WHO vaccine advisers update COVID vaccine recommendations
For the first time, the recommendations factor in cost-effectiveness for vaccinating those at lower risk, partly due to concerns about maintaining coverage of crucial routine vaccines such as measles.
The World Health Organization (WHO) vaccine advisory group today announced its latest recommendations for COVID-19 vaccines, which takes into account high levels of immunity due to vaccine and prior infection, prioritizes highest risk groups, and balances COVID vaccination for lower risk groups with other preventive health actions.
In a statement, the WHO Strategic Advisory Group of Experts (SAGE) along with a prioritization roadmap weighed in on booster doses, timing of booster doses, and vaccine composition. It laid out three prioritization tiers—high, medium, and low—based on risk for severe disease and death.
The highest tier includes older adults, younger adults who have underlying health conditions, immunocompromised people ages 6 months and older, pregnant women, and frontline health workers. For the highest tier, the group recommends a booster shot 6 or 12 months after the last dose, depending on age and underlying conditions. It emphasized that the interval applies only to the current epidemiological situation and isn’t a recommendation for annual boosters. “The aim is to serve countries planning for the near- to mid-term,” it said.
The medium priority group includes healthy adults younger than 60 and children and adolescents with underlying conditions, who should get their primary series and one booster. Though additional boosters are safe, SAGE said it didn’t recommend them, because public health returns are relatively low.
Meanwhile, the low priority group is made up of healthy children and adolescents as old as 17. The group said the primary series and booster doses are safe, but due to the low burden of disease, countries should base their decisions on a range of factors, including cost-effectiveness and other health priorities. It added that the public health impact of vaccinating healthy kids against COVID is lower than the benefits of other routine vaccinations such as rotavirus, measles, and pneumococcal conjugate.
The group examined the data about the impact of COVID-19 vaccine on long COVID, but said the evidence on the extent of the impact is inconsistent.
Separately, WHO’s SAGE also recommended that countries consider using bivalent mRNA vaccines for the primary series.
