CDC Endorses ACIP’s Updated COVID-19 Vaccine Recommendations

Credit ACIP/CDC

#16,424

With any drug or medication there is always some (usually minor) risk of having a serious adverse reaction.  No drug is 100% safe for 100% of the population, not even vaccines and common over-the-counter remedies. A few examples include:

• NSAIDs, have been linked to serious, sometimes fatal, cardiovascular events and bleeding (see FDA Strengthens Warnings Of Cardiovascular Risks With NSAIDs). 

• A study published in 2011 in the American Journal of Preventive Medicine (see Emergency Department Visits for Overdoses of Acetaminophen-Containing Products) found that - in the United States alone – there are an estimated 78,414 ER visits each year due to acetaminophen (aka Tylenol, paracetamol, APAP) poisoning.

• Early in the roll-out of the mRNA COVID Vaccines we began to see rare, scattered cases of anaphylaxis (see MMWR: Allergic/Anaphylactic Reactions After Receipt of the 1st Dose of Pfizer-BioNTech COVID-19 Vaccine).

Almost every decision we make in life is based on a risk-benefit calculation.  And while there are risks to taking NSAIDs, Acetaminophen, or getting a vaccine, for most people they are negligible, and are far  outweighed by the benefits. 

Over time, that calculation may change as more data becomes available, which is why the CDC now warns parents against using many OTC cold remedies for very young children (see Kids, Colds, And OTC Meds). 

Yesterday the CDC's ACIP (Advisory Committee on Immunization Practices) met to review the latest evidence on the relative safety and effectiveness of the Janssen COVID vaccine and the mRNA vaccines (Pfizer & Moderna).  

All three have had some safety signals (see here, here, and here), but their benefits in preventing COVID have always been deemed to outweigh any risks.

With declining protection against new COVID variants, and more data on (still rare) adverse events associated with these vaccines, ACIP has voted unanimously that mRNA vaccines are preferred over the the J&J (Janssen) vaccine for everyone 18 and older in the United States. 

This doesn't remove the J&J vaccine from service, but does recommend when the option is available, that people choose one of the mRNA vaccines.  Their risk-benefit analysis from one of their slide presentations follows:

Late yesterday the CDC released the following endorsement of the ACIP committee's recommendation.  I'll have a brief postscript after the break.

CDC endorses ACIP’s updated COVID-19 vaccine recommendations

Media Statement

For Immediate Release: Thursday, December 16, 2021

Contact: Media Relations

(404) 639-3286

Today, CDC is endorsing updated recommendations made by the Advisory Committee on Immunization Practices (ACIP) for the prevention of COVID-19, expressing a clinical preference for individuals to receive an mRNA COVID-19 vaccine over Johnson & Johnson’s COVID-19 vaccine. ACIP’s unanimous recommendation followed a robust discussion of the latest evidence on vaccine effectiveness, vaccine safety and rare adverse events, and consideration of the U.S. vaccine supply. The U.S. supply of mRNA vaccines is abundant – with nearly 100 million doses in the field for immediate use. 

This updated CDC recommendation follows similar recommendations from other countries, including Canada and the United Kingdom. Given the current state of the pandemic both here and around the world, the ACIP reaffirmed that receiving any vaccine is better than being unvaccinated. Individuals who are unable or unwilling to receive an mRNA vaccine will continue to have access to Johnson & Johnson’s COVID-19 vaccine.

The following is attributable to CDC Director, Dr. Rochelle Walensky

“We have made important strides in the year since the COVID-19 vaccination program started. More than 200 million Americans have completed their primary vaccine series, providing protection against COVID-19, preventing millions of cases and hospitalizations, and saving over a million lives. Today’s updated recommendation emphasizes CDC’s commitment to provide real-time scientific information to the American public. I continue to encourage all Americans to get vaccinated and boosted.”

While the effectiveness of our current crop of COVID vaccines have declined since they were released a year ago - and appear to be even further diminished by the emerging Omicron variant - they still appear to offer significant protection against severe illness and death from COVID.

Given what appears to be a difficult 1st quarter of 2022 ahead of us, I'd rather face it fully vaccinated (and boosted) than not. I accept I may still get infected, but my odds of staying out of the hospital should be improved. 

And given the size and potential impact of the Omicron wave we appear to be facing, that's still a pretty good benefit-to-risk ratio.