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As cases rise, expanding COVID-19 vaccine access will help

Where do we stand with COVID-19 vaccinations? I have been fielding many questions in the past couple of months about the national COVID-19 vaccine strategy.

To put things in perspective, we have many tools in our toolbox when it comes to combating the COVID-19 pandemic caused by the SARS-CoV-2 virus. I like to think of the public health response to COVID-19 as a three-legged stool, each component of which is necessary to stabilize and curb the pandemic.

These components include our public health measures (masking, respiratory hygiene, testing, quarantine/isolation, contact tracing), emerging treatments and vaccines. Each play a critical role.

Beginning in December 2020, we have had access to safe and highly-effective COVID-19 vaccines. Since then, vaccine eligibility groups have grown to include children and adolescents ages 5 years and older.

With evidence of waning immunity from initial vaccination, eligibility has also increased to include third doses for those with a compromised immune system as well as booster doses.

It is widely anticipated that younger children (ages 6 months to 4 years) will soon become eligible for COVID-19 vaccines. Regulatory review by the U.S. Food and Drug Administration is tentatively planned for this age group in the coming weeks, with Centers for Disease Control and Prevention review likely to follow. The availability of COVID-19 vaccines to infants and pre-school-aged children will broaden eligibility across the age spectrum.

Meanwhile, COVID-19 vaccines manufactured by Sanofi and Novavax and which use a different vaccine platform (similar to that used for seasonal flu vaccine) are anticipated to undergo review soon as well.

As we anticipate these regulatory reviews for new vaccines and new eligibility groups, there has already been action on boosters, expanding access to current eligibility groups. Recently, a second-dose booster was authorized and recommended for all people ages 12 years and older who have a moderately to severely compromised immune system as well as all people ages 50 and older. For the latter group, this represents the fourth recommended dose, while for those with immune compromise it represents the fifth recommended dose.

Meanwhile, earlier this month the FDA and CDC took actions to recommend an initial booster dose for children 5 to 11 years old.

The timing of these expanded booster dose recommendations is important, because it coincides not only with evidence of waning immunity but also a rise in cases nationwide resulting from omicron subvariants. The waning of vaccine-induced immunity and the impact of new viral variants is not uncommon and is the reason why booster doses have long been recommended for vaccine-preventable illnesses, including seasonal influenza.

While a substantial portion of eligible Americans have been fully vaccinated against COVID-19, it remains clear that the single best strategy in preventing serious illness, including death, from COVID-19 disease among eligible populations is completing a primary vaccine series. Vaccination among those who are unvaccinated or partially vaccinated offers the best opportunity to save lives.

Dr. Matthew A. Clark, a board-certified physician in internal medicine and pediatrics, works for the Indian Health Service.