All Americans aged 6 months and older should receive one of the new Covid-19 vaccines when they become available this fall, scientific advisers to the Centers for Disease Control and Prevention said Thursday.
The recommendation comes as the country faces a summer surge of Covid, with infections rising in at least 39 states and territories.
Most Americans have gained some immunity to the coronavirus through repeated infections or vaccine doses, or both. Vaccines now offer gradual improvement, which only remains effective for a few months, as immunity wanes and the virus continues to evolve.
However, across all age groups, a large majority of Americans hospitalized with Covid did not receive one of the shots offered last fall, according to data presented at a meeting of the Advisory Committee on Health Practices. CDC vaccination.
“Professionals and the general public 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.”
Novavax’s vaccine will target JN.1, the variant that dominated for months in the winter and spring. Pfizer and Moderna’s vaccines will target KP.2, which until recently appeared to be the dominant variant.
But KP.2 appears to be giving way to two related variants, KP.3 and LB.1, which now account for more than half of new cases. The three variants, descendants of JN.1, are together nicknamed FLiRT, named after two mutations in the virus’s genes that contain these letters.
The mutations are thought to help the variants evade some immune defenses and thus spread more quickly, but there is no evidence that the variants cause more severe disease.
Covid-related emergency room visits in the week ending June 15 increased by almost 15%, and deaths by almost 17%, compared to the previous week’s totals. Hospitalizations also appear to be rising, but the trends are based on data from a subset of hospitals that continue to report their 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, president of the American Academy of Family Physicians, said in an interview.
The main risk factor for severe form of the disease is age. Adults aged 65 and over represent two-thirds of Covid-related hospitalizations and 82% of hospital deaths. Yet only about 40% 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 could prevent a lot of hospitalizations,” said Dr. Fiona Havers, a CDC researcher who presented the hospitalization data.
Although young adults are much less likely to become seriously ill, no group is completely safe from risk, CDC researchers said. Children – especially those under 5 – are also vulnerable, but only about 14% were vaccinated against Covid last fall.
Many parents mistakenly believe the virus is harmless to children, said Dr. Matthew Daley, a panelist and senior researcher at Kaiser Permanente Colorado.
“Because the burden was so high in the older 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 spread the virus, especially once they return to school, Dr. Furr said.
“They are the ones who, if exposed, are more likely to pass the virus on to their parents and grandparents,” he said. “By immunizing all groups, we have a better chance of preventing the spread. »
Among children, infants under 6 months of age were hardest hit by Covid, according to data presented at the meeting. But they are not eligible for the new shots.
“It’s critical that pregnant women get vaccinated, not only to protect themselves, but also to protect their infants until they are old enough to be vaccinated,” said Dr. Denise Jamieson, one of the panelists and dean of the University of Iowa Carver College of Medicine, in an interview.
Among both children and adults, vaccination coverage was lowest among groups at highest risk of Covid: Native Americans, Black Americans and Hispanic Americans.
In polls, most Americans who said they probably or definitely would not get vaccinated last fall cited unknown side effects, a lack of studies or distrust of the government and drug companies.
The CDC has said the vaccines are linked to only four serious side effects, 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, for the first time, detected that Pfizer’s Covid vaccine may have caused four additional cases of Guillain-Barré syndrome, a rare neurological disorder, for every million doses given to older adults. (The numbers available for the Moderna and Novavax vaccines were too small to analyze.)
The risk may not be real, but even if it is, the incidence of GBS is comparable to the rate seen with other vaccines, the researchers said.
The CDC has also studied a potential risk of stroke after vaccination, but the results so far are inconclusive, agency scientists said. In all cases, the benefits of the vaccines outweigh the potential harms, they said.
Panelists lamented the sharp decline in the number of health care providers advising patients about the importance of COVID vaccination. Nearly half of providers said they were not recommending vaccines because they thought their patients would refuse.
There has also been an increase in physical and verbal abuse in hospitals and health care settings, said Dr. Helen Keipp Talbot, a professor of medicine at Vanderbilt University and chair of the committee.
“Some of our doctors may not recommend it because of concerns about their safety and the safety of their staff,” she said.
Although the panelists unanimously recommended Covid vaccination for people of all ages this time, they debated the feasibility of universal recommendations in the future. The vaccines are much more expensive than other vaccines and are more cost-effective when given to older people.
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 lack health insurance.
The Bridge Access Program, a federal initiative that makes vaccines available to underinsured and uninsured Americans, will end in August.
Unless the price of vaccines falls, the cost of vaccinating all Americans may not be sustainable, the panelists said.
“As more and more members of society are exposed to either vaccines or diseases, it will become much less cost-effective,” Dr. Talbot said. “We will need a less expensive vaccine for this to work.”