Credit ACIP/CDC
#18,155
This week, following advice from ACIP (The Advisory Committee on Immunization Practices) the CDC has released updated recommendations for RSV, COVID, and seasonal flu vaccinations.
As we noted at the end of May (see MMWR: Early Safety Findings Among Persons Aged ≥60 Years Who Received a RSV Vaccine — United States, May 3, 2023–April 14, 2024) there are some concerns over a higher-than-expected incidence of GBS (Guillain-Barré syndrome) among those who received this recent addition to the vaccine lineup.
The spike wasn't huge, and given the heavy impact of RSV infection on the elderly, pending more information, the advice from the CDC remained:
RSV vaccination continues to be recommended for adults aged ≥60 years using shared clinical decision-making (9). CDC and FDA are conducting active safety evaluations to assess risks for GBS and other adverse events of special interest after RSV vaccination.
This week's recommendation scales back the recommendation for those aged 60-74, to those ` . . . who are at increased risk of severe RSV, meaning they have certain chronic medical conditions, such as lung or heart disease, or they live in nursing homes . . .'
The announcement from the CDC follows:
CDC Updates RSV Vaccination Recommendation for Adults
For the upcoming respiratory virus season, CDC recommends everyone age 75 and older receive the RSV vaccine
Media Statement
For Immediate Release, Wednesday, June 26, 2024
Contact: Media Relations
(404) 639-3286
media@cdc.gov
Today, CDC updated its recommendation for the use of Respiratory Syncytial Virus (RSV) vaccines in people ages 60 and older. For this upcoming respiratory virus season, CDC recommends:
- Everyone ages 75 and older receive the RSV vaccine.
- People ages 60–74 who are at increased risk of severe RSV, meaning they have certain chronic medical conditions, such as lung or heart disease, or they live in nursing homes, receive the RSV vaccine.
This recommendation is for adults who did not get an RSV vaccine last year. The RSV vaccine is not currently an annual vaccine, meaning people do not need to get a dose every RSV season. Eligible adults can get an RSV vaccine at any time, but the best time to get vaccinated is in late summer and early fall before RSV usually starts to spread in communities.
Today’s updated recommendation for people 60 and older replaces the recommendation made last year to simplify RSV vaccine decision-making for clinicians and the public.
Immunizations were available last year for the first time to protect people at increased risk for severe RSV, including infants and young children, and people ages 60 and older. Today’s updated recommendation is based on analyses of RSV disease burden among people 60 and older, as well as RSV vaccine effectiveness and cost-effectiveness studies. Those studies included the first real-world data since RSV vaccines were recommended for people 60 and older.
Healthcare providers should recommend RSV vaccines to their eligible patients, as well as discuss what other vaccines they will need this fall to help prevent respiratory infections.
The following is attributable to CDC Director Dr. Mandy Cohen:
“The CDC has updated its RSV vaccination recommendation for older adults to prioritize those at highest risk for serious illness from RSV,” said Mandy Cohen, M.D., M.P.H. “People 75 or older, or between 60-74 with certain chronic health conditions or living in a nursing home should get one dose of the RSV vaccine to provide an extra layer of protection.”
The advice this year for receiving both the flu and COVID vaccines is basically unchanged, although for the first time in a decade the quadrivalent vaccine will not be offered as they B/Yamagata strain has not been seen in 4 years.
The CDC reports that COVID continues to claim more lives than influenza in the United States (75,500 in 2023). Two weeks ago the FDA Updated COVID Vaccine Recommendations: Use KP.2 Strain If Feasible, due to its constant and rapid evolution.
CDC Recommends Updated 2024-2025 COVID-19 and Flu Vaccines for Fall/Winter Virus Season
Media Statement
For Immediate Release: June 27, 2024
Contact: Media Relations
(404) 639-3286
Today, CDC recommended the updated 2024-2025 COVID-19 vaccines and the updated 2024-2025 flu vaccines to protect against severe COVID-19 and flu this fall and winter.
It is safe to receive COVID-19 and flu vaccines at the same visit. Data continue to show the importance of vaccination to protect against severe outcomes of COVID-19 and flu, including hospitalization and death. In 2023, more than 916,300 people were hospitalized due to COVID-19 and more than 75,500 people died from COVID-19. During the 2023-2024 flu season, more than 44,900 people are estimated to have died from flu complications.
