CDC, FDA endorse Covid-19 boosters for all adults

WASHINGTON, DC -- The U.S. is opening Covid-19 vaccine boosters to all adults 18 and older, and is particularly encouraging them for anyone 50 and older.

The decision Friday afternoon by U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky seeks to simplify what has been a confusing list of who's eligible. Earlier Friday, the U.S. Food and Drug Administration also authorized boosters for everyone 18 and older.

The only requirement is to be at least six months past their last dose of a Pfizer or Moderna vaccine or two months past the single-dose Johnson & Johnson vaccine.

The government is trying to get ahead of rising coronavirus cases that experts fear could snowball into a winter surge with upcoming holiday travel.

"Even temporary protection may factor into the benefit risk balance, especially as we approach the winter holidays with increased travel and holiday gatherings," the CDC's Dr. Sara Oliver said.

Previously, boosters had been authorized for anyone 65 and older who was vaccinated with the Pfizer or Moderna vaccines at least six months ago and for certain adults at high risk of infection or of severe disease. Friday's vote streamlines this, making clear every adult should or may get a booster six months after finishing the first two doses.

Recent real-world studies suggested that immunity from Covid-19 vaccines begins to wane and protection against milder and asymptomatic disease, in particular, may drop. Studies have shown that booster doses restore that immunity.

Members of the CDC's Advisory Committee on Immunization Practices heard safety data from the CDC, from Pfizer and from Moderna that showed the boosters have not caused worrying adverse events. The most common reactions are pain at the injection site, headache and fatigue.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said this week that recent data from Israel show that, among people age 60 and older, those who received a booster were less likely to become severely ill than vaccinated people who had not received a booster. Rates of severe disease remained highest among those who weren't vaccinated.

The majority of adults had already been eligible to receive boosters, and several states have already moved to open up boosters to all adults.

'Everyone is eligible'

Expanding booster eligibility to all adults in the United States may not change the logistics around getting shots into arms.

The vaccine supply for boosters is already established in many places. There are no "extra steps" on the administration side of the booster rollout that need to happen, Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials, said.

"Looking national, we have enough vaccine. There are lots of places that have appointments. Obviously, that varies a little bit depending upon where you live geographically because there's more demand in some areas than others," Casalotti said.

"But that being said, I think the main preparation is on the communication side," Casalotti added. "The communication for the local health care providers and public health departments is that now you don't have to worry about eligibility if someone asks if they need to get a booster. This is the information -- everyone is eligible after six months."

Around 32 million people in the United States -- about 17% of those who are fully vaccinated -- have received a booster dose of Covid-19 vaccine, according to CDC data.

About 18 million seniors have received a booster dose of Covid-19 vaccine, according to CDC data, accounting for more than half of all booster doses administered and increasing the immune response for more than a third of fully vaccinated seniors.

The future of boosters

The U.S. is now averaging 94,943 new Covid-19 cases each day, according to Johns Hopkins University -- a 31% increase over last week and back to levels last seen more than a month ago. Midwestern states account for more than a third (38%) of new cases.

There's concern that winter weather that drives people indoors and holiday gatherings could lead to even more cases.

"We certainly want people to be as well protected as they could possibly be going into the season," said Dr. Marci Drees, chief infection prevention officer and hospital epidemiologist for Delaware-based ChristianaCare.

Drees is a Society for Healthcare Epidemiology of America liaison to the CDC's vaccine advisory committee.

"I think we're at the point now where for lots of people who were vaccinated last winter and spring, now would be the time that their protection is waning," she said.

Once people do receive their Covid-19 vaccine booster shots, it's not clear when they might need another vaccine dose -- if ever.

"That certainly is the million-dollar question. We know that the boosters boost people's immunity back up to that 90% to 95% range in the short term. We don't know how long that will last," Drees said.

"In some ways, we're forging a new path -- and a lot of it is driven by can we get enough immunity in the population so that we can really shut down further transmission," Drees said. "We know that boosters are not going to end the pandemic. They will help and prevent people from getting sick, but we really still need to push on getting first and second doses into people as well."