Meningococcal Vaccine: Protection, Risk, Schedule
CDC Recommends 2 Or More Doses For Those 65+ Or Immunocompromised
The importance of getting an updated COVID-19 vaccine this holiday season, especially for Americans ... [+] ages 50 and older. (Photo by SAUL LOEB / AFP) (Photo by SAUL LOEB/AFP via Getty Images)
AFP via Getty ImagesThe Centers for Disease Control and Prevention announced new recommendations for COVID-19 vaccination doses. It was no surprise to many in healthcare that it advised a second dose for those 65 and older or for those younger who are moderately or severely immunocompromised.
What was somewhat unexpected, although positive, is that it now recommends "flexibility for additional doses (i.E., three or more) for those who are moderately or severely immunocompromised, in consultation with their healthcare provider (a strategy known as shared clinical decision making)."
The Advisory Committee on Immunization Practices had discussed such an approach last summer. Some argue that a standard, universal approach is easier for patients and providers to understand. Others advocated for moving toward a risk-based strategy. The CDC still recommends one dose of the 2024-2025 COVID-19 vaccine for people ages 5–64 years who are not immunocompromised.
There had been quite a push from the public for the changes and for a recommendation that everyone get vaccinated every six months instead of yearly. Many urged that immunocompromised people be allowed to get a second COVID-19 vaccine two months after the first.
Over the past four and a half years, we've seen that COVID-19 does not have the seasonality that influenza does — waves of infection have occurred year-round. That's why it made no sense to many to only suggest an annual fall immunization in combination with the flu vaccine.
One of the problems is that there is poor uptake of the vaccines, even when available. Only 22.5% of adults and 14.1% of children received the 2023-2024 vaccine. Fewer than 9% of adults 65 years and older received two or more doses of the 2023-24 COVID-19 vaccine.
Uptake has undoubtedly decreased since then because the CDC's Bridge Access Program, which provides free COVID-19 vaccines for under- or insured patients, ended in August. Since then, the cost of the vaccine for uninsured people has not been paid for by the government, but has been passed on to individuals, and many can ill afford it.
There is also ample data that the vaccine effectiveness against hospitalization wanes significantly by four to six months in those age 65 years and older. During 2023-2024, vaccine effectiveness against hospitalization in immunocompromised people waned even more, to 0 by about four to six months (p. 17).
Vaccine effectiveness over time. ... [+] https://www.Cdc.Gov/acip/downloads/slides-2024-10-23-24/04-COVID-Link-Gelles-508.Pdf
CDCOne issue is what criteria will have to be met for Medicare/Medicaid or private insurers to cover additional doses for immunocompromised patients. Can patients pay out of pocket if they want an extra dose but don't meet criteria? If someone is trying to protect an at-risk family member, can they get three or four doses per year covered?
Another interesting recommendation from ACIP is to use vaccines from the same manufacturer (homologous vaccines). This was surprising because, in some earlier studies, a mix-and-match (heterologous) approach seemed advantageous. For example, the FDA noted that heterologous boosters resulted in similar or higher serologic responses than did homologous boosters.
Why is the CDC recommending staying with the same manufacturer now?
Dr. Eric Topol, founder of the Scripps Research Translational Institute, said that perhaps it is because there is a great variability in responses (neutralizing Abs and T cells) to mix-and-match strategy, but no studies showing clearcut differences in clinical outcomes. Another expert hypothesized that it is because the vaccines from different manufacturers target different strains of the virus. Novavax is strongest against the JN.1 lineage, but the mRNA vaccines target the FLiRT variants.
The CDC has not responded to specific, detailed questions about these issues. It's welcome news that immunocompromised patients can be more protected by flexibility in being allowed more frequent immunizations. But the devil is in the details as to how this can — or will — work in practice. It appears we must await further clarification.*
*CDC responded 10/25 6 pm that "If ACIP approves modifications to the schedule, then insurers cover the cost of vaccines."
