Boost high-risk groups before first COVID doses for low risk, says WHO

Countries that have achieved moderate to high levels of COVID-19 vaccinations among high-risk groups — including older people and health workers — should next prioritize giving these people booster shots rather than offering first doses to low-priority groups, said the World Health Organization.

This will “usually yield greater reductions in severe disease and death than use of equivalent vaccine supply to increase the primary vaccination series coverage rates of lower risk priority use groups,” said Alejandro Cravioto, chair of WHO’s strategic advisory group of experts on immunization, or SAGE, during a press conference on Friday.  

Road map for boosters: This new guidance comes out of an extraordinary meeting of SAGE held on Wednesday. With these changes, WHO’s vaccine road map now includes booster shots as part of the strategy to achieve the best impact of available vaccines, said Kate O’Brien, director of WHO’s department of immunization, vaccines, and biologicals.

“This does not mean giving boosters, as a priority, to everybody in all ages, and all priority groups. We continue to have the highest focus on the full vaccination of the highest priority groups,” she said.

But WHO has not defined the threshold of when a country has achieved “moderate-to-high primary series coverage” of vaccinations for high-risk groups “because they may differ from country to country,” said Joachim Hombach, executive secretary of SAGE.

Positive outlook: WHO’s analysis of the supply of COVID-19 vaccines this year shows adequate global production, said O’Brien, but the harder task is to ensure the vaccines end up in the places they are needed most.

“There is likely to be sufficient supply, should that supply be distributed in an equitable way,” she said, adding that 34 countries are still below 10% of populations vaccinated.