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The latest on Covid-19 boosters in the US

WH unveiled plans to vaccinate children. Hear from US surgeon general
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What we covered

  • CDC Director Dr. Rochelle Walensky endorsed recommendations for booster doses for the Moderna and Johnson & Johnson vaccines, opening the way for millions more Americans to get booster shots.
  • Walensky also endorsed the mix-and-match approach to boosters, saying eligible people could choose whichever vaccine they wished as a booster.
  • Vaccine advisers to the FDA are scheduled to meet next week to consider Pfizer’s request to authorize its vaccine to children ages 5 to 11.

Our live coverage has ended. Read more about Covid-19 vaccine boosters here.

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More than 90% of US counties still have "high" or "substantial" Covid-19 transmission, CDC says

New Covid-19 cases continue to fall in the United States, but more than 90% of counties – home to more than 319 million people – still have “high” or “substantial” community transmission, according to thresholds set by the US Centers for Disease Control and Prevention. 

A community is considered by the CDC to have “high” transmission if there have been 100 or more new cases per 100,000 people over the past seven days or if the test positivity rate is 10% or higher. A community is considered to have “substantial” transmission with at least 50 new cases per 100,000 people over the past week or a test positivity rate of 8% or higher. 

“We still have 75,000 cases (per day) in this country, and I am very encouraged to watch these trends coming down. But as you know, we have still over 90% of our counties that are in substantial or high community transmission,” CDC Director Dr. Rochelle Walensky said at a news briefing Friday. 

About two-thirds of the US population – more than 221 million people – live in a county with “high” transmission, and another 30% – about 98 million people – live in a county with “substantial” transmission, according to a CNN analysis of federal data.

At the state level, seven states are considered to have “substantial” transmission – California, Florida, Hawaii, Louisiana, Maryland, Mississippi and New Jersey – while all others are considered to have “high” transmission, CDC data shows.

In those areas with “high” or “substantial” transmission, current CDC guidance recommends universal masking in all public indoor spaces and other layered prevention strategies.

In response to a question about whether the CDC will update recommendations for fully vaccinated people as trends in community spread change, Walensky said “we’re watching that very carefully.”

“As we watch the community levels come down, we will update our recommendations,” she said. “It’s important to note that as we look at the current situation, we are also heading into respiratory virus season. During that season, we know respiratory viruses tend to thrive, and so we’re taking all of those into consideration.”

There are fewer participants in kids' Covid-19 vaccine trials. Here's what that means for the process.

Dr. Salma Elfaki examines 16-year-old Diego Alvarez, a patient in a Moderna COVID-19 vaccine clinical trial for adolescents being conducted by Accel Research Sites with Nona Pediatric Center in Orlando, Florida.

Data on the use of a Covid-19 vaccine in children ages 5 to 11 comes from a much smaller number of trial participants than the adult trials, which means having enough information is important, Dr. Paul Offit, a vaccine adviser with the US Food and Drug Administration, told CNN on Friday. 

“When we reviewed, for example, Pfizer’s vaccine for adults, that was a 40,000 person trial. Here, you know you’re only talking about really a few thousand children. So the question is, is that enough?” Offit, a member of the FDA’s Vaccines and Related Biological Products Advisory Committee, told CNN’s John King.

Pfizer’s trial included around 2,000 children with twice as many children receiving the vaccine as the placebo. There were three Covid-19 cases among the group that received the vaccine and 16 cases in the placebo group.

“When you look at data for a few thousand children, you’re then about to make a recommendation for millions or tens of millions of children, and you want to make sure you have enough information to do that.” 

Offit said the advisory committee, which is scheduled to meet on Oct. 26 to discuss the use of Pfizer’s Covid-19 vaccine in children ages 5 to 11, only offers advice based on the data given to the US Food and Drug Administration. After the FDA, the US Centers for Disease Control and Prevention then has to make the full recommendation for the use of the vaccine. 

“I can promise you that when we have this discussion that if we do end up recommending this vaccine, we would only do it if we would give it to our own children,” Offit said. 

“It’s true that you never know everything, the question is when do you know enough and that’s going to be the question we’re going to try and answer next Tuesday.”

