ACIP recommends ≥1 updated COVID-19 vaccine booster for all children, adolescents

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) has recommended 2024 – 2025 COVID-19 vaccination with any vaccine approved or authorized through the US Food and Drug Administration (FDA) for all persons aged ≥6 months old.¹

A report published in the CDC Morbidity and Mortality Weekly Report (MMWR) this week confirmed the ACIP recommendation that children and adults ≥6 months old receive an FDA-approved or emergency-authorized COVID-19 vaccination to provide protection against circulating strains through the remainder of 2024, into 2025. The recommended vaccines include monovalent COVID-19 shots from Moderna, Pfizer-BioNTech or Novavax that have been updated to protect against the highly circulating Omicron JN.1 lineage of SARS-CoV-2.

COVID-19 associated hospitalizations among US patients aged 0 – 17 years old during the week of August 31 were at their lowest mark since May, according to data from the CDC showing a rate of 0.4 pediatric hospitalizations per 100,000.² In emphasizing the importance of the recommendation from the ACIP, CDC investigators wrote that among all children and adolescents admitted to a hospital with COVID-19 from July 2023 – March 2024, half had no underlying medical condition other than the infection.¹

“Among hospitalized children and adolescents aged ≤17 years with COVID-19 and no underlying medical conditions, 18% were admitted to an intensive care unit,” investigators wrote Age-adjusted COVID-19–associated hospitalization rates during October 2023–May 2024 were highest among non-Hispanic American Indian or Alaska Native persons, and non-Hispanic Black or African American persons.”

The FDA approved the updated 2024 – 2025 COVID-19 vaccines from both Moderna and Pfizer-BioNTech for use in persons aged ≥12 years old on August 22. The agency additionally granted an authorization—not full approval—for their use in children aged 6 months to 11 years old. Both products were designed to prevent SARS-CoV-2 via the KP.2 strain. A week later, the FDA granted another emergency authorization to Novavax’s 2024 – 2025 COVID-19 vaccine, based on the JN.1 strain, for persons aged ≥12 years old.

Because the FDA only granted emergency authorizations to each of the Novavax 2024 – 2025 vaccine as well as the Pfizer-BioNTech and Moderna vaccines for use in younger children, the ACIP’s recommendations for essentially any updated COVID-19 vaccine for use in children aged 6 months to 11 years old should be considered an “interim recommendation.”

The ACIP further recommended that children aged 5 – 11 years old without moderate to severe immunocompromised conditions need only 1 dose of a 2024 – 2025 COVID-19 vaccine from either of Pfizer-BioNTech, Moderna, or Novavax. Persons aged ≥12 years old without moderate to severe immunocompromised conditions need 1 dose of the updated vaccine from either Pfizer-BioNTech or Moderna.

Persons aged ≥12 years old who previously did not receive any COVID-19 vaccine and choose to get the Novavax shot should receive 2 doses of the updated vaccine. ACIP additionally recommended that children aged 6 months to 4 years old receive an initial multidose vaccination series with their first COVID-19 vaccination, which would require them to receive multiple COVID-19 vaccine doses to be up to date.

Among children aged ≥6 months old with a moderate to severe immunocompromised condition, ACIP recommends they receive ≥1 dose of the updated COVID-19 vaccines.

“Depending on vaccination history, additional doses may be recommended,” investigators wrote. “Unvaccinated persons aged 6 months–11 years who are moderately or severely immunocompromised are recommended to receive an initial 3-dose vaccination series of a 2024–2025 mRNA COVID-19 vaccine, with all doses from the same manufacturer.”

References

1. ^{Panagiotakopoulos L, Moulia DL, Godfrey M, et al. Use of COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024–2025. MMWR Morb Mortal Wkly Rep. ePub: 10 September 2024. DOI: http://dx.doi.org/10.15585/mmwr.mm7337e2}
2. ^{Centers for Disease Control and Prevention. COVID Data Tracker. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2024, September 11. https://covid.cdc.gov/covid-data-tracker}