COVID Boosters Still Recommended — But Only for Those Who Need Them Most

Credit: Adobe Stock/Azeemud-Deen Jacobs/peopleimages.com

For the past five years, the United States has taken an aggressive approach to COVID-19 vaccination, recommending annual boosters for nearly everyone over the age of 6 months. This strategy has been more expansive than that of other high-income nations, which tend to limit booster recommendations to older adults or those with specific health risks. Now, the U.S. Food and Drug Administration (FDA) is introducing a new, more targeted strategy: continue recommending annual COVID-19 boosters for high-risk groups while pausing broad booster guidance for healthy individuals under age 65 until more clinical trial data become available.

The shift comes amid growing public hesitancy and declining vaccine uptake.

“Although the rapid development of multiple COVID-19 vaccines in 2020 represents a major scientific, medical and regulatory accomplishment, the benefit of repeat dosing — particularly among low-risk persons who may have previously received multiple doses of COVID-19 vaccines, had multiple COVID-19 infections, or both — is uncertain,” Vinay Prasad, M.D., MPH, associated with the Center for Biologics Evaluation and Research at the FDA, said in a statement.

Over the past two fall seasons, fewer than 25% of Americans received COVID-19 boosters. Uptake was especially low among children under 12 (less than 10%) and even among health care workers, with fewer than one in three participating in the most recent booster campaign. These numbers suggest that many people are unconvinced about the need for repeated vaccination.

More concerning, public skepticism about COVID-19 boosters may be spilling over into attitudes toward other vaccines. Vaccination rates for long-standing immunizations, such as the MMR (measles, mumps and rubella) vaccine, have begun to decline. This raises fears of preventable outbreaks and underscores the need to rebuild public trust in science-based vaccination policies.

Under the new framework, the FDA will continue to recommend annual COVID-19 boosters for the following groups:

• Adults aged 65 years and older
• Anyone 6 months and older with at least one high-risk medical condition, such as obesity, diabetes, heart or lung disease, cancer or mental health conditions like depression

For healthy individuals between 6 months and 64 years old, however, the FDA is pressing pause on routine booster approvals. Instead, it is calling for new, large-scale clinical trials that specifically examine the benefit of boosters in this group. These studies must show whether a booster actually reduces symptomatic illness, hospitalizations or death — and must include people with past infections and prior vaccine doses, to better reflect real-world conditions.

This updated policy reflects a balance between regulatory flexibility and scientific rigor. On one hand, the FDA is ensuring timely protection for those most vulnerable to severe COVID-19. On the other, it’s requiring high-quality evidence before expanding recommendations to the broader population.

This approach also opens the door to stronger, more reliable data. Future trials will help answer important questions: Does a seventh dose help a healthy, middle-aged person who’s already had COVID-19 and received multiple vaccines? Is annual boosting necessary for younger adults and children?

What Should You Do Now?

If you are over 65 or have a condition that puts you at higher risk for severe COVID-19, stay up to date with your annual boosters. If you are healthy and under 65, your provider may advise a more individualized approach based on your health history and personal risk factors.

The FDA’s new policy is a step toward rebuilding public trust by ensuring vaccine recommendations are grounded in the strongest possible science.