CDC Recommends Spring Booster for Over 65s

On Wednesday, a notable advisory panel guiding the Centers for Disease Control and Prevention (CDC) issued a consequential recommendation concerning Covid-19 vaccines. Their counsel emphasizes the importance of administering an additional vaccine dose to individuals aged 65 and above specifically during the spring season.

 

CDC Director Mandy Cohen has thrown her weight behind this recommendation, aligning the United States with Canada and the United Kingdom's proactive measures. Both nations have initiated plans to roll out booster shots this spring, with a focus on safeguarding high-risk individuals from severe Covid-19 illness.

 

As we prepare for the third consecutive year of administering spring boosters, it underscores the relentless transmission of the SARS-CoV-2 virus throughout the year. In contrast to seasonal viruses such as influenza and RSV, which tend to diminish during late spring and summer, the spread of Covid continues to pose significant challenges. This persistence highlights the importance of ongoing vigilance and vaccination efforts to mitigate the impact of the virus on public health.

 

CDC Briefing Highlights Covid Impact and Recommendations

 

In a recent briefing to members of the Advisory Committee on Immunization Practices, CDC experts highlighted the enduring impact of Covid. Despite a surge during the holiday season, Covid-related hospitalizations still average around 20,000 weekly, with approximately 2,000 deaths attributed to the disease each week. Megan Wallace, a respected CDC vaccine expert, revealed that new Covid hospitalizations have consistently exceeded 6,000 per week over the past year.

 

Wallace highlighted that the demographic most commonly hospitalized due to Covid comprises individuals aged 65 and above, while those aged 75 and older are at the highest risk of succumbing to the infection. Shockingly, CDC data reveals that just approximately 40% of individuals in the 65 and older age bracket have received the vaccine for the 2023-2024 period.

 

After a resounding 11 to 1 vote, with one abstention, the committee has greenlit a recommendation aimed at individuals aged 65 and older who have previously received a Covid vaccine for the 2023-2024 period. This guidance advises opting for a second shot during the forthcoming spring season, provided a minimum of four months has passed since their initial vaccination.

 

COVID Booster Dose Recommendations and Discussions by ACIP

 

Thanks to a prior committee directive from last fall, individuals classified as moderately or severely immunocompromised now have the opportunity to receive multiple booster doses within a single year. For those in this category, a mandatory waiting period of two months between doses is prescribed, with any further doses administered post-consultation with a healthcare provider.

 

Initially, there were indications that the committee might stipulate a mandatory consultation with a healthcare provider for individuals aged 65 and older seeking an additional Covid shot. The proposed language of the initial voting question suggested that those interested in an extra dose "may" receive one. Such a recommendation, known as a permissive recommendation, requires approval from a healthcare provider.

 

However, committee members voiced concerns, advocating for an unequivocal recommendation—asserting that individuals aged 65 and older should receive another shot this spring—which would be clearer for both healthcare providers and vaccine recipients. This clarity is especially vital given the increasing number of individuals obtaining Covid shots at pharmacies. Camille Kotton, Clinical Director for Transplant and Immunocompromised Host Infectious Diseases at Massachusetts General Hospital in Boston and an ACIP member, underscored the public's difficulty in interpreting a "may" recommendation.

 

During the discussion, it became clear that the ACIP's Covid vaccine work group was carefully balancing accessibility for vaccine seekers while avoiding discouraging hesitant individuals. Concerns arose that those who've paused their vaccination efforts, a significant portion of the population, might perceive an additional dose recommendation negatively.

 

Demetre Daskalakis, Director of the National Center for Immunization and Respiratory Diseases at the CDC, emphasized the accommodating nature of the term "may" for individuals predisposed to vaccination. Nevertheless, he warned against employing overly conclusive language, which might dissuade those who have not yet received the vaccine from doing so.

 

In the end, the committee leaned towards endorsing a more robust recommendation.

 

David Kaslow, a representative from the Food and Drug Administration and a temporary voting member, cautioned against postponing the administration of a second dose beyond June. This advice holds especially true considering the potential approval of a new vaccine for the 2024-2025 winter season.