Know Who Needs a COVID-19 “Booster” This Spring

You’ll hear questions about which patients need another COVID-19 vaccine this spring.

CDC now says that patients age 65 or older who already had a 2023-2024 COVID-19 vaccine should get an additional dose.

It’s partly because COVID-19 transmission remains substantial year-round and cases tend to go up in the summer...unlike flu or RSV.

And vaccine effectiveness is expected to wane over time.

But be aware that about 60% of patients 65 and up still haven’t even received a first 2023-2024 COVID-19 vaccine.

Expect clinicians to continue to recommend vaccination...discuss concerns...and share info with these patients.

For example, there are still about 20,000 COVID-19 hospitalizations and 2,000 deaths weekly...and older adults are most at risk. But vaccination may cut the risk of severe illness by about half.

Anticipate that older patients who already got the 2023-2024 COVID-19 vaccine will be offered an additional dose...especially in those at greatest risk, such as over 75 or with chronic conditions (heart disease, diabetes, etc).

Keep in mind that there should be an interval of at least 4 months after the last COVID-19 vaccine...or 3 months since a COVID-19 infection...prior to administration of the additional dose.

And ideally patients should get the additional dose by they can also get a 2024-2025 COVID-19 vaccine in fall.

Note that older adults can get any brand of an age-appropriate COVID-19 vaccine for the additional dose.

Be aware, there’s no change to the recommendations for moderately or severely immunocompromised patients 6 months and older. These patients and their providers can consider additional doses of the 2023-2024 COVID-19 least 2 months after the prior dose as needed.

Don’t expect immunocompetent adults under 65 to get an additional dose...there’s not enough added benefit and it’s not cost-effective.

Anticipate that FDA will decide on the strains for the 2024-2025 COVID-19 vaccines in May...and CDC will vote on the fall plan in June.

Check our resource, COVID-19 Vaccines, for updates.

Key References

  • CDC. Use of COVID-19 vaccines in the United States. Interim clinical considerations. Last updated March 1, 2024. (Accessed March 5, 2024).
  • CDC. Older Adults Now Able to Receive Additional Dose of Updated COVID-19 Vaccine. Last updated February 28, 2024. (Accessed March 5, 2024).
  • CDC. ACIP Presentation Slides: February 28-29, 2024 Meeting. Last updated February 29, 2024. (Accessed March 5, 2024).
  • Wallace M. Evidence to Recommendations Framework: Additional Dose of 2023-2024 Formula COVID-19 Vaccine in Older Adults. Last updated February 28, 2024. (Accessed March 5, 2024).
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