Updated (October 2024) CDC guidelines recommend more frequent Covid vaccination for those at risk

In late October 2024, the Centers for Disease Control and Prevention (CDC) updated its Covid vaccine guidance, recommending additional doses for high-risk groups (Figure 1). The new guidelines focus on adults aged 65 and older and individuals with moderate to severe immunocompromised conditions.

People 65+ are advised to get a second dose of the updated Covid vaccines (released in fall) six months after their initial dose. Those with compromised immune systems, such as advanced HIV patients, chemotherapy recipients, and those on certain autoimmune therapies, are eligible for three or more doses.

The rationale is to provide additional protection to those at higher risk of severe illness or death from Covid. It is known that vaccine efficacy wanes over time with the amount of neutralizing antibody in the blood elicited by the vaccine declining at around 6 months.

Unlike flu which tends to be seasonal and reappear every year in a new form (i.e. new strain), Covid has been more persistent and hence the need for year-round protection. The current generation of vaccines (2024-25) have been designed to combat circulating Covid variants, which have not changed too dramatically in recent months.

Despite the recommendation, Covid vaccine uptake has been low; as of October 12, only about 12% of adults had received an updated vaccine dose. More public education should be a priority.

In summary, the CDC’s new recommendation (which still applies today) represents a shift in vaccination policy from the annual one-size-fits-all vaccination strategy used with flu to a more flexible approach with more frequent dosing for those at risk, which makes sense given the persistent and deadly nature of Covid.

Figure 1. Updated CDC guidelines recommending more frequent Covid vaccination for those at risk (https://www.cdc.gov/media/releases/2024/s1023-covid-19-vaccine.html).