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CDC Director Walensky Overrules Advisers On Boosters For At-Risk Workers

STEVE INSKEEP, HOST:

This story underlines the complexities of scientific decisions that health officials are making in real time during the pandemic. The question is, who should receive an extra shot of a COVID vaccine? As we reported this week, the FDA said several groups should receive a Pfizer shot, including at-risk workers. A panel from the Centers for Disease Control then said several groups should receive the shot, but not at-risk workers. Overnight, Rochelle Walensky, the head of the CDC, overruled her own board and agreed with the FDA. President Biden talked today and who should get boosters.

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JOE BIDEN: Based on that review, the majority of Americans who are fully vaccinated with the Pfizer vaccine are now able to receive the booster shot six months after they've received their second shot.

INSKEEP: NPR health correspondent Rob Stein joins us now to talk more about this. Hey there, Rob.

ROB STEIN, BYLINE: Good morning, Steve.

INSKEEP: What was unusual here?

STEIN: Yeah. You know, it is very unusual for the CDC director to overrule the agency's own advisers. The CDC director usually accepts those recommendations, even though they aren't binding. And, you know, Steve, it's the latest whiplash that kind of encapsulates all the mixed signals and intense debate that's been going on around boosters in the U.S. Ever since the Biden administration announced plans to start offering boosters, there have been really deep divisions and unusually public debates among federal officials and agency scientists about whether boosters are really needed, and if they are, who should be at the front of the line to get them?

Yesterday, the CDC advisory committee voted unanimously to endorse boosters for anyone age 65 and older who had received the Pfizer/BioNTech vaccine beginning six months after they were fully vaccinated. They also supported a third dose for adults who have health problems that put them at risk for severe COVID-19. But that's where they drew the line. They rejected the FDA's authorization for boosters for workers like doctors, nurses and teachers.

INSKEEP: Yeah. Let's talk about that. I mean, in an administrative sense, this is resolved because both agencies ended up at the same place...

STEIN: Right.

INSKEEP: ...Approving for workers. But why did some advisers - a majority of the CDC advisers, apparently - vote against doing that?

STEIN: Yeah. So the CDC panel was really closely split on this question. Six members voted to open up boosters for those folks, but nine voted against it. The opponents basically argued that there simply isn't enough evidence to support giving boosters to otherwise healthy people, no matter what jobs they do. You know, sure, immunity seems to be waning for older people, and maybe people with health problems are more vulnerable. But so far, all the vaccines are still doing a great job of keeping relatively young, healthy people out of the hospital and keeping them alive. And there may be risks from a third dose, like an inflammation of the heart, known as myocarditis, which is a - rare but has been showing up most frequently among younger men.

Here's Dr. Lynn Bahta from the Minnesota Department of Health during yesterday's meeting.

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LYNN BAHTA: I feel like we're being pulled into an emotional decision. And this is an emotional decision. But we really do have to stay with the science. And I don't think we have the data in younger age groups to make a decision for a booster dose.

STEIN: But, you know, on the flip side, others argued quite passionately at times that many workers in risky jobs deserve whatever protection they can get, especially health care workers who've been putting their lives on the line every day.

Here's what Dr. Marci Drees from the Society for Healthcare Epidemiology of America told the committee.

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MARCI DREES: They've been on the front lines of this from the beginning. And even though we have PPE, it's very frustrating and demoralizing for them to get COVID anyway.

STEIN: So you can see they've really wrestled with this decision.

INSKEEP: Well, Rochelle Walensky ended up on the yes side - yes, front-line workers should get the extra shot. Why did she make that decision?

STEIN: You know, in a statement released early this morning, CDC Director Rochelle Walensky sided with the argument many workers needed additional protection in the face of the delta surge. In a pandemic, she said, the CDC is, quote, "tasked with analyzing complex, often imperfect data and take action that we anticipate will do the greatest good, even when there is uncertainty." So these new recommendations open the door now for boosters for tens of millions of Americans who received the Pfizer/BioNTech vaccine. And the FDA and CDC are also considering boosters for people who got Moderna and Johnson & Johnson vaccines.

INSKEEP: An acknowledgment of some uncertainty there about whether it's worth it, but she says, go ahead. Rob, thanks so much.

STEIN: Exactly - you bet, Steve.

INSKEEP: NPR health correspondent Rob Stein. Transcript provided by NPR, Copyright NPR.