CDC ACIP Must Recommend Vaccines For All Every 6 Months

Posted by Eric Stein - September 9, 2023 CE @ 04:36:03 UTC
I'm really hoping that the CDC ACIP committee has the sense to recommend the vaccine every 6 months to anyone willing to take it. It's an open question whether that will be their decision on September 22nd. The meeting was originally announced to be taking place on September 12th but it appears this has been changed. I just submitted my written comment about their upcoming meeting to the federal register a few minutes ago shortly before the written comment period expired. Please give it a read.

Docket No. CDC–2023–0060


Vaccines have been the cornerstone of public health response since they were first developed. At this point in the COVID-19 pandemic, while the HHS declared PHE has been ended, nobody who is following the state of infections, disease, and long term effects of any infection believes that the pandemic is "over". One of the last effective things that people are encouraged to do by public health messaging and public officials to blunt the impact of the pandemic on their lives is to get vaccinated. It is rational for people to not want to get sick. People getting sick despite vaccination can and does happen in the absence of masking and ventilation improvements, but getting boosted regularly reduces this risk. The efficacy against any infection is of course not the only reason to encourage vaccination, but everyone in the US and around the world deserves the best protection against getting sick and vaccinations at this time, are most effective for a bit less than six months[1]. People want to avoid illness for all kinds of reasons: because it's unpleasant to be sick, because of the risk of death or hospitalization, because of the high[2] and increasing[3] with each infection risk of long term COVID complications - or even because they can lose income or their jobs if they do not show up to work.

Due to the clear loss of a majority of the protection against any infection (each infection carrying with it severe risks to long term quality of life directly and indirectly) at around six months, everyone deserves the right to a COVID vaccine every 6 months. If CDC does not recommend an every 6 month schedule, many or most people will have significant trouble getting one every six months whether logistically because their doctor won't prescribe it, or their pharmacist won't administer it, or their insurance will not pay for it. Recommending a vaccine every six months won't stop people who only want to get vaccinated once a year from only getting vaccinated once per year. There is no reason to move to a yearly-only schedule with the vaccines we have today that wane in this manner.

It would also also makes no sense to increase the risk of young people to become infected, which comes with a 12%-16% risk of Long COVID per infection[4] by making an arbitrary decision to remove access from those who are not either high risk or elderly. To add to this, every infection of a child - like every other infection - also comes with a risk of infecting others either at school, at home, or in the community.

In sum, everyone must be eligible and recommended a COVID-19 vaccine dose every 6 months as a bare minimum of public health response in the continuing pandemic. Even if COVID-19 were to become endemic instead of a continual series of epidemic outbreaks overlapping each other as we see today in the continuing pandemic, this would mean that the risk of infection with COVID-19 with its severe impacts on quality of, or continuance of, human life, would be ever present and the availability of a vaccine every 6 months is essential. COVID-19 shows no signs of becoming seasonal in any sense similar to influenza at this point and we should not make policy as if it has done so.

Citations

1) Chemaitelly H, Tang P, Hasan MR, AlMukdad S, Yassine HM, Benslimane FM, Al Khatib HA, Coyle P, Ayoub HH, Al Kanaani Z, Al Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul Rahim HF, Nasrallah GK, Al Kuwari MG, Al Romaihi HE, Butt AA, Al-Thani MH, Al Khal A, Bertollini R, Abu-Raddad LJ. Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar. N Engl J Med. 2021 Dec 9;385(24):e83. doi: 10.1056/NEJMoa2114114. Epub 2021 Oct 6. PMID: 34614327; PMCID: PMC8522799. - figure 2 (https://pubmed.ncbi.nlm.nih.gov/34614327/#&gid=article-figures&pid=figure-2-uid-1)
2) Ford ND, Slaughter D, Edwards D, et al. Long COVID and Significant Activity Limitation Among Adults, by Age — United States, June 1–13, 2022, to June 7–19, 2023. MMWR Morb Mortal Wkly Rep 2023;72:866–870. DOI: http://dx.doi.org/10.15585/mmwr.mm7232a3
3) Bowe, B., Xie, Y. & Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 28, 2398–2405 (2022). https://doi.org/10.1038/s41591-022-02051-3
4) Long COVID in Children and Young after Infection or Reinfection with the Omicron Variant: A Prospective Observational Study
Pinto Pereira, Snehal M.Buszewicz, Marta et al. The Journal of Pediatrics, Volume 259, 113463
Last Edited September 9, 2023 CE @ 04:49:20 UTC

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