Countries should consider vaccination for groups at highest risk of severe COVID-19 disease

Countries should consider routine COVID-19 vaccination with two doses per year, six months apart, for groups at highest risk of severe COVID-19 disease due to limited protection beyond six months after the last dose. These groups include the oldest adults; older adults with significant comorbidities or severe obesity; residents of nursing and long-term care facilities; An update was issued by the Strategic Advisory Group of Immunization Experts (SAGE), which held its regular biennial meeting March 9-12, to discuss, among other topics, current COVID-19 epidemiology and COVID-19 vaccine recommendations for different population groups, typhoid conjugate vaccine (TCV) dosing schedules, and the number of bivalent oral polio vaccine (bOPV) doses for moderately or severely immunocompromised individuals. routine vaccination.

SAGE on Immunization was established in 1999 by the Director-General of the World Health Organization (WHO) to provide guidance on WHO’s work and is WHO’s principal advisory group on vaccines and immunization. SAGE is interested not only in childhood vaccinations and immunization, but also in all vaccine-preventable diseases.

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At its last meeting, the group discussed the future of vaccination; experts considered how to strengthen global vaccination planning for the rest of the decade and help shape a long-term vision for the future of vaccines and immunization from 2026 to 2050.

“SAGE addressed vaccine prioritization and portfolio optimization and how WHO can support countries as they make difficult decisions about vaccination programs at a time when health budgets are tightening,” the statement said.

Meanwhile, the recommendation also stated that countries may consider routine COVID-19 vaccination for additional groups, with at least one dose per year, depending on local context, cost-effectiveness and programmatic feasibility. These include older adults without comorbidities; young adults, adolescents, and children with significant comorbidities; and health and other care workers.

The report states that countries may also consider vaccinating pregnant people with one dose per pregnancy; and previously unvaccinated healthy children aged six to 23 months, only in countries where significant burden has been documented in this age group.

SAGE has recommended the use of conjugated typhoid vaccine (TCV) in countries or settings with a high or very high incidence of typhoid fever or a high burden of antimicrobial-resistant S. Typhi. “Countries should consider administering a booster dose around the age of 5 in settings where the incidence of typhoid is very high for children who receive a primary TCV dose at 9-24 months of age,” the report stated.

In addition, countries at low risk for poliovirus import and already giving three doses of inactivated polio vaccine (IPV) in the first year of life may reduce the number of bivalent oral polio vaccine (bOPV) doses in routine schedules from three to two, as this combined schedule will maintain mucosal immunity.

He added that the vaccine portfolio optimization and prioritization approach helps countries make tough, evidence-based choices about how to achieve the most health impact from their vaccination programs at a time when budgets are tightening.