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A Centers for Disease Control and Prevention advisory panel on Wednesday voted to recommend Pfizer-BioNTech Covid-19 booster shot for kids ages 12 to 15, a critical step in distributing additional shots to adolescents this week.

The panel, called the Advisory Committee on Immunization Practices, voted 13-1 in favor of giving 12- to 15-year-olds the boosters at least five months after their second dose. That’s in line with newly released guidance from the CDC for people age 16 and older who were initially immunized with the Pfizer vaccine.

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The recommendation came two days after the Food and Drug Administration cleared the extra doses for the age group. CDC Director Dr. Rochelle Walensky could sign off on the recommendation within hours, allowing health care providers to begin administering the shots. Around 5 million children would immediately be eligible for the extra doses, a CDC official told the committee Wednesday.

Before the vote, committee members grappled with how strong the language for the recommendation should be, weighing the risk of the highly contagious omicron variant of the coronavirus as well as data showing adolescents, in general, are less likely to suffer from severe disease from Covid than adults.

“I think we need to highlight that children are not OK,” committee member Dr. Katherine Poehling, a pediatrician at Atrium Health Wake Forest Baptist in North Carolina, told her colleagues. “It is true children are hospitalized at a less frequent rate than adults, but Covid is overwhelming our hospitals and our children’s hospitals.”

Dr. Helen Keipp Talbot, a professor of medicine at Vanderbilt University who was the only committee member who voted against the recommendation, said she is not against boosters for kids but worried that it would distract from unvaccinated teens getting their first shots.

Dr. Sara Oliver, an epidemic intelligence service officer for the CDC, said in a presentation to the committee that U.S. cases have “rapidly increased” since the start of December because of the increased prevalence of omicron, which now accounts for around 95 percent of all new cases.

Children generally experience severe illness from Covid less often than adults, but kids are now being hospitalized with the disease at record numbers as the new variant spreads across the country.

At a separate briefing Wednesday, Dr. Anthony Fauci, the White House’s chief medical adviser, said omicron appears to be less severe than previous variants, but the sheer volume of infections because of its profound transmissibility means that many more children will get infected and end up in the hospital.

Oliver told the committee that the majority of adolescents hospitalized with Covid are unvaccinated. She said Covid cases and hospitalizations are seven to 11 times higher in unvaccinated adolescents when compared to vaccinated adolescents.

“We see a slight increase in hospitalization rates from over the summer, but overall rates remained relatively steady,” she said, stressing that it’s still too early to say how the variant might behave in younger age groups.

The FDA said Monday its decision to broaden eligibility for Pfizer booster shots to adolescents was based in part on real-world data from Israel, which began offering additional shots before many other countries.

Dr. Sharon Alroy-Preis of Israel’s Health Ministry presented the data to the CDC committee on Wednesday. She said the country saw a “significant drop” in the rate of infections in adolescents following the start of its booster campaign for the age group.

No new safety concerns were identified out of more than 41,000 booster shots administered in Israel, she said, and there were only two confirmed cases of myocarditis. Both cases occurred in boys, one of whom had a history of an inflammation condition, she said.

The scant data on the risk of myocarditis was criticized by a few health experts in December when the CDC signed off on boosters for 16- and 17-year-olds.

The first two shots of the Pfizer vaccine appear to be well tolerated in the 12- to 15-year-olds who received them, according to data shared to VAERS, a government-funded system for reporting adverse reactions to vaccines.

The most common adverse events reported to VAERS for the age group were dizziness, fainting and headaches, according to the data shared with the committee.

There have been 265 confirmed cases of myocarditis as of Dec. 19, with all but 27 cases occurring in men, according to the data. The CDC said it will continue to monitor vaccine safety among the age group.

Oliver said the Pfizer vaccine appears to be highly protective against multisystem inflammatory syndrome in children, or MIS-C, a rare but serious Covid-related complication.

More than 71 million people in the U.S. have already received a booster dose of either the Pfizer-BioNTech, Moderna or Johnson & Johnson vaccine, according to CDC data.

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