As Covid-19 hospitalizations continue to drop in many parts of the United States, CDC's Advisory Committee on Immunization Practices (ACIP) on Wednesday said most Americans can wait until the fall to receive a second booster shot.

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Covid-19 hospitalizations drop around the US as cases rise

Some areas of the United States are starting to see Covid-19 cases rise slightly. In Massachusetts, local health officials have found that coronavirus levels in wastewater have continued to climb. The Alaska Department of Health and Social Services also reported an increase of Covid-19 cases in the state over the past week.

And in New York, Gov. Kathy Hochul (D) announced that Covid-19 cases are starting to rise in the state but added there is no reason to worry. "We're not panicking about this. We're not changing, but we also want to make sure we are smart about this," she said.

However, according to data from local health officials, while cases are on the rise in some areas of the United States, Covid-19 hospitalizations are dropping to new lows.

In Nevada, the Nevada Hospital Association reported a "record low" for statewide Covid-19 hospitalizations. Meanwhile, data from the Iowa Department of Public Health and HHS found the Covid-19 hospitalizations in Iowa have dropped, and health officials in California reported that Covid-19 hospitalizations in the state dropped below an average of 1,000, marking the first time that's happened since June 2021.

ACIP discusses additional booster shots for Americans

Meanwhile, ACIP met on Wednesday to discuss whether second booster shots should be recommended to all Americans. Currently, second booster shots are only recommended for the immunocompromised and adults 50 and older.

ACIP determined that the immunocompromised, those living with the immunocompromised, and those at high risk for severe Covid-19 could benefit from a second booster shot, but added that healthy adults who have had Covid-19 within at least the last three months are likely fine to wait until the fall before getting another booster shot.

Sara Oliver, an epidemic intelligence service officer at the Division of Viral Diseases at CDC, said at the meeting that before ACIP recommends additional booster shots, committee members need to assess case counts, hospitalization rates, and vaccine effectiveness, as well as the impact of coronavirus variants.

ACIP also warned that public health agencies need to define the purpose and goals of booster shots to avoid giving the American public "booster fatigue."

Beth Bell, director of the National Center for Emerging and Zoonotic Infectious Diseases, said that recommending multiple booster shots gives "the impression that the vaccines aren't effective."

"People are losing confidence in the vaccination program," she said, adding that asking the public to get a booster shot every four to six months is not a sustainable strategy. As it stands, a two-shot primary series with one booster dose provides enough protection for those with healthy immune systems, Bell said.

"I'm just very concerned about us meeting and considering additional doses for a smaller and smaller return and creating an impression that we don't have a very effective vaccination program," Bell said.

Other ACIP members said vaccines shouldn't be focused on preventing Covid-19 infection but on preventing severe disease.

"With the vaccines currently available, we should not chase the rainbows of hoping that those vaccines could prevent infection," said Sarah Long, a professor of pediatrics at Drexel University College of Medicine. "We don't have the vaccines to do more, except to prevent severe disease and death."

However, Grace Lee, a professor of pediatrics at Stanford University School of Medicine and chair of ACIP, noted that the United States should invest in vaccines that prevent infection because even a mild case of Covid-19 can lead to long Covid, which comes with significant health consequences.

"If we focus in on hospitalization and death in the acute illness, you're not thinking about the long-term consequences of Covid, and that can occur even in mildly symptomatic individuals," Lee said.

As it stands, ACIP said it plans to continue discussions around being "more proactive than reactive" regarding the future need for more Covid-19 vaccines, according to Matthew Daley, a senior investigator at the Kaiser Permanente Institute for Health Research and chair of ACIP's vaccine working group.

"We had plenty on our plate before, but then we want to take what we've heard in this meeting and take it to the work group and discuss each and every one of these issues," he said. "Given the unpredictability of the pandemic, we've needed to be reactive, but I think this is a place where we can also try to be more proactive." (Howard, CNN, 4/20; Walker, MedPage Today, 4/20; Soucheray, CIDRAP News, 4/20; Rutherford/Castronuovo, Bloomberg, 4/20; Kimball, CNBC, 4/21; Dylan, Las Vegas Review-Journal, 4/20; Webber, Des Moines Register, 4/20; Vaziri/Ho, San Francisco Chronicle, 4/21; Anchorage Daily News, 4/21; Beals, The Hill, 4/20; Finucane/Huddle, The Boston Globe, 4/20)