CDC Recommends a New Round of COVID Boosters for Older Adults

Adults 65 and older should get an additional dose of the updated COVID-19 vaccine this spring, according to the Centers for Disease Control and Prevention (CDC).

The agency gave its recommendation soon after a panel of advisors to the CDC met to discuss the vaccine strategy.

The committee agreed that older adults would benefit from another booster shot if it has been at least four months since their last vaccine dose. People older than 65 made up two-thirds of the COVID-related hospitalizations since March 2020.

People with compromised immune systems may also get additional vaccine doses two months after their last dose. The CDC didn’t approve any new recommendations for those individuals but said they should ask their health providers about when to get their next booster shot.

People receiving a dose this spring will get the updated vaccine that rolled out in September. That vaccine is designed to target the XBB.1.5 Omicron subvariant. According to CDC data, it appears to protect against JN.1, the COVID variant that makes up about 92% of U.S. cases.

About 70% of U.S. adults have not received the most recent monovalent vaccine nor the bivalent vaccine that preceded it. Only 4% of adults have gotten a dose of the most recent vaccine formulation. Vaccine uptake was lower in rural areas and among Native Americans and Alaska Natives.

The CDC said they hope the latest recommendation will encourage older adults to get a shot of the updated vaccine to tide them over until the next generation of COVID vaccine is available.

A Food and Drug Administration advisory panel will meet in May to discuss the formulation of the vaccine for the fall. The CDC panel will then meet in June to provide clinical recommendations for the new vaccine.

Four years into the pandemic, the virus still does not follow a clear seasonal pattern. There may be an uptick in cases this summer, which is part of the reason the CDC recommended a top-up dose for older adults this spring.

“We all feel that things with COVID are still unpredictable, particularly as new variants arise. I hope that we are moving in the direction of getting more flu-like where there is a really clear season, but I don’t think that we are there yet,” Megan Wallace, DrPH, MPH, an epidemiologist at the CDC, told the committee.

During Wednesday’s meeting, the CDC committee deliberated whether to say that older adults should get a booster shot or if they may do so. Some panelists argued that a strongly worded recommendation may further vaccine fatigue.

The group settled on saying older adults should get the vaccine to emphasize the importance of an extra dose of protection for this age group.

“From my perspective as an active clinician in the field, many people did not even know that they should have had an updated vaccine since September. If we say ‘may,’ for me, that’s too soft,” said Camille Kotton, MD, a physician at Massachusetts General Hospital and a member of the scientific advisory panel.

The CDC shared data showing the vaccine lowered the odds of COVID hospitalization by 54% in otherwise healthy people 65 years and older.

When the COVID vaccines were first approved, they had an efficacy of 90% or more. Now that nearly every American has vaccine- or infection-induced immunity, the vaccines provide a relatively smaller boost to immune protection, explained Ruth Link-Gelles, PhD, MPH, vaccine effectiveness program lead for COVID-19 and other respiratory viruses at CDC.

Older adults can expect the vaccines to reduce their risk of hospitalization by about 50%.

“Whether you were infected or vaccinated multiple times, your protection will decrease, and the vaccines can then provide really important extra protection,” Link-Gelles said. “That’s important for all people in the United States, but especially important for those that are the highest risk.”