An independent panel that advises the US Centers for Disease Control and Prevention voted unanimously Friday to recommend COVID-19 boosters for everyone age 18 and up who received Pfizer’s or Moderna’s COVID-19 vaccines, at least six months after their second dose. CDC Director Dr. Rochelle Walensky endorsed the committee’s expanded booster recommendations shortly after on Friday, making the guidance official.

«Booster shots have demonstrated the ability to safely increase people’s protection against infection and severe outcomes and are an important public health tool to strengthen our defenses against the virus as we enter the winter holidays,» Walensky said in a statement. «Based on the compelling evidence, all adults over 18 should now have equitable access to a COVID-19 booster dose.»

Everyone who received Johnson & Johnson’s vaccine at least two months ago was already eligible for a booster, as well as some vaccinated adults who got Pfizer or Moderna, including people 65 and older, adults with underlying medical conditions, and adults at a high risk of infection due to their job, such as hospital workers, teachers or grocery store workers.

Last month, the FDA and CDC gave the OK for all adults eligible for a booster to «mix and match» and get any of three available COVID-19 vaccines as a booster dose. More than 32 million Americans have already received a COVID-19 booster, according to CDC data.

Earlier on Friday, the US Food and Drug Administration expanded emergency use authorization for both the Moderna and Pfizer-BioNTech COVID-19 vaccines, clearing the booster doses for all fully vaccinated adults 18 and older. The move opened booster eligibility to millions more people and gave official backing to steps some were already taking.

The CDC committee also voted to strengthen the COVID-19 booster recommendation for individuals age 50 and older. This means the CDC now says someone who is 50 or older «should» get a booster, a younger age than the earlier recommendation that people age 65 or older should get a booster.

In addition to the recommendation everyone over 50 should get a booster, residents of long-term care facilities should also get one. For all other adults age 18 and up, the newest CDC recommendation will be that they can get a booster if they need or want one, after considering their individual benefits and risks.

Experts at the meeting expressed a need to clear up the language in the CDC’s recommendation on who should get a booster. For many adults and their health care providers, the criteria for booster eligibility was confusing and created barriers for people who may really benefit from a booster, they said.

Looking at the CDC’s extensive list of medical conditions for eligibility — which includes common conditions like being overweight, having mood disorders or ever having been a smoker — «it’s almost harder to figure out who’s not eligible,» said Dr. Grace Lee, the committee’s chair. By opening it up to all adults, the message is more clear.

The COVID-19 vaccines are highly effective in preventing hospitalization and death, but multiple studies show that the effectiveness of vaccines may start to decline after six to eight months.

Prior to Friday, at least 12 states were already encouraging all residents 18 and older to get a booster shot, regardless of their official eligibility.