The World Health Organization’s Strategic Advisory Group of Experts (SAGE) on Immunizations (WHO) updated recommendations for vaccination against COVID-19 and noted that the priority of a booster dose, between 6 and 12 months after above is maintained only in the highest risk groups, such as the elderly, immunosuppressed people and health personnel. Meanwhile, adults in good health do not need a supplemental dose of vaccine, beyond the primary dose and a first booster, since the benefits are minimal.
The new guidelines emerged after a meeting held between March 20 and 23 in which the roadmap to prioritize the use of COVID-19 vaccines was reviewed, in order to reflect the impact caused by the omicron variant and the high level of population immunity due to infection and vaccination.
“The roadmap has been updated to reflect that a large portion of the population is vaccinated, has been previously infected by COVID-19, or both,” Dr. Hanna Nohynek , president of SAGE, said in a statement. then add that the new updates re-emphasize “the importance of vaccinating, even with additional boosters, those who are still at risk of severe disease, which are primarily older adults and people with underlying conditions.”
But “countries must take into account their particular context when deciding whether to continue vaccinating low-risk groups, such as healthy children and adolescents, without compromising the administration of routine vaccines, which are so important for health and the well-being of this age group,” added the expert in a document released by the WHO.
The revised version of the roadmap establishes three priority groups for vaccination against COVID-19: high, medium and low. The definition of these groups is based primarily on the risk of severe disease and death, and takes into account issues such as vaccine effectiveness, cost-effectiveness, programmatic factors, and community acceptance.
• The high priority group includes older people, young adults with significant comorbidities (for example, diabetes and heart disease), people with immunocompromising conditions (for example, people living with HIV and transplant recipients). ), including children 6 months and older, pregnant people, and frontline health workers. For this group, SAGE recommends giving an additional booster dose within 6 or 12 months after the last dose, depending on factors such as age and immunodeficiency conditions. “Any recommendation on the COVID-19 vaccine is only valid for a certain time, and only refers to the current epidemiological scenario. Consequently, it should not be interpreted as recommending that additional booster doses be administered each year on an ongoing basis. The objective is to help countries plan in the short and medium term,” the text clarifies.
• The medium priority group includes healthy adults without comorbidities, generally between the ages of 50 and 60, and children and adolescents with comorbidities. For this group, SAGE recommends primary vaccination and the first booster dose. “Although additional boosters are safe for this group, SAGE does not routinely recommend them as they offer comparatively low public health benefits,” the document highlights.
• The low priority group includes healthy children and adolescents between 6 months and 17 years old. “Primary and booster doses are safe and effective in children and adolescents. However, given the low burden of disease in this age group, SAGE urges countries considering vaccination to base their decisions on contextual factors, including the aforementioned burden of disease and cost-effectiveness. as well as other health or programmatic priorities and opportunity costs,” highlighted the panel of experts.
Although the burden of severe COVID-19 among infants younger than 6 months is generally low, it is still higher than that among children aged 6 months to 5 years . Vaccination of pregnant people, even with an additional dose if more than six months have passed since the previous dose, protects both mother and fetus, and in turn tends to reduce the likelihood that babies will be hospitalized due to COVID-19.
Aside from the roadmap, SAGE also updated its recommendations on bivalent COVID-19 vaccines, and now recommends countries consider primary vaccination with the bivalent BA subvariant mRNA vaccine. 5.
