Why the CDC recommends everyone get the new COVID vaccine booster for fall 2023

In anticipation of the deployment of the new COVID-19 vaccines this falla Centers for Disease Control and Prevention task force has debated for months whether the shots should be recommended to all eligible Americans or only to some of the most vulnerable groups.

The latter approach, for example, has been adopted by other countries such as the United Kingdom, which is once again offering its fall vaccines only to those most at risk of severe illness, such as the elderly and those with severe illness. underlying health problems.

But a panel of outside CDC experts ultimately voted Tuesday in favor of broad recommendations for the shots, thanks in part to CDC data revealing that healthy, young and mostly unboosted Americans are still hospitalized due to of the virus.

“There was concern that the task force began its deliberations this summer assuming that a universal vaccination strategy was the obvious policy choice, but I just want to reiterate that that was absolutely not the case.” , said Dr. Matthew Daley, head of the COVID-19 Vaccine Task Force within the CDC’s Advisory Committee on Immunization Practices said during its Tuesday meeting. But that’s where the data took them.

The updated shots, which received the green light Monday from the Food and Drug Administration, were reformulated to target the new XBB. variants of the virus.

All Americans, including children as young as 6 months old who are eligible for the revised shots, are now encouraged to receive a dose ahead of schedule. fall and winter virus season.

“The CDC now recommends an updated COVID-19 vaccination for everyone 6 months and older to better protect you and your loved ones,” CDC Director Dr. Mandy Cohen said in a statement Tuesday following the panel’s vote.

Daley said the group “basically started with a blank slate” as it sought to re-evaluate vaccine recommendations before this fall.

Among the data they asked the CDC to collect was whether healthy children and young adults were still at risk of severe illness from the virus.

While rates of COVID-19 hospitalizations remain highest among older adults and babies younger than 6 months, the agency presented data revealing that otherwise healthy Americans of all ages , are still hospitalized due to COVID-19.

Among school-age children ages 5 to 11, 23% of hospitalizations were among children without underlying conditions. The majority of children experiencing severe COVID-19 had not received a booster shot and many were not vaccinated.

“That was the most compelling argument for me, knowing that there have been deaths, including among children, including those who do not suffer from chronic illnesses. And my perception is that these deaths can be prevented by vaccination,” Daley said.

Only one member of the 14-member panel voted against the universal recommendation.

“I just want to be clear that I’m not against this vaccine. The data looks great,” ACIP member Dr. Pablo Sanchez said following his dissenting vote. Sanchez expressed concern over what he considered “extremely limited data” on the vaccine’s benefits for healthier children and young adults.

The balance of benefits and risks might be too narrow for some young adult men who are at higher risk of myocarditis, a rare side effect of the injections, Sanchez suggested. That put him at odds with other panel members who cited data suggesting the benefits of the shots outweigh the risks, even for those at the highest risk of myocarditis.

Myocarditis, an inflammation of the heart muscle, generally responds well to treatment, according to the CDC, and research shows that people are more likely to develop myocarditis from a COVID infection than from the vaccine.

“I think all of this needs to be weighed. That’s why I’m hesitant to just make it a universal recommendation, even though I support vaccination with the COVID vaccine,” Sanchez said.

Trying to offer personalized recommendations could also prove impractical to implement, CDC officials said, the task force concluded, and risk creating barriers to vaccination for those most at risk.

More than 7 in 10 adults are already at higher risk of developing severe COVID-19 due to being overweight, the agency said, and would be considered a higher risk group anyway.

“Modelling projects that more hospitalizations and deaths are avoided when updated doses are universally recommended, compared to no recommendation or a recommendation only for people 65 and older,” said Megan Wallace of the CDC to the panel.

Officials also stressed that, unlike other vaccines, insurance coverage of the shots would not be directly tied to the committee’s recommendations.

Insurers were required to cover the shots immediately after receiving the green light from the FDA under a law passed earlier in the pandemic.

And although most Americans are now recommended to get vaccinated, officials said they still plan to focus their vaccine promotion on those who are at greatest risk of serious illness and could benefit the most. .

“As part of a universal recommendation, we will still have targeted communications for older adults, immunocompromised people and others at higher risk,” said Dr. Barbara Mahon of the CDC.