Dr. Rochelle Walensky, the Centers for Disease Control and Prevention (CDC) director, signed off on a limited COVID-19 booster shot plan Thursday, only a month after President Joe Biden publicly suggested that he wanted a booster shot plan that was far broader.
The plan endorses Pfizer booster shots for those at risk of severe COVID-19, including seniors over the age of 65, residents of long-term care centers, adults between 50-64 with underlying medical conditions, and adults who work in high-transmission occupational settings, such as hospitals, six months after the initial vaccination regimen. It does not apply to anyone who received the Moderna vaccine regimen or the Johnson & Johnson one-shot COVID-19 vaccine.
“While today’s action was an initial step related to booster shots, it will not distract from our most important focus of primary vaccination in the United States and around the world,” said Dr. Walensky.
An ‘unusual’ decision
Walensky’s decision was broader than expected and follows a more reserved recommendation from a CDC advisory panel on Thursday. Although that panel, the Advisory Committee on Immunization Practices, did vote to recommend booster shots for seniors, nursing home residents, and adults with medical conditions, they did not endorse booster shots for people who work in high-transmission occupational settings — something that the Food and Drug Administration (FDA) authorized last week.
The panel’s recommendations aren’t binding, but historically, the CDC director typically follows the panel’s advice. As such, many have described Walensky’s move as “unusual.”
“I am surprised that Dr. Walensky overturned one of the four A.C.I.P. votes today, and I believe others will be as well,” Dr. Yvonne Maldonado, an infectious disease expert and the American Academy of Pediatrics liaison to the ACIP, told The New York Times.
Others disagree that Walensky made an unusual decision.
“I wouldn’t characterize it as highly unusual or ‘overruling’ — it’s a tough spot to be in and the alternative was the FDA and CDC saying different things,” said Mayo Clinic Professor Vincent Rajkumar on Twitter. “This was a unique situation. It’s the kind of judgment call we want leaders to make. Otherwise, they would be rubber stamps.”
The WH booster push
The move comes after protracted debate among experts over whether booster shots were even necessary, given that the three vaccines available domestically remain highly effective at preventing severe disease and death. But the Biden administration tossed accelerant on the debate last month when they anticipated widespread use of COVID-19 boosters among Americans beginning as early as September 20.
“It will make you safer, and for longer, and it will help us end the pandemic faster,” Biden said in a speech at the White House last month. “This is no time to let our guard down. We just need to finish the job with science, with facts, and with confidence.”
The Biden administration’s top-down booster push, however, may have also helped push out two top FDA regulators, both of whom — according to a source who spoke to POLITICO — were angry over the lack of autonomy at the agency. The CDC Director and the Acting FDA Commissioner later had to inform the White House that the booster plan would likely not be as ambitious as the president had envisioned.