This story was updated at 9:32 a.m. Jan. 6, 2022.
Jan. 5, 2022 – CDC Director Rochelle Walensky, MD, late Wednesday endorsed an advisory panel’s recommendation that 12- to 17-year-olds in the United States should get the Pfizer COVID-19 booster shot at least 5 months after a primary series of vaccinations.
Just a few hours earlier the agency’s Advisory Committee on Immunization Practices voted 13-1 in favor of the recommendation.
The CDC had already said 16- and 17-year-olds “may” receive a Pfizer booster but today’s recommendation adds the 12-15 group and strengthens the “may” to “should” for 16- and 17-year-olds.
The vote comes after the FDA on Monday authorized the Pfizer vaccine booster dose for 12- to 15-year-olds.
The FDA action updated the authorization for the Pfizer vaccine, and the agency also shortened the recommended time between a second dose and the booster to 5 months or more (from 6 months). A third primary series dose is also now authorized for certain immunocompromised children between 5 and 11 years old. Full details are available in an FDA news release.
The CDC on Tuesday also backed the shortened time frame and a third primary series dose for some immunocompromised children 5 to 11 years old. But the CDC delayed a decision on a booster for 12- to 15-year-olds until it heard from its Advisory Committee on Immunization Practices today.
The decision came as school districts nationwide are wrestling with decisions of whether to keep schools open or revert to a virtual format as cases surge, and as pediatric COVID-19 cases and hospitalizations reach new highs.
The only dissenting vote came from Helen Keipp Talbot, MD, associate professor of medicine at Vanderbilt University in Nashville.
She said after the vote, “I am just fine with kids getting a booster. This is not me against all boosters. I just really want the U.S. to move forward with all kids.”
Talbot said earlier in the comment period, “If we divert our public health from the unvaccinated to the vaccinated, we are not going to make a big impact. Boosters are incredibly important but they won’t solve this problem of the crowded hospitals.”
She said vaccinating the unvaccinated must be the priority.
“If you are a parent out there who has not yet vaccinated your child because you have questions, please, please talk to a health care provider,” she said.
Among the 13 supporters of the recommendation was Oliver Brooks, MD, chief medical officer of Watts HealthCare Corporation in Los Angeles.
Brooks said extending the population for boosters is another tool in the toolbox.
“If it’s a hammer, we should hit that nail hard,” he said.
Sara Oliver, MD, ACIP’s lead for the COVID-19 work group, presented the case behind the recommendation.
She noted the soaring Omicron cases.
“As of Jan. 3, the 7-day average had reached an all-time high of nearly 500,000 cases,” Oliver noted.
Since this summer, she said, adolescents have had a higher rate of incidence than adults.
“The majority of COVID cases continue to occur among the unvaccinated,” she said, “with unvaccinated 12- to 17-year-olds having a 7-times-higher risk of testing positive for SARS-Cov-2 compared to vaccinated 12- to 17-year-olds. Unvaccinated 12- to 17-year-olds have around 11 times higher risk of hospitalization than vaccinated 12- to 17-year-olds.”
“Vaccine effectiveness in adolescents 12- to 15-years-old remains high,” Oliver said, but evidence shows, there may be “some waning over time.”
Discussion of risk centered on myocarditis.
Oliver said myocarditis rates reported after the Pfizer vaccine in Israel across all populations as of Dec. 15 show that “the rates of myocarditis after a third dose are lower than what is seen after the second dose.”