WHO Strategic Advisory Group of Experts on Immunization updates recommendations on booster doses and COVID-19 vaccination for children – PAHO/WHO

New guidance continues to prioritize reaching full protection of the most vulnerable first and reflects evidence of declining vaccination efficacy and increasing dose delivery

21 January 2022 – The World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) has updated its guidance on booster doses and vaccination in children in light of increased supply and vaccine coverage, new evidence on the need for booster doses and the evolution of the epidemiological situation of COVID-19.

The revised SAGE Roadmap for Prioritizing Uses of COVID-19 Vaccines, originally published in October 2020, identifies four categories of priority groups, based on risk of disease and social disruption, and taking into account the equity of vaccines and the broader benefits to society.

SAGE continues to advise that the highest priority for vaccination be given to older adults, immunocompromised people and healthcare workers, followed by adults with comorbidities, pregnant women, teachers and other essential workers, as well as disadvantaged demographic groups. at higher risk of severe COVID-19.

Changes to the SAGE recommendations include:

  • Booster (third) doses should be offered 4 to 6 months after completion of the primary vaccination series. This is because the efficacy of the vaccine decreases over time, also against mild and asymptomatic infection with the omicron and delta variants.
  • The order of application of the booster doses must be the same as that of the primary vaccination series: to the groups from highest to lowest priority.
  • Countries should consider the individual and population benefits of vaccinating children.
  • Although severe COVID-19 is rare in children, it does occur occasionally, and vaccinating children has the added benefit of minimizing disruption to their education, thereby improving their overall well-being.
  • Countries that have achieved high vaccination coverage in high-risk populations should prioritize global delivery of COVID-19 vaccines before vaccinating healthy children and adolescents who are at the lowest risk of serious outcomes.

The interim recommendations apply to the Pfizer BioNTech vaccine, for which SAGE has data to update its guidance. When data become available for other vaccines, SAGE will review the evidence and update the respective recommendations.

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