New Covid vaccines recommended for Americans 6 months and older this fall

All Americans ages 6 months and older should get one of the new COVID-19 vaccines when they become available this fall, science advisers to the Centers for Disease Control and Prevention said Thursday.

The recommendation comes as the country faces a summer wave of Covid, with the number of infections rising in at least 39 states and territories.

Most Americans have acquired some immunity to the coronavirus through repeated infections or vaccine doses, or both. Vaccines now offer a gradual improvement, which remains effective for only a few months as immunity wanes and the virus continues to evolve.

Yet across all age groups, a large majority of Americans hospitalized with Covid received none of the shots offered last fall, according to data presented at a meeting of the CDC’s Advisory Committee on Immunization Practices.

“The 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 was prevalent for months in winter and spring. The vaccines from Pfizer and Moderna 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.

Mutations are thought to help variants evade certain immune defenses and spread more quickly, but there is no evidence that 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’s ever going to go away,” Dr. Steven P. Furr, president of the American Academy of Family Physicians, said in an interview.

The main risk factor for serious illness is age. Adults aged 65 and over account for two-thirds of Covid-related hospitalizations and 82% of hospital deaths. Yet only about 40% of Americans in this age group have been immunized with the 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 get seriously ill, no group is completely safe from the risk, CDC researchers said. Children, especially those under 5, are also vulnerable, but only 14% of them 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 oldest 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 they are exposed, are more likely to report it to their parents and grandparents,” he said. “By vaccinating all groups, you 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 prove 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 any case, the benefits of vaccines outweigh the potential harms, they said.

Panelists lamented the sharp decline in the number of health care providers advising patients on the importance of Covid vaccination. Nearly half of providers said they didn’t recommend the shots because they thought their patients would refuse.

According to Dr. Helen Keipp Talbot, professor of medicine at Vanderbilt University and chair of the committee, physical and verbal abuse are on the rise in hospitals and health care settings.

“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 this time unanimously recommended Covid vaccination for people of all ages, they debated the feasibility of universal recommendations in the future. 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 for free. But nearly 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 vaccine prices come down, 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.”

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