Second Dose Of This Year's COVID Vaccine Recommended For People Age 65 And Up
Immunocompromised people and those who are age 65 or older should get a second dose of the 2024-2025 COVID-19 vaccine, according to the latest recommendations from the Centers for Disease Control and Prevention.
In a statement released Wednesday, the CDC said the second dose should be received six months after the first dose.
The CDC also said its recommendations allow for flexibility for those who are moderately or severely immunocompromised to consider additional doses (three or more). In consultation with their health care provider.
In August, the Food and Drug Administration greenlit updated COVID-19 vaccines from Pfizer and Moderna for the 2024 fall season. The updated shots were revised to target the KP.2 variant of SARS-CoV-2, the virus that causes COVID-19, and medical experts say it will also provide protection against other recent strains.
This was part of a now-annual process undertaken by the FDA and health authorities around the world to update the vaccines to protect against newer strains of the virus.
Similar to previous seasons, the Centers for Disease Control and Prevention recommends that all Americans ages 6 months and older get a shot of the updated 2024-2025 COVID-19 vaccine to protect against another expected surge of the virus this fall and winter.
Still, as another fall virus season approaches, not everyone is following the CDC's advice. According to a survey from Ohio State Wexner Medical Center last month, less than half of Americans were planning to get their COVID or flu shots this season.
"Data continues to confirm the importance of vaccination to protect those most at risk for severe outcomes of COVID-19," the CDC noted in the latest release. "Receiving recommended 2024-2025 COVID-19 vaccines can restore and enhance protection against the virus variants currently responsible for most infections and hospitalizations in the United States."
The CDC also reminded the public that the COVID-19 vaccine can help reduce the chances of suffering the effects of long COVID.
Editor's note: This story has been updated to clarify that the second dose is recommended for everyone age 65 or over, as well as people who are immunocompromised.
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MoreSara MoniuszkoModerna, Pfizer Or Novavax? How The Three Covid-19 Vaccines Differ According To Yale Medicine
With flu season underway and new, developing COVID-19 strains, health professionals continue to stress the importance of receiving an updated vaccine. On Oct. 23, the Centers for Disease Control and Prevention updated its COVID-19 vaccine recommendations for people 65 years and older and for people who are moderately or severely immunocompromised.
The recommendation, made by the CDC's Advisory Committee on Immunization Practices, acknowledges the increased risk of severe disease from COVID-19 in older adults and those who are immunocompromised, along with the currently available data on vaccine effectiveness and year-round circulation of COVID-19, a news release stated.
"This vote allows people to make the best decisions possible to keep themselves and their loved ones safe from COVID-19," said CDC Director, Mandy Cohen in a statement. "CDC will continue to educate the public on how and when to get their updated vaccinations so they can risk less severe illness and do more of what they love."
There are three types of vaccines available in the United States — Pfizer-BioNTech, Moderna and Novavax. According to the CDC, there is no preference for one vaccine over the other.
Wondering how the three vaccines differ? Yale Medicine has published a report comparing the three vaccines. Here's what they found.
More: When will COVID-19 vaccines be available for fall-winter season? What to know
Pfizer-BioNTech, Moderna and Novavax: How do the three vaccines compare?Frontline healthcare workers receive the Pfizer-BioNTech COVID-19 vaccine at Ascension St. Vincent in Indianapolis on Thursday, Dec. 17, 2020.
Pfizer-BioNTech: The Pfizer-BioNTech vaccine was the first COVID vaccine to receive FDA Emergency Use Authorization from the Food and Drug Administration back in December 2020. It was later granted full FDA approval in August 2021 for people ages 16 and older.
Pfizer's and Moderna's vaccine has been updated over time to target currently circulating variants, most recently in August, and is recommended for everyone six months and older. Children ages six months to four years may get multiple doses while children five and older may get one dose of the 2024-2025 updated vaccine.
People 65 years and older, and those who are moderately or severely immunocompromised, may receive a second dose six months after their first dose, read the report.