Earlier this week, the White House unveiled its plans to roll out Covid-19 vaccines for children ages 5 to 11, pending FDA authorization.

Booster shots may help reduce transmission of coronavirus, Fauci says

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during a hearing in Washington, DC, on May 11.

Data so far seems to suggest that Covid-19 booster shots can help reduce the spread of coronavirus, but more research is needed to confirm that, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday.

In a White House virtual briefing, Fauci said data out of Israel suggests that giving fully vaccinated people booster shots can reduce transmission of the virus.

“There is highly suggestive data – from the Israeli cohort who was well into their boosting program – that in the boosting, which they are essentially doing for everyone from 12 years old or older, they are finding that simultaneously with the clinical effect of decrease in infection and severe disease, they are seeing a gradual diminution coincident with the booster, in what we call the R-naught, or namely the transmissibility from one person to any of a number of other people. It has gone down from 1.33 to 1.11 to now 0.985,” Fauci said.

“So, although that’s not definitive, it does strongly suggest that there is an impact on transmissibility,” Fauci added. “But further studies would have to confirm that.”

Pregnant or nursing women who are eligible should get a Covid-19 booster, CDC director says

People eligible for Covid-19 vaccine booster doses should get their shots, including those who may be pregnant or nursing, Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said on Friday.

“First and foremost, I want to really emphasize how important it is to get a primary series if you’re pregnant. We have relatively low rates of vaccination for pregnant women in general,” Walensky said during a virtual White House news briefing.

“You should get vaccinated if you are pregnant,” Walensky added. “If you are eligible for a boost and you are pregnant, you should also get your boost during that period of time – and I would say for nursing as well.”

You can now get a Moderna and Johnson & Johnson Covid-19 booster at Walgreens nationwide

Walgreens announced today that eligible individuals can now get Moderna and Johnson & Johnson Covid-19 vaccine booster shots in stores nationwide following new guidance from the Centers for Disease Control and Prevention late Thursday.

“As new guidance regarding COVID-19 vaccines continues to emerge, our communities are relying on pharmacists for information, support and guidance more than ever. Walgreens pharmacy teams are available to answer questions and make it easy to understand eligibility requirements and access COVID-19 vaccine, whether it’s a first dose or booster shot,” Rina Shah, group vice president pharmacy operations and services, Walgreens, said in a news release.

Some background: The director of the CDC, Dr. Rochelle Walensky, signed off Thursday on booster shots for some Americans who received the Moderna and Johnson & Johnson vaccines. Last month, she did the same for some people who have received the Pfizer vaccine.

You can find more information on eligibility and how to book an appointment here,

Covid-19 booster shots appear to be as safe as first or second doses, CDC official says

Booster doses of coronavirus vaccines so far seem to be as safe as first and second doses, vaccine advisers to the US Centers for Disease Control and Prevention were told Thursday.

One question the Advisory Committee for Immunization Practices (ACIP) discussed when they met Thursday was whether adding a third dose of Moderna’s vaccine or a second dose of Johnson & Johnson’s is safe.

So far, the answer is yes, Anne Hause of the CDC’s Covid-19 Vaccine Task Force told the ACIP meeting.

She reviewed data from two vaccine safety monitoring programs – the Vaccine Adverse Reporting System (VAERS) and the cellphone-based vSafe system set up to monitor Covid-19 vaccines. 

“Overall, 94% of the 4,990 adverse reports following dose two of Janssen or dose three of mRNA Covid-19 vaccinations were non-serious,” Hause said. She said rates are similar to what’s been seen for Covid vaccines in general. The most common serious adverse event was the wrong vaccine having been administered. 

“Anyone can submit a VAERS report regardless of the possibility of vaccine causing the event or the clinical seriousness of the events,” Hause noted. 

Nonetheless, few worrying reports came in.

“We did not observe any unexpected patterns of adverse events,” Hause told the meeting. “Nearly all reports to VAERS were non-serious.” Common adverse events included sore arms, headaches, fevers and muscle aches. A sore arm was considered a local event, while a fever or headache would be a systemic event.

