CDC Urges All Vaccinated Adults to Get COVID Boosters

As scientists investigate the Omicron variant, health officials advise everyone ages 18 and older to get a booster shot.

CDC Urges All Vaccinated Adults to Get COVID Boosters

Medically reviewed in December 2021

Updated on December 1, 2021

U.S. health officials are taking a stronger stance on boosters, advising all fully vaccinated adults in the United States to get a COVID-19 booster shot as soon as they are eligible.

The move comes amid a widespread uptick in new coronavirus cases and the first reported U.S. case of the new Omicron variant in California. Scientists are still working to understand if  Omicron is more contagious or better at evading the immune system than other variants. But the fact that this variant has more worrisome mutations than any others has raised alarms.

The Centers for Disease Control and Prevention (CDC) cautions that being fully vaccinated and boosted is still the best way people can protect themselves from severe disease.

"Everyone ages 18 and older should get a booster shot either when they are six months after their initial Pfizer or Moderna series or two months after their initial J&J vaccine,” said CDC director, Rochelle P. Walensky, MD, MPH in a November 29 statement. “The recent emergence of the Omicron variant (B.1.1.529) further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against COVID-19.”

On November 19, Walensky quickly signed off on the FDA's move to amend its Emergency Use Authorization (EUA) of the two mRNA boosters. That change finally opened boosters up to all fully vaccinated adults.

“Booster shots have demonstrated the ability to safely increase people’s protection against infection and severe outcomes and are an important public health tool to strengthen our defenses against the virus as we enter the winter holidays," she said in a November 19 statement.

New cases on the rise
As winter sets in, many Americans are making holiday plans and gathering more often indoors. Meanwhile, the CDC predicts that between 260,000 and 1,100,000 new COVID cases will likely be reported the week ending December 11. The highly contagious Delta variant remains dominant, accounting for nearly all new cases in the United States. But amid a sharp rise in new Omicron cases in South Africa, Europe, Canada and other parts of the world, scientists are concerned that this new variant has the potential to out-compete Delta.

As of November 30, about 60 percent of the U.S. population is fully vaccinated and nearly 21 percent of people who are fully vaccinated have gotten a COVID booster.

Well before the rise of Omicron, Pfizer and Moderna’s booster shots were previously authorized for only certain groups of adults considered at high risk for severe disease and exposure due to their age, preexisting medical conditions, their job or communal living situation.

The CDC's more recent approval of COVID boosters for everyone ages 18 and older greatly simplified booster eligibility requirements in order to help bolster protection against COVID-19.

Now, all adults who received two doses of either the Pfizer or Moderna vaccines should get a booster once six months have elapsed since their second shot. And all adults who got the Johnson & Johnson (J&J) COVID vaccine should get a booster if it’s been at least two months since their shot.

Anyone getting a booster can choose to receive the same vaccine their got initially or they can “mix and match” and get one of the other COVID vaccines available for use in the United States.

What the latest data shows
Experts point out the vaccines still protect well against hospitalization and death from COVID-19, but a November study published in Science found that the effectiveness of Pfizer’s vaccine dropped from 86 percent in February to 43 percent in October. Similarly, Moderna’s efficacy against symptomatic COVID-19 fell from 89 percent to 58 percent and Johnson & Johnson’s efficacy fell from 86 to 13 percent.

On November 9, Pfizer also submitted more recent findings from its Phase 3 trial to the FDA. The trial, which involved more than 10,000 people aged 16 or older who received a booster vaccine or a placebo, took place while the Delta variant accounted for nearly all new COVID-19 cases. All of the participants were fully vaccinated against COVID-19 and had received their shots 11 months earlier, on average.

The trial found that the group who got the booster had a 95.6 percent reduction in symptomatic COVID-19 over an average 2.5-month monitoring period. Some 109 people developed a symptomatic case of COVID-19 in the non-boosted group, compared to only five of the people in the booster group. The results held true regardless of age, sex, ethnicity, and participants’ other disease conditions, and no new safety concerns were reported.

A separate study conducted by Israeli researchers came to similar conclusions. The study, which was published on October 29 in The Lancet, examined the safety and efficacy of the Pfizer booster among 1.1 million fully vaccinated people. Compared to the placebo group, far fewer people experienced COVID-19-related admission to hospital, severe disease, or COVID-19-related death if they got a third dose of the vaccine. The third dose was 93 percent effective in preventing hospitalization, 92 percent effective in preventing severe disease, and 81 percent effective in preventing death from COVID-19.

