We’ve seen second COVID-19 boosters recommended for older adults and people with underlying health conditions — but what about the general population? Well, it’s looking like a new booster shot will be recommended in the coming months.
Earlier this summer, the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee met to discussthe next round of boosters, and voted in favor of updated shots to be distributed as boosters in the fall.
The Biden administration announced earlier this month that the new shots ― designed to more effectively fight off omicron variants ― are expected to roll out in September. The U.S. has purchased 171 million doses of Moderna and Pfizer’s bivalent boosters, which target both the original COVID-19 strain and omicron, particularly the now-dominant BA.4 and BA.5 variants.
The U.K. also recently approved an omicron-targeting Moderna vaccine, and is the first country to approve an omicron-specific booster.
Both Pfizer and Moderna’s updated booster shots offer a strong immune response against omicron and its subvariants. The preliminary results found an increase in antibodies and added protection.
Infectious disease experts generally agree that developing a booster strategy is a complicated task.
“The solution isn’t just throwing vaccines at everybody. It’s actually having a meaningful understanding of what are the goals of the vaccine program and what can we expect the vaccines to do,” Isaac Bogoch, an infectious disease physician and scientist at the University of Toronto, told HuffPost in June.
Some people should still get a booster before the rollout of the bivalent shots
Bogoch said in order to determine if, when and how boosters will be needed, it’s crucial to first look at the goals. In the case of these new bivalent boosters, the goal is to target the soaring number of infections caused by the latest COVID variants.
The current boosters have waning protection against infection and onward transmission, Bogoch explained, but they continue to be safe and very effective at preventing severe outcomes like hospitalizations and death.
But certain populations should be boosted with the current shots instead of waiting.
The effectiveness of vaccines varies between people. Immunocompromised individuals and older people’s antibody levels wane earlier, which makes these people strong candidates for booster doses, said Arjun Venkatesh, a Yale Medicine emergency medicine doctor and associate professor at Yale School of Medicine. That’s why those who are over 60 or immunocompromised were eligible for a second round of booster shots earlier this year.
“The reason we want to boost older adults first is because in many ways, the vaccine — their first two doses — didn’t work as well as it worked in younger people,” Venkatesh said. That second booster has helped at-risk groups be “as vaccinated” as healthier individuals who got only two or three doses.
Venkatesh also believes we will continue to see booster campaigns targeting at-risk populations more often than blanket booster recommendations. It’s not uncommon for booster campaigns to roll out for select groups — we already do this for shingles, pneumonia and flu shots.
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Instead of a second booster of the original vaccine for the general population, the U.S. is eyeing a new omicron-specific shot.
Why do we need this specific booster?
Trials have shown that a fourth dose of the currently available vaccines doesn’t provide much more protection against mild or asymptomatic infections than a third dose in healthy people under 50, according to Supriya Narasimhan, the division chief of infectious diseases and hospital epidemiologist and medical director of infection prevention at Santa Clara Valley Medical Center.
“The increase in vaccine efficacy was small and short-lived, therefore the benefit of an additional dose is not thought to be great,” Narasimhan said, noting that the benefits of a fourth dose were much more pronounced in people over 60, who are more at risk.
All of this makes the need for the omicron-specific booster even greater. This next round in September is expected to be recommended for both vulnerable people and the general public.
Moderna announced its omicron-specific booster was well tolerated and demonstrated a more robust antibody response against omicron variants than the original COVID shot. Pfizer’s fall booster also elicited a strong immune response against omicron.
The FDA recently recommenced authorization for the Novavax vaccine’s primary series, but the shot is still being studied as a booster.
Venkatesh suspects that, like the flu, we will eventually have annual vaccines for COVID. At some point, we may pivot to different types of vaccines — like intranasal vaccines that can help fight transmission and pan-coronavirus vaccines that can target various types of coronaviruses at once. But we won’t see these in 2022, Bogoch noted.
For now, experts want to tread carefully when it comes to boosters, and prioritize them for the people who need them most while addressing the waning protection that the original shots show.
People who are eligible to get a booster now should get one, rather than holding off for the new shots. And everyone should continue to practice other mitigation measures: wearing a mask, staying home if you’re sick, improving ventilation indoors and testing regularly.
This article, originally published June 17, has been updated to include the latest advice.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
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