The director of the Centers for Disease Control and Prevention early Friday endorsed recommendations for a third dose of the Pfizer Covid-19 vaccine for certain at-risk groups, clearing the way for millions of Americans to get a booster.

Dr. After Thursday’s approval by advisers, Rochelle P.walensky approved the booster shots of the Pfizer BioNTech vaccine.

She supported the recommendations, but also recommended a third dose for high-risk workers and institutionalized workers.

“This updated interim guidance from CDC allows for millions of Americans who are at highest risk for COVID-19 to receive a Pfizer-BioNTech COVID-19 booster shot to help increase their protection,” the agency said in a statement.

The CDC now says that people 65 years and older and residents in long-term care settings should get a booster, and so should people 50 to 64 years old who have an underlying medical condition.

Those 18 to 49 with underlying medical conditions, and those 18 to 64 who are at an increased risk because of an occupational or institutional setting, “may” get a shot, the CDC says.

The committee of advisers voted Thursday against recommending a booster for people younger than 65 who have a high risk of being exposed to the virus at work, including health care workers and teachers.

OSU student Ashlyn Gerlach of Saint Henry, Ohio, receives her second dose of the Pfizer coronavirus disease vaccine at a clinic at Ohio State University in Columbus, Ohio, U.S., Sept. 15, 2021. GAELEN MORSE / Reuters, file

Walensky said that recommending a booster for those in at-risk work and other environments mirrors Food and Drug Administration emergency use authorization.

The FDA on Wednesday authorized a third dose of the Pfizer vaccine for those 65 and older, and those 18 and older who are at high risk. The booster must be administered at least six months following the second dose of Pfizer vaccine. The CDC will review data over the next few weeks and make recommendations to those who received the Moderna or Johnson & Johnson vaccines.

Moderna submitted its FDA application for its booster dose. Johnson & Johnson provided data, but it has not yet said when they will seek emergency use authorization. Walensky stated in a statement, that the primary goal is to get more Americans vaccinated.

As of Thursday, around 64 percent of people 12 years and older have been fully vaccinated against Covid, according to the CDC. For those 18 and older, that number is around 66 percent.

But the rate of vaccinations varies by state, with some states at around less than 45 percent of total residents fully vaccinated, although those numbers include children not eligible for it. Some parts of the country have recently seen overwhelmed hospitals due to a surge of Covid patients.

Phil Helsel is a reporter for NBC News.

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