The US Centers for Disease Control and Prevention recommends that individuals aged 65 and above receive an extra dose of the current Covid-19 vaccine.
On Wednesday, the independent vaccine advisors of the agency voted to recommend the additional shot, a decision endorsed by CDC Director Dr. Mandy Cohen.
The Advisory Committee on Immunization Practices of the CDC voted with 11 members in favor, one opposed, and one abstaining.
According to the new recommendation, individuals aged 65 and older are eligible to receive an additional dose of any updated Covid-19 vaccine, with at least four months between the previous shot.
The current Covid-19 vaccine, updated last fall, is widely regarded as highly effective. Early CDC studies suggest that while there's currently no significant decline in effectiveness, protection is expected to diminish over time. Moreover, vaccine effectiveness diminishes more rapidly in older individuals due to their less robust immune responses.
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Initially, the proposal used the term "may," but the committee revised it to "should" to underscore the importance of Covid-19 vaccination.
Dr. Ruth Link-Gelles, a CDC epidemiologist, informed the advisers during Wednesday's meeting that approximately 98% of the US population has some level of immunity to Covid-19, whether through prior infection, vaccination, or both. However, this immunity only offers partial protection against infection or severe illness.
“It doesn’t protect absolutely,” she emphasised.
“What the vaccines are doing now is providing an incremental benefit or an extra benefit beyond whatever benefit someone has remaining from their past infection or past vaccination, and we know that protection from past vaccination and past infection wanes,” Link-Gelles said. “That’s important for all people in the United States but especially important for those that are the highest risk.”
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CDC data indicates that older adults have consistently been the most vulnerable to the severe consequences of Covid-19 throughout the pandemic.
Covid-related hospitalizations among adults aged 65 and older have consistently exceeded those of all other age demographics. According to CDC data, approximately two-thirds of Covid-related hospitalizations involve individuals in this age group. Furthermore, seniors represent the largest proportion of Covid-related deaths in hospitals, with high mortality rates even after discharge.
Data presented to the committee on Wednesday from last fall revealed that among older adults hospitalized with Covid, the majority had no vaccination record against the virus since receiving the initial shot.
Although the vaccine is recommended for everyone aged 6 months and older, CDC data indicates that vaccination rates have not met the desired levels.
Recent research provides strong evidence that the vaccine not only prevents severe illness but may also reduce the likelihood of symptomatic infection by half, including against JN.1, the predominant variant. However, despite this, only approximately 21% of adults and 12% of children have received the vaccine since its update in September, as reported by the CDC. In comparison, nearly half of adults and children in the US have received the flu vaccine this season.
The National Immunization Survey indicates that while most Americans still view Covid-19 vaccines as safe and crucial, confidence in the vaccine has declined from 83.9% in January 2022 to 69.6% last month.
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According to the survey, there has been a shift in disease risk perception, with fewer adults expressing moderate to high concern about contracting Covid-19. However, despite this changing perception, Covid-19 remains a significant threat, particularly to vulnerable populations such as older individuals and those with underlying health conditions.
Representatives from the CDC informed the advisory committee that as of the week ending February 17, there were approximately 20,000 new hospital admissions and 2,000 Covid-19-related deaths per week. Even during the lowest point last summer, there were still around 500 Covid-19 deaths per week.
A potential contributing factor to the low vaccine uptake could be the lack of consistent advice from doctors regarding Covid vaccination. According to the National Immunization Survey, fewer individuals reported their healthcare providers encouraging them to get vaccinated in January, compared to 2021.
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Dr. Camille Kotton, a member of the advisory committee and the clinical director of transplant and immunocompromised host infectious diseases at Massachusetts General Hospital, expressed concern over the relatively low vaccination rates among high-risk populations, “It is shocking to see that 30% to 40% of the higher-risk populations — at least for elderly, and I think it’s a similar number for immunocompromised — are getting the updated vaccine.”
“For me, this is a life and death situation for many of the patients that I take care of,” she said.
