Older Americans should get another Covid vaccine this spring, panel says

Americans 65 and older should receive an additional dose of the latest Covid vaccine this spring, scientific advisers to the Centers for Disease Control and Prevention said Wednesday.

The spring shot would be a second dose of the most recent version of the Pfizer-BioNTech, Moderna or Novavax vaccines introduced in the fall. The recommendation now goes to CDC Director Dr. Mandy Cohen, who is likely to accept it.

At a meeting of the agency’s Advisory Committee on Immunization Practices, federal researchers presented preliminary data showing the latest vaccines are about 40 to 50 percent effective against symptomatic infection or hospitalization, although estimates against variants currently circulating were based on small numbers.

In October and November, adults who received a drop dose accounted for 4 percent of Covid-related hospitalizations. Those who received a booster in the fall of 2022, but not the updated vaccine this fall, represented 25 percent.

Still, a second dose this spring would not be cost-effective for adults ages 18 to 64, who have a lower risk of severe illness and hospitalization than older adults, according to modeling presented at the meeting.

The advisors concluded that older adults and those with weakened immune systems due to illness or medications would benefit the most from a spring dose.

“I was impressed by the data supporting the need for an additional dose of vaccine for people 65 and older,” Dr. Camille Kotton, a physician at Massachusetts General Hospital and a member of the scientific advisory panel, said in an interview.

“Given the risk of severe, even life-threatening, illness, I would encourage those with moderate to severe immune systems to take the opportunity to receive another dose,” he added.

Adults aged 65 and older accounted for two-thirds of all Covid-related hospitalizations between October 2023 and January 2024, and those aged 75 and older accounted for almost half. Adults in this age group were also the most likely to opt for the fall vaccine.

More than 43 percent of Americans age 75 and older received the fall vaccine, compared to less than 10 percent of adults ages 18 to 29. Vaccination rates were lowest among American Indians and Alaska Natives, and among those living in rural areas. Less than 13 percent of pregnant women opted for the vaccine.

Nearly half of those who did not plan to get the vaccine said they were worried about unknown serious side effects, according to data from the January National Immunization Survey.

Other reasons for low uptake may include lack of vaccine availability in the first weeks after the CDC recommendation and confusion over insurance coverage for the shots.

Agency advisers met in September to discuss whether to recommend the shots and for whom, but that left little time for vaccine manufacturing and distribution before the fall peak of infections, said Lakshmi Panagiotakopoulos, an infectious diseases doctor and researcher. from the CDC.

Dr. Panagiotakopoulos presented a revised plan for making a decision on next fall’s Covid vaccine, and CDC advisors met in June to make recommendations on who should receive the vaccine. A Food and Drug Administration advisory meeting is already scheduled for May 16, which should precede the CDC guidelines.

At Wednesday’s meeting, CDC advisers debated whether to suggest that older adults “can” choose to receive a spring Covid vaccine in consultation with their health care providers, or more strongly recommend that they “should” do so.

Some panelists said the softer recommendation would be more acceptable to Americans and less likely to contribute to vaccine fatigue. Others argued that stronger language would make it clearer to those at high risk of contracting the virus that a vaccine would provide protection in the spring.

The advisers ultimately voted to recommend that Americans 65 and older “should” get a spring shot.

“I hope that clarity around the need for a second dose can encourage vaccination and protection in both those who have not yet received a first vaccine and those who would benefit from a second vaccine,” Dr. Kotton said.