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The Centers for Disease Control and Prevention on Friday endorsed the distribution of Pfizer and BioNTech’s Covid-19 booster shots to older Americans and other vulnerable people, including those in high risk occupational and institutional settings.

Millions of Americans who are at the highest risk for Covid will now be able to receive a Pfizer-BioNTech booster shot to increase their protection.

Earlier, the agency’s Advisory Committee on Immunization Practices unanimously endorsed giving third Pfizer shots to people 65 and older and nursing home residents, and made other recommendations.

However, CDC Director Dr. Rochelle Walensky made a recommendation that the advisory panel had rejected. The panel voted against giving booster shots to people from 18 to 64 years old who were at a higher risk of exposure to the virus due to their workplace or institutional setting, but Walensky put that recommendation back in.

Here’s what the CDC recommends:

people 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s Covid vaccine at least 6 months after their Pfizer-BioNTech primary series;
people from 50-64 years old with underlying medical conditions should receive a booster shot from Pfizer-BioNTech at least 6 months after their Pfizer-BioNTech primary series;
people from 18–49 years old with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s vaccine at least 6 months after their Pfizer-BioNTech primary series, depending on their individual benefits and risks;
people aged 18-64 years who are at increased risk for Covid-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.
“I believe we can best serve the nation’s public health needs by providing booster doses for the elderly, those in long-term care facilities, people with underlying medical conditions, and for adults at high risk of disease from occupational and institutional exposures to COVID-19,” said Dr. Walensky.

The move aligns with the FDA’s booster authorization, she added.

Earlier Thursday, the CDC advisory panel struggled over a controversial proposal to give boosters to wide swath of the U.S. population, rejecting the plan by a vote of 9-6. It would have distributed the shots to nursing home staff, people who live or work in prisons and homeless shelters, front-line health employees, unpaid caregivers, and other essential workers, like teachers.

“I mean, we might as well just say just give it to everybody 18 and over,” committee member Dr. Pablo Sanchez said before voting against the proposal.

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