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Healthy adults don’t need annual COVID boosters, WHO advisors say

The advice clashes with FDA's suggestion to treat COVID boosters like flu shots.

ARS TECHNICA – A vaccine advisory group for the World Health Organization said Tuesday that, at this point, it does not recommend additional, let alone annual COVID-19 booster shots for people at low to medium risk of severe disease.

It advised countries to focus on boosting those at high risk—including older people, pregnant people, and those with underlying medical conditions—every six to 12 months for the near- to mid-term.

The new advice contrasts with proposed plans by US Food and Drug Administration, which has suggested treating COVID-19 boosters like annual flu shots for the foreseeable future.

That is, agency officials have floated the idea of offering updated formulations each fall, possibly to everyone, including the young and healthy.

In a viewpoint published last May in JAMA, the FDA’s top vaccine regulator, Peter Marks, along with FDA Commissioner Robert Califf and Principal Deputy Commissioner Janet Woodcock, argued that annual COVID booster campaigns in the fall, ahead of winter waves of respiratory infections—such as flu, COVID-19, and RSV—would protect health care systems from becoming overwhelmed.

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And they specifically addressed the possibility of vaccinating those at low risk.

“The benefit of giving additional COVID-19 booster vaccines to otherwise healthy individuals 18 to 50 years of age who have already received primary vaccination and a first booster dose is not likely to have as marked an effect on hospitalization or death as in the other populations at higher risk,” the FDA officials wrote.

“However, booster vaccinations could be associated with a reduction in health care utilization (e.g., emergency department or urgent care center visits).”

In a press briefing Tuesday, WHO advisors called the benefit of boosting those at low or even medium risk “actually quite marginal” and suggested that countries could even roll back offering primary COVID-19 vaccination series to low-risk healthy children and teens based on country-specific conditions and resources.

Context and limits

These updated recommendations “reflect that much of the population is either vaccinated or previously infected with COVID-19, or both … ”

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