for Pfizer-BioNTech primary series recipients in certain high risk occupational and institutional settings. The recommendations are:

• people age 65 years and older and residents in long-term care settings should receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series;
• people age 50 through 64 with certain underlying medical conditions should receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series;
• people age 18 through 49 who are at high risk for severe COVID-19 due to certain underlying medical conditions may receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks; and 
• people age 18 through 64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

Individuals requesting a booster dose due to an underlying medical condition are not required to provide documentation of their condition; self-attestation is sufficient.
 
CDC has issued updated clinical considerations providing guidance on these booster recommendations. Discussions on booster doses for recipients of Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines will be held following FDA authorization of additional doses of those products. Due to limitations of the FDA authorization, Moderna and Janssen vaccine recipients are not recommended to receive a Pfizer-BioNTech booster at this time.
 
ACIP noted that the booster recommendations do not change the definition of who is considered “fully vaccinated” for public health or administrative purposes. “Fully vaccinated” status begins 2 weeks after completing a 2-dose mRNA vaccine (Pfizer-BioNTech or Moderna) series or the single dose of the Janssen COVID-19 Vaccine (Johnson & Johnson).
 
In making these recommendations, ACIP members and the CDC Director emphasized that vaccination of unvaccinated people continues to be the top priority. Data presented at the meeting indicate hospitalization rates for unvaccinated adults were 13- to 23-times higher (varying by age) than for vaccinated adults.
 
During its two-day meeting, ACIP also heard presentations (presentation slides available online) from CDC experts on the current epidemiology of COVID-19 disease in the United States and updates on COVID-19 vaccine safety and effectiveness assessed through multiple surveillance systems. Additional presentations highlighted the growing body of evidence supporting the benefits and safety of COVID-19 vaccination during any stage of pregnancy as routinely recommended by CDC and the American College of Obstetricians and Gynecologists (ACOG), among others. Despite this recommendation, only 30% of pregnant people are currently fully vaccinated with COVID-19 vaccine.
 
Clinicians administering Pfizer-BioNTech COVID-19 Vaccine should give vaccine recipients the updated (September 22, 2021) EUA Fact Sheet for Recipients and Caregivers. Clinicians should familiarize themselves with the revised Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Healthcare Providers.
 
Future ACIP Meetings
The next announced ACIP meetings are scheduled for today, September 29 (see story in “Upcoming Meetings”), and the regularly scheduled meeting on October 20–21. Additional meetings may be announced; information about past and future ACIP meetings may be found on the ACIP website.
 
Related Links

• CDC: Statement on ACIP Booster Recommendations
• CDC: ACIP Presentation Slides September 22–23 Meeting
• CDC: Pfizer-BioNTech COVID-19 Vaccine 
• CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States
• FDA: Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Healthcare Providers (9/22/2021)
• FDA: Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers (9/22/2021)
• FDA: Comirnaty and Pfizer-BioNTech COVID-19 Vaccine web page
• ACOG: COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care

IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination now features 1,156 organizations, including two new facilities

There are now 1,156 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, long-term care facilities, medical practices, pharmacies, professional organizations, health departments, and other government entities that take a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since September 8, when IAC Express last reported on the Influenza Vaccination Honor Roll, two additional healthcare organizations have been enrolled.

• Leidos Biomedical Research, Inc, Frederick, MD
• Delaware Valley Community Health, Philadelphia, PA

To be included in the Influenza Vaccination Honor Roll, the institutional mandate you report must require influenza vaccination for all staff. Additionally, the application must describe measures to prevent transmission of influenza from unvaccinated personnel to patients (e.g., masking for the entire work shift, reassignment to non-patient-care duties, dismissal).

IAC urges qualifying healthcare organizations to complete the Application page.

Related Links

• IAC: List of Influenza Vaccination Honorees, all healthcare settings, by state
• IAC: Long-Term Care/Assisted Living Influenza Vaccination Honorees by state
• IAC: Influenza Vaccination Honor Roll program, including:
  • Position statements from professional societies and leading healthcare organizations in support of mandatory influenza vaccination
  • Application form for Influenza Vaccination Honor Roll
• IAC: Honor Roll for Patient Safety web page

Journalists interview IAC experts
 
Journalists seek out IAC experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a selection of our recent citations.

• USA Today: More than 20M Americans Are Eligible for Pfizer-BioNTech Booster Shots. Should You Get One? (9/26/21)
• The Journalist's Resource: It’s Flu Season. Here’s What Research Shows about Adult Vaccinations. (9/22/21)
• American Medical Association: L.J Tan, PhD, MS, Talks about a Call to Action to Increase Adult Immunizations (9/21/21)
• Fintech Zoom: CVS – Flu Season Prep, Complicated by COVID-19, Starts Early This Year (9/19/21)
• New York Times: It's That Time of Year, Experts Warn: Get a Flu Shot (9/17/21)
• ABC News: What Vaccines Are Already Required to Attend School in the U.S. (9/17/21)
• Washington Post: Can You Get a COVID Booster and a Flu Shot Together? Here’s What You Need to Know. (9/13/21)
• AARP: 7 Things We've All Learned about Vaccines (9/10/21)

Related Link

• IAC in the News main page