The Newest Version of COVID-19 Vaccines - Who Will Benefit Most?

Friday - September 15 2023, 11:17 UTC - 1 year ago

Covid case numbers have been rising across the United States since mid-July, so the updated covid-19 shots from Moderna and Pfizer comming as a relief. The new vaccine has been recommended to those six months and older, with higher risk of serious illness and death given to those immunocompromised and with existing conditions. Nearly all Americans have some sort of immunity for covid, so those without boosted immunity still have high levels of protection against severe illness.

Covid case numbers have been rising across the United States since mid-July. So the news that updated covid vaccines are finally available comes as a relief to many. The first updated covid-19 shots from Moderna and Pfizer, which target an omicron variant known as XBB, hit some pharmacies as early as yesterday, and many more doses will be administered in the coming days.

On September 12, the US Centers for Disease Control and Prevention recommended that everyone six months or older get the new vaccine, predicting that following this advice could prevent 400,000 hospitalizations and 40,000 deaths over the next two years. The announcement has once again sparked a debate about who should get vaccinated, and who will benefit most from the new formulation.

"I would not recommend anything to others that I wouldn’t recommend for my own family," wrote CDC director Mandy Cohen in an op-ed on Wednesday. "My 9- and 11-year-old daughters, my husband, my parents and I will all be rolling up our sleeves to get our updated Covid-19 vaccines along with our flu shots soon." .

A universal recommendation has the benefit of being simple to communicate and implement, but some other medical experts have mixed feelings about the decision. "What I want to see is the ability of parents and physicians to choose to vaccinate across the age span," says Gregory Poland, a vaccine expert at the Mayo Clinic in Rochester. "That’s different than saying, ‘I think everybody aged six months and older should receive this vaccine.’"Jennifer Nuzzo, an epidemiologist at Brown University, agrees. "The data don’t say that the vaccines produce equal benefits for all age groups," she says. "I think the recommendation should reflect that fact." .

For Kawsar Talaat, an infectious disease physician at Johns Hopkins School of Medicine, the benefits outweigh the risk for almost everyone: "The reality is [covid] can be severe in anybody." That includes younger people who are otherwise healthy. The CDC presented data to its advisory panel on Tuesday showing that 54% of infants, children, and adolescents who ended up in the hospital with covid did not have an underlying condition.

So who will benefit most from a booster? On that question, experts agree. Older adults, people who are immunocompromised, and those with multiple underlying conditions that put them at risk for serious illness should get the updated vaccine. That group includes Poland, who is 68. Adults 65 and older have a far greater risk of hospitalization and death than any other age group.

Between January and the third week of July, more than 24,000 adults over 65 died of covid-19 related causes, nearly nine times the number of deaths reported in people aged 45 to 64. Pregnant people also have a higher risk of developing serious illness.

The benefits for other groups aren’t quite as stark. Nearly all Americans have some existing immunity to covid through infection, vaccination, or both. "We still think that people who are not boosted have high levels of protection against severe illness, and we know that we’re using vaccines primarily to prevent severe illness," Nuzzo says. A modeling analysis by Talaat and others supports that conclusion.