Though these studies showed existing vaccines still protect against severe COVID-19 and hospitalizations, boosters for all adults could help slow the spread of the coronavirus, defend against the current surge in new cases and help turn the tide of the pandemic.

Sources:
Centers for Disease Control and Prevention. “CDC Expands COVID-19 Booster Recommendations.” Nov 29, 2021.
Oliver S. “Updates to the Evidence to Recommendation Framework: Pfizer-BioNTech and Moderna COVID-19 vaccine booster doses.” Nov 19, 2021.
Centers for Disease Control and Prevention. "CDC Expands Eligibility for COVID-19 Booster Shots to All Adults." Nov 19, 2021.
U.S. Food and Drug Administration. “Coronavirus (COVID-19) Update: FDA Expands Eligibility for COVID-19 Vaccine Boosters.” Nov 19, 2021.
Cohn BA, Cirillo PM, Murphy CC et al. Science. “SARS-CoV-2 vaccine protection and deaths among US veterans during 2021.” Nov 4, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: COVID-19 Vaccinations in the United States.” Nov 16, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory.” Nov 15, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: COVID-19 Forecasts: Cases.” Nov 17, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: Variant Proportions.” Nov 13, 2021.
Pfizer-BioNTech. “Pfizer and BioNTech Announce Phase 3 Trial Data Showing High Efficacy of a Booster Dose of Their COVID-19 Vaccine.” Oct. 21, 2021.
Pfizer-BioNTech. “PFIZER AND BIONTECH SUBMIT REQUEST TO AMEND U.S. FDA EMERGENCY USE AUTHORIZATION OF THEIR COVID-19 VACCINE BOOSTER TO INCLUDE ALL INDIVIDUALS 18 AND OLDER.” Nov. 9, 2021.
Centers for Disease Control and Prevention. COVID-19 Data Tracker. “COVID-19 Vaccinations in the United States.” Accessed Nov. 10, 2021.
Barda N, Dagan N, Cohen C, et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. The Lancet. Oct. 29, 2021.
Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. The Lancet. Oct 4, 2021.

Article sources open article sources

Centers for Disease Control and Prevention. “CDC Expands COVID-19 Booster Recommendations.” Nov 29, 2021.
Oliver S. “Updates to the Evidence to Recommendation Framework: Pfizer-BioNTech and Moderna COVID-19 vaccine booster doses.” Nov 19, 2021.
Centers for Disease Control and Prevention. "CDC Expands Eligibility for COVID-19 Booster Shots to All Adults." Nov 19, 2021.
U.S. Food and Drug Administration. “Coronavirus (COVID-19) Update: FDA Expands Eligibility for COVID-19 Vaccine Boosters.” Nov 19, 2021.
Cohn BA, Cirillo PM, Murphy CC et al. Science. “SARS-CoV-2 vaccine protection and deaths among US veterans during 2021.” Nov 4, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: COVID-19 Vaccinations in the United States.” Nov 16, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory.” Nov 15, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: COVID-19 Forecasts: Cases.” Nov 17, 2021.
Centers for Disease Control and Prevention. “COVID Data Tracker: Variant Proportions.” Nov 13, 2021.
Pfizer-BioNTech. “Pfizer and BioNTech Announce Phase 3 Trial Data Showing High Efficacy of a Booster Dose of Their COVID-19 Vaccine.” Oct. 21, 2021.
Pfizer-BioNTech. “PFIZER AND BIONTECH SUBMIT REQUEST TO AMEND U.S. FDA EMERGENCY USE AUTHORIZATION OF THEIR COVID-19 VACCINE BOOSTER TO INCLUDE ALL INDIVIDUALS 18 AND OLDER.” Nov. 9, 2021.
Centers for Disease Control and Prevention. COVID-19 Data Tracker. “COVID-19 Vaccinations in the United States.” Accessed Nov. 10, 2021.
Barda N, Dagan N, Cohen C, et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. The Lancet. Oct. 29, 2021.
Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. The Lancet. Oct 4, 2021.

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