Updated 2024-2025 COVID-19 Vaccine Recommendation
CDC recommends everyone ages 6 months and older receive an updated 2024-2025 COVID-19 vaccine to protect against the potentially serious outcomes of COVID-19 this fall and winter whether or not they have ever previously been vaccinated with a COVID-19 vaccine. Updated COVID-19 vaccines will be available from Moderna, Novavax, and Pfizer later this year. This recommendation will take effect as soon as the new vaccines are available.
The virus that causes COVID-19, SARS-CoV-2, is always changing and protection from COVID-19 vaccines declines over time. Receiving an updated 2024-2025 COVID-19 vaccine can restore and enhance protection against the virus variants currently responsible for most infections and hospitalizations in the United States. COVID-19 vaccination also reduces the chance of suffering the effects of Long COVID, which can develop during or following acute infection and last for an extended duration.
Last season, people who received a 2023-2024 COVID-19 vaccine saw greater protection against illness and hospitalization than those who did not receive a 2023-2024 vaccine. To date, hundreds of millions of people have safely received a COVID-19 vaccine under the most intense vaccine safety monitoring in United States history.
Updated 2024-2025 Flu Vaccine Recommendation
CDC recommends everyone 6 months of age and older, with rare exceptions, receive an updated 2024-2025 flu vaccine to reduce the risk of influenza and its potentially serious complications this fall and winter. CDC encourages providers to begin their influenza vaccination planning efforts now and to vaccinate patients as indicated once 2024-2025 influenza vaccines become available.
Most people need only one dose of the flu vaccine each season. While CDC recommends flu vaccination as long as influenza viruses are circulating, September and October remain the best times for most people to get vaccinated. Flu vaccination in July and August is not recommended for most people, but there are several considerations regarding vaccination during those months for specific groups:
- Pregnant people who are in their third trimester can get a flu vaccine in July or August to protect their babies from flu after birth, when they are too young to get vaccinated.
Children who need two doses of the flu vaccine should get their first dose of vaccine as soon as it becomes available. The second dose should be given at least four weeks after the first.
Vaccination in July or August can be considered for children who have health care visits during those months if there might not be another opportunity to vaccinate them.
For adults (especially those 65 years old and older) and pregnant people in the first and second trimester, vaccination in July and August should be avoided unless it won’t be possible to vaccinate in September or October.
Updated 2024-2025 flu vaccines will all be trivalent and will protect against an H1N1, H3N2 and a B/Victoria lineage virus. The composition of this season’s vaccine compared to last has been updated with a new influenza A(H3N2) virus.
For more information on updated COVID-19 vaccines visit: Coronavirus Disease 2019 (COVID-19) | CDC. For more information on updated flu vaccines visit: Seasonal Flu Vaccines | CDC.
The following statement is attributable to CDC Director Dr. Mandy Cohen:
“Our top recommendation for protecting yourself and your loved ones from respiratory illness is to get vaccinated,” said Mandy Cohen, M.D., M.P.H. “Make a plan now for you and your family to get both updated flu and COVID vaccines this fall, ahead of the respiratory virus season.”
And we've seen evidence suggesting that repeated influenza infections may be linked to an increase risk of developing Parkinson's later in life (see 2017's Nature Comms: Revisiting The Influenza-Parkinson's Link).
In early 2023, in Neuron: Virus Exposure and Neurodegenerative Disease Risk Across National Biobanks, we also looked at a study published in Cell Neuron which found a statistical linkage between viral illnesses and developing neurodegenerative diseases later in life.
At an AAIC Meeting in 2020 (see Flu & Pneumonia Shots Appear To Reduce Dementia Risk In Elderly, researchers presented evidence suggesting:
● At least one flu vaccination was associated with a 17% reduction in Alzheimer’s incidence. More frequent flu vaccination was associated with another 13% reduction in Alzheimer’s incidence.
● Vaccination against pneumonia between ages 65 and 75 reduced Alzheimer’s risk by up to 40% depending on individual genes.
While the current flu vaccine is nowhere near as effective as we'd like it to be, and the promise of a universal flu vaccine remains elusive (see J.I.D.: NIAID's Strategic Plan To Develop A Universal Flu Vaccine), there is growing evidence to suggest the benefits of vaccination may extend beyond simply reducing the risk of influenza infection.
I view getting a yearly flu shot like always wearing a seat belt in an automobile. It doesn't guarantee a good outcome in a car wreck, but it certainly increases your odds of walking away.