Possible side effects of the Pfizer vaccine include pain, redness, or swelling where the shot was administered. Patients may also experience tiredness, headaches, muscle pains, chills, fever, or nausea. If side effects occur they typically wear off in a few days. Few side effects are serious, although rare, reported Yale.
The updated vaccines were approved based on preclinical studies of their efficacy against circulating strains. People may still become infected even after receiving a vaccine, however, the goal of the vaccines now is to prevent severe disease, hospitalization and death. According to Yale, research has suggested that people who are infected after vaccination are less likely to report "long COVID" — signs, symptoms, and conditions that continue or develop after acute COVID infection — compared to those who were not vaccinated.
Vials of the Moderna Covid-19 vaccine at the Rockland County Fire Training Center in Pomona March 1, 2021. Rockland County worked with Refuah Health Center, Good Samaritan Hospital and the Rockland County Office for the Aging to vaccinate 280 seniors from the Office the AgingÕs Senior Covid-19 vaccine waitlist.
Moderna: Moderna was granted FDA Emergency Use Authorization in December 2020, just a week after Pfizer. The FDA later granted the Moderna vaccine full approval for people 18 and older in January 2022.
People ages 6 months and older are eligible to receive the Moderna vaccine, with specific recommendations for certain groups. Children ages six months to four years need multiple doses including at least one dose of the 2024-2025 updated vaccine. People ages five and older years may get one dose of the 2024-2025 updated vaccine.
People 65 years and older, and those who are moderately or severely immunocompromised, may receive a second dose six months after their first dose. People who are moderately or severely immunocompromised may decide to receive additional doses in accordance with their healthcare provider, reported Yale.
For more information about dose recommendation, visit the CDC website.
The side effects from Moderna's vaccine are similar to Pfizer's — pain, redness, swelling where the shot was administered, and/or tiredness, headache, muscle pain, chills, fever, or nausea throughout the rest of the body.
Syringes with needles are seen in front of a displayed Novavax logo in this illustration taken on November 27, 2021.
Novavax: The Novavax was the fourth COVID vaccine to be administered in the U.S., after Johnson & Johnson, which is no longer available. The Novavax vaccine is the only non-mRNA updated COVID vaccine that has been available in the U.S. The vaccine had a 90% efficacy in its clinical trial, performing almost as well as the mRNA vaccines in their early trials.
The FDA authorized an updated COVID vaccine from Novavax at the end of August for people ages 12 and older, reported Yale.
People 12 and older are eligible to receive the Novavax vaccine. People 65 and older, and those who are moderately or severely immunocompromised, may receive a second dose six months after their first dose. People who are moderately or severely immunocompromised may receive additional doses in consultation with their healthcare provider.
Novavax's side effects are similar to those of Moderna and Pfizer. In rare cases, myocarditis and pericarditis was reported in clinical trial participants as well as severe allergic reactions.
While Novavax's 2024-2025 updated vaccine targets the JN.1 variant, and not KP.2 like Pfizer and Moderna, Novavax has reported that non-clinical data has demonstrated broad cross-neutralizing antibodies against multiple variant strains such as JN.1, KP.2 and KP.3.
What is the circulating COVID-19 strain in Tennessee? Updated data for Davidson CountyAcross the United States, KP.3.1.1 of the Omicron family, is the leading variant, accounting for 57% of cases throughout the two-week period ending on Oct. 26. The CDC's data tracker tool did not provide nowcast estimates for the Southeast region, due to estimates only being available for regions having over 300 sequences.
According to the Tennessee Health Department, Davidson County has averaged 29 new COVID-19 cases reported per day for the seven-day period ending on Oct. 19, 2024.
Throughout that same time period, the county had an average daily case rate of 4 cases per 100,000 residents per day. The week prior, Davidson County averaged 15 new cases per day.
Diana Leyva covers trending news and service journalism for The Tennessean. Contact her at Dleyva@gannett.Com or follow her on X, the platform formerly known as Twitter, at @_leyvadiana
This article originally appeared on Nashville Tennessean: Best COVID-19 vaccine? Comparing Moderna, Pfizer and Novavax vaccines
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