“For Pfizer/BioNTech, local and systemic reactions were reported less frequently following dose three than dose two. For Moderna, local reactions were reported slightly more frequently and systemic reactions slightly less frequently following dose three than dose two,” she said.

Not many people have received a second dose of Johnson & Johnson’s Janssen Covid-19 vaccine, Dr. Helen Keipp Talbot, an associate professor of medicine at Vanderbilt University who heads one of ACIP’s safety working groups, told the meeting. The vaccine is linked with a slightly higher risk of two rare but dangerous side effects – a blood clotting condition called thrombosis with thrombocytopenia syndrome, and a neurological condition called Guillain-Barré syndrome. “There have been no new safety signals following a second dose,” Talbot told the meeting.

CDC director says agency will follow the data and update booster guidance as it emerges

US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky endorsed recommendations for booster doses for Moderna’s and Johnson & Johnson’s coronavirus vaccines Thursday evening, clearing the way for millions more Americans to get booster shots. Some adults were already eligible to get booster shots of Pfizer’s Covid-19 vaccine.

Currently Pfizer’s and Moderna’s Covid-19 boosters are authorized for those 65 and older as well as those 18 and older who live in long-term care settings, have underlying medical conditions or who work or live in high-risk settings. 

A booster of Johnson & Johnson is recommended two months after vaccination for everyone 18 and older.

While speaking to NBC’s “Today” Friday morning, Walensky was asked about expanding booster eligibility to people as young as 40. 

“We will continue to follow those data. And as those data emerge that show waning immunity for others, for people who don’t have underlying conditions, for example, we will update our booster guidance in real time,” she said.

Asked by NBC’s Savannah Guthrie if those who fell outside of the eligible categories should be worried about waning immunity, Walensky said “I don’t think that there’s reason to be concerned now.” She added “Our vaccines are still working really well against severe disease, hospitalization and death.

Walensky also recommended that people follow prevention measures as there is “a lot of disease out there.” She said the CDC will continue to follow any data that demonstrates if and when there is waning protection for people who are generally healthy. 

Pfizer says its vaccine is 90.7% effective against symptomatic Covid-19 in children ages 5 to 11

Bridgette Melo, 5, holds her father's hand while receiving a dose of the Pfizer/BioNTech Covid-19 vaccine during a trial at Duke University in Durham, North Carolina.

In new documents posted ahead of a key meeting of the US Food and Drug Administration’s vaccine advisers, Pfizer says its vaccine is safe and 90.7% effective against symptomatic Covid-19 in children ages 5 to 11.

In the trial, which included around 2,000 children, there were three Covid-19 cases among the group that received the vaccine and 16 cases in the placebo group. In the trial, twice as many children received the vaccine as the placebo.

Pfizer/BioNTech are seeking FDA emergency use authorization (EUA) of a two-dose regimen of their 10-microgram dose for children ages 5 to 11. The two doses would be administered three weeks apart.

Last month, Pfizer released details of a Phase 2/3 trial that showed its Covid-19 vaccine was safe and generated a “robust” antibody response in children ages 5 to 11. The trial included 2,268 participants ages 5 to 11. Participants’ immune responses were measured by looking at neutralizing antibody levels in their blood and comparing those levels to a control group of 16- to 25-year-olds who were given a two-dose regimen with the larger 30-microgram dose. Pfizer said the levels compared well with older people who received the larger dose, demonstrating a “strong immune response in this cohort of children one month after the second dose.”

The FDA’s Vaccines and Related Biological Products Advisory Committee is scheduled to meet Oct. 26 to discuss whether to recommend the vaccine for authorization for those ages 5 to 11.

If authorized, this would be the first Covid-19 vaccine for younger children. The Pfizer/BioNTech vaccine is approved for people age 16 and older and has an EUA for people ages 12 to 15.

What's the best booster shot to get? Here's what Fauci says.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN’s John Berman that while it makes sense to get a booster shot that is the same as the original vaccine series, it’s also OK to mix and match. 

