CDC Recommends Additional Dose of New COVID-19 Vaccines for Older Adults

An infectious disease expert breaks down what to know about the FDA-approved shots that target the circulating COVID-19 variants.

The Centers for Disease Control and Prevention (CDC) recently announced that Americans 65 years of age and older are eligible to receive an additional dose of the updated 2023-2024 COVID-19 vaccine.

Older adults are at an increased risk of severe disease from COVID-19, the CDC noted – more than half of COVID-19 hospitalizations from October 2023 to December 2023 were people in this age range.

In the fall of 2023, the Food and Drug Administration (FDA) approved and authorized new COVID-19 vaccines for use that better target current circulating variants. The CDC later recommended at least one dose of the updated vaccines, made by Pfizer-BioNTech, Moderna, and Novavax for anyone 6 months and older.

“It is important to get vaccinated with one of these new formulations to stay protected from COVID-19 and stay up to date with other vaccines, such for the flu and RSV,” says Dr. Magdalena Sobieszczyk, chief of the Division of Infectious Diseases at NewYork-Presbyterian/Columbia University Irving Medical Center. “For older adults and immunocompromised people, who are also eligible for additional shots, getting another dose of the new vaccines will better protect them against new variants as the virus continues to evolve.”

Currently, JN.1 accounts for about 96.4% of the variants that are currently circulating in the U.S., the CDC estimates. A report released in February 2024 from the CDC shared that the updated vaccine provided approximately 54 percent protection against symptomatic infection, compared with no receipt of the updated vaccine. “We are seeing good data that this updated vaccine can elicit robust antibodies against current and emerging SARS-CoV-2 variants,” says Dr. Sobieszczyk, who is also a professor of infectious diseases in medicine at Columbia University Vagelos College of Physicians and Surgeons. “That’s good news for effectiveness of the vaccine in preventing some degree of infection and severe disease.”

CDC’s 2023–24 COVID-19 Vaccine Recommendations

  • Everyone ages 5 years and older is recommended to get one dose of the 2023-24 COVID-19 vaccine to be up to date.
  • Children ages 6 months to 4 years and people who are moderately or severely immunocompromised need multiple doses, including at least one 2023-24 COVID-19 vaccine dose, to be up to date. Older adults 65 years of age and older are also eligible to receive an additional dose at least 4 months following the previous dose of the updated vaccine.
  • People who are moderately to severely immunocompromised may get additional doses of the 2023-24 COVID-19 vaccine.

Following guidance from the FDA in June 2023, Moderna, Pfizer, and Novavax updated their vaccines to target the Omicron variant XBB.1.5. “Compared to the bivalent booster, an older formulation, the updated shots improve protection by creating an immune response in our bodies against new variants,” says Dr. Sobieszczyk.

Dr. Magdalena Sobieszczyk

The bivalent booster is no longer available in the U.S. since it targeted the BA.4 and BA.5 lineages of the Omicron variant and the original coronavirus strains, which are no longer circulating.

Similar to the yearly flu vaccine, the FDA is anticipating that they will need to meet on an annual basis to understand how COVID-19 is evolving, review data on circulating strains, and advise manufacturers on which strains should be selected for the vaccine each year.

“Updating the vaccine composition might be a continuous process given that COVID-19 is mutating a lot,” says Dr. Sobieszczyk. “Getting vaccinated with an updated shot will not only benefit the individual but also the community around them. While the vaccine does not eliminate the risk of getting COVID-19, it makes the virus mild, shortens the duration of infection, lowers the risk of transmitting it to others, and protects those who are more vulnerable from severe disease.”

Magdalena Sobieszczyk, M.D., is the chief of the Division of Infectious Diseases at NewYork-Presbyterian/Columbia University Irving Medical Center and is the Harold Neu professor of infectious diseases in medicine at Columbia University Vagelos College of Physicians and Surgeons. Dr. Sobieszczyk is also a clinical virologist and the principal investigator of the Columbia Collaborative Clinical Trials Unit, funded by the National Institutes of Health, which has been advancing the science of infections like SARS-CoV-2 and HIV.

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