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

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

The spring shot would be a second dose of the latest version of the Pfizer-BioNTech, Moderna or Novavax vaccines introduced in the fall. The recommendation now goes to the CDC director, Dr. Mandy Cohen, who will probably accept this one.

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

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

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

Older adults and people with weakened immune systems due to illness or medications would benefit most from a spring dose, the advisors concluded.

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

“Given the risk of serious, even life-threatening disease, I would encourage those who are moderately to severely immunocompromised to take the opportunity for another dose,” she added.

Adults aged 65 and over accounted for two-thirds of all Covid-related hospital admissions between October 2023 and January 2024, and those aged 75 and over accounted for almost half. Adults in this age group also most often opted for the fall shot.

More than 43 percent of Americans aged 75 and older received the trap shot, compared to less than 10 percent of adults aged 18 to 29. Vaccination rates were lowest among Native Americans and Alaska Natives, and among those living in rural areas. Less than 13 percent of pregnant women chose the vaccine.

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

Other reasons for the low uptake may include the lack of vaccine availability in the first few weeks after the CDC recommendation, and confusion about insurance coverage for the vaccinations.

The agency’s advisers met in September to discuss whether to recommend the shots, and for whom, but that left little time for vaccine production and distribution before the fall peak of infections, said Lakshmi Panagiotakopoulos, an infectious disease doctor and CDC researcher.

Dr. Panagiotakopoulos presented a revised plan for a decision on next fall’s Covid shot, with CDC advisers meeting in June to make recommendations on who should get the vaccine. A meeting of Food and Drug Administration advisers to precede the CDC guidelines is already scheduled for May 16.

At Wednesday’s meeting, CDC advisers wrestled with whether to suggest that older adults “can” opt for a spring Covid vaccine in consultation with their health care providers, or whether they “should” recommend it more emphatically.

Some panelists said the softer recommendation would be more palatable to Americans and less likely to contribute to vaccine fatigue. Others argued that stronger language would make it clearer to those at high risk from the virus that a vaccine would protect them through the spring.

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

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