CDC Updates Clinical Considerations for Use of COVID-19 Vaccines

Posted on February 17, 2022 by Jonathan Lips

The Centers for Disease Control and Prevention (CDC) has updated their Interim Clinical Considerations for Use of COVID-19 Vaccines.

According to the updated guidance, people who previously received antibody products (anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma) as part of COVID-19 treatment, post-exposure prophylaxis, or pre-exposure prophylaxis can be vaccinated at any time. COVID-19 vaccination does not need to be delayed after receiving monoclonal antibodies or convalescent plasma.

“Although some reduction in vaccine-induced antibody titers was observed in people who previously received antibody products,” says CDC, “the clinical significance of this reduction is unknown, and the balance of benefits vs. risks favors proceeding with vaccination even considering the possibility of diminished vaccine effectiveness in this situation.”

Among other reasons to note this change, the CMS vaccination mandate for nursing homes requires all staff to become vaccinated, except those with a qualifying exemption or those who are identified as having a temporary delay as recommended by the CDC. We are seeking confirmation from the Minnesota Department of Health whether and when this change in the CDC’s recommendation will affect the calculation of a facility’s compliance with the mandate.

We will provide additional information as soon as we obtain it. In the meantime, we encourage settings to discuss the updated guidance with their medical directors and other clinical leadership, identify staff who currently are delaying vaccination due to having received monoclonal antibodies or convalescent plasma, and develop a plan for communicating with those staff.

CDC also provides updated guidance for vaccination of moderately or severely immunocompromised people:

• Clarification of the current recommendation to receive a three-dose mRNA vaccine primary series followed by a booster dose for a total of four doses
• New guidance to shorten the interval between completion of the mRNA vaccine primary series and the booster dose to at least three months (instead of five months)
• New guidance for those who received the Janssen COVID-19 Vaccine primary series to receive an additional dose and a booster dose, for a total of three doses to be up to date

The complete updated considerations are available here.