July 27, 2022 – Revised COVID-19 vaccine boosters that target Omicron subvariants may become available sooner than expected this year.
If so, the Biden administration may skip its plans to allow younger adults to get a second booster this summer, and instead speed up access to the new boosters for the fall, according to NPR.
Federal officials are trying to strike a balance between protecting people this summer as the BA.5 subvariant continues to infect more than 100,000 Americans per day and keeping people safe in the winter, when the U.S. is expected to have another major wave.
The FDA could make a final decision by the end of this week, weighing the pros and cons of delaying a second booster as the immunity from vaccines and previous infections continues to fade.
Since March, people ages 50 and older and those with a weak immune system who are ages 12 and older have been eligible for a second booster shot. The FDA has considered making all adults eligible this summer.
But opening eligibility now could have several consequences, NPR reported. Allowing more people to get boosted with the original vaccine, for instance, could interfere with the plans to boost people with an updated vaccine in the fall – both from a public health messaging standpoint and the potential that a fourth shot could train the immune system to fight the original strain of the coronavirus, rather than the latest subvariants.
Pfizer and Moderna are already moving quickly to meet the FDA’s request to create new boosters by October or November, NPR reported. The “bivalent” boosters would target both the original coronavirus strain and the Omicron subvariants, including BA.5.
Now the FDA is trying to prompt the companies to make the shots available sooner, potentially as soon as early to mid-September, according to The Washington Post. If the bivalent booster timeline can be sped up, the FDA will likely skip the authorization of second boosters of the original vaccines for all adults.
The shift in strategy is facing mixed reactions. Some public health experts believe the move is the best strategy since three shots still protect most young, healthy adults from severe COVID-19. It could also improve booster rates in the fall.
“I think this will increase trust. We can’t give a booster now and then again in 1.5 months or 2 months – that will decrease trust,” Monica Gandhi, MD, a professor of medicine at the University of California, San Francisco, told NPR.
Giving two boosters close together could also backfire from an immunity perspective.
“If you get a booster now with the original formulation of the vaccine, this may in fact be counter-productive. It may prevent the second booster dose given this fall from taking and from you developing an immune response to that booster,” Celine Gounder, MD, a senior fellow at the Kaiser Family Foundation, told NPR.
But other public health experts aren’t sure that the new vaccines will be much better or dramatically improve antibody rates more than the current boosters.
“People should not regard them as some sort of magic bullet that gives them super-strong protection. They are not going to be magic bullet game-changers, because they’re not that much better than the already available vaccine boosters,” John Moore, PhD, a professor of microbiology and immunology at Weill Cornell Medicine in New York City, told NPR.
What’s more, the boosters may not be ready by September, and experts can’t predict whether BA.5 will be the dominant virus in the fall and winter.
“I don’t see the benefit of waiting for a BA.5-specific booster since BA.5 may be in the rearview mirror and well past us by the time that’s available,” Peter Hotez, MD, dean of the Baylor College of Medicine National School of Tropical Medicine, told the news outlet.
For some adults under age 50, now may be a good time to get a booster to protect themselves against the BA.5 surge.
“You’re talking about literally hundreds of millions of people who are at a higher risk than they need to be for months,” Robert Wachter, MD, chair of the Department of Medicine at the University of California, San Francisco, told NPR.
“That will mean potentially millions of preventable infections, certainly thousands of preventable hospitalizations, and probably hundreds of preventable deaths,” he said.