Tony's Diary Package — page 883

• individuals 18 through 64 years of age at high risk of severe COVID-19; and • individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19. Now we have a serious problem of how the CDC is going to interpret this regulatory approval . Clearly there is strife within the FDA which lead to this completely confusing authorization. Rochelle has her own problems with the acip who are not going to want to recommend anything for people less than 30 or 40 years old. What a mess. Let us see if in the long run we can make some lemonade out of these lemons. PRESS: CBS Major Garrett "The Takeout"; Washington Post 202 Blog with Jackie Alemay September 23, 2021 Highly eventful day!!! Today was the day that the acip would make their recommendation to the CDC regarding the use of boosters. Inexplicably, they voted to allow boosters for people 65 years of age or older, which is fine, as well as those from 18 to 64 with underlying conditions leading to severe disease, which is fine . However, they rejected the proposal to give boosters to people who by occupational or institutional exposure would find themselves at high risk for infection. There was absolutely no reason at all to do this since that would mean that a 25 year old person who was obese would get a booster, but a 55 year old school teacher or a 55 year old intensive care nurse could not get a boost. The rationale for the acip was completely discombobulated. It had nothing to do with safety since they were talking about policy that was unrelated to the scientific issues at hand . They got distracted and began talking about what they were going to do with people who had Moderna as their primary regimen or J&J as their primary regimen, avoiding the fundamental scientific and public health question at hand. When I heard this we began a series of phone calls, multiple phone calls, among me, Leslie Dach, Jeff, and Vivek - all outrages by the recommendation. I texted Rochelle and I begged her to call me in order that I could explain to her how this would be a fatal mistake if she took the recommendation of the acip since none of us would be able to defend this. It was a very dramatic situation where she was in with the secretary and I was texting her late in the evening to please call me so that I can tell her what I feel she must do. Jeff and Courtney Rowe and Ian Sams were suggesting that I call up the secretary and give him my opinion. Things were getting very dicey since the hours were going by and no decision was made. I finally got a chance to speak with Rochelle and literally begged her to override that decision which was only a 9 to 6 decision and not an overwhelming unanimous recommendation. The tweets that were coming in when they heard of the recommendation of the acip were absolutely overwhelmingly against that decision. Yet Rochelle still felt she could not go against her committee. I pleaded with her over the phone telling her that I would absolutely strongly defend her publicly if she made allowance for teachers and healthcare workers to get vaccinated even though they were healthy. Again, she seemed hesitant to overrule them. Jeff called me multiple times asking me to call the secretary