Next year’s COVID vaccine recommendations from the U.S. Centers for Disease Control and Prevention appear likely to be less expansive than in previous years.
Notes from a recent meeting of the CDC’s Advisory Committee on Immunization Practices’ COVID-19 Work Group show health officials are considering narrowing the recommended age range for universal vaccination from everyone over 6 months to those 65 and older and people with health complications for the next respiratory virus season.
A majority of the working group’s members indicated they will vote to endorse such a risk-based recommendation, rather than the current universal recommendation.
Some Bay Area doctors are praising the possible move, while others have reservations about the shift.
The change would be “long overdue,” said Monica Gandhi, a UC San Francisco infectious disease expert. “I think it is the right approach, to give people boosters when they’re at risk,” she said.
Public health officials in Alameda, Contra Costa, Santa Clara and San Mateo counties did not immediately respond to requests for comment on the possible changes.
A new more narrow COVID vaccine recommendation would also put the United States more in line with the rest of the world. “Most of the world, in fact the entire planet, including the World Health Organization, only recommends COVID vaccination for certain risk groups,” she said.
Gandhi, who was often a critic of some of the Bay Area’s more restrictive pandemic precautions, including prolonged school closures, has researched and published papers on the efficacy of vaccinations and boosters. She hopes the CDC adjusting its recommendations might restore some of the public’s trust in public health officials.
But there is another common respiratory virus for which the CDC has long recommended universal annual inoculation. The agency recommends a flu shot every year for every person 6 months and older, and while flu vaccination coverage is far from universal, in recent years, uptake of the flu vaccine has been suppressed by the politicization of vaccinations that stemmed from the conversation around COVID vaccines.
Since the first COVID vaccine was released, the agency has recommended that everyone six months and older get at least one dose of the annually reformulated COVID vaccine each year. The process of yearly shots was more similar to the system for the flu vaccine than other respiratory viruses for which universal but less frequent vaccination is recommended, like measles. The measles vaccine is administered in two doses during childhood, with no additional boosters recommended.
In recent years, additional doses of the COVID vaccine have been recommended for the elderly and those at high risk of serious illness.
Not all public health experts agree that a change to the recommendations is the right idea.
“There are reasonable people coming down on both sides of it,” said Dr. John Swartzberg, clinical professor emeritus at the UC Berkeley School of Public Health.
“I think the best thing for a society is to have the maximum protection we can have,” Swartzberg said. “Therefore, I tilt toward continuing the way we’re doing it.”
According to data presented at the working group meeting this week, as of mid-March, just 12.8% of children between 6 months old and 17 years old reported having received this year’s COVID vaccine, slightly lower than the percentage who had been vaccinated the year before. Those rates are lower than the rate of flu vaccination for children, despite similar recommendations.
“If no one’s doing what you’re recommending, you’ve obviously lost their trust,” Gandhi said. “It’s really important to regain trust in public health.”
While next year’s recommendations may not call for a vaccine for those under 65 without a high risk, a vast majority of the working group members indicated they want to allow anyone to get an annual shot if they choose to.
Some worry that, given the patchwork nature of the country’s health care and health insurance system, the change could make it harder for some to get vaccinated, but the implications are not clear.
“If it is ‘recommended’ for people … the insurance pays for it, but if it is ‘suggested,’ then the insurance may or may not pay for it,” said Swartzberg.
“That’s why there have been all these battles over the language that the CDC uses,” he said. “It has big implications.”
The working group is expected to vote on its final recommendation in June.