What’s the news: Centers for Disease Control and Prevention (CDC) Director Rochelle P. Walensky, MD, MPH, has clarified the bottom line for single booster doses of the Pfizer-BioNTech COVID-19 vaccine. Those doses should be administered at least six months after the primary series and are recommended for people 65 or older, those who live in long-term care facilities, and people 50–64 years old who have underlying medical conditions.

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Meanwhile, adults 18–49 with certain underlying medical conditions and adults 18–64 at increased risk for COVID-19 exposure and transmission because of where they work or live—including physicians and other health professionals—may also get a Pfizer vaccine booster based on their individual benefits and risks.

“At CDC, we are tasked with analyzing complex, often imperfect data to make concrete recommendations that optimize health,” Dr. Walensky said. “In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”

The AMA supported the move. AMA President Gerald E. Harmon, MD, said “we applaud and fully support the leadership shown” by Dr. Walenksy to broaden the Pfizer vaccine booster recommendations to include doctors and others at high risk of exposure to SARS-CoV-2.

“Given that we are in the midst of a global pandemic that continues to cause widespread illness and death, we must do everything we can to protect our front-line health care professionals,” Dr. Harmon added. “We believe this recommendation is a critical step to preserve our nation’s health care capacity and prevent illness among those who have continued to put their own health and safety at risk to care for patients.”

Other categories of people who may consider getting a Pfizer booster based on their individual risks and benefits include teachers, day care staff, grocery store workers, and those in homeless shelters or correctional facilities.

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The benefits of boosters clearly outweigh the risks for seniors, those in long-term care facilities, and for adults between 50 and 64 who have underlying medical conditions, according to the CDC Advisory Committee on Immunization Practices (ACIP).

ACIP also supported a booster dose of the Pfizer COVID-19 vaccine based on individual benefit and risk for those 18–49 with underlying medical conditions. The ACIP recommendations will help further protect against COVID-19 cases, hospitalizations and deaths, Dr. Harmon said.

More than 182 million Americans have been fully vaccinated and that more than 220 million doses of the Pfizer-BioNTech vaccine have been administered, according to data presented during the ACIP meeting.

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Why it’s important: COVID-19 has killed over 675,000 in the U.S., and ACIP member Katherine A. Poehling, MD, MPH, estimated that 2,500 died just during the course of their two-day meeting.

“The latest data shows a decline in vaccine effectiveness against SARS-CoV-2 infection in individuals 65 years of age and older, particularly during the Delta wave,” Dr. Harmon said. “The good news is data also shows that a booster dose of the Pfizer-BioNTech COVID-19 vaccine, given six months after the primary series, increases the immune response in this population.”

It was, however, stressed at the ACIP meeting that the first focus is to get vaccines into the arms of the unvaccinated to protect as many people as possible from hospitalization and death from COVID-19.

Dr. Harmon strongly agreed.

“With hospitalization rates 10 to 22 times higher in the unvaccinated compared to the vaccinated, our top priority should remain reaching those individuals who remain unvaccinated against COVID-19,” he said. “We continue to strongly urge everyone who has not yet been vaccinated against COVID-19 and is eligible, including pregnant people, to get vaccinated as soon as possible to protect themselves and their loved ones from severe complications, hospitalization and death.”

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Learn more: Though COVID-19 vaccines are not on the draft agenda for ACIP’s Sept. 29 meeting, the CDC has pledged to review whether boosters should be administered for the Moderna or Johnson & Johnson (J&J) vaccines.

“ACIP only reviewed data for the Pfizer-BioNTech vaccine,” Dr. Walensky noted. “We will address, with the same sense of urgency, recommendations for the Moderna and J&J vaccines as soon as those data are available.”

Find the latest information on COVID-19 booster doses from the CDC.

Sandra Fryhofer, MD, the AMA's liaison to ACIP, will further explain what doctors and patients need to understand about Pfizer vaccine booster recommendations in an episode of the “AMA COVID-19 Update” available next week.

Subscribe or follow the AMA on these channels to get notified when the Dr. Fryhofer episode is live:

Each episode of the “AMA COVID-19 Update” is also made available on the AMA Connect app for smartphone (Apple App Store; Google Play).

Visit the AMA COVID-19 resource center for clinical information, guides and resources, and updates on advocacy and medical ethics.

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