CDC recommends Covid-19 boosters for all adults
US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky endorsed the use of Covid-19 vaccine boosters Friday for all adults.
Walensky made her recommendation just hours after CDC vaccine advisers voted unanimously to recommend booster doses of Pfizer/BioNTech's and Moderna's Covid-19 vaccines for all US adults six months after they finish their first two doses.
The recommendations simplify previous, complicated guidance for boosters.
Earlier Friday, the US Food and Drug Administration authorized boosters of the Pfizer/BioNTech and Moderna Covid-19 vaccines for everyone 18 and older.
"CDC continues to encourage the 47 million adults who are not yet vaccinated to get vaccinated as soon as possible to protect themselves, their families, loved ones and communities," the CDC said in a statement.
"We also strongly encourage those who were already eligible -- older populations and individuals with underlying medical conditions -- to get boosted before the holidays."
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.
"After critical scientific evaluation, today's unanimous decision carefully considered the current state of the pandemic, the latest vaccine effectiveness data over time, and review of safety data from people who have already received a COVID-19 primary vaccine series and booster," Walensky said in a statement.
"Booster shots have demonstrated the ability to safely increase people's protection against infection and severe outcomes and are an important public health tool to strengthen our defenses against the virus as we enter the winter holidays," she added.
"Based on the compelling evidence, all adults over 18 should now have equitable access to a COVID-19 booster dose."
The vote comes just in time for people to get boosters before the holidays, the CDC's Dr. Sara Oliver told the meeting. Even if the added immunity given by boosters doesn't last long, she said, it can help.
"Even temporary protection may factor into the benefit risk balance, especially as we approach the winter holidays with increased travel and holiday gatherings," Oliver said.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN 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, told CNN.
"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 told CNN.
"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 US 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."
CNN's Deidre McPhillips contributed to this report.
CDC 向所有成年人推荐 Covid-19 加强针
美国疾病控制与预防中心主任罗谢尔·瓦伦斯基博士周五批准对所有成年人使用 Covid-19 疫苗加强剂。
就在 CDC 疫苗顾问一致投票推荐辉瑞 / BioNTech 和 Moderna 的 Covid-19 疫苗给所有美国成年人接种前两剂疫苗六个月后，瓦伦斯基提出了她的建议。
这些建议简化了以前对助推器的复杂指导。
周五早些时候，美国食品和药物管理局授权辉瑞/BioNTech 和 Moderna Covid-19 疫苗用于 18 岁及以上的所有人。
CDC 在一份声明中说：“CDC 继续鼓励尚未接种疫苗的 4700 万成年人尽快接种疫苗，以保护自己、家人、亲人和社区。”
“我们还强烈鼓励那些已经符合条件的人——老年人和有基础疾病的人——在假期前得到提升。”
此前，任何 65 岁及以上且至少在六个月前接种过辉瑞或 Moderna 疫苗的人以及某些感染或患有严重疾病的高风险成年人都已获准使用加强剂。周五的投票简化了这一点，明确每个成年人在完成前两剂后六个月应该或可能会得到加强剂。
最近的现实世界研究表明，对 Covid-19 疫苗的免疫力开始减弱，尤其是对较轻和无症状的疾病的保护可能会下降。研究表明，加强剂量可以恢复这种免疫力。
CDC 免疫实践咨询委员会的成员听取了来自 CDC、辉瑞和 Moderna 的安全数据，这些数据表明加强剂没有引起令人担忧的不良事件。最常见的反应是注射部位疼痛、头痛和疲劳。
瓦伦斯基说：“经过严格的科学评估，今天的一致决定仔细考虑了大流行的现状、随着时间推移的最新疫苗有效性数据，以及对已经接种过 COVID-19 初级疫苗系列和加强剂的人的安全数据的审查。”在一份声明中。
她补充说：“加强注射已经证明能够安全地提高人们对感染和严重后果的保护，并且是重要的公共卫生工具，可以在我们进入寒假时加强我们对病毒的防御。”
“根据令人信服的证据，所有 18 岁以上的成年人现在都应该公平地获得 COVID-19 加强剂量。”
CDC 的 Sara Oliver 博士在会议上说，投票来得正是时候，人们可以在假期前获得助推器。她说，即使助推器提供的额外免疫力不会持续很长时间，它也会有所帮助。
奥利弗说：“即使是临时保护也可能影响利益风险平衡，尤其是当我们接近寒假，旅行和假期聚会增加时。”
美国国家过敏和传染病研究所所长安东尼·福奇博士本周告诉美国有线电视新闻网，以色列最近的数据显示，在 60 岁及以上的人群中，接受加强免疫的人比接种疫苗的人患重病的可能性更小。谁没有接受助推器。在未接种疫苗的人群中，严重疾病的发病率仍然最高。
大多数成年人已经有资格获得助推器，一些州已经开始向所有成年人开放助推器。
'每个人都有资格'
将助推器资格扩大到美国的所有成年人可能不会改变将枪打入武器的流程。
许多地方已经建立了加强疫苗的供应。全国县市卫生官员协会政府和公共事务负责人阿德里亚娜·卡萨洛蒂 (Adriane Casalotti) 告诉美国有线电视新闻网，在推出助推器的行政方面没有需要采取的“额外步骤”。
“从全国来看，我们有足够的疫苗。有很多地方都有预约。显然，这取决于你居住的地理位置，因为某些地区的需求比其他地区更多，”卡萨洛蒂告诉 CNN。
“但话虽如此，我认为主要的准备工作是在沟通方面，”卡萨洛蒂补充道。 “当地医疗保健提供者和公共卫生部门的沟通是，现在如果有人问他们是否需要接种助推器，你不必担心是否有资格。这就是信息——每个人在六个月后都有资格。”
根据疾病预防控制中心的数据，美国约有 3200 万人（约占完全接种疫苗者的 17%）接种了加强剂量的 Covid-19 疫苗。
根据疾病预防控制中心的数据，大约有 1800 万老年人接种了加强剂量的 Covid-19 疫苗，占所有加强剂量的一半以上，并增加了超过三分之一完全接种疫苗的老年人的免疫反应。
助推器的未来
根据约翰霍普金斯大学的数据，美国现在平均每天有 94,943 例新的 Covid-19 病例——比上周增加了 31%，回到了一个多月前的水平。中西部各州占新病例的三分之一以上（38%）。
人们担心，促使人们呆在室内和假日聚会的冬季天气可能会导致更多病例。
“我们当然希望人们在进入季节时得到尽可能好的保护，”特拉华州 ChristianaCare 的首席感染预防官和医院流行病学家 Marci Drees 博士说。
Drees 是美国医疗保健流行病学协会与 CDC 疫苗咨询委员会的联络人。
她说：“我认为，对于去年冬天和春天接种疫苗的许多人来说，现在是他们的保护力减弱的时候了。”
一旦人们确实接受了 Covid-19 疫苗加强注射，就不清楚他们何时可能需要另一剂疫苗——如果有的话。
“这当然是一个价值数百万美元的问题。我们知道，在短期内，增强剂可以将人们的免疫力提高到 90% 到 95% 的范围。我们不知道这会持续多久，”德雷斯说。
“在某些方面，我们正在开辟一条新途径——其中很多是因为我们能否在人群中获得足够的免疫力，以便我们能够真正关闭进一步的传播，”德雷斯说。 “我们知道助推器不会结束大流行。它们将帮助和防止人们生病，但我们确实仍然需要推动将第一剂和第二剂注射到人们身上。”
CNN 的 Deidre McPhillips 为本报告做出了贡献。