“It’s generally recommended that you get the booster that is the original regimen that you got in the first place,” Fauci said when asked which booster people should get when they’re eligible. “But, for one reason or other, and they may be different circumstances for people, availability or just different personal choices, you can, as we say, mix and match,” he said on CNN’s New Day Friday. 

Some background: US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky endorsed recommendations for booster doses for Moderna’s and Johnson & Johnson’s coronavirus vaccines Thursday evening, which cleared the way for millions more Americans to get booster shots. Some adults were already eligible to get booster shots of Pfizer’s Covid-19 vaccine.

Confused about whether you can get a Covid-19 booster? Here's what you need to know.

Chine Knifsend prepares to receive a Covid-19 booster shot at a clinic in San Rafael, California, on October 1.

The authorization process for Covid-19 vaccines can get confusing. Here’s a look at where we stand on Covid-19 boosters in the US today:

Pfizer

In September, the US Food and Drug Administration and US Centers and Disease Control and Prevention signed off on boosters of the Pfizer/BioNTech Covid-19 vaccine for adults 65 and older, adults at high risk of severe Covid-19 and adults with frequent exposure to the coronavirus through their work. Those boosters were authorized only for people who had already received the Pfizer vaccine at least six months earlier. 

On Wednesday, US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky endorsed the mix-and-match approach to boosters, meaning the Pfizer/BioNTech booster can be taken by those who may be eligible but are fully vaccinated with either the Moderna or Johnson & Johnson coronavirus vaccines.

Additionally, next week, vaccine advisers to the FDA are scheduled to meet next week to consider Pfizer’s request to authorize its vaccine to children ages 5 to 11.

Moderna

The FDA gave emergency use authorization on Wednesday for a half dose of Moderna’s vaccine as a booster for people fully vaccinated at least six months ago who are also at least 65, or who are at least 18 and at high risk of severe Covid-19 or have frequent institutional or occupational exposure to the virus.

Walensky endorsed a recommendation for booster doses for the Moderna vaccine on Thursday.

Johnson & Johnson

On Wednesday, the FDA authorized booster doses of Johnson & Johnson’s vaccine for anyone who received It at least two months ago. The J&J vaccine authorized only for those 18 and older.

The company announced last month that a two-dose version of the vaccine provides 94% protection against symptomatic infection.

Walensky endorsed a recommendation for booster doses for the Johnson & Johnson vaccines on Thursday.

Mixing and matching boosters

The FDA said any of the three authorized vaccines could be used as a booster in a “mix-and-match” approach.

Dr. Peter Marks, director of the FDA’s vaccine arm, the Center for Biologics Evaluation and Research, said the ability to use any authorized vaccine as a booster will simplify matters for people.

The FDA said it decided to allow the mix-and-match boosters after National Institutes of Health researchers presented their findings last week to its vaccine advisers. Although the findings were limited, they made it clear mixing up the different vaccines was safe.

Walensky also endorsed the mix-and-match approach to boosters, saying eligible people could choose whichever vaccine they wished as a booster.

Fauci confident that age groups eligible for boosters will be lowered over the next weeks to months

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he is confident that within the next weeks to months, the age of people eligible to get a Covid-19 booster will be lowered.  

“I would be rather confident that as we get further and further over the next weeks to months, that the age limit of it is going to be lowered, and you might soon fall into the age category where you can get eligible for a boost,” Fauci told CNN’s John Berman on New Day Friday. “I would not be surprised if that’s the case within a reasonable period of time.”  

Fauci said that more data would come from both US cohorts and from cohorts in Israel. 

Asked about how much evidence of waning immunity for people with two doses is being seen, Fauci said, “there’s no question about that, John, that that occurs.” 

He added that it has been seen in US cohorts as well as in Israel, which is about a month ahead of the US in its timetable and “is seeing substantial waning of immunity over several months, first against infection and then in some age groups against severe disease.” 

This is the reason why boosters are being given, he said, and why Israel, as an example, is “much, much more proactive in giving boosters for people.” 

Here's who's eligible to get a vaccine booster in the US

The director of the US Centers for Disease Control and Prevention, Dr. Rochelle Walensky, signed off yesterday on booster shots for some Americans who received the Moderna and Johnson & Johnson vaccines. Last month, she did the same for some people who have receive the Pfizer vaccine.

