Article from the “Washington Post”
Rachel Roubein, McKenzie Beard

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A new coronavirus booster shot is likely coming this fall.

In a unanimous vote yesterday, the Food and Drug Administration’s expert advisers issued their recommendation: The next round of coronavirus shots should target the XBB variants, a branch of omicron causing almost all of the nation’s recent covid-19 infections.

That poses another challenge for the nation’s beleaguered public health officials, who’ll be tasked with encouraging vaccinations amid poor uptake of the most recent booster. Just 1 in 5 adults have received the bivalent shot, which became available September 2022.

“It is concerning to us that the last booster hasn't really had the same kind of participation as we had with the covid vaccine initially,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials.

Officials and experts point to several messaging strategies that could be deployed in the fall. For one, this is the second time the vaccine will likely be offered alongside the flu shot, which could help frame it as part of a routine vaccination schedule. Others say efforts should be heavily targeted toward those who are most at risk of falling severely ill to the virus, such as the immunocompromised and older adults.

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The details

The FDA still needs to make a decision on the vaccine’s formula, which is expected in the coming days. The agency isn’t required to follow the guidance of its advisers, though it often does.

One thing to note: This will likely be the first time a coronavirus shot doesn’t target the original strain of the virus that emerged in late 2019. The currently available bivalent shot targets both the original strain and the more recent BA.4 and BA.5 omicron variants.

Meanwhile, the timeline for distributing the shots varies, up to whichever specific XBB strain is chosen by the FDA. Companies are able to provide XBB.1.5 vaccines — for what is currently the most dominant variant — earlier than other options, our colleague Carolyn Y. Johnson notes.

Immunity from vaccinations and infections wanes over time, though the shots continue to protect most people from severe illness and death. Data presented at the FDA advisory panel meeting showed protection against hospitalization dropping considerably four to six months after the bivalent vaccines, with older adults most vulnerable, per Carolyn.

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But will Americans get the shot?

Top federal health officials are cognizant of the challenge.

“Barring some exceptional development of a resistant virus … I think we have one chance this fall to get vaccines into arms,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said during yesterday’s advisory committee meeting.

• About half of adults say they’re likely to get a coronavirus vaccine annually if one was offered like the flu shot, according to a KFF survey from this spring.

• That’s much higher than the roughly 20 percent of adults who have gotten the most recent booster shot.

Whether more Americans decide to get the shot this time around could come down to what a fall vaccination campaign looks like.

“We need to continue to reassure the public that it’s safe,” Plescia said. “The longer we’ve had experience with it, the more evidence there is that it’s very safe. It’s also effective.”

Jeremy Faust, an emergency physician at Brigham and Women’s Hospital, says the priority should be to ensure the most vulnerable Americans are protected. “There’s this big panic about uptake … but the focus and the concern should be, do the high-risk people have access? And do they know when it’s time for them to get another one?”

It’s unclear how much funding and resources public health officials will have to launch another vaccination campaign. That’s concerning to some health experts who worry even the clearest messaging could be nullified by the fact that not enough Americans know the new booster shot exists.

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On a personal note, my husband & I were among the 20% of Americans who got the Omicron Bivalent booster last Fall. My husband got another booster just last month. Therefore, it is most likely we also both will be getting this new, updated COVID vaccination in the Fall to try to remain as safe as possible. The Pandemic may be over, but COVID still is a very serious threat to many.

Vaccinations (for all kinds of things) save lives. Beyond staying alive, quality of life also matters. With the most recent pandemic virus, Long COVID remains a concern for all.

Hopefully, there will eventually be a longer lasting vaccine that actually can prevent coronavirus infections. Meanwhile, mNRA vaccines and boosters seem to be the best we (as a society) can do to dampen COVID-19 and its aftermath.