All American adults should be eligible for COVID booster

November 19, 2021
All American adults should be eligible for COVID booster


COVID-19 booster shots are likely to soon become available to any adult who wants one. 

An expert advisory panel of the Centers for Disease Control and Prevention voted unanimously Friday to support expanding booster shot availability and recommended that everyone over 50 get a booster. The committee spent three hours reviewing safety data and considering the benefit booster shots would have in fighting the COVID-19 pandemic.

CDC Director Dr. Rochelle Walensky is expected to quickly sign off on their decision making it federal policy.

Earlier Friday, the Food and Drug Administration Friday remove limits on who could could get booster shots and decided that people over 50, many of whom have medical conditions putting them at extra risk for severe COVID-19, should get an additional shot.

The Moderna and Pfizer-BioNTech shots, which have been available to a select group for some time, should be immediately available to any adult who had their initial shots at least six months ago.

People who received the single-dose Johnson & Johnson vaccine were already encouraged to receive a booster shot at last two months after their initial dose to bring their protection up to the same level as those who received the two-dose vaccines from Pfizer-BioNTech or Moderna. 

Mixing and matching vaccine brands is allowed.

The J&J and Pfizer-BioNTech booster shots are identical to initial vaccines, while Moderna decided that a half-dose would be protective and lead to fewer side effects.

Initial vaccines are still doing an excellent job of protecting against severe disease and hospitalization, particularly of young healthy people. But their effectiveness against any infection starts to fade at about six months. Boosting brings the level of protection back up above 90%, Pfizer-BioNTech data shows.

Widespread booster shots should also help cut down on transmission of the virus. Although vaccines have only been shown to reduce someone’s infectiousness for a short period, that may be enough to get through the holiday season and the coldest part of the winter, when the risk for more COVID-19 cases is highest, officials said.

Although boosters have been available to a limited population for a while, only about 16% of those eligible for the extra shots have gotten them so far.Some states have already allowed boosters for all adults.

Committee members said they hoped that loosening the restrictions would reduce confusion about who is eligible and encourage more people to get an additional shot.

“The current guidelines, though well intentioned and thoughtful…create confusion,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention.

Shah, who is not a voting member but who participated in Friday’s committee meeting as president of the Association of State and Territorial Health Officials said state health officials are unanimously in favor of loosening restrictions on boosters. “We want to remove confusion and replace it with clarity,” he said. “Eligible individuals are not receiving boosters at the moment because of this confusion.”

Booster shots have been shown to be extremely safe, with no additional side effects beyond those seen in initial shots.

In Israel, where about 4 million people have received boosters, fewer side effects have been seen after the second dose than the third. This was also true for a rare side effected called myocarditis, in which the heart muscle becomes inflamed. 

On balance, the committee members said the data convinced them that boosters should be available to everyone.

“It is reasonable for us to facilitate an individual being able to make the choice of benefit versus risk,” said committee member Dr. Sarah Long, a pediatric infectious disease expert at Drexel University College of Medicine and St. Christopher’s Hospital for Children, both in Philadelphia.

The committee decided everyone over 50 “should” get a booster rather than simply permitting them in that age group. They also recommended that anyone living in a long-term care facility, regardless of age, should get a booster.

All other adults “may” get boosters, the committee decided, at least six months after their previous shots.

Data shows that the risk for serious disease goes up with age, although all age groups are vulnerable to infection with COVID-19. Between 50 and 80 adults under 30 would need to get booster shots to prevent one COVID-19 infection, compared to 85 to 135 of the oldest adults.

The committee initially restricted boosters to those at high-risk for infection or for severe COVID-19, but decided to lift those restrictions because of confusion about the restrictions, as well as data from Israel showing that widespread booster shots were safe and helped bring down infection rates.

Infection rates in the U.S. had fallen substantially in September and October, but have been climbing again over the last three weeks. Cases are also rising substantially in much of Europe.

Unvaccinated people still account for the vast majority of those hospitalized with COVID-19, data shows.

The Biden administration has already pre-purchased enough doses to provide boosters free of charge to whoever qualifies. Those doses should be widely available immediately at pharmacies and clinics nationwide.

Contact Karen Weintraub at [email protected]

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.


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