CDC Updates Vaccine Recommendations

Summary

What CDC knows

Vaccines are an effective tool for protecting Americans against the most severe effects of many infectious diseases.

What CDC is doing

CDC updated its vaccine recommendations for COVID-19 and pneumococcal disease based on advice from the Advisory Committee on Immunization Practices (ACIP). These updated recommendations are now official CDC public health guidance and will be published as official recommendations in the Morbidity and Mortality Weekly Report (MMWR). CDC will communicate these recommendations to the public, healthcare providers, and public health professionals to ensure everyone has the information needed to protect their health from vaccine-preventable diseases.

CDC recommends second dose of COVID-19 vaccine for certain populations

CDC now recommends a second dose of the 2024-2025 COVID-19 vaccine for two groups:

• People 65 years and older and
• Everyone 6 months and older who are moderately or severely immunocompromised

The second dose of the 2024-2025 COVID-19 vaccine is recommended six months after the first dose. These groups remain at higher risk of severe COVID-19, and these updated recommendations help maximize their protection year-round. Data continue to confirm the importance of vaccination to protect those most at risk for severe outcomes of COVID-19. Also, data on COVID-19 vaccine effectiveness indicate that protection against COVID-19-associated emergency department and urgent care visits and hospitalization likely wanes by four to six months after vaccination. Fortunately, protection from admission to the intensive care unit, a sign of critical illness, lasts longer.

Additionally, data show that SARS-CoV-2, the virus that causes COVID-19, continues to circulate year-round, with peaks typically occurring in the winter and late summer.

CDC previously recommended that people who are moderately or severely immunocompromised may get additional doses of the COVID-19 vaccine, in consultation with a healthcare provider. Historically in years past, uptake of these additional doses for this group was low. ACIP voted to provide a clear recommendation for people who are six months or older and are moderately or severely immunocompromised to receive a second dose of 2024-2025 COVID-19 vaccine 6 months after their first dose.

These updated recommendations also allow for flexibility for additional doses (i.e., three or more) for people who are moderately or severely immunocompromised, in consultation with their healthcare provider (a strategy known as shared clinical decision making). These additional doses can be timed around immunosuppressive treatments, such as chemotherapy, after which some people may be at increased risk of severe COVID-19. These doses can also be timed around activities like travel or other life events, during which people may have increased risk of exposure to the virus that causes COVID-19.

CDC expands age-based recommendations for pneumococcal vaccine

CDC also lowered the age for which it recommends adult pneumococcal vaccination from 65 to 50 years old. Pneumococcal bacteria can cause serious illnesses, including pneumonia, meningitis, and bloodstream infections. Vaccination is the best way to prevent pneumococcal disease.

The updated age-based recommendation could improve pneumococcal vaccination coverage among adults 50 through 64 years old with a risk condition. Risk conditions include chronic conditions, immunocompromising conditions, and other factors that can increase someone's risk for pneumococcal disease. Previously, a healthcare provider and patient needed to be aware of a risk condition to know pneumococcal vaccination was recommended.

Now, all adults in the 50 through 64 age range should get vaccinated, which could improve equity since Black adults tend to get pneumococcal disease at a younger age than non-Black adults.

Adults who are 19 through 49 years old with risk conditions should continue to get vaccinated against pneumococcal disease. Examples of risk conditions include:

• Cigarette smoking
• Diabetes
• Chronic heart, liver, or lung disease
• Sickle cell disease
• Immunocompromising conditions

There are now three pneumococcal conjugate vaccines (PCV15, PCV20, PCV21) available for adult vaccination. Healthcare providers can use any of these products to vaccinate adults against pneumococcal disease. Typically, only one dose of pneumococcal vaccine is needed as an adult. However, if PCV15 is used, a second type of vaccine (pneumococcal polysaccharide vaccine, PPSV23) is needed.