CDC advisers recommend certain adults get booster dose of Pfizer's Covid-19 vaccine

[BumRushDaShow]

Source: CNN

(CNN) Vaccine advisers to the US Centers for Disease Control and Prevention endorsed giving booster doses of Pfizer's Covid-19 vaccine to people 65 and older long-term care facility residents, and certain people with underlying conditions. However, the advisers voted against recommending a booster dose for people whose jobs or situations put them at high risk of breakthrough infections. Late on Wednesday, the US Food and Drug Administration had authorized giving boosters to people 65 and older and those at higher risk of severe disease and death, as well as people such as health care workers at higher risk of breakthrough infections because of their work.

Members of CDC's Advisory Committee on Immunization Practices met Thursday to decide who they should be recommended to. The CDC advisers voted unanimously to recommend a single Pfizer/BioNtech Covid-19 vaccine booster to people 65 years or older and long-term care facility residents at least six months after they were fully vaccinated. The advisers also voted 13-2 to endorse giving booster doses of Pfizer's Covid-19 vaccine to people ages 50 to 64 with underlying medical conditions. But that was short of the FDA's emergency use authorization, which OK'd giving boosters to anyone 18 and older at high risk of severe disease from breakthrough infections.

ACIP instead limited its recommendation to people over 50 with such conditions after members expressed doubts about recommending boosters too broadly. So, staff added a third question that would allow a younger group to access boosters. Members were less enthusiastic about this option. Vaccine advisers voted 9-6 Thursday to recommend younger adults, those ages 18 to 49, get a booster Covid-19 vaccine dose if they have underlying health conditions. The vaccine advisers then voted against the question of allowing booster Covid-19 vaccines for people 18 to 64 whose jobs or situations put them at high risk of breakthrough infections.

These might have included frontline workers, include healthcare workers, caregivers for frail or immunocompromised people, people in homeless shelters and people in correctional facilities, the CDC said. Earlier in the day, a CDC analysis showed it was much more beneficial to give a booster dose to people 65 and older than to people in younger age groups. fter CDC Director Dr. Rochelle Walensky signs off on the ACIP recommendations, booster shots may be given immediately to those for whom they are recommended.

Read more: https://www.cnn.com/2021/09/23/health/pfizer-acip-booster-recommendation/index.html

---

After the presentation of data today, ACIP ended up developing 4 questions to vote on at the end. The first most closely matched the voting question by FDA's VRBPAC from last week, recommending the booster for age 65+.

The other questions broadened the ages for boosters, and looked at different circumstances - "50 - 64 with underlying health conditions", "18 - 49 with underlying health conditions" and finally "18 - 64 based on individual benefit/risk in certain settings/occupations with more exposure".

The first 3 passed (15 - 0, 13 - 2, 9 - 6) and the last one failed (6 - 9).









ETA - they apparently plan to meeting later at some point to address any other voting questions, although not right away (they said they have a non-COVID-related meeting coming up first).

[durablend]

1. "Sorry frontline workers"

"Guess you'll need to suck it up"

[BumRushDaShow]

2. I expect there are many frontline workers

(particularly those who are POC and are often the most vulnerable) who have underlying conditions that could make them eligible just from that aspect of the recommendations. Hell... I expect 3/4 of the U.S. has some kind of "underlying condition".

This is just the Committee votes. It's up to the GS-1000s to make the final decision.

[SheltieLover]

5. Have you seen a list of the approved "underlying conditions?"

I know a young person with asthma. Wondering if that would be allowed as a qualifier?

[BumRushDaShow]

6. I have to go through the slides to see if there was one that was explicit

I know they were discussing what the conditions might be - e.g., "obesity, smoker, COPD, hypertension, etc).

[SheltieLover]

9. Ty

No need to for me, as I'm sure it will come out in news soon.

Did you see anything about when Walensky will sign the order?

Ty so much again!

[BumRushDaShow]

13. LOL I found one

Not sure when Wallensky is going to sign off but I wouldn't be surprised if she did it tomorrow, if not some time this weekend since she was there - at least at the beginning with some remarks.

The above was from this slide deck (PDF) - https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-9-23/04-COVID-Dooling.pdf



ETA, that slide (as part of the deck) had a link to a full list (and how those with them are impacted by COVID-19) - https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html

[SheltieLover]

15. Ty!

Ridiculous!

We should not have to beg for readily avail vaxes imo.

Wading through their stuff now.

Ty so much!

