CDC Simplifies COVID-19 Vaccine Recommendations, Offers High-Risk Adults Extra Booster

Mimi Nguyen Ly
By Mimi Nguyen Ly
April 20, 2023Vaccines
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CDC Simplifies COVID-19 Vaccine Recommendations, Offers High-Risk Adults Extra Booster
Exterior of the Center for Disease Control (CDC) headquarters is seen in Atlanta on Oct. 13, 2014. (Jessica McGowan/Getty Images)

The Centers for Disease Control and Prevention (CDC) said on April 19 that older people and people with weakened immune systems may obtain additional doses of the updated (bivalent) COVID-19 vaccines.

The change comes as part of the CDC’s efforts to simplify its COVID-19 vaccine recommendations. The agency said the move also gives people at higher risk of COVID-19 the option of taking additional vaccine doses.

The CDC’s new recommendations (pdf) are:

  • Adults aged 65 and older are recommended to take an updated (bivalent) COVID-19 vaccine dose and have the option to obtain a second dose, provided four months have elapsed since the last one.
  • Meanwhile, those who are immunocompromised can obtain even more additional doses, provided two months have elapsed since the last one. “This allows more flexibility for healthcare providers to administer additional doses to immunocompromised patients as needed,” according to the agency.
  • Those aged 6–64 are recommended by the CDC to take one updated (bivalent) COVID-19 vaccine. This is regardless of whether they previously received a primary series of a COVID-19 vaccine. But those who have already received an updated (bivalent) vaccine “do not need to take any action.”
  • As for children under 6, the agency said the recommendations would vary by age, as well as by which COVID-19 vaccines the child has previously taken.

The CDC noted that the original (monovalent) mRNA-based COVID-19 vaccines from Pfizer/BioNTech and Moderna, which were targeted toward the original Wuhan strain, “will no longer be recommended for use in the United States.”

It also noted that options other than the mRNA COVID-19 vaccines are available “for people who cannot or will not receive an mRNA vaccine.” The recommendations for the original (monovalent) Novavax or Johnson & Johnson’s Janssen COVID-19 vaccines weren’t affected by the changes.

The recommendations refer to the mRNA-based updated bivalent vaccines, which are available from Pfizer/BioNTech and Moderna. They are targeted toward the original strain from Wuhan as well as the omicron BA.4/BA.5 strains. The vaccines were authorized and recommended as boosters in the fall of 2022, even though there were no clinical data in support of their safety or effectiveness.

The BA.4 and BA.5 strains are no longer in circulation in the United States. The CDC estimates the omicron XBB.1.5 strain as comprising 78 percent of new COVID-19 cases in the country as of April 15.

Earlier on April 19, the CDC’s Advisory Committee on Immunization Practices (ACIP) met to discuss the vaccine recommendation changes. ACIP members “expressed their support” for the recommendations although there was no vote at the meeting, according to the CDC.

The CDC’s changes align with those made by the U.S. Food and Drug Administration (FDA) on April 18, which included issuing an emergency use authorization for additional doses of the updated (bivalent) COVID-19 vaccines for the high-risk population.

Don’t Protect Well: CDC Data

Data reported by the CDC on April 19 showed that the bivalent COVID-19 vaccines from either Pfizer/BioNTech or Moderna offered limited and short-lived protection against severe illness.

The unpublished CDC data was drawn from the CDC’s VISION Vaccine Effectiveness Network, which are sites that collect data on vaccinations and COVID-19 admissions, and covered the period spanning September 2022 to March 2023.

Data showed the protection against severe illness for adults from either the Pfizer/BioNTech or Moderna bivalent vaccines started above 50 percent, but quickly dropped within months.

In those who were not immunocompromised, data showed that for people aged 18–65, a shot increased the protection against hospitalization from 21 to 68 percent, but the protection quickly falls to 27 percent within 60–119 days later.

Meanwhile, for those aged 65 and older, data showed the protection of the bivalent vaccine dose against hospitalization increased from 25 to 64 percent but fell to 39 percent by 120–179 days later.

In those who were immunocompromised, protection against hospitalization peaks at 43 percent, never reaching past 50 percent at any point.

U.S. officials and World Health Organization experts say 50 percent is the threshold for a successful vaccine.

Vaccines typically protect against infection, but the COVID-19 vaccines have never entirely prevented infection and have performed increasingly worse against the outcome as newer variants have emerged.

Earlier observational studies have found the bivalents give transient protection against hospitalization and poor shielding against infection.

Zachary Stieber contributed to this report.

From The Epoch Times

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