Health and Wellness

What you need to know

Jan. 24, 2023 – Is pivoting to an annual COVID-19 shot a smart move? FDA is the agency that Proposed Monday’s change suggests that an annual shot rather than periodic boosters could make it easier to ensure that more people get vaccinated and protect them against severe COVID-19 infections. 

On Thursday, a national advisory panel will vote on the recommendation.

Accepted, the vaccine formula could be determined each June. Americans could then begin their annual vaccinations. COVID-19 Taken in the fall, just like your annual flu shot.  

Be aware that elderly Americans and people with compromised immune systems may require multiple doses of the annual COVID-19 shot.

The majority of Americans aren’t up-to-date with their COVID-19 vaccine boosters. Only 15% have received their latest booster doses, and nine out of ten Americans over 12 years old have finished their primary vaccine series. The FDA, in briefing documents for Thursday’s meeting, says problems with getting vaccines into people’s arms makes this a change worth considering. 

Given these complexities, and the available data, a move to a single vaccine composition for primary and booster vaccinations should be considered,” the agency says.

A yearly COVID-19 vaccine It could be simpler but it would still be just as efficient. WebMD invites health experts to answer your most pressing questions regarding the proposal.

The pros and cons of an annual shot

Leana Wen MD, a former Baltimore commissioner for health and public health, said that having an annual COVID-19 vaccine alongside the flu shot could make it easier to communicate vaccination recommendations and reminders with doctors and other health care professionals.

“It would be easier [for primary care doctors and other health care providers] to encourage our patients to get one set of annual shots, rather than to count the number of boosters or have two separate shots that people have to obtain,” she says.

“Employers, nursing homes, and other facilities could offer the two shots together, and a combined shot may even be possible in the future.”

Even though it’s a greater convenience, not all people are enthusiastic about the idea for an annual COVID shot. COVID-19 does not behave the same as the flu, says Eric Topol, MD, editor-in-chief of Medscape, WebMD’s sister site for health care professionals.

Trying to mimic flu vaccination and have a year of protection from a single COVID-19 immunization “is not based on science,” he says. 

Carlos del Rio, MD, of Emory University in Atlanta and president of the Infectious Diseases Society of America, agrees. 

“We would like to see something simple and similar like the flu. But science must be there to guide us. I don’t think it is. I am looking forward to the Thursday debates by VRBAC’s advisory committee. Based on the information I’ve seen and the data we have, I’m not convinced that this is a strategy that is going to make sense,” he says. 

“One thing we’ve learned from this virus is that it throws curveballs frequently, and when we make a decision, something changes. So, I think we continue doing research, we follow the science, and we make decisions based on science and not what is most convenient.” 

COVID-19 Isn’t Seasonal Like the Flu

“Flu is very seasonal, and you can predict the months when it’s going to strike here,” Topol says. “And as everyone knows, COVID is a year-round problem.” He says it’s less about a particular season and more about times when people are more likely to gather indoors. 

European officials have so far not considered an annual COVID-19 vaccine schedule, according Annelies Zinkernagel MD, PhD of the University of Zurich and president of European Society of Clinical Microbiology and Infectious Diseases. 

Regarding seasonality, she says, “what we do know is that in closed rooms in the U.S. as well as in Europe, we can have more crowding. And if you’re more indoors or outdoors, that definitely makes a big difference.”

What Variant(s), Would It Target?

Wen suggests that the FDA could use the same process as the flu vaccine to decide which variants the annual COVID-19 shot will target.

“At the beginning of flu season, it’s always an educated guess as to which influenza strains will be dominant,” she says.

“We cannot predict the future of which variants might develop for COVID, but the hope is that a booster would provide broad coverage against a wide array of possible variants.”

Topol agrees it’s difficult to predict. A future with “new viral variants, perhaps a whole new family beyond Omicron, is uncertain.”

Read the FDA briefing document “to me was depressing, and it’s just basically a retread. There’s no aspiration for doing bold things,” Topol says. “I would much rather see an aggressive push for next-generation vaccines and nasal vaccines.”

To provide the longest protection, “the annual shot should target currently predominant circulating strains, without a long delay before booster administration,” says Jeffrey Townsend, PhD, a professor of biostatistics and ecology and evolutionary biology at Yale School of Public Health. 

“Just like the influenza vaccine, it may be that some years the shot is less useful, and some years the shot is more useful,” he says, depending on how the virus changes over time and which strain(s) the vaccine targets. “On average, yearly updated boosters should provide the protection predicted by our analysis.”

Townsend, along with colleagues, published a prediction study January 5, 2009, in the Journal of Medical Virology. They look at both Moderna and Pfizer  vaccines and how much protection they would offer over 6 years based on people getting regular vaccinations every 6 months, every year, or for longer periods between shots. 

According to them, a Moderna vaccine booster would provide 75% protection from infection while a Pfizer vaccine would provide 69%. Townsend states that these predictions are based on the behavior of coronaviruses and new variants that may emerge over time.

“These percentages of fending off infection may appear large in reference to the last 2 years of pandemic disease with the massive surges of infection that we experienced,” he says. “Keep in mind, we’re estimating the eventual, endemic risk going forward, not pandemic risk.”

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