CDC panel still has questions about need for booster shots

Experts still uncertain about benefits of booster shots

Briona Arradondo reports

TAMPA, Fla. - The Centers for Disease Control and Prevention’s independent advisory committee met Monday to discuss COVID-19 booster shots, raising several questions and concerns about the need for a third shot and who should get it.

The path to third doses for vaccinated people may not be clear as the nation approaches President Biden’s September 20 rollout goal. Several of the doctors and scientists on the CDC’s Advisory Committee on Immunization Practices said they want to see how third doses could help the general public in their own communities and they want more evidence.

"Going forward we need to think what are we trying to accomplish with these vaccines, and I think there’s a tension here between waiting to see evidence of increasing serious outcomes to make a recommendation for a third dose," said Dr. Jeff Duchin of Infectious Diseases Society of America, and ACIP liaison representative.

The independent group had questions like who needs a booster shot and why. The shot is already approved through emergency use for immuno-compromised people, so the group wants to know what a third Pfizer dose does for the general public.

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"At the moment we don’t have a lot of evidence about reduced vaccine effectiveness against important outcomes in most of the population based on our current data," said Dr. Beth Bell, a clinical professor at the University of Washington School of Public Health and an ACIP board member.

The group is considering a risk-based approach for third doses to vaccinate the elderly, healthcare workers and nursing home residents. Some members brought up questions whether recent breakthrough infections are related to the time after a person is fully vaccinated or if the delta variant is just good at evading the vaccine. Many said they want to see more data from Pfizer to give them answers.

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USF Health virologist Dr. Michael Teng said the advisory board needs time to make sure a third dose is safe for everyone not approved to get one.

"They want to make sure that they have not just some data and not just the topline results that you see in a press release," said Teng. "They want to see the underlying data. They want to be able to dissect it to make sure that if they're going to put their names on it, it better be safe and it better be necessary."

But doctors on the advisory board said some people are doing it anyway right now after hearing President Biden’s September 20 rollout date.

"Since the South is having a horrible outbreak of delta, many, many, many hospitals have already started vaccinating healthcare workers with third doses and patients. Now I know the White House had that small caveat in that it had to be approved by the FDA and the ACIP, but I think since it was given with a date, many assumed that it was given the blessing by the White House and this was the next step. So, it makes me a little concerned that these healthcare providers will not be covered by the PREP Act," said Dr. Helen Talbot, an associate professor of medicine at Vanderbilt University and an ACIP board member. "So I think this highlights the need for any vaccine recommendations to go through the normal avenues and not come from outside normal avenues."

The CDC advisory committee said they can have another meeting in mid-September about booster shots with more data from Pfizer and an additional meeting after FDA authorization for a possible vote on recommendations for use for a third dose. The advisory committee said it strongly advises against giving people a third dose outside of currently approved recommendations.