EU agencies advise second COVID-19 boosters for people above 60 years

In April 2022, the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) suggested that people over 80 years of age be considered for a second booster.

However, the agencies noted, at the time, that it might be necessary to consider second boosters in people between 60 and 79 years old and vulnerable persons of any age if there was a resurgence of infections.

As a new wave is now underway in Europe, with increasing rates of hospital and intensive care unit (ICU) admissions, public health authorities should heed the latest advice from both organizations, they said.

The second booster vaccine could be given at least four months after the previous one, with a focus on people who have received a previous booster more than six months ago, said the agencies. 

Currently authorized vaccines continue to be highly effective in reducing COVID-19 hospitalizations, severe disease and deaths in the context of emerging SARS-CoV-2 variants, they added.

New wave

‘We are currently seeing increasing COVID-19 case notification rates and an increasing trend in hospital and ICU admissions and occupancy in several countries mainly driven by the BA 5 sublineage of Omicron,’​ commented Dr Andrea Ammon, ECDC director.

Such developments signal the start of a new, widespread COVID-19 wave across the EU, she said.

“Adults 60 years and older and medically vulnerable populations are the groups most at risk of severe disease and giving a second booster to those groups now will avert a significant number of hospitalizations and deaths from COVID-19,” ​said the ECDC lead.

Stella Kyriakides, EU Commissioner for Health and Food Safety, called on EU-27 countries to roll-out second boosters for everyone over the age of 60 as well as all vulnerable persons immediately.

No clear evidence for boosting those under 60

There is no clear evidence to support giving a second booster dose to people below 60 years of age who are not at higher risk severe disease, said the ECDC and the EMA.

“Neither is there clear evidence to support giving early second boosters to healthcare workers or those working in long-term care homes unless they are at high risk.​

“However, residents at long-term care homes are likely to be at risk of severe disease and should be considered for booster doses in line with national recommendations.”​

The agencies are also urging public health authorities across the EU to plan for additional boosters during the autumn and winter seasons for people with highest risk of severe disease, possibly combining COVID-19 vaccinations with those for influenza.

Adapted vaccines​

The latest ECDC/EMA advice comes amid work to adapt vaccines for Omicron variants of concern.

‘We are working towards possible approvals of adapted vaccines in September,​’ said EMA’s executive director, Emer Cooke, noting that “our human medicines committee is currently reviewing data for two adapted vaccines.”​

‘In the meantime, it is important to consider using currently authorized vaccines as second boosters in people who are most vulnerable. Authorized vaccines in the EU continue to be effective at preventing hospitalizations, severe disease and deaths from COVID-19, even as new variants and subvariants continue to emerge.’​

She said that the authorities in the EU are working closely with the World Health Organization (WHO) and international partners on policies concerning adapted vaccines.