The Centers for Disease Control and Prevention (CDC) on Wednesday said children from 12 to 17 years old should get a COVID-19 vaccine booster, despite scant effectiveness data and concerns about post-vaccination heart inflammation.
The agency endorsed recommendations from its vaccine advisory panel, which voted 13–1 to advise the CDC to say children in the age group “should” get a booster of Pfizer’s vaccine five months after their primary series. The panel could have advised children “may” get a booster.
“We now recommend that all adolescents aged 12–17 years should receive a booster shot 5 months after their primary series. This booster dose will provide optimized protection against COVID-19 and the Omicron variant. I encourage all parents to keep their children up to date with CDC’s COVID-19 vaccine recommendations,” Dr. Rochelle Walensky, the CDC’s director, said in a statement.
Panel members in support said they were convinced by the recent rise in COVID-19 cases and data that suggest a booster will increase protection against the virus that causes COVID-19, at least for a period of time.
“I am seeing many families where there is transmission from children to adults and in some cases there are devastating outcomes, so I think as much as we can prevent what might be mild-to-moderate disease in children, but as much as we can decrease disease in families, I really think that’s the way to go,” said Dr. Camille Kotton, clinical director for transplant and immunocompromised host infectious diseases at the Massachusetts General Hospital and a panel member.
The CDC and Food and Drug Administration, relying on data from Israel, determined the booster’s benefits outweigh its risks.
Early data from the country suggest the booster leads to fewer cases of COVID-19.
Dr. Sharon Alroy-Preis of Israel’s Health Ministry informed the meeting that two cases of myocarditis, or post-vaccination heart inflammation, have been detected after a Pfizer booster in the country out of over 41,610 boosters administered.
And researchers found recently that Pfizer’s booster presents a higher risk of myocarditis to young men than COVID-19 itself.
But members repeatedly said they hoped boosting children would help staunch the surge in cases driven by the Omicron variant of the CCP (Chinese Communist Party) virus and lower the number of COVID-19 hospitalizations among children.
Several expressed concern, though, about that hope, pointing to data from the United Kingdom that showed booster protection against infection dropped after just four weeks and a lack of data on reducing hospitalizations.
The short term antibody boost “will not last” and “it will probably give no protection against asymptomatic infection,” said one member, Dr. Sarah Long, professor of pediatrics at Drexel University College of Medicine.
Dr. Helen Keipp Talbot, the only “no” vote to the recommendation, said she thinks children should get a booster but worries the push for boosters will distract from vaccinating the unvaccinated.
“I don’t think it’s fair for a 12- to 17-year-old who has been vaccinated to risk myocarditis again for an unknown benefit because their colleagues will not get vaccinated,” she said.
Detractors said the discussion and vote highlighted an avoidance of the dearth of data on boosters, particularly in children.
“They are essentially ignoring lack of data on efficacy of booster in this age group for severe disease, and focusing instead on benefits of preventing infection,” while not addressing how emerging data that indicate the booster’s effectiveness against infection quickly drops, Dr. Walid Gellad with the University of Pittsburgh, who is not on the panel, said on Twitter.