A federal vaccine committee discussed priorities for a future COVID-19 vaccine Wednesday in addition to approving flu vaccine recommendations and a new meningococcal vaccine.
The director of the Centers for Disease Control and Prevention (CDC) must approve the committee’s recommendations, before they can be published as official recommendations in the Morbidity and Mortality Weekly Report.
The CDC’s Advisory Committee on Immunization Practices (ACIP) has formed a work group to study COVID-19 vaccines as they are developed and formulate policies for use in the U.S. The group said its objectives are to ensure vaccines are safe, effective and distributed equitably. Leaders said the group wants to reduce illnesses and deaths as well as disruption to society.
Among the group’s considerations is who should be prioritized for a vaccine once one is available. Priority populations likely will include health care workers and people at highest risk of severe disease.
There are 141 COVID-19 vaccine candidates in development around the world, of which 16 are in clinical trials, according to a report from the World Health Organization.
Both SARS-CoV-2 and influenza are likely to be circulating in the fall, making flu vaccines even more important than usual, officials said. They expect more than 180 million doses to be available.
“I don’t care if you think the flu shot is something you’re never going to do in a million years. This is the year you’ve got to do it,” said John T. Brooks M.D., chief medical officer of the CDC’s COVID response team.
ACIP did not make major changes to the CDC’s flu vaccine policy for the 2020-’21 season. It continues to recommend everyone 6 months and older without contraindications be vaccinated with either a flu shot or nasal spray. The AAP is making the same recommendation.
The CDC’s policy will clarify that live attenuated influenza vaccine (LAIV) should not be used for people with asplenia, cochlear implants or active cerebrospinal fluid leaks.
It also includes updated recommendations on the use of antivirals that can interfere with LAIV4. This interference may occur if oseltamivir or zanamivir is used 48 hours before to two weeks after LAIV4, if peramivir is used five days before to two weeks after LAIV4 or if baloxavir is used 17 days before to two weeks after LAIV4.
Two egg-free vaccines are included in the policy. People who have severe egg allergies and are not getting one of these two vaccines should be vaccinated by a health care provider who can manage a severe reaction.
Other changes in CDC policy for the 2020-’21 season include updated strains in the vaccine and the addition of two new vaccines that have been licensed for people 65 and older.
During the 2019-’20 season, flu vaccines reduced visits to a doctor by 39% overall, which is lower than preliminary estimates from February. The vaccine was 31% effective against influenza A (H1N1)pdm09 and 44% effective against influenza B/Victoria, according to the CDC.
An early surge of influenza B made the 2019-’20 season an especially tough one for children. The latest figures show 185 children died, nearly reaching the regular season record of 188 in 2017-’18. Typically, about 80% of the children who die each season were not fully vaccinated.
Overall, the CDC estimates as many as 39 million to 56 million people got sick, 410,000 to 740,000 were hospitalized and 24,000 to 62,000 died this past season.
ACIP also voted to add a new meningococcal conjugate (MenACWY) vaccine to the Vaccines for Children program, which provides vaccinations to low-income children.
The Food and Drug Administration licensed MenACWY-TT (MenQuadfi) from Sanofi in April for people ages 2 and older. The vaccine uses a tetanus toxoid as a protein carrier.
ACIP continues to recommend routine vaccination for meningococcal disease at ages 11-12 years and a booster dose at age 16. Children 2 months and older who are at increased risk for meningococcal disease also should be vaccinated.
Roughly 10% of people with meningococcal disease die despite antibiotics, and about 20% of survivors have long-term health impacts like hearing loss, amputations and cognitive defects, according to the CDC.