Vote comes as health officials push back against CDC’s quarantine guidance

The CDC’s Advisory Committee on Immunization Practices (ACIP) agreed it is time to “boost” teens age 12 to 15 with an additional shot of BNT162b2 Covid-19 vaccine. ACIP’s decision is an official stamp of approval to action taken by the FDA two days ago when it expanded the vaccine’s emergency use authorization (EUA) to this younger age group.

Previously, the FDA issued an EUA to allow a booster dose of the BNT162b2 vaccine for patients ages 16 and older. In its decision earlier this week, the agency also shortened the minimum time from primary vaccination to boosting to 5 months, down from the originally authorized 6 months.

By a vote of 13 to 1, ACIP members backed the following interim recommendation: “A single Pfizer-BioNTech Covid-19 vaccine booster dose is recommended for persons aged 12-17 years at least 5 months after primary series under the FDA’s Emergency Use Authorization.”

The CDC has already issued a recommendation backing Covid boosting at five months after the initial shots, as well as the FDA’s authorization of an additional dose of BNT162b2 after a second dose in kids ages 5-11 who are immunocompromised.

When ACIP first convened in 2021 to discuss Covid booster shots, younger patients were largely not considered—in fact, there was debate among committee members over whether booster doses were warranted at all, particularly when many U.S. residents had still not received their primary shots. However, with the highly mutated Omicron variant sweeping across the country in the new year, the push to expand the U.S. booster program has kicked into high gear.

That being said, committee members emphasized that increasing primary vaccine coverage should still be the top priority. And, they added, the onus should not only be on those who deign to get the shots; mitigation efforts such as frequent hand washing, masking, and self-isolating remain crucial in controlling spread of the virus.

What’s more, the committee members largely agreed that the emphasis of the vaccines should be on preventing Covid-related hospitalizations and deaths, not on preventing Covid cases altogether.

“We need to make sure that the message is to prevent serious disease,” ACIP member Pablo J. Sanchez, MD, of The Ohio State University and the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, commented during the meeting. “And I think that’s been a fault of from the beginning of the vaccination program. And I think… the talk of preventing just a regular infection has contributed to vaccine hesitance. I think we have to be clear that that’s it.”

AMA Criticizes CDC’s Quarantine Guidance

On the same day that ACIP made it’s vote, Gerald E. Harmon, MD, president of the American Medical Association, issued a statement calling the CDC’s latest quarantine and isolation for Covid-19 “confusing” and “counterproductive.”

At the end of 2021, the CDC shortened the quarantine period for individuals with Covid-19 infection, whittling it down from 10 to five days for patients who are asymptomatic or whose symptoms are resolving, followed by five days of masking in public. What’s more, these patients would not require a negative Covid test to end isolation.

In its media statement, the CDC explained that the change was motivated by evidence that “the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after.”

“Nearly two years into this pandemic, with Omicron cases surging across the country, the American people should be able to count on the Centers for Disease Control and Prevention (CDC) for timely, accurate, clear guidance to protect themselves, their loved ones, and their communities,” Harmon wrote. “Instead, the new recommendations on quarantine and isolation are not only confusing, but are risking further spread of the virus.”

He pointed out that, according to the CDC’s own reasoning for the guidance, “an estimated 31 percent of people remain infectious 5 days after a positive Covid-19 test. With hundreds of thousands of new cases daily and more than a million positive reported cases on January 3, tens of thousands—potentially hundreds of thousands of people—could return to work and school infectious if they follow the CDC’s new guidance on ending isolation after five days without a negative test. Physicians are concerned that these recommendations put our patients at risk and could further overwhelm our health care system.”

Harmon concluded that the CDC should reinstate the requirement of a negative Covid test in order to end isolation after testing positive for SARS-CoV-2.

“Test availability remains a challenge in many parts of the country, including in hospitals, and we urge the administration to pull all available levers to ramp up production and distribution of tests,” he wrote. “But a dearth of tests at the moment does not justify omitting a testing requirement to exit a now shortened isolation.”

John McKenna, Associate Editor, BreakingMED™

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