(Bloomberg) -- Healthy children and adolescents may no longer need Covid shots, the World Health Organization said, updating its guidance on vaccines as the world adjusts to living permanently with the virus. 

Older people and higher-risk groups — including those with underlying conditions — should get Covid boosters between six and 12 months after their last injections, the WHO said in a statement announcing a revised vaccine road map for the new stage of the pandemic. 

“Countries should consider their specific context in deciding whether to continue vaccinating low-risk groups, like healthy children and adolescents, while not compromising the routine vaccines that are so crucial for the health and well-being of this age group,” said Hanna Nohynek, chair of the WHO’s Strategic Advisory Group of Experts on Immunization.

The Geneva-based organization’s latest advice comes as booster rates fall in countries from China to the US, with just 16% of Americans lining up for the latest round of shots targeting the omicron variant, Bloomberg reported earlier this month. 

The dropoff won’t just have financial consequences for vaccine makers — including Pfizer Inc. and Moderna Inc. — but is also sparking concerns among public health experts who say updated vaccinations are the best way to protect against Covid. 

Read more: Covid Boosters Sour for Pfizer, Moderna With Uptake Rate at 16%

The US Centers for Disease Control and Prevention still recommends that everyone ages six months and older stay up to date with all Covid vaccines. The disparity between that advice and the new WHO protocol could confuse the public, said Stanley Perlman, a professor of microbiology and immunology at the University of Iowa.

It will “add to uncertainty about whether to trust the health-care system,” he said. “The message from the CDC and others must be very clear.”

A CDC spokesperson, speaking generally, said health policy decisions can be difficult in the face of limited resources and opportunity costs, and sometimes require “trade-offs.” The updated recommendations give countries more flexibility, according to the agency.

Healthy children between the ages of six months and 17 years typically experience less severe reactions to Covid than adults. They’re a low-priority group for vaccinations and health officials need to think of cost effectiveness and other contextual factors when issuing vaccine recommendations, the WHO said.

Vaccine makers expect to release a new Covid booster this fall, which will serve as a good opportunity for US health policy groups to revisit their guidelines, according to William Schaffner, a professor at the Vanderbilt University School of Medicine. 

“I predict there will be substantial debate at that time,” he said.

(Updates with health expert comments starting in sixth paragraph.)

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