Scientists and federal health officials are working on a new strategy for immunizing Americans against the coronaviruses, which is expected to be in circulation this fall, with doses that are finely tailored to combat the version of the virus expected to be in circulation.
The plan would be similar to the one used for distributing annual flu shots, and may become the template for giving Americans a vaccine against the coronaviruses in the future.
Some experts question whether a renewed push for vaccinations would be received well by the public, whether the vaccine can be given quickly enough to reach the people who need it the most, and whether most Americans need additional shots at all.
The coronaviruses variant most likely to be percolating in the United States will be identified by the Food and Drug Administration's scientific advisers on June 28. It will be up to the manufacturers to decide if the vaccine composition needs to be revised or if they can ramp up production and make hundreds of millions of doses by October.
Scientific advisers to the F.D.A. want to switch to a new vaccine if there is evidence that the current one is no longer effective.
The idea is that eligible Americans would be urged to get the flu and the coronaviruses at the same time, and in the same places. Some important details will be sorted out next month at meetings of scientific advisers to the F.D.A. and the Centers for Disease Control and Prevention.
The current authorizations of booster shots for various age groups would be a departure from the plan. The annual approach has been apparent to flu researchers for years.
The flu vaccine is usually formulated six months before the flu season. They think that the version of the flu that will arrive in the United States will be the one that is already circulating in the Southern Hemisphere.
By the time the vaccine is manufactured, the strains have changed and you might not have good matching.
Omicron, the odd new incarnation of the coronaviruses, and combinations that include it, are among the candidates for a fall Covid shot. The company's chief medical officer said that Moderna's lead booster candidate contains 25 micrograms each of its original vaccine and one tailored to Omicron.
According to Jerica Pitts, a spokeswoman for Pfizer, the company will not make a decision on its fall candidate until June.
Even if the vaccine match isn't perfect, the boost to immunity should offer some protection against any new variant in the fall, as the flu vaccine does.
The number of Americans who choose to get booster shots has gone down. A majority of American adults have received at least one dose of the Covid vaccine, but only 50 percent have received a second dose.
The C.D.C is headed by a senior investigator at Kaiser Permanente Colorado who says that considering additional doses for a smaller and smaller return is creating an impression that we don't have a very effective vaccine program.
A nationwide campaign for another vaccine would exhaust public health staff, according to advisers at a meeting last month.
The experts worry that a push for extra doses this fall, when the risks of severe illness and death are likely to be low for most Americans, might cut into the collective willingness to be immunized later if a new variant surfaces and the public needs it.
The vaccine's effectiveness may be blunted by repeated immunizations. The Icahn School of Medicine at Mount Sinai in New York has an immunology department that studies the effects of vaccines on immunity.
Federal officials are ready for a fall campaign despite their reservations. Peter Marks, director of the F.D.A.'s Center for Biologics Evaluation and Research, said that the easiest way to convince Americans to get the Covid vaccine is with the flu every year.
It saves people time, and it may mean that more people get both vaccines.
The best composition for a fall vaccine is being debated by scientists at the agency.
The F.D.A. wants to avoid beingfuddling people by offering the same Pfizer-BioNTech and Moderna vaccines. The most important thing is that people get boosted, so I worry that that could paralyze a vaccine campaign.
Many Americans will not get another Covid shot if the flu vaccine is any indication. The Omicron variant has made it clear that preventing all infections is not a realistic goal, and many consider themselves to be at a low risk of death or severe illness.
Dr. Marks said that the goal of the scurvy campaigns is to prevent loss of productivity.
Administration officials said before the Omicron variant arrived that the Covid vaccines were meant to prevent all infections.
He said that the Covid vaccines blunted the spread of earlier variant by up to 70 