Economy 29 March 2023, 9:47am

Not everyone needs COVID-19 shots anymore - WHO

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Updating its guidance on vaccines, the World Health Organisation (WHO) has said that healthy children and adolescents may no longer need to be vaccinated against SARS-CoV-2. The world is gradually adapting to living with the virus permanently, while fewer people are queuing up for vaccinations.

Following its 20-23 March meeting, WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) revised the roadmap for prioritizing the use of COVID-19 vaccines, to reflect the impact of Omicron and high population-level immunity due to infection and vaccination.

The roadmap

continues SAGE’s prioritization of protecting populations at the greatest risk of death and severe disease from SARS-CoV-2 infection and its focus on maintaining resilient health systems
newly considers the cost-effectiveness of COVID-19 vaccination for those at lower risk – namely healthy children and adolescents – compared to other health interventions.
also includes revised recommendations on additional booster doses and the spacing of boosters.

The current COVID-19 vaccines’ reduction of post-COVID conditions is also considered but the evidence on the extent of their impact is inconsistent, the WHO said.

“Updated to reflect that much of the population is either vaccinated or previously infected with COVID-19, or both, the revised roadmap reemphasizes the importance of vaccinating those still at-risk of severe disease, mostly older adults and those with underlying conditions, including with additional boosters,” stated SAGE Chair Dr Hanna Nohynek.

Countries should consider their specific context in deciding whether to continue vaccinating low risk groups, like healthy children and adolescents, while not compromising the routine vaccines that are so crucial for the health and well-being of this age group.

The revised roadmap outlines three priority-use groups for COVID-19 vaccination: high, medium, and low. These priority groups are principally based on risk of severe disease and death, and consider vaccine performance, cost-effectiveness, programmatic factors and community acceptance.

The high priority group includes

older adults;
younger adults with significant comorbidities (e.g. diabetes and heart disease);
people with immunocompromising conditions (e.g. people living with HIV and transplant recipients), including children aged 6 months and older;
pregnant persons; and
frontline health workers.

For the high priority group, SAGE recommends an additional booster of either 6 or 12 months after the last dose, with the timeframe depending on factors such as age and immunocompromising conditions. All the COVID-19 vaccine recommendations are time-limited, applying for the current epidemiological scenario only, and so the additional booster recommendations should not be seen as for continued annual COVID-19 vaccine boosters. The aim is to serve countries planning for the near- to mid-term.

The medium priority group includes

healthy adults – usually under the age of 50-60 – without comorbidities and children and adolescents with comorbidities.

SAGE recommends primary series and first booster doses for the medium priority group. Although additional boosters are safe for this group, SAGE does not routinely recommend them, given the comparatively low public health returns.

The low priority group includes

healthy children and adolescents aged 6 months to 17 years.

Primary and booster doses are safe and effective in children and adolescents. However, considering the low burden of disease, SAGE urges countries considering vaccination of this age group to base their decisions on contextual factors, such as the disease burden, cost effectiveness, and other health or programmatic priorities and opportunity costs.

The public health impact of vaccinating healthy children and adolescents is comparatively much lower than the established benefits of traditional essential vaccines for children – such as the rotavirus, measles, and pneumococcal conjugate vaccines – and of COVID-19 vaccines for high and medium priority groups.

Children with immunocompromising conditions and comorbidities do face a higher risk of severe COVID-19, so are included in the high and medium priority groups respectively.

Though low overall, the burden of severe COVID-19 in infants under 6 months is still higher than in children aged 6 months to 5 years. Vaccinating pregnant persons – including with an additional dose if more than 6 months have passed since the last dose – protects both them and the fetus, while helping to reduce the likelihood of hospitalization of infants for COVID-19.

The organisation's recommendations come as vaccination uptake is falling in every country from China to the United States, with just 16% of Americans, for example, taking the latest dose, which was targeted at the Omicron version, Bloomberg reported earlier this month.

The downturn will not only have financial implications for vaccine manufacturers, including Pfizer and Moderna, but also raise concerns among public health experts who believe that the best way to protect against the coronavirus is to administer booster shots.

Key coronavirus and vaccination statistics in Hungary

A total of 434 doses of Covid vaccines were administered in Hungary on the seven days up to 28 March, which translates into 62 per day. The number of 4th shots rose by 53% to 197, there was a 7.3% rise to 44 in the number of 3rd doses administered, a 5.1% growth to 143 in 2nd jabs and a 6.4% growth to 50 in 1st shots.