Updated guidance on COVID vaccination by the World Health Organization (WHO) states that only high-risk groups should receive ongoing booster doses because they offer little impact in the general population. Instead, efforts should focus on high-risk populations.
Notably, WHO assigns the lowest priority to healthy children and adolescents aged six months to 17 years, states Doctors for Disaster Preparedness (DDP) president Jane M. Orient, M.D.
In low-to-medium risk groups, the benefit of additional boosters is “actually quite marginal, based on what we know of the immune status of these people,” stated Hanna Nohynek, chair of WHO’s Strategic Advisory Group of Experts on Immunization (SAGE).
Priority groups, according to SAGE, are principally defined based on risk of severe disease and death. Considerations include vaccine performance, cost-effectiveness, programmatic factors, and community acceptance. The high priority group includes older persons, pregnant persons, and frontline health workers.
WHO’s assumption about effectiveness against severe disease and death has been challenged on the basis of inadequate evidence, Dr. Orient points out. Pregnant persons were excluded from vaccine trials, and SAGE does not comment on pregnancy outcomes. Some physicians consider safety signals significant enough to warrant withdrawal of COVID-19 vaccines from the market.
SAGE considers both the primary series and boosters to be safe. It urges countries to base their decisions on “contextual factors, such as the disease burden, cost effectiveness, and other health or programmatic priorities and opportunity costs.”
DDP urges decisionmakers to review WHO’s revised guidance, as well as other views, in making risk-to-benefit assessments.Doctors for Disaster Preparedness provides information to help save lives in the event of natural or man-made disasters.