Enlarge / A vial containing Moderna COVID-19 booster vaccine at a vaccination center. (credit: Getty | SOPA Images )

A vaccine advisory group for the World Health Organization said Tuesday that, at this point, it does not recommend additional, let alone annual COVID-19 booster shots for people at low to medium risk of severe disease. It advised countries to focus on boosting those at high risk—including older people, pregnant people, and those with underlying medical conditions—every six to 12 months for the near- to mid-term.

The new advice contrasts with proposed plans by US Food and Drug Administration , which has suggested treating COVID-19 boosters like annual flu shots for the foreseeable future. That is, agency officials have floated the idea of offering updated formulations each fall, possibly to everyone, including the young and healthy.

In a viewpoint published last May in JAMA , the FDA's top vaccine regulator, Peter Marks, along with FDA Commissioner Robert Califf and Principal Deputy Commissioner Janet Woodcock, argued that annual COVID booster campaigns in the fall, ahead of winter waves of respiratory infections—such as flu, COVID-19, and RSV—would protect health care systems from becoming overwhelmed. And they specifically addressed the possibility of vaccinating those at low risk.

Enlarge / A health worker exits an ambulance outside a quarantine center in the Goregaon suburb of Mumbai, India, on Tuesday, April 27, 2021. (credit: Getty | Bloomberg )

As the pandemic coronavirus continues to ravage India, doctors are reporting a disturbing uptick in cases of a rare, potentially fatal fungal infection among people recovered or recovering from COVID-19.

The infection is called mucormycosis , or sometimes “black fungus” in media reports, and it appears to be attacking COVID-19 patients through the nose and sinuses, where it can aggressively spread to facial bones, the eyes, and even the brain (rhinocerebral mucormycosis). In other cases, the fungus can also attack the lungs, breaks in the skin, and the gastrointestinal system or spread throughout the body in the blood stream.

A classic feature of mucormycosis is tissue necrosis—the death of flesh, essentially—which, in the rhinocerebral form of the disease, can lead to black, discolored lesions on and in the face, particularly on the bridge of the nose and the roof of the mouth. Mucormycosis is fatal in around 50 percent of cases.

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