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WHO Revises COVID-19 Vaccine Recommendations for Omicron-Era

Workers walk on a street in Beijing, China, 27 March, 2023. (EPA)
Workers walk on a street in Beijing, China, 27 March, 2023. (EPA)
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WHO Revises COVID-19 Vaccine Recommendations for Omicron-Era

Workers walk on a street in Beijing, China, 27 March, 2023. (EPA)
Workers walk on a street in Beijing, China, 27 March, 2023. (EPA)

The World Health Organization has tailored its COVID-19 vaccination recommendations for a new phase of the pandemic, suggesting that healthy children and adolescents may not necessarily need a shot but older, high-risk groups should get a booster between 6 to 12 months after their last vaccine.

The UN agency said the aim was to focus efforts on vaccinating those facing the greatest threat of severe disease and death from COVID-19, considering the high-level population immunity worldwide due to widespread infection and vaccination.

The health agency defined high-risk populations as older adults, as well as younger people with other significant risk factors. For this group, the agency recommends an additional shot of the vaccine either 6 or 12 months after the latest dose, based on factors such as age and immunocompromising conditions.

Meanwhile, it said healthy children and adolescents were "low priority" for COVID-19 vaccination, and urged countries to consider factors like disease burden before recommending vaccination of this group. It said the COVID-19 vaccines and boosters were safe for all ages, but the recommendations took into account other factors like cost-effectiveness.

The WHO said in September last year that the end of the pandemic was "in sight". In a briefing on Tuesday, the agency said its latest advice reflected the current disease picture and global immunity levels, but should not be seen as long-term guidance over whether annual boosters would be needed.

The recommendations come as countries take differing approaches. Some high-income countries like the United Kingdom and Canada are already offering those at high-risk COVID-19 boosters this spring, six months after their last dose.

"The revised roadmap re-emphasizes the importance of vaccinating those still at-risk of severe disease," said Hanna Nohynek, chair of the WHO's Strategic Group of Experts on immunization, which made the recommendations.

The committee also called for urgent efforts to catch up on routine vaccinations missed during the pandemic and warned of a rise in vaccine-preventable diseases like measles.

For COVID, it said that vaccines beyond the initial two shots and a booster were no longer routinely recommended for those at "medium risk" as benefits were marginal.

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Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
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Blood Tests Allow 30-year Estimates of Women's Cardio Risks, New Study Says

A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights
A woman jogs in a park in Saint-Sebastien-sur-Loire near Nantes, France January 19, 2024. REUTERS/Stephane Mahe/File Photo Purchase Licensing Rights

Women’s heart disease risks and their need to start taking preventive medications should be evaluated when they are in their 30s rather than well after menopause as is now the practice, said researchers who published a study on Saturday.

Presenting the findings at the European Society of Cardiology annual meeting in London, they said the study showed for the first time that simple blood tests make it possible to estimate a woman’s risk of cardiovascular disease over the next three decades.

"This is good for patients first and foremost, but it is also important information for (manufacturers of) cholesterol lowering drugs, anti-inflammatory drugs, and lipoprotein(a)lowering drugs - the implications for therapy are broad," said study leader Dr. Paul Ridker of Brigham and Women’s Hospital in Boston, Reuters reported.

Current guidelines “suggest to physicians that women should generally not be considered for preventive therapies until their 60s and 70s. These new data... clearly demonstrate that our guidelines need to change,” Ridker said. “We must move beyond discussions of 5 or 10 year risk."

The 27,939 participants in the long-term Women’s Health Initiative study had blood tests between 1992 and 1995 for low density lipoprotein cholesterol (LDL-C or “bad cholesterol”), which are already a part of routine care.

They also had tests for high-sensitivity C-reactive protein (hsCRP) - a marker of blood vessel inflammation - and lipoprotein(a), a genetically determined type of fat.

Compared to risks in women with the lowest levels of each marker, risks for major cardiovascular events like heart attacks or strokes over the next 30 years were 36% higher in women with the highest levels of LDL-C, 70% higher in women with the highest levels of hsCRP, and 33% higher in those with the highest levels of lipoprotein(a).

Women in whom all three markers were in the highest range were 2.6 times more likely to have a major cardiovascular event and 3.7 times more likely to have a stroke over the next three decades, according to a report of the study in The New England Journal of Medicine published to coincide with the presentation at the meeting.

“The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces,” Ridker said.

“The therapies we might use in response to an elevation in each biomarker are markedly different, and physicians can now specifically target the individual person’s biologic problem.”

While drugs that lower LDL-C and hsCRP are widely available - including statins and certain pills for high blood pressure and heart failure - drugs that reduce lipoprotein(a) levels are still in development by companies, including Novartis , Amgen , Eli Lilly and London-based Silence Therapeutics.

In some cases, lifestyle changes such as exercising and quitting smoking can be helpful.

Most of the women in the study were white Americans, but the findings would likely “have even greater impact among Black and Hispanic women for whom there is even a higher prevalence of undetected and untreated inflammation,” Ridker said.

“This is a global problem,” he added. “We need universal screening for hsCRP ... and for lipoprotein(a), just as we already have universal screening for cholesterol.”