C.D.C. Panel Endorses Moderna and J.&J. Boosters for Millions

In a sweeping victory for the Biden administration, the Centers for Disease Control and Prevention on Thursday endorsed booster shots of the Moderna and the Johnson & Johnson Covid-19 vaccines for tens of millions of Americans.

The decision follows an agency endorsement last month of booster shots of the Pfizer-BioNTech vaccine and opens the door for many Americans to seek out a booster shot as early as Friday.

The coronavirus vaccines “are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating Delta variant,” Dr. Rochelle Walensky, director of the C.D.C. said in a statement on Thursday night.

Her approval brings the country closer to fulfilling President Biden’s promise in August to offer boosters to all adults. The pandemic is now retreating in most parts of the country, but there are still about 75,000 new cases every day, and about 1,500 Covid deaths.

That pledge angered many experts, including some advising the Food and Drug Administration and the C.D.C., who said that scientists had not yet had a chance to determine whether boosters were actually necessary.

Studies showed that the vaccines remained very effective against severe disease and death, although their effectiveness might have waned against milder infections, particularly as the Delta variant spread across the nation this summer.

The purpose of the vaccines is to prevent illness severe enough to require medical attention, not to prevent infection, Dr. Wilbur Chen, an infectious disease physician at the University of Maryland and a member of the C.D.C. panel, the Advisory Committee on Immunization Practices, said during the deliberations on Thursday.

“It might be too much to ask for a vaccine, either a primary series or the booster, to prevent all forms of infections,” Dr. Chen said.

The C.D.C.’s advisers last month tried to narrow the number of Americans who should receive a booster dose of the Pfizer-BioNTech vaccine, saying that research did not support boosters for people whose jobs exposed them to the coronavirus, as the F.D.A. had indicated.

But in a highly unusual move, Dr. Walensky overturned their decision, aligning the agency’s advice with the criteria laid out by the F.D.A.

On Wednesday, the Food and Drug Administration authorized booster shots for millions of people who received the Moderna and the Johnson & Johnson vaccines, just as it did for recipients of Pfizer-BioNTech shots last month. The F.D.A. also gave the green light for people eligible for booster shots to get a dose of a different brand.

But in practice, who will get the shots and when depends greatly on the C.D.C.’s final guidance. Though the agency’s recommendations do not bind state and local officials, they hold great sway in the medical community.

On Thursday, members of the C.D.C.’s panel endorsed the so-called mix-and-match strategy, saying people fully immunized with one company’s vaccine should be allowed to receive a different vaccine for their booster shot.

What to Know About Covid-19 Booster Shots

The F.D.A. has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.

Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.

The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.

The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.

Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.

Limited evidence strongly suggests that booster doses of one of the two mRNA vaccines — Moderna or Pfizer-BioNTech — more effectively raise antibody levels than a booster dose of the Johnson & Johnson vaccine.

The committee advised that recipients of the single-dose Johnson & Johnson Covid vaccine should receive a booster shot at least two months after their first dose.

Among Americans initially immunized with an mRNA vaccine, adults over 65, adults who are 50 to 65 with certain medical conditions, and those who reside in long-term care settings should receive a single booster dose six months or longer after their second dose, the committee decided.

For adults ages 18 to 49 with certain medical conditions and adults whose jobs regularly expose them to the virus, the panel opted for softer language, saying they may choose to get a booster after considering their individual risk.

The experts emphasized that people who have received two mRNA vaccine doses or a single Johnson & Johnson dose should still consider themselves fully vaccinated. Federal health officials said they would continue to study whether those who had weak immune systems and had already received a third dose of a vaccine should go on to get a fourth dose.

Some advisers were concerned that young and healthy Americans who don’t need a booster might choose to get one anyway. Side effects are uncommon, but in younger Americans they may outweigh the potential benefits of booster doses, the scientists said.

“Those that are not at high risk should really be thoughtful about getting that dose,” said Dr. Helen Talbot, an infectious disease expert at Vanderbilt University.



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