Physicians have been bombarded with questions from patients and colleagues regarding second booster shots, which the U.S. cleared for people 50 and older March 29, The Washington Post reported April 2.
When the CDC signed-off on the additional doses, it said those eligible can get the additional shots but stopped short of an explicit recommendation. Data from Israel has shown there's little downside to getting another shot, but federal officials didn't feel evidence was strong enough to make an explicit recommendation. The agency's director, Rochelle Walensky, MD, said those most likely to benefit from another booster are those 65 and older and those 50 and older "with underlying medical conditions that increase their risk for severe disease from COVID-19."
Physicians have said this is all the information they've received from federal health agencies, and they had no warning the policy shift was coming, leaving them unprepared to deal with a wave of clinical questions about why people younger than 50 with chronic health issues were left out, and what to advise healthy patients who fall into the eligible age groups but have no risk factors.
"It does feel like we're a little bit of an afterthought," said Kavita Patel, MD, a primary care physician at Mary's Center, a community health center in Washington, D.C. "We're understaffed, under-resourced, and now we're being asked to exert clinical nuance when we don't have the tools to do it," she told the Post.
The lack of an explicit recommendation means physicians are left with more to decipher.
"I would have liked to have seen more clarification … [the CDC] could say, 'We don't have the data to give a definitive recommendation, but you can consider it in these scenarios,'" Jason Goldman, MD, a physician in Florida and liaison member of the CDC's Advisory Committee on Immunization Practices, told the news outlet.
Some experts said the agencies made the best call they could given the backdrop of limited data and the rise of omicron subvariant BA.2.
"I think this is the right move because there's minimal downside to getting a booster, and they appear to be safe," said Albert Ko, MD, infectious disease physician and epidemiologist at Yale School of Public Health in New Haven, Conn. "A lot of the risk is going to have to be decided by individual people given the evidence gap and uncertainty. And having individuals make that decision at this point is the right way to go."
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