All Americans aged 6 months and older should receive one of the new Covid-19 vaccines when they become available this fall, scientific advisers for the Centers for Disease Control and Prevention said Thursday.
The recommendation comes as the nation faces a summer wave of Covid, with the number of infections rising in at least 39 states and territories.
Most Americans have acquired layers of immunity against the coronavirus from repeated infections or vaccine doses, or both. Vaccines now offer a boost, remaining effective for only a few months as immunity wanes and the virus continues to evolve.
However, in every age group, an overwhelming majority of Americans who were hospitalized for Covid did not receive one of the vaccines offered last fall, according to data presented at a meeting of the CDC’s Advisory Committee on Immunization Practices.
“Professionals and the general public don’t realize 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 protect against this year’s virus.”
A vaccine from Novavax will target JN.1, the variant that prevailed for months in the winter and spring. The filming that will be carried out by Pfizer and Moderna is aimed at KP.2, which until recently seemed ready 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 collectively nicknamed FLiRT, after two mutations in the virus genes containing those letters.
The mutations are thought to help the variants evade some immune defenses and spread more quickly as a result, but there is no evidence that the variants cause more severe disease.
Emergency department visits related to Covid in the week ending June 15 rose by nearly 15 percent and deaths by nearly 17 percent, over the previous week’s total. Hospitalizations also appear to be on the rise, but the trends are based on data from a subset of hospitals that still report numbers to the CDC even though the requirement to do so ended in May.
“Covid is still there and I don’t think it’s ever going to go away,” said Dr. Steven P. Furr, president of the American Academy of Family Physicians, in an interview.
The biggest risk factor for serious illness is age. Adults aged 65 and over account for two-thirds of Covid hospitalizations and 82 per cent of in-hospital deaths. However, only about 40 percent of Americans in that age group were immunized with a Covid vaccine offered last fall.
“This is an area where there is a lot of room for improvement and could prevent many hospital admissions,” said Dr. Fiona Havers, a CDC researcher who presented the hospitalization data.
Although younger adults are much less likely to get seriously ill, there are no groups completely free of risk, CDC researchers said. Children — especially those younger than 5 — are also vulnerable, but only about 14 percent were immunized against Covid last fall.
Many parents mistakenly believe that the virus is harmless in children, said Dr. Matthew Daley, a panelist and senior investigator at Kaiser Permanente Colorado.
“Because the burden was so high in the older age groups, we lost sight of the absolute burden in the pediatric age groups,” said Dr. Daley.
Even if children don’t get sick themselves, they can promote the circulation of the virus, especially after returning to school, said Dr. Oven.
“They’re the ones who, if exposed, are more likely to bring it home to their parents and grandparents,” he said. “By immunizing all groups, you are more likely to prevent the spread.”
Among children, babies younger than 6 months have been hit hardest by Covid, according to data presented at the meeting. But they are not suitable for new shoots.
“It is critical that pregnant people get vaccinated, not only to protect themselves, but also to protect their babies until they are old enough to be vaccinated,” Dr. Denise Jamieson, one of the panelists and dean of the Carver College of Medicine at the University of Iowa, said in an interview.
Among children and adults, vaccine coverage was lowest among the groups most at risk from Covid: Native Americans, Black Americans and Hispanic Americans.
In polls, most Americans who said they probably or definitely wouldn’t get the vaccines last fall cited unknown side effects, insufficient studies or distrust of the government and pharmaceutical 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 found, for the first time, that Pfizer’s Covid vaccine may have led to four more cases of Guillain-Barré syndrome, a rare neurological condition, per one million doses administered to the elderly. (The numbers available for the Moderna and Novavax vaccines were too small for analysis.)
The risk may not turn out to be 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 investigated a possible risk of stroke after vaccination, but the findings 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 healthcare providers advising patients on the importance of the Covid vaccination. Almost half of the providers said they did not recommend the injections because they believed their patients would refuse.
There has also been increased physical and verbal abuse in hospitals and health care settings, said Dr. Helen Keipp Talbot, a professor of medicine at Vanderbilt University and chair of the committee.
“Some of our doctors may not recommend it because of concerns for their safety and that of their staff,” she said.
Although the panelists unanimously recommended vaccination against Covid for people of all ages this time, they debated the feasibility of universal recommendations in the future. Vaccines are much more expensive than other vaccines, and they are more cost-effective when given to older adults.
At the individual level, the Affordable Care Act requires that insurers, including Medicare and Medicaid, cover vaccines recommended by the advisory committee at no cost. But up to 30 million Americans do not have health insurance.
The Bridge Access program, a federal initiative that makes vaccines available to uninsured and underinsured Americans, will end in August.
Unless the price of vaccines comes down, the cost of immunizing all Americans may not be sustainable, the panelists said.
“As more and more of society is exposed to the vaccine or disease, it will become much less cost-effective,” said Dr. Talbot. “We’re going to have to have a less expensive vaccine to make this work.”