51˶

CDC Panel Pushes Boosters for All Teens

— Boosters will protect a population hit hard by COVID in many ways, committee said

Last Updated January 6, 2022
MedpageToday
A female nurse gives a pre-teen boy a covid vaccination.

Adolescents ages 12-17 should receive a booster dose of Pfizer's COVID-19 vaccine (Comirnaty), the CDC's Advisory Committee on Immunization Practices (ACIP) said on Wednesday.

ACIP voted 13-1 to recommend a booster dose of Pfizer vaccine at least 5 months after the two-dose primary series. The committee also boosted their recommendation for 16-17 year-olds, which CDC previously said could receive a booster dose at least 6 months after the primary series, based on individual benefits and risks.

On Wednesday night, CDC Director Rochelle Walensky, MD, endorsed these recommendations .

"It is critical that we protect our children and teens from COVID-19 infection and the complications of severe disease," she said. "This booster dose will provide optimized protection against COVID-19 and the Omicron variant."

The Omicron surge, its transmissibility and its effect on children's well-being, ultimately tipped the scales for the committee. ACIP members spoke about experiences with children waiting 18 hours in the emergency department to be seen in the hospital.

"Hospitals are full ... it is true that children are hospitalized at a less frequent rate than adults, but COVID is overwhelming our hospitals and children's hospitals," said Kathy Poehling, MD, of Wake Forest School of Medicine in Winston-Salem, North Carolina.

Camille Kotton, MD, of Massachusetts General Hospital in Boston, said that in her practice, she is seeing family transmission from children to adults with "devastating outcomes," and this would help reduce disease in families.

Several committee members reiterated that the goal of the vaccine was to prevent hospitalization and death. Sarah Long, MD, of Drexel University College of Medicine in Philadelphia, still supported the recommendation, saying it would "help us understand over time if there will be any protection against hospitalization and death for those who are otherwise fully vaccinated."

Boosters "allow us to whack-a-mole for another month or two" to try to reduce transmission, Long added.

ACIP Chair Grace Lee, MD, of Stanford University School of Medicine in California, said that a goal of the vaccine should be trying to prevent infection.

"We have burdened an entire generation of children ... with the impact of COVID," she said. "We are trying to reduce risk of infection to protect ourselves and others."

CDC staff also said there were no additional safety concerns, with real-world data from Israel showing that out of the more than 41,000 booster doses administered in individuals ages 12-15, there were only two cases of vaccine-associated myocarditis reported.

In a statement, the agency added that ACIP reviewed data from over 25 million vaccine doses in adolescents.

Oliver Brooks, MD, of Watts Healthcare Corporation in Los Angeles, likened the booster to a "tool in our toolbox" and "a hammer that should hit that nail hard."

However, Helen Keipp Talbot, MD, of Vanderbilt University in Nashville, was the only naysayer, wanting to focus more public health resources on the half of unvaccinated teens and 75% of unvaccinated kids ages 5-11.

"The booster is not going to be a hammer, the booster is going to hit that nail in a millimeter" when there's "20 millimeters to go," she noted. "We need to spend our days and nights vaccinating those who are not vaccinated."

After the vote, Talbot reiterated that she is "not against kids getting a booster," but she wants the U.S. to focus on vaccinating all children.

Liaison members in the public health arena said that a strong recommendation is much easier to implement, and much less confusing for the public.

CDC staff added that the agency has recently shifted language about vaccination from "fully vaccinated" to "up-to-date" on vaccination, in the hopes of better communicating that all who are eligible for a booster should receive a booster.

Amanda Cohn, MD, of the CDC, said that over the course of the next several days, the agency will be "rolling out additional communications around this issue."

  • author['full_name']

    Molly Walker worked for 51˶ from 2014 to 2022, and is now a contributing writer. She is a 2020 J2 Achievement Award winner for her COVID-19 coverage.