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The Biden administration’s plan for a widespread Covid-19 booster programme was dealt another blow on Thursday when a panel of scientists advising the top public health agency recommended that a third dose be offered only to the elderly, care home residents and those with underlying health issues.
The vaccine committee advising the US Centers for Disease Control and Prevention voted unanimously to recommend booster doses of the BioNTech/Pfizer vaccine to people aged over 65 years and care home residents, and 13-2 to approve boosters for people aged 50-64 with underlying medical conditions.
The committee voted 9-6 to offer boosters to people aged over 18 with underlying health conditions. However, they rejected endorsing a third jab for those working in jobs with high risk of exposure to Covid, in a 9-6 vote.
The Biden administration had planned to launch a widespread programme for all Americans over the age of 16 starting next week, even before regulators had given the go-ahead. That angered some scientists, leading to the retirement of two top FDA officials earlier this month.
An FDA advisory panel subsequently declined to endorse BioNTech/Pfizer boosters for everyone over age 16, and instead recommended a more limited group of older and at-risk individuals. The FDA heeded that recommendation on Wednesday, authorising a third dose for people aged 65 and over and adults at high risk of severe Covid-19 or whose jobs mean they are frequently exposed to the virus.
The CDC panel recommended a narrower set of qualifications after some members questioned whether the need for an extra dose outweighed potential risks, especially in younger people.
Several scientists questioned the logistics of giving boosters only to people who had received the BioNTech/Pfizer vaccine and voiced frustrations about the scarcity of data on a booster dose of the single-shot Johnson & Johnson vaccine.
“I just don’t understand how we can say to people 65 years and up ‘you are at severe risk of hospitalisation . . . but only half of you can protect yourselves right now’,” said Sarah Long, paediatrics professor at Drexel University College of Medicine.
The scientists noted that their priority remains full vaccination, defined as two weeks after the second dose of an mRNA jab, such as those made by BioNTech/Pfizer and Moderna, or a single J&J shot. The FDA has already authorised a third dose of mRNA vaccines to people with weak immune systems.
Some members questioned the extent of available data. Camille Kotton, infectious diseases specialist at Massachusetts General Hospital, said that black and Latino people under the age of 65 had a higher death toll and more data were needed to reflect ethnicities. “It is not the same outcome across all racial groups,” she said.