Recommending Covid-19 vaccines for everyone in the US could save thousands more lives than limiting to high-risk groups

By Deidre McPhillips, CNN

(CNN) — As a group of advisers to the US Centers for Disease Control and Prevention meets to make recommendations on who should get the updated Covid-19 shot this season, a newly published analysis from dozens of researchers emphasizes the “substantial” benefits of broad vaccine recommendations.

The US Food and Drug Administration has already made significant changes to this season’s shots: limiting approval to adults 65 and older, and younger people who are at higher risk from Covid-19. The forthcoming vote from the CDC’s Advisory Committee on Immunization Practices, or ACIP, carries additional implications for vaccine access – and there are signs that the group could restrict access even further.

But scientific projection models from nine teams of researchers, summarized in a study published Thursday in JAMA Network Open, show that sticking to a universal Covid-19 vaccine recommendation – as has been in place in the US in recent years – has the potential to save thousands more lives than limiting the recommendation to high-risk groups.

“While focusing on vaccination among individuals at the highest risk for severe outcomes, including those aged 65 and older and those with comorbidities, remains an effective ongoing strategy, our scenario projections demonstrate that maintaining the recommendation for all individuals to receive reformulated vaccines has the potential to save thousands more lives through both direct and indirect effects,” the researchers wrote.

Over the past five years, the US COVID-19 Scenario Modeling Hub has provided nearly 20 rounds of projections estimating Covid-19 disease burden. Various teams build their models with a unique set of assumptions, which are then combined into ensemble projections for six scenarios based on different vaccine recommendations and viral immune escape — vulnerability to things like a new variant or waning immunity from prior infection or vaccination. The group’s work was used to guide the expansion of the primary COVID-19 vaccine schedule to school-age children in 2021, and booster recommendations in fall 2022.

Models for last season – covering the period from April 2024 to April 2025 – included a worst-case scenario where there was no vaccine recommendation and high immune escape, and a best-case scenario where there was a universal vaccine recommendation and low immune escape.

The scenario that the researchers say was most similar to the way last season actually played out involved high immune escape. The universal vaccine recommendation that was in place in this scenario was projected to reduce hospitalizations by 11% and deaths by 13% – essentially averting 104,000 hospitalizations and 9,000 deaths.

If vaccine recommendations had been limited to high-risk individuals, the benefit of the vaccine would still be substantial: an 8% reduction in hospitalizations and 10% reduction in deaths. But the expanded recommendations for all ages was projected to prevent an additional 28,000 hospitalizations and 2,000 deaths, the study showed.

Adults ages 65 and older benefit the most under all vaccine scenarios, both directly and indirectly. A universal vaccine recommendation would reduce the burden of Covid-19 on seniors by an additional 3 to 4%, averting about 11,000 hospitalizations and 1,000 deaths in this group.

“This finding suggests substantial indirect benefits of universal vaccination and the continued value of broad vaccine recommendations,” the researchers wrote.

The projections for last season were first published by the Scenario Modeling Hub in June 2024, to help inform decision-making ahead of last year’s ACIP meeting. Actual epidemiological trends differed from assumptions that were made in the models at that time – burden was greater than expected during the summer and less in the winter – but projected deaths aligned closely with the models, creating confidence in the “robust accuracy” of the models among the researchers.

Projections for this season, published by the US COVID-19 Scenario Modeling Hub in June, paint a similar picture to last season.

Recommending updated Covid-19 vaccines only for high-risk individuals will help to avoid an estimated 90,000 hospitalizations and 7,000 deaths – but broadening the recommendation for all people in the US would save an additional 1,000 lives and prevent an additional 26,000 hospitalizations.

“We expect continued substantial burden of disease from COVID-19 in the US,” the researchers wrote in an executive summary of the findings. “All vaccination strategies are projected to significantly reduce disease burden. The greatest benefits will be seen if vaccines are offered to all ages.”

All work by the US COVID-19 Scenario Modeling Hub is public and “available for consideration” by ACIP and other experts, said Dr. Justin Lessler, a leader with the modeling hub and professor of epidemiology at the University of North Carolina.

The modeling work was not presented at ACIP’s June meeting this year and there’s “no indication” that it will presented at this week’s meeting, he said.

“We continue to share our results with the CDC and are working to make them more easily available to a broader range of organizations who are providing vaccine guidance,” Lessler said.

The-CNN-Wire
™ & © 2025 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.