New Covid shots recommended for Americans 6 months and older this fall

All Americans ages 6 months and older should get one of the new COVID-19 vaccines when they become available this fall, the Centers for Disease Control and Prevention said Thursday.

The recommendation comes as the country faces a summer surge in Covid, with the number infections are increasing in at least 39 states and territories.

Most Americans have acquired immunity to the coronavirus through repeated infections or vaccine doses, or both. The vaccines now provide a step-by-step boost and remain effective for only a few months as immunity wanes and the virus continues to evolve.

Yet in every age group, a large majority of Americans hospitalized for COVID did not receive any of the shots offered last fall, according to data presented Thursday at a meeting of the CDC’s Advisory Committee on Immunization Practices.

Dr. Mandy Cohen, the agency’s director, on Thursday accepted the panel’s unanimous advice to recommend a new round of vaccinations.

“Professionals and the public in general don’t understand how much this virus has mutated,” said Carol Hayes, the committee’s liaison to the American College of Nurse-Midwives. “You need this year’s vaccine to be protected against this year’s strain of the virus.”

A vaccine from Novavax will target JN.1, the variant that prevailed for months in the winter and spring. The Pfizer and Moderna shots target KP.2, which until recently appeared to be becoming the dominant variant.

But KP.2 appears to be giving way to two related variants, KP.3 and LB.1, which are now responsible for more than half of new cases. All three variants, descendants of JN.1, are together called FLiRT, after two mutations in the virus’s genes that contain these letters.

It is thought that the mutations help the variants avoidance of some immune defenses and therefore spread more quickly, but there is no evidence that the variants cause more serious illness.

Emergency room visits related to Covid in the week ending June 15 rose by almost 15 percent, and deaths by almost 17 percent, compared to the previous week’s totals. Hospital admissions also appear to be increasing, but the trends are based on data from a subgroup of hospitals who are still reporting numbers to the CDC, even though the requirement to do so ended in May.

“Covid is still here and I don’t think it will ever go away,” Dr. Steven P. Furr, the president of the American Academy of Family Physicians, said in an interview.

The biggest risk factor for severe disease is age. Adults 65 and older account for two-thirds of Covid hospitalizations and 82 percent of hospital deaths. Yet only about 40 percent of Americans in that age group have been vaccinated with a Covid vaccine offered last fall.

“This is an area where there is a lot of room for improvement and that could prevent a lot of hospitalizations,” said Dr. Fiona Havers, a CDC researcher who presented the hospitalization data.

While younger adults are much less likely to get seriously ill, there are no groups that are completely at risk, CDC researchers say. Children — particularly those under 5 — are also vulnerable, but only 14 percent were vaccinated against Covid last fall.

Many parents mistakenly believe the virus is harmless in children, said Dr. Matthew Daley, panelist and senior investigator at Kaiser Permanente Colorado.

“Because the burden was so high in the oldest age groups, we lost sight of the absolute burden in the pediatric age groups,” Dr. Daley said.

Even if children don’t get sick themselves, they can help spread the virus, especially when they go back to school, Dr. Furr said.

“They are the ones who, if exposed, are more likely to bring the virus home to their parents and grandparents,” he said. “By vaccinating all groups, you are more likely to prevent the spread.”

Among children, babies under 6 months have been hit hardest by Covid, according to data presented at the meeting. But they are not eligible for the new shots.

“It is critical that pregnant individuals get vaccinated, not only to protect themselves, but also to protect their babies until they are old enough to be vaccinated,” said Dr. Denise Jamieson, one of the panelists and dean of the Carver College of Medicine at the University of Iowa, in an interview.

Among both children and adults, vaccination rates were lowest in the groups most at risk from Covid: Native Americans, Black Americans and Hispanic Americans.

In surveys, most Americans who said they probably or definitely would not get the shots last fall cited unknown side effects, insufficient research or distrust of the government and drug companies.

The CDC has said the vaccines are linked to only four serious adverse events, but thousands of Americans have filed claims for other medical injuries they say were caused by the shots.

At the meeting, CDC researchers said they had discovered for the first time that Pfizer’s Covid vaccine may have led to four additional cases of Guillain-Barré syndrome, a rare neurological disorder, per million doses administered to older adults. (The numbers available for Moderna and Novavax vaccines were too small for analysis.)

The risk may not be real, but even if it is, the incidence of GBS is similar to that seen with other vaccines, the researchers said.

The CDC has also investigated a potential risk of stroke after vaccination, but the findings so far have been inconclusive, agency scientists said. Either way, the benefits of the vaccines outweigh any potential harms, they said.

The panelists lamented the sharp decline in the number of healthcare providers advising patients on the importance of Covid vaccination. Nearly half of health care providers said they did not recommend the shots because they thought their patients would refuse.

There is also increasing physical and verbal violence in hospitals and health care settings, said Dr. Helen Keipp Talbot, a professor of medicine at Vanderbilt University and chair of the commission.

“Some of our physicians may not recommend it because of concerns about their own safety and the safety of their staff,” she said.

While the panelists unanimously recommended Covid vaccination for people of all ages, they discussed the feasibility of universal recommendations in the future. The vaccines are much more expensive than other shots and are most cost-effective when given to older adults.

At the individual level, the Affordable Care Act requires insurers, including Medicare and Medicaid, to cover vaccines recommended by the advisory committee at no cost. But up to 30 million Americans don’t have health insurance.

The Bridge Access Program, a federal initiative that makes the vaccines available to underinsured and uninsured Americans, ends in August.

Unless the price of vaccines comes down, the cost of immunizing all Americans may not be sustainable, the panelists said.

“As more and more of society is exposed to vaccines or diseases, it will become much less cost-effective,” said Dr. Talbot. “We’re going to need a cheaper vaccine for this to work.”