CDC panel weighs updates to COVID vaccine recs

COVID vaccination in Ivory Coast

World Bank, Erick Kaglan / Flickr cc

Officials from the Centers for Disease Control and Prevention (CDC) today presented proposed COVID vaccine policy updates to its vaccine advisory group, which are similar to those in yesterday's Food and Drug Administration (FDA) authorization.

The updated booster guidance from the FDA and CDC is part of a plan to boost protection in vulnerable groups and simplify current recommendations for unvaccinated or partially vaccinated people ahead of a fresh push—potentially with an updated vaccine—in the fall.

Vaccine uptake is still low, with only about 20% of adults ages 18 and older having received the bivalent (two-strain) vaccine. Uptake is dramatically lower in children, with coverage levels in the single digits and decreasing by age.

The CDC didn't ask its Advisory Committee on Immunization Practices (ACIP) to vote today on recommendations, which await finalization and could come as soon as today. However, the agency was eager to get ACIP's input.

Monovalent vaccine phase-out

Like the FDA's plan, the CDC's proposed recommendation phases out use of the monovalent (single-strain) vaccine, which it said would cut down the number of mRNA vaccine formulations that healthcare providers stock from 11 to 5.

Similar to the FDA authorization, the CDC says people ages 65 and older may get a second booster 4 months or more after they received their last dose. Its guidance for people with weakened immune systems also mirrors the FDA's authorization, with additional doses as needed at least 2 months apart.

Concerns over confusing advice

Several advisory group members and others who spoke during the public comment period today raised concerns about confusing dose recommendations, especially for children ages 4 to 6. Also, some raised concerns about a possible gap in protection for pregnant women, especially those who are pregnant now.

At the end of today's discussion, Melinda Wharton, MD, MPH, associate director of vaccine policy with the CDC's National Center for Immunization and Respiratory Diseases, said the CDC hasn't crossed the finish line yet with its COVID vaccine policy changes, but it is moving closer.

CDC officials said the agency is working on a breadth of supplemental materials, adding flow charts and tables to help parents and providers navigate children's vaccine doses, and updating resources that already exist, such as its booster decision tool. They also said they will hold a clinicians outreach and communication activity (COCA) call on the policy updates on May 11.

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