CDC recommends seniors get another Covid-19 shot

People age 65 and older should get an additional dose of the current Covid-19 vaccine, the US Centers for Disease Control and Prevention recommends.

The agency’s independent vaccine advisers voted Wednesday to recommend the additional shot, and CDC Director Dr. Mandy Cohen endorsed the recommendation.

The vote of CDC’s Advisory Committee on Immunization Practices was 11 yes and one no, with one person abstaining.

Under the new recommendation, people 65 and older can receive an additional dose of any updated Covid-19 vaccine at least four months after the previous shot.

The current Covid-19 vaccine, which was updated last fall, is considered highly effective. Early estimates from CDC studies show that although there has been no substantial waning yet, protection will wane over time. However, the protection offered by any vaccine disappears even quicker in older people because their immune systems don’t respond as well.

The initial proposal used the word “may,” but the committee changed the language to “should” to emphasize how important it is to get vaccinated against Covid-19.

Although 98% of the US population has some kind of immunity to Covid-19, whether from infection, vaccination or both, that gives only some protection against infection or severe disease, CDC epidemiologist Dr. Ruth Link-Gelles told the advisers during Wednesday’s meeting.

“It doesn’t protect absolutely,” she said.

“What the vaccines are doing now is providing an incremental benefit or an extra benefit beyond whatever benefit someone has remaining from their past infection or past vaccination, and we know that protection from past vaccination and past infection wanes,” Link-Gelles said. “That’s important for all people in the United States but especially important for those that are the highest risk.”

Data from the CDC shows that throughout the pandemic, older adults have been the most vulnerable to the severe effects of Covid-19.

Covid-related hospitalizations for adults 65 and older have been consistently higher than for all other age groups. About two-thirds of Covid hospitalizations are people in this age group, CDC data shows. Seniors also make up the greatest proportion of those who died in a hospital with Covid and have the highest numbers of deaths even after they’ve been discharged.

Of older adults hospitalized with Covid, the highest percentage had no record of any vaccination against the coronavirus since the original shot, according to data from last fall that was presented to the committee Wednesday.

The vaccine is recommended for everyone ages 6 months and older, but data from the CDC shows that people haven’t been getting the shots.

Strong evidence from new research shows that the vaccine can not only prevent severe disease but may cut the chances of getting a symptomatic infection by half, including against JN.1, the most common circulating variant of the virus. Yet only about 21% of adults and about 12% of children have gotten the vaccine since its update in September, according to the CDC. By comparison, nearly half of adults and kids in the US have gotten a flu vaccine this season.

The National Immunization Survey shows that most Americans still consider Covid-19 vaccines to be safe and important, but people’s confidence in the vaccine has fallen from 83.9% in January 2022 to 69.6% last month.

Disease risk perception has also changed, according to the survey, and fewer adults say they are moderately or very concerned about getting Covid. Despite the general perception, Covid is still very much a threat, particularly to vulnerable populations like older people and those with underlying conditions.

There were about 20,000 new hospital admissions and 2,000 Covid-19 deaths a week as of the week ending February 17, CDC representatives told the advisory committee. Even when numbers were at their lowest last summer, there were still about 500 Covid-19 deaths per week.

Part of the problem may be that doctors aren’t always advising their patients to get a Covid shot. The National Immunization Survey shows that in January, relative to 2021, fewer people said their providers encouraged them to get the vaccine.

“It is shocking to see that 30% to 40% of the higher-risk populations — at least for elderly, and I think it’s a similar number for immunocompromised — are getting the updated vaccine,” said advisory committee member Dr. Camille Kotton, clinical director of transplant and immunocompromised host infectious diseases at Massachusetts General Hospital.

Kotton thinks Americans have been confused about whether they should get the vaccine and thinks health leaders need to be clearer about the recommendations.

“For me, this is a life and death situation for many of the patients that I take care of,” she said.