COVID
CDC Panel Recommends COVID Vaccines for Ages 6 Months and Up Amid Concerns Doctors Afraid to Recommend Shots
The CDC’s Advisory Committee on Immunization Practices on Thursday also recommended everyone 6 months and older get a flu shot.
Advisers to the Centers for Disease Control and Prevention (CDC) on Thursday voted to again recommend the COVID-19 vaccines in 2024 for all people ages 6 months and older — despite concerns about recent safety signals, drastically reduced efficacy among a population with high immunity levels and rising costs.
CDC’s Advisory Committee on Immunization Practices (ACIP) also recommended everyone 6 months and older get a flu shot.
The CDC affirmed the recommendations, which will take effect as soon as the new vaccines from Moderna, Novavax and Pfizer become available, the agency said.
“Our top recommendation for protecting yourself and your loved ones from respiratory illness is to get vaccinated,” CDC Director Mandy Cohen said in a statement. “Make a plan now for you and your family to get both updated flu and COVID vaccines this fall, ahead of the respiratory virus season.”
The U.S. Food and Drug Administration (FDA) asked vaccine manufacturers earlier this month to update the new COVID-19 shots to target the KP.2 variant if feasible, instead of the JN.1 lineage — which now reportedly accounts for only 4.4% of cases — the agency it had sought to target earlier, Reuters reported.
ACIP recommended the COVID-19 vaccines for most Americans, while also conceding the vaccines offer only a small boost in immunity that lasts for just a couple of months, given that most people have acquired immunity from infection or multiple vaccine doses.
After the COVID-19 working group made its presentation, committee member Dr. Sarah Long said the presentation made it seem that “this is not a great vaccine” and that the “summary slides are a little brighter than the data seemed to be.”
Long said it’s possible the results imply the vaccine “doesn’t have the kind of effectiveness we’d like to see if we give it to the entire population.” Or, she said, more people have partial protection from prior immunity or the vaccine.
That makes it difficult, she said, to tell “if more and more and more immunizations are going to be helpful.”
In particular, Long said, it was striking that COVID-19 hospitalizations were consistent across time, rather than seasonal, especially given that the vaccines’ effectiveness waned in just a couple of months.
Karl Jablonowski, Ph.D., a research scientist at Children’s Health Defense, told The Defender, “That short-acting vaccination strategy would really only make sense if the disease were seasonal, where the population vaccinates right before the disease season.”
The committee reviewed data on 2023-2024 adverse events following immunization from the CDC’s analysis of its Vaccine Safety Datalink, which showed a safety signal for Guillain-Barré syndrome (GBS) associated with the Pfizer vaccine among people 65 and older.
There was also a signal for ischemic stroke with the Moderna vaccine for people 65 and older and for the Pfizer vaccine for people ages 50-64.
The committee said the GBS signal is “similar to what is considered acceptable” and more data would be needed to confirm whether the stroke signal indicated a real safety problem.
The presenter, the CDC’s Dr. Lakshmi Panagiotakopoulos, also said in the presentation that vaccine-related myocarditis, a known risk, resolved quickly.
Jablonowski said that was an error:
“The longest study of vaccine-induced myocarditis shows that it does not act like other forms of myocarditis. The scar tissue persists much longer in the vaccinated — so long that the longest study of patients wasn’t long enough to actually see the scar tissue resolve.”
Shannon Stokley, Dr.PH, presented data showing that recent COVID-19 vaccine booster coverage as of May 2024 was very low — only 22.5% among adults 18 and older and 14.4% among children ages 6 months to 17 years.
The committee members voiced concerns about data showing fewer providers are recommending the vaccines to their patients. Panagiotakopoulos noted there is a lot of “vaccine fatigue” among the public.
Vaccine fatigue was a recurrent theme in the meeting, with one committee member stating in the discussion of the pneumococcal vaccines that people were starting to feel like “pincushions.”
The committee’s chair, Dr. Helen Talbot, said some providers aren’t recommending the COVID-19 vaccines because they’re concerned for their own safety when recommending the vaccine to people who did not want it.
“There has been increasing physical and verbal abuse in hospitals and outpatient healthcare settings,” she said. “This is a very sensitive topic to many people and some of our physicians may not be recommending it due to concerns about safety for them and their staff.”
“I think that is something that needs to be quantified and studied,” she said.
Dr. Camille Kotton said it will be difficult to “flip” the 40-50% of Americans who have now said they will never get a COVID-19 vaccine.
The committee also observed there is a significant difference between insured and uninsured people getting vaccinated. Throughout the meeting, they often raised concerns about the cost of vaccines, both to people and to the public health system.
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Third day of meetings on Friday
Thursday was the second day of a three-day meeting that ends today. In the first two days of the meetings ACIP also:
- Walked back recommendations for RSV vaccines for adults, narrowing the recommended age group to adults 75 and older.
- Recommended Merck’s new pneumococcal 21-valent conjugate vaccine Capvaxive as an “option” for people ages 19 and up. The drug was just approved by the FDA on June 17.
- Recommended two types of flu vaccines — high-dose inactivated and adjuvanted inactivated — for all solid organ transplant recipients ages 18-64 who are on immunosuppressants, in addition to those currently available.
- Discussed Chikungunya vaccines for adolescents, which will be on the agenda for October and Dengue vaccines, but no vote was proposed.
- Gave an update on bird flu in the U.S., maintaining it is not currently a threat to public health, but the CDC is monitoring the situation.
The votes for recommendations were unanimous, with the exception of Yvonne Moldonado, Stanford principal investigator for Pfizer’s pediatric COVID-19 and RSV vaccines and adult varicella vaccine trials, who recused herself from all decisions due to her conflict of interest.
Today, the committee is discussing the meningococcal vaccines, the maternal RSV vaccines — including the results of safety monitoring — and the pediatric RSV monoclonal antibody treatments. It is also announcing the formation of an ACIP work group for the HPV vaccines.
ACIP work groups are responsible for the collection, analysis and preparation of information for presentation, discussion, deliberation and vote by the ACIP.
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