CDC: Adults 65-Plus Should Get a Spring COVID Shot

Here’s why heath officials updated their vaccine recommendations for older adults

Rachel Nania,

AARP

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Published February 29, 2024

/ Updated November 20, 2024

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Older Americans who recently had — or intend to get — this year’s updated coronavirus vaccine should plan on rolling up their sleeves again in the spring for another shot.

The Centers for Disease Control and Prevention (CDC) issued a recommendation on Oct. 23 that adults ages 65 and older receive a second dose of the latest COVID-19 vaccine six months after the first. The same recommendation applies to immunocompromised individuals, such as those who have cancer or take certain medications to treat an autoimmune disorder. People who are moderately or severely immunocompromised have the flexibility to get three or more COVID vaccines at the advice of their doctor.

The decision was made after a panel of experts that advises the CDC reviewed the latest data on the durability and effectiveness of the vaccines in older adults. “We know that the COVID vaccines provide really pretty good protection in the short term, but by the time you get to month four, five and six, that protection begins to wane,” says William Schaffner, M.D., professor of preventive medicine at Vanderbilt University School of Medicine in Nashville and medical director of the National Foundation for Infectious Diseases.

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What’s more, COVID has settled into a more predictable pattern in the last few years, though the virus continues to spread throughout the year. Cases climb in the winter months when flu, RSV and other respiratory illnesses spike. But they also tend to surge in the summer.

“And so the committee said, if we want to provide maximum protection for those people at highest risk, they should get their vaccine in the fall in order to help get them through the winter. But by the time they get to May, their protection will have waned, and that's just the time the summer increase comes up. So let's give them two doses in the year: one in the fall to protect against the winter, and one in the late spring to protect against the summer increase,” Schaffner explains.

This isn’t the first time health officials have recommended a second shot for adults 65 and older, who accounted for 70 percent of all COVID-related hospitalizations between October 2023 and April 2024. But it is the first time the recommendation has come so far in advance.

“Part of why the recommendation is coming out now is because we have a couple of years of data to say with more confidence that [a second shot] is beneficial,” says Kisha Davis, M.D., a director with the American Academy of Family Physicians and chief health officer for Montgomery County, Maryland. And giving people some notice helps “folks plan and think about the benefit of that vaccine,” she says.

Roughly 9 percent of older adults received a second COVID vaccine in the spring of 2024, federal data shows.

Variants, other uncertainties could influence recommendations

The COVID vaccines that are available in pharmacies and clinics were recently updated to target KP.2 (Pfizer-BioNTech and Moderna) and JN.1 (Novavax), two descendants of the omicron variant that were behind the latest summer surge of infections and hospitalizations.

These two strains are no longer dominant in the United States, but their close relatives are, and public health experts say the updated vaccines are expected to be a good match against them. If the variants that circulate in the spring are similar, Schaffner says the vaccines should continue to provide protection. “Of course, if a substantially new variant crops up, then we'll have to reevaluate,” he says.

Another wait-and-see: Whether two-shots-a-year becomes the standard recommendation going forward for people 65-plus. “At least for this year, it's going to be beneficial for folks to get that additional shot in about six months, but it's hard to say what that will look like in future years,” Davis says.

Don’t neglect other routine vaccines

All well and good to plan for spring, but don’t forget to get the COVID-19 vaccine now, in time for the winter virus season, Schaffner says. So far, 17.9 percent of U.S. adults have received it, according to the latest CDC data. That share is higher for older adults, who are at greater risk of complications from COVID-19. As of Nov. 15, 38.5 percent of people 65 and older have received this year’s updated vaccine.

A new survey from Pew Research Center, however, finds that many Americans — 6 in 10 — plan to sit this one out. Major reasons for abstaining include concerns over side effects and not thinking the shot is needed. Deaths from COVID-19 are down from the summer surge, but 675 Americans are still dying each week from the infection, federal data from Oct. 19 shows.

It’s also important not to neglect other routine vaccines that can help keep you healthy this time of year. The CDC recommends that everyone 6 months and older get a flu shot in the fall to cut their risk of complications from the common illness. And people 75 and older who did not get the RSV vaccine last year should get it this year. (It’s not an annual vaccine.) So should adults ages 60 to 74 with certain risk factors, like heart disease, lung disease and diabetes.

New guidelines also recommend that adults 50 and older get a pneumococcal vaccine, which can help prevent some of the worst outcomes of pneumonia, such as meningitis and sepsis, Davis says.

Editor's note: This article, originally published February 29, 2024, has been updated with new information.