Older Americans should roll up their sleeves for another COVID-19 vaccine, even if they received a booster shot last fall, US health officials said.
The Centers for Disease Control and Prevention said Americans aged 65 and older should get another dose of the updated vaccine that became available in September, if at least four months have passed since their last shot. In making the recommendation, the agency endorsed guidance proposed by an expert advisory panel the same day.
“Most COVID-19 deaths and hospitalizations last year occurred among people aged 65 and older. An additional vaccine dose can provide added protection… for those at highest risk,” said CDC Director Dr. Mandy Cohen in a statement.
The advisory panel’s decision followed a lengthy discussion on whether to say older adults “may” receive the vaccines or “should” do so. This reflects a debate among experts about how necessary another booster is and whether another recommendation would further increase the growing public vaccine fatigue.
Some physicians argue that most older adults are adequately protected by the fall vaccine, which relies on immunity from previous vaccines and exposure to the virus itself. So far, preliminary studies have not shown a substantial decline in vaccine effectiveness within six months.
However, vaccine-induced defenses in the body tend to wane over time, and this happens faster in older adults than in other age groups. The committee had recommended COVID-19 booster doses for older adults in 2022 and 2023.
COVID-19 remains a threat, especially for older adults and those with underlying medical conditions. There are still more than 20,000 hospitalizations and over 2,000 deaths each week due to the coronavirus, according to the CDC. And people aged 65 and older have the highest rates of hospitalization and death.
Some advisory panel members said a “should” recommendation aims to more clearly prompt doctors and pharmacists to offer the shots.
In September, the government recommended a new COVID-19 vaccine formula designed to target a version of the coronavirus called XBB.1.5. That single-target vaccine replaced the bivalent shots that had targeted both the original coronavirus strain and an earlier omicron variant.
The CDC recommended the new vaccines for everyone aged 6 months and older and allowed people with weakened immune systems to receive a second dose as soon as two months after the first.
Most Americans have not gotten the shot. According to the latest CDC data, 13% of US children have received the vaccine, and about 22% of US adults have done so. The vaccination rate is higher for adults aged 65 and older, at nearly 42%.
“With each successive vaccine, uptake has declined,” said Dr. David Canaday, an infectious disease expert at Case Western Reserve University who studies COVID-19 in older adults.
“People are tired of getting all these vaccines all the time,” said Canaday, who is not part of the committee. “We have to be careful not to over-recommend the vaccine.”
But there is a subset of Americans—those at highest risk of severe illness and death—who have been asking if another dose is allowed, said Dr. William Schaffner, a vaccine expert at Vanderbilt University who is part of a committee working group that has been debating the booster question.
In fact, CDC survey data suggests the group’s biggest concern about the vaccine is whether it is effective enough.
Agency officials say that among those who received the latest version of the COVID-19 vaccine, 50% fewer will get sick after exposure to the virus compared to those who did not receive the fall vaccine.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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