The WHO recommends primary doses and a first booster in healthy adults, children and adolescents with co-morbidities.
The World Health Organization (WHO) says it no longer recommends additional COVID-19 vaccine booster doses for normal adults at average risk because the benefit is marginal.
For people who have received their primary course of vaccination and one booster dose, there is no risk of further jabs, but the benefits are small, WHO vaccine experts said Tuesday.
The UN Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE) has released updated recommendations following its regular semi-annual meeting. The new advice reflects the impact of the dominant Omicron variant of the virus and the high levels of immunity now achieved in the population through infection and vaccination, the WHO said.
SAGE introduced three new, simplified priority categories for COVID-19 vaccination: high, medium, and low, based on the risk of serious illness or death.
It also recommended additional booster shots after the first one only for those at the highest risk of developing serious COVID-19 disease. They include older adults; younger adults with comorbidities such as diabetes; people with immunocompromising conditions such as HIV; pregnant woman; and frontline health workers.
The medium-risk group includes healthy adults, mostly younger than 60 years, and children and adolescents with comorbidities. SAGE recommends a primary series and an initial booster dose.
“When it comes to the intermediate risk group, additional booster doses … are no longer recommended,” says SAGE President Hanna Nohynek.
“The vaccine is safe and it’s effective against serious illness and death,” she said, pointing out that for the intermediate-risk group, while there’s no harm in getting another shot, “the benefit of these extra boosters is actually quite marginal”.
Burden higher in infants
The low-risk group includes healthy children and adolescents aged six months to 17 years.
While primary and booster doses are safe and effective for this group given the low disease burden of COVID-19, SAGE said countries’ vaccination decisions should be based “on contextual factors,” such as health program priorities and cost-effectiveness.
“While generally low, the burden of severe COVID-19 in infants under 6 months of age is still higher than in children aged 6 months to 5 years,” it said.
Vaccinating pregnant people – even with an extra dose if more than six months have passed since the last dose – protects both them and the foetus, while helping to reduce the likelihood of infants being hospitalized for COVID-19.
As for the impact of COVID-19 vaccines on long-term COVID or post-infection conditions, “evidence on the magnitude of their impact is inconsistent,” SAGE said.
Nearly 13.3 billion COVID-19 vaccine doses have been administered worldwide.
WHO looking for new vaccines
WHO vaccine chief Kate O’Brien said that with the Omicron variant, the existing vaccines provide very good immunity against severe disease, but “frankly they don’t last very long for the performance they have against mild disease or infection”.
The WHO is looking for new COVID-19 vaccines that cover a broad spectrum of variants, have a longer shelf life and better performance against infection and transmission.
It’s also looking for vaccines beyond injection methods and ultra-cold-chain storage, O’Brien said, citing nasal, oral and skin patch vaccine methods.
Speaking about two nasal-administered vaccines, specifically one used in China, Joachim Hombach, SAGE’s executive secretary, said: “We know they are immunogenic…a big difference.”
