In an emergency meeting on Dec. 19, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) approved new recommendations for the Moderna COVID-19 vaccine, which recently received FDA emergency approval for people age 18 and older. It is also recommending that it be added to the CDC’s 2021 Adult and Child/Adolescent immunization schedules.
On Dec. 20 in another emergency meeting, the ACIP also updated its recommendation for which groups should receive the next phase of vaccinations: people ages 75 and over and frontline essential workers.
These updates follow the ACIP’s recommendation of the Pfizer-BioNTech COVID-19 vaccine for people who are 16 or older last week.
Stanley E. Grogg, DO, the AOA’s liaison to the ACIP, shared additional relevant information about the vaccine and the emergency meetings with the AOA. Here is a summary of his reports from the meetings this past weekend.
Things to know about the Moderna COVID-19 vaccine
- Overall efficacy of the vaccine is 94.1%; one of the clinical trial participants who received the vaccine contracted COVID-19.
- The vaccine has 89% efficacy in preventing hospitalization.
- The vaccine will be free of charge to the U.S. population, though health systems and departments could incur costs.
- The vaccine requires two doses at least 28 days apart. It cannot be interchanged with other COVID-19 vaccines.
- The vaccine should not be given within 14 days of other vaccinations.
- Patients with a prior symptomatic or asymptomatic COVID-19 infection can receive the vaccine.
- Patients who have a current COVID-19 infection should not receive the vaccine until after recovering from acute illness and after their quarantine period is over.
- Patients who received passive antibody therapy for COVID-19 should wait 90 days before getting the vaccine.
- People with underlying medical conditions who have no contraindication to vaccination can receive the vaccine.
- Data on the safety of the vaccine for people with HIV and other immunocompromising conditions is not currently available; these patients can still receive the vaccine if they choose to do so.
- Adequate data is not available on the safety of the vaccine in pregnant women to make a specific recommendation. On the other hand, pregnant women who are part of a group, such as health care workers, that is recommended to receive the vaccine may choose to be vaccinated after discussing the issue with a clinician.
- There is no data on the safety of the vaccine in breastfeeding and lactating women or the effect of the vaccine on breastfed infants or on milk production. The vaccine is not thought to pose a risk to a breastfeeding infant. If a breastfeeding woman is part of a group, such as health care personnel, that is recommended to receive the vaccine, she may choose to be vaccinated.
- The ACIP is proposing that patients who have had a severe allergic reaction to any vaccine or injectable therapy do not receive the vaccine at this time. The ACIP is also proposing that patients with a history of anaphylaxis should be observed for 30 minutes after vaccine administration (and that all other patients should be observed for 15 minutes after getting the vaccine).
Vaccine side effects
Before vaccination, clinicians should counsel vaccine recipients about expected local and systemic post-vaccination symptoms, which onset one to two days post-vaccination, and typically resolve within two to three days. Patients can take antipyretic or analgesic medication to treat fever and pain following vaccination.
Guidance for vaccinated people
Information on how long the vaccine lasts, how well it works in the general population and how much it reduces disease and transmission is currently limited. At this time, people who receive the vaccine are advised to continue following the current guidance to protect themselves and others from COVID-19, including wearing a mask in public places and social distancing.
Next phases of vaccination
After the initial phase of vaccination for health care personnel and long-term care facility residents is completed, those who are 75 or older or are frontline essential workers should be next. Following that group should be those between the ages of 65-74 and those between ages 16-64 with high-risk medical conditions, as well as other essential workers.
If the vaccine is in limited supply for frontline essential workers during the next phase, the ACIP recommends that those workers in areas where high rates of transmission and/or outbreaks have occurred, or who are at an increased risk of severe illness based on age or underlying health conditions, be considered first.
For any questions, please contact Dr. Grogg at firstname.lastname@example.org.