Key COVID-19 Recommendations for 2024-2025 Respiratory Virus Season

This article originally appeared on Drug Topics^®.

A presentation at the National Community Pharmacists Association Annual Meeting and Exposition focused on the latest on COVID-19 vaccination.

Image credit: Konstantin Yuganov - stock.adobe.com

Respiratory virus season is here, according to David Ha, PharmD, BCIDP, but the worst is not upon us yet. The CDC has predicted that this year’s respiratory season is going to look similar—"or maybe slightly less intense”—compared with last year’s season, “but we’ve been fooled before,” Ha said.

In his presentation at this year’s National Community Pharmacists Association (NCPA) Annual Meeting and Exposition, Ha—infectious diseases manager at Stanford Health Care—provided a comprehensive overview of vaccines for 4 common respiratory viruses and touched on the latest updates from the October 2024 CDC Advisory Committee on Immunization Practices (ACIP) meeting, held just days before the conference.

COVID-19 Vaccination

The 2024-2025 COVID-19 vaccine is not a new vaccine, but a strain change. This year’s shots are monovalent, targeting the Omicron JN.1 lineage of SARS-CoV-2. The FDA authorized the new versions of these vaccines—mRNA versions from Moderna and Pfizer, and a protein-based version from Novavax—in August 2024.

Despite the availability of new shots, the low rates of vaccination may be indicative of another phenomenon: COVID-19 fatigue. “You may be getting questions…from your patients. Year after year, new variants, ‘Does it still make sense for me to continue to get vaccinated?’” Ha said. One way to address these questions? Safety and efficacy data from the previous season.

Across all age groups, the 2023-2024 COVID-19 vaccine—a monovalent vaccine targeting the SARS-CoV-2 XBB.1.5 sublineage—was effective against COVID-19 infection, emergency department and urgent care visits, and hospitalizations. What’s more, this efficacy persisted for at least 6 months after immunization, with waning observed around the 4- to-6-month mark. Safety data showed similar rates of adverse reactions to the 2023-2024 vaccine as in prior seasons, and no signal for myocarditis or pericarditis in men aged 12 to 39 years.

“Vaccination rates have declined, as I’m sure you’re aware, in the past [few] years, especially since the peak of the COVID-19 pandemic,” Ha said. Data from earlier this year indicate that more than one-third or less of eligible individuals reported that they are up to date with their COVID-19 vaccination.

But with more than 8 in 10 Americans receiving their COVID-19 vaccinations at a pharmacy, “the responsibility is now in our hands to make sure that we are advocating for COVID-19 vaccination.”

ACIP Recommendations

The CDC Advisory Committee on Immunization Practices (ACIP) met on October 23 and 24, 2024, to make recommendations for the 2024-2025 COVID-19 vaccine. At the time of Ha’s presentation (and the writing of this article), those changes had not yet been made to the CDC’s website. Major changes from the ACIP 2024 October update include:

• Recommendation of a second dose of the COVID-19 vaccine for adults aged 65 years and older. Ideally, this dose should be administered 6 months from the initial or prior dose.
• In patients 6 months and older who are moderately to severely immunocompromised, 2 doses are recommended. A third—or more—dose may be recommended based on shared clinical decision making.
• Although it is ideal for patients to receive their vaccine from same manufacturer, mRNA vaccines are interchangeable if the same dose is not available.
• New this year, for those who receive the Novavax vaccine: The initial 2-dose series should be with the Novavax vaccine, but if it has been more than 8 weeks since the first dose, the mRNA vaccine can be substituted, if that is the only immunization available
• Self-attestation of immunocompromise status is sufficient, and specific documentation is not required. Conditions include organ transplant, cancer, chronic kidney or hematologic disease, HIV, and/or primary immunodeficiency, among others.

There is no specific timing recommended for COVID-19 vaccination. Protection is at its highest within the first weeks to months after vaccination; therefore, high-risk patients should not wait. Co-administration of the COVID-19 vaccine with other respiratory virus vaccines is encouraged.

For more from this presentation about influenza, respiratory syncytial virus, and pneumococcal disease, check out the full article.