[BumRushDaShow]

18. You are welcome!

I think a lot of the problem here with some members of the Committee, is that the work that they do has always been "behind the scenes" and generally "boring" to the average person. So they have never really been in the spotlight much, if at all, except maybe when they had approved Gardasil for a HPV vaccine (back in 2017). And normally, the vaccine approval process can take 2 - 3 years and they have been pushed to jam it all in a year.

So they were in the habit of doing their regular process without the glare of the media. But like everything else, COVID-19 has completely upended "the normal".

[SheltieLover]

21. I see their problem as one related to not accepting Israeli data at face value

Typical of US agencies, in my experience.

Israel no longer considers 2 shots fully vaxed because of the efficacy drop over time.

They are already planning for 4th booster, should it be needed.

What a concept ti get ahead of covid!

[BumRushDaShow]

29. They are including the Israeli data in the reivew

Last edited Thu Sep 23, 2021, 07:44 PM - Edit history (1)

but also have other data as well.

The big slide deck on that is here (PDF) - https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-9-23/03-COVID-Oliver.pdf

I think there are several factors going on -

1.) Two of the vaccine types have never been used before (mRNA), let alone on such a huge scale, so I really think they are trying to hedge enough so that if something goes wrong in the future, they won't be pilloried for the rest of their lives.

2.) They are trying to function in a literal unprecedented global pandemic, the likes of which has pretty much surpassed the 1918 one (where obviously none of them were even born then). And back in 1918, the medical personnel didn't even know what was really causing the pandemic, yet here we are today with a complex knowledge of what the virus "looks like" down to the molecular and genetic level, and generally know how it gets into cells within the body to replicate. But the end result, even with a vaccine, has ended up being almost the same as that a century ago.

3.) Many of them are techies in their fields but that doesn't translate well to the general public. There are certain expectations for vaccines in general that have always been par for the course, but the message that had gone out initially in order to get as many people vaccinated as possible, was by sortof glossing over what they normally tell people when it comes to vaccines. The repetitive "get the vaccine and 'get back to normal'", ended up being the albatross around their neck because the public got the impression that a vaccine could be a "shield", and any medical doctor or immunologist knows that has never been the case. But to the public, anything less than what was promoted - "getting back to normal, including going maskless", became a "failure", and that seemed to set the stage for a lot of frustration.

We have a long way to go but hopefully what will come out of this is a new way to do annual vaccines, like the flu one.

[SheltieLover]

32. True

I wouldn't want to be in their shoes.

But, even with the unknowns, we now know that even asymptomatic & mild cases increases risk for kidney problems by a factor if 2, which increases exponentially with the severity of disease.

I'll take my chances with my 3rd vax because the odds on the other side are awful. 😷

[ShazzieB]

37. I'll happily take the third vax, too.

Fortunately for me, I'm over 65, so I'm automatically eligible. Good for me, I guess?

On the other hand, my husband had the Moderna, so he's not eligible for a booster yet, even though he's higher risk than I am (diabetes, plus males are at greater risk of death from covid in general). It will feel funny to go ahead and get my booster without him getting one, even though but I know he'll want me to. And of course, anything that makes one of us safer will also make the other one safer.

On the other, other hand, though, I've been reading that the effectiness of the Moderna vaccine doesn't decrease over time as much as Pfizer (https://news.yahoo.com/moderna-vs-pfizer-both-knockouts-182810753.html), so he evidently may not even need a booster to the same extent I do.

It's all so confusing, especially since we were all told earlier on that there was virtually no difference in effectiveness between the two. But I guess when things happen as fast as they have with the covid vaccines, there are bound to be new discoveries and realizations along the way.

So I will get my booster shot as soon as it's available to me and hope for the best! Living in the time of covid is just full of surprises, isn't it? And not fun ones, either. Ugh.

[BumRushDaShow]

39. Yeah more and more has been coming out regarding how Moderna has fared

although they are still not sure whether it's because Moderna's shot has 100ug of active biologic vs Pfizer's 30ug or it's due to Moderna waiting an extra week between doses (4 weeks vs Pfizer's 3 weeks) or whether the candidate entities that each picked are different enough to cause the difference.

This actually gives them more ways to test out how to handle the dosing in the future because some of the research has been showing better immune response when the doses are actually spaced further apart.

I also know, and they keep reiterating, that since the "minimum" vaccine effectiveness ("VE" ) requested by FDA for vaccines in general is "50%", the fact that in the case of mRNA vaccines, we're talking in 95% range (at least initially), which is amazing. They didn't want to consider a drop from that lofty figure, down to the 70s or 80s, as a big deal considering you are lucky if the flu vaccine can get 60% during a season, where more often than not, it is in the 40% - 50% range due to missing some variant that wasn't expected.

