The World Health Organization (WHO) has updated its recommendations for the distribution of COVID-19 vaccines. The new guidelines from the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) prioritize high-risk groups, including older adults, people with comorbidities, pregnant persons, and healthcare workers. SAGE also acknowledges the competing health priorities when it comes to vaccinations, such as the need for children to catch up on routine vaccines missed during the pandemic.
WHO Revises Roadmap for Prioritizing COVID-19 Vaccines
According to the revised roadmap from SAGE, three priority-use groups for COVID-19 vaccination are outlined: high, medium and low risk. The revised plan prioritizes protecting populations at the greatest risk of death and severe disease from SARSCoV-2 infection while maintaining resilient health systems. For high-risk groups, SAGE recommends an additional booster dose of COVID-19 vaccine, including older adults, younger adults with comorbidities, people with immunocompromising conditions, pregnant persons, and frontline health workers.
For medium-risk groups, SAGE recommends primary series and the first booster doses with additional booster doses not routinely recommended. For low-risk groups, primary and booster doses are safe and effective but countries should base their decisions on contextual factors such as disease burden, cost-effectiveness, and other health or programmatic priorities.
WHO Updates Recommendations in Light of Omicron Stage
The new recommendations from SAGE take into consideration the current Omicron stage of the pandemic along with high population immunity levels due to vaccines and infection. These updates prioritize vaccines for those at greatest risk of death and severe disease while focusing on high-, medium-, and low-risk groups.
Additionally, SAGE recommends spacing out boosters based on the current COVID-19 vaccines’ reduction of post-COVID conditions. However, the evidence on the extent of their impact remains inconsistent.
Revised Guidance Indicates Falling Demand for COVID-19 Vaccines
The WHO’s revised guidance represents a significant step away from the previous stance of recommending a dose of a bivalent Covid-19 vaccine booster for anyone over the age of six months. WHO officials have voiced skepticism over the advantages of bivalent vaccines, which Moderna and Pfizer have rolled out in response to FDA requests.
The latest WHO guidelines also indicate falling global demand for COVID-19 vaccines. Pfizer and Moderna are expected to see a drop in COVID-19 vaccine sales from 2022 to 2024, according to FactSet. Despite this, Pfizer reaffirmed the importance of vaccination as one of the best lines of defenses against COVID-19.
Pregnant People and Children
SAGE advises vaccinating pregnant persons to protect infants under six months old. The vaccines are safe and effective for healthy children and teens up to 17 years old. Still, given the low burden of disease in that age group, countries should focus their efforts elsewhere.
Overall, the revised recommendations from SAGE aim to prioritize vaccination for those at greatest risk while balancing competing health priorities. These changes emphasize a need for adapting vaccine distribution strategies to address new developments in the pandemic.
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