Updated September 23, 2021 at 5:14 PM ET

Advisers to the Centers for Disease Control and Prevention have recommended a third dose of Pfizer's COVID-19 vaccine for people 65 and older as well as others at a high risk of severe illness.

The committee's unanimous vote to allow older adults and long-term care residents to receive an extra dose of the Pfizer-BioNTech vaccine was announced after two days of presentations reviewing scientific evidence on the safety and effectiveness of a third vaccine dose.

The committee, in a 13-2 vote, also recommended that people 50 to 64 years old with underlying medical conditions get a third shot.

It also endorsed people ages 18 to 49 who have an underlying medical risk access to another dose. The panel split 9-6 on this point but settled on advising that these people consider their individual benefit and risk, possibly in consultation with a medical provider, before they get a Pfizer booster shot.

In what might've been the most contentious deliberation, the committee said people 18 to 65 who work in a job or other setting where they are at high risk of exposure to COVID-19 should not yet be allowed to receive an extra Pfizer dose.

Committee member Dr. Matthew Zahn, a pediatric infectious diseases specialist, expressed concern about the difficulty of implementing such an action. Another member, Institute for Health Research investigator Dr. Matthew Daley, said he was worried that the potential guidance would be "broad enough that it could limit access to other groups."

The CDC has yet to offer guidance on the use of COVID-19 boosters for fully vaccinated Americans. The influential federal public health agency usually follows the advice of its advisory committees although it's not required to do so.

The recommendation follows the Food and Drug Administration's authorization on Wednesday to offer a booster shot for people 65 and older and those who run a high risk of severe disease. The FDA also gave the OK to give people a booster to ages 18 and up whose exposure to the coronavirus puts them at high risk of serious complications from COVID-19.

Vaccine providers must follow the CDC's recommendation

The CDC recommendations, when issued, are crucial at this phase in the pandemic. As cases surge across the country, the booster guidelines will determine how widely doctors and other health care workers administer those vaccine doses.

Dr. Sara Oliver, a CDC scientist, stressed at Thursday's advisory meeting that because the federal government has purchased all of the COVID-19 vaccines on an emergency basis for the pandemic, including the Pfizer vaccine, vaccine providers are required to follow the recommendations of the CDC and the FDA.

CDC and FDA recommendations will inform Biden's booster plan

The FDA authorization also allows the Pfizer booster dose to go to health care workers, teachers, grocery workers and those in homeless shelters or prisons, Dr. Janet Woodcock, the agency's acting commissioner, said in a statement.

U.S. regulators will rule on booster guidance for those who have gotten the Moderna or Johnson & Johnson vaccine at a later date, The Associated Press reported. Moderna's two-shot vaccine and Johnson & Johnson's one-shot vaccine are currently offered under an emergency use authorization, pending formal FDA approval.

Like the FDA, the CDC panel's decision breaks with the Biden administration's sweeping booster strategy to offer an extra dose to most age groups as early as this week in an effort to protect Americans against the highly contagious delta variant.

But the White House said that Biden's booster rollout, laid out last month, would also continue to heed the guidance of government scientists as it awaited both FDA authorization and CDC guidance on COVID-19 vaccine boosters.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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