CDC Recommends Expanded COVID-19 Booster and Early Pneumococcal Vaccination for High-Risk Adults

The CDC has updated its vaccine recommendations for COVID-19 and pneumococcal disease following a recent review by the Advisory Committee on Immunization Practices (ACIP). Key updates include a new recommendation for a second COVID-19 vaccine dose for high-risk groups and an expanded age range for pneumococcal vaccination.

To enhance protection for at-risk populations, the CDC now recommends a second dose of the 2024-2025 COVID-19 vaccine for adults aged 65 and older, as well as for individuals aged 6 months and older with moderate or severe immunocompromising conditions. This second dose should be administered 6 months after the initial dose. This guidance aims to counter waning immunity observed 4 to 6 months post-vaccination, particularly against emergency room and hospital visits related to COVID-19. Protection against severe outcomes, such as intensive care unit admissions, generally lasts longer. However, given the consistent circulation of SARS-CoV-2, especially during winter and late summer, these updated recommendations support sustained immunity in populations at increased risk.

In line with these COVID-19 updates, the CDC also clarified that individuals who are immunocompromised may receive additional doses of the COVID-19 vaccine through shared clinical decision-making with their healthcare providers. This flexibility can be used to time vaccinations around immunosuppressive treatments, travel, or other factors that could elevate exposure risk.

The CDC also adjusted pneumococcal vaccination guidelines, reducing the minimum recommended age for routine adult pneumococcal vaccination from 65 to 50 years of age. This shift aims to improve vaccine uptake among adults aged 50 to 64 who have risk factors such as chronic conditions or compromised immune systems. Unlike previous recommendations, which required both patients and providers to be aware of specific risk factors, the new guidance simplifies access by making pneumococcal vaccination routine for all adults in this age group. This update also addresses equity concerns, as Black adults have been observed to develop pneumococcal disease at younger ages than non-Black adults.

Adults between the ages of 19 and 49 with specific risk factors, including diabetes, chronic liver or lung disease, cigarette smoking, and immunocompromising conditions, are still advised to receive pneumococcal vaccinations. Healthcare providers now have three pneumococcal conjugate vaccines available for adult patients: PCV15, PCV20, and PCV21. Most adults only need a single dose, though individuals receiving PCV15 will require an additional dose of pneumococcal polysaccharide vaccine (PPSV23) for full protection.

These recommendations, now part of official CDC public health guidance, will soon be published in the Morbidity and Mortality Weekly Report (MMWR) and disseminated broadly to healthcare providers and the public.

Reference:

CDC updates vaccine recommendations. U.S. Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases. October 29, 2024. Accessed October 30, 2024. https://www.cdc.gov/ncird/whats-new/cdc-updates-vaccine-recommendations.html