In a highly unusual move, the C.D.C. director, Rochelle Walensky, endorsed the expanded use of the Pfizer-BioNTech vaccine for health care workers, teachers, and other workers at risk.

D.C. Chief Recommends BioNTech-Pfizer Booster for Workers At Risk

In a Friday decision, the CDC director overruled the recommendation of an agency advisory panel to allow frontline workers to receive booster shots of the BioNTech-Pfizer Covid vaccine.

D.C. Chief Recommends BioNTech-Pfizer Booster for Workers At Risk

It was an unusual move, but Dr. Rochelle Walensky aligned C.D.C. policy with FDA endorsements over her advisory committee.

It advised Friday that a wide range of Americans, including tens of millions of children and older adults at high risk for the disease, must receive boosters. Yet they excluded employees in health care, education, and other occupations with potential risks. Their policy contradicts the FDA’s recommendation that booster shots be given to all adults at high occupational risk. Dr. Walensky decided to grant greater access to boosters that gave President Biden’s campaign a boost. As part of the regulatory process, the White House had been criticized for getting ahead of it. White House officials could begin promoting booster shots from Friday. According to earlier announcements, the administration intends to offer those additional shots this week.

C.D.C.’s letter arrived well past midnight, a sign that the boosters’ decision-making process was complicated and unclear. Similar to the C.D.C. advisers, they argued for two days on whether the occupational risk should be considered a criterion for booster shots.

A.C.I.P. liaison Dr. Yvonne Maldonado believes others will be surprised as well upon learning that Dr. Walensky overturned one of the four A.C.I.P. votes today. Dr. Maldonado said the vote was close on boosters for occupational risks. Dr. Walensky was also in agreement with the decision. As a result, Dr. Maldonado said, waning immunity, as well as those at high risk of exposure, are addressed.

Dr. Amanda Cohn, who led the panel’s two-day meeting, tried to prepare the advisers for Dr. Walensky’s statement minutes before her presentation. The decision by Dr. Walensky not to recommend a booster dose for high-risk occupational or institutional exposure is being reversed, Dr. Cohn wrote in an email. The news should be shared with everyone before it appears in the press.

Dr. Walensky’s decision to ignore her own agency’s advisors surprised some of her staff members: in most cases, the designation of the advisory committee is just a formality. The agency’s insiders predicted she would stick to tradition because doing otherwise would upset her advisers and her personnel.

Dr. Walensky had no choice but to follow the U.S. Food and Drug Administration’s decision, say experts outside the C.D.C. Because Dr. Walensky was involved in the White House announcement on boosters, said Dean Ashish Jha of Brown’s School of Public Health. He said health care workers and others who might contract the disease on the job should receive booster shots.

Her panel voted to endorse third shots for elderly patients, nursing home patients, and those with underlying medical conditions. As Dr. Walensky’s decision reflects, federal regulators and outside consultants continue to be divided over how to contain the virus two years after it broke out.

A large group of the CDC’s advisers disagreed that such large quantities of the doses were necessary even for healthy people. It is estimated that millions of Americans will seek booster shots, whatever the scientific reservations. In one survey, the majority of vaccinated Americans said that if the doses were available, they would choose a booster. However, after finding a pharmacist who would offer boosters to Americans without FDA authorization, many Americans sought them by claiming they did not have vaccines.

As a result of this scant research, the C.D.C. ‘s advisers mulled over conflicting data points that seldom pointed one way or the other. It was unanimously agreed that booster shots should be given to over-65s and long-term care residents, who are most likely to benefit from them. Based on an assessment of their individual needs, the committee also recommended the shots for people 50 to 64 with certain medical conditions who are at risk for Covid-19.