Here’s who is eligible for booster shots in the US now:

For people who got a Pfizer-BioNTech or Moderna Covid-19 vaccine, only some groups of people are eligible for a booster shot six months or more after they got their second initial dose, the CDC said.

They include people who are:

  • 65 years and older
  • Age 18+ who live in long-term care settings
  • Age 18+ who have underlying medical conditions
  • Age 18+ who work or live in high-risk settings

For Americans who got the Johnson & Johnson Covid-19 vaccine, booster shots are recommended for people who are 18 and older and who got their single first shot two or more months ago.

CDC endorses booster doses of Moderna and Johnson & Johnson vaccines

US Centers for Disease Control and Prevention Director Dr. Rochelle Walensky endorsed recommendations for booster doses for Moderna’s and Johnson & Johnson’s coronavirus vaccines Thursday, allowing millions more Americans to begin getting booster shots.

Walensky also endorsed the mix-and-match approach to boosters, saying eligible people could choose whichever vaccine they wished as a booster.

The CDC re-aligned its recommendation for the existing recommendation for Pfizer boosters, placing Moderna’s and Pfizer’s boosters in the same category.

“For individuals who received a Pfizer-BioNTech or Moderna COVID-19 vaccine, the following groups are eligible for a booster shot at 6 months or more after their initial series,” it said.

They include people:

  • 65 years and older
  • Age 18+ who live in long-term care settings
  • Age 18+ who have underlying medical conditions
  • Age 18+ who work or live in high-risk settings

“For the nearly 15 million people who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those who are 18 and older and who were vaccinated two or more months ago,” it added.

“These recommendations are another example of our fundamental commitment to protect as many people as possible from COVID-19. The evidence shows that all three COVID-19 vaccines authorized in the United States are safe – as demonstrated by the over 400 million vaccine doses already given. And, they are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating Delta variant,” Walensky said in a statement.

The CDC’s Advisory Committee for Immunization Practices had just hours earlier voted to accept the US Food and Drug Administration emergency use authorizations for each vaccine – after considerable discussion about whether such broad authorization was needed for Moderna’s.

Members agreed that people who got Johnson & Johnson’s vaccine need a second vaccination, as that vaccine is less effective than Moderna’s and Pfizer’s in preventing infection.

“There are now booster recommendations for all three available COVID-19 vaccines in the United States,” the CDC said.

“Eligible individuals may choose which vaccine they receive as a booster dose,” it added.

“Some people may have a preference for the vaccine type that they originally received and others, may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.”

Already, the pace of Americans getting booster doses is higher than the rate of those being vaccinated for the first time. CDC officials and others have made it clear the best way to reduce spread of the coronavirus is to get more people vaccinated in the first place.

“Millions of people are newly eligible to receive a booster shot and will benefit from additional protection. However, today’s action should not distract from the critical work of ensuring that unvaccinated people take the first step and get an initial COVID-19 vaccine. More than 65 million Americans remain unvaccinated, leaving themselves — and their children, families, loved ones, and communities — vulnerable,” the CDC said in Thursday’s statement.

“Available data right now show that all three of the COVID-19 vaccines approved or authorized in the United States continue to be highly effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. Vaccination remains the best way to protect yourself and reduce the spread of the virus and help prevent new variants from emerging.”

CDC officials said they’d issue more guidance on boosters in an upcoming report.

Read more about the CDC’s decision here.

GO DEEPER

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New York City vaccine mandate extends to all city workers and includes a new $500 bonus, mayor says
Pentagon outlines punishments for civilian employees if they fail to get vaccinated

GO DEEPER

India delivers 1 billion Covid vaccines, but millions are yet to receive a single dose
Pfizer vaccine is 93% effective in preventing Covid-19 hospitalization among adolescents, CDC study finds
Five times as many police officers have died from Covid-19 as from gunfire since start of pandemic
New York City vaccine mandate extends to all city workers and includes a new $500 bonus, mayor says
Pentagon outlines punishments for civilian employees if they fail to get vaccinated