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After the US Food and Drug Administration authorized new monovalent COVID vaccines on Monday, the Centers of Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices backed the decision today with a nearly unanimous vote in favor of universal XBB-containing shots.

Reports of a mutating virus and COVID hospitalizations of about 17,000 people a week in the United States, according to the health protection agency, led to a 13-to-1 vote by the committee.

“We have more tools than ever to prevent the worst outcomes from COVID-19,” CDC director Mandy Cohen, MD, MPH, noted in a statement after the vote. “CDC is now recommending updated COVID-19 vaccination for everyone 6 months and older to better protect you and your loved ones.”

The group met today in Atlanta to crunch the numbers and review scientific data to vote on the new recommendations. Their meetings are open to the public and available online by webcast.

Beth Bell, MD, MPH, department of global health, University of Washington, Seattle, pointed out at the meeting that the comprehensive evidence available so far is showing “robust benefit of vaccination to prevent deaths and risks from long-COVID.”

Nearly Unanimous Vote

Close to 153 million doses of last year’s bivalent booster have already been administered in the United States, and now, vaccination rates are declining. It is a concern that was raised in the meeting with predictions showing that hospitalizations are expected to rise again this year.

“I’m astonished by the number of people who are not vaccinated,” committee member Camille Nelson Kotton, MD, infectious diseases division, Massachusetts General Hospital, Boston, said at the meeting. “We need a universal recommendation to add clarity for people. Let’s keep America strong, healthy, and do away with COVID,” she said before casting her vote.

Opposing the decision was Pablo Sanchez, MD, PhD, Ohio State University College of Medicine and Nationwide Children’s Hospital, Columbus. In the one lone vote against the universal vaccine mandate, Sanchez voiced his preference to focus vaccination efforts on the most-at-risk groups — people who are elderly, immunocompromised, or pregnant. “I’m not against the vaccines,” he said, “but I’m not in favor of a universal mandate this time and I’d prefer we wait for more data.”

Weighing the Risks

The committee heard that deaths among children with COVID were uncommon; however, half of those who died had no underlying medical conditions.

“These are deaths from a vaccine preventable disease,” Matthew Daley, MD, Institute for Health Research, Kaiser Permanente, Aurora, Colorado, said at the meeting before voting in favor of the 2023-2024 monovalent, XBB-containing vaccines.

Some committee members said they hoped their strong, universal mandate would help encourage access to vaccines for the uninsured as the government moves out of the vaccine business and mRNA vaccines are acquired directly from manufacturers on the commercial market.

Moving forward, the public will continue to be directed to Vaccines.gov to find providers offering COVID vaccines.

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