[TygrBright]

10. Only if the asthma is "severe/uncontrolled" - not sure of the exact wording there.

I have asthma but am not eligible because my asthma is under control, I need only a rescue inhaler PRN.

What's problematic about this is, as every asthmatic knows, your asthma can go from under control and mild to life-threatening without warning and in very short order.

But if you are currently under 65 and your asthma is not treatment-resistent, severe, uncontrolled, etc., you are shit outta luck.

irritatedly,
Bright

[SheltieLover]

12. Sorry to hear, Bright

Maybe you can find a doc to write for you?

Is this under the new order from today?

Ridiculous all these requirements! It's not like there is a shortage of vaxes.

[LisaL]

20. I presume it's going to be under "honor" system again.

In other words, no verification will be needed on whether your asthma is uncontrolled or not.

[TygrBright]

30. Not so. They will verify that you are being treated for/medicated for severe asthma.

Severe asthma is often co-diagnosed with COPD, so they will check for that Dx in medical records also.

philosophically,
Bright

[LisaL]

33. Who will verify?

Right now immunocompromised are allowed boosters. It's an honor system. Nobody verifies anything.

[TygrBright]

34. Here in NM you sign up on the DoH website and give your insurance information. n/t

[LisaL]

36. Here we don't do that.

I already got my booster for immunocompromised.

[ShazzieB]

38. It must vary by state.

[SheltieLover]

3. +1,000!

Wth is wrong with the CDC?

[thesquanderer]

7. It actually does make some sense.

The value of the booster is not based on how likely you are to exposed to covid, but rather how likely it is that you will get very sick or die if you DO get exposed to vocid. While a frontline worked may have a higher than average risk of being exposed to the virus, they don't necessarily have any higher risk of getting seriousily ill or dying from that exposure. The things that determine how likely it is that you have serious consequences from exposure are determined by your age and underlying conditions, not by your likelihood of getting exposed in the first place.

[SheltieLover]

14. My goal is to not end up with long haul

Which, according to Harvard epidemiologist, Dr. Eric Ding's twitter, is substantial, even in asymptomatic cases.

Additionally, per Dr. Ding's twitter, the 3rd booster decreases likelihood of infection dramatically, thereby decreasing the spread. To quote his twitter (sorry, I don't know how to post pix here):

3rd dose presented to FDA panel - shows 17x-fold & +2000 increase in neurtalization with 3rd dose...

Posted on 9/17.

So I'm at odds with the CDC on this one, although I do qualify just on age alone.

I'm not ok with kidney failure or other long haul issues.

[SheltieLover]

4. Yay for those approved!

Going to schedule mine right now!

Ty for posting, BRTS!

[BumRushDaShow]

8. It's not "completely" approved by CDC yet

The bosses still have to give the go-ahead as these are just Committee "recommendations" to the top levels.

[SheltieLover]

11. Ok. Ty!

I thought I read vaxes will be avail as soon as she signs it. 😊

Not that I'm eager to get the jab or anything.

Ty again!

[BumRushDaShow]

16. Yeah I think all of the states are gearing up

A booster is already approved via an EUA for immuno-compromised (as of last month).

But vaccine providers are supposed to wait - at least for this broader set of categories - until the final sign off. I know the Committee members were mentioning that they expect people would "self-certify" that they meet the requirements so the providers shouldn't have to be obligated for going through a whole verification process.

[SheltieLover]

17. Good "self-certify"

Works for me!

[dweller]

19. Smokers huh ...

Haven’t seen special considerations for them since … I dunno …. WATERWORLD ?



✌🏻

[SheltieLover]

22. Yet not for asthmatics, per Bright (#10 above)

[dweller]

24. Saw that

Doesn’t seem right, smokers brought it on themselves
Asthma sufferers did not …

✌🏻

[SheltieLover]

26. Both should be eligible, imo.

[BumRushDaShow]

23. ...

(I still love that movie as much as it has been panned)

[dweller]

25. Me too !

Early DVD purchase, frequently watched

✌🏻

[BumRushDaShow]

31. I first bought it on laserdisc because DVDs weren't even out yet

and that way I could get it with Dolby Digital 5.1 sound (vs the VHS regular Dolby Surround). I eventually did get it on DVD.

[SheltieLover]

27. Lol

[deurbano]

28. For those who qualify, does this include those who received Moderna shots initially?

[dweller]

35. No

Don’t think so

✌🏻