ACIP voted on guidance for Pfizer boosters today. A few surprises. A good example of how hard it is to decide appropriate vaccination policy with mixed and incomplete data and complex priorities.
On the first vote, unanimous vote for 65+ and long term care residents to get boosters.
On the second vote, 13-2 for 50-64 with underlying conditions to get boosters.
On the third vote, 9-6 for 18-49 with underlying conditions to get boosters based on "indvidual benefit and risk". This is weaker guidance than the second vote. ACIP is recommending people in this group decide individually if a booster is appropriate or not based on their circumstances. Ideally in consult with their doctor, but self-attestation in practice.
The fourth and final vote fails 6-9 for people 18-64 who are at high risk of exposure (healthcare workers/teachers/etc) to get boosters. So this group will not be currently eligible for boosters.
This is all regarding the Pfizer vaccine. Those who got Moderna and J&J will have to wait for the upcoming meetings on boosters for those vaccines in the coming weeks. ACIP members wanted to first see the data on mixing these vaccines before approving different booster doses. Data on mixing these vaccines should be available soon from the NIH study, so this guidance might change in the coming weeks. Since the booster is under EUA and not full approval off-label use will not be allowed.
12-17 year olds are ineligible for boosters currently. We do not have data to suggest young people are having waning immunity and there isn't safety data for this age group regarding boosters yet.
Walensky is expected to decide on the final guidance tonight. Typically ACIP guidance is followed, but she has the final authority to change the guidance if she sees fit. I'll update it if she changes the guidance.