CDC revises guidelines for pneumonia and COVID-19 vaccines

November 4, 2024

Summary: Those 50-64 are now recommended to get a pneumonia vaccination, and those 65 and over or with special risk factors are recommended to get a second COVID-19 vaccination

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) met last week, and revised recommendations for adult vaccinations.

The ACIP recommended a single pneumonia vaccine for those ages 50-64 who have not had a previous pneumonia vaccine, and a single pneumonia vaccine for those ages 19-49 with a risk factor. Risk factors include chronic heart, liver, lung or kidney disease, tobacco use, immune deficiency, diabetes and alcoholism. There are multiple different available pneumonia vaccines covering different serotypes (strains) of the pneumococcal bacteria, and vaccinating children has decreased the risk of pneumococcal pneumonia for older adults, too

The ACIP also recommended a second 2023 formulation COVID-19 vaccine this year for two groups: those over 65, and those with moderate to severe immunocompromise, regardless of age. Previous research shows that about 7% of the adult insured population is immunocompromised, usually due to medication use. The second dose is recommended six months after the first dose.

Implications for employers:

-        The Affordable Care Act requires that vaccinations recommended by ACIP be provided without cost sharing as of the plan year that begins 12 months after the ACIP recommendation. Most plans will implement this change right now, as opposed to waiting for the 2026 plan year.

-        Plans should cover whichever vaccine is available at a patient’s provider to decrease barriers to vaccination.

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Illustration by Dall-E

Tuesday: IRS expands allowable preventive care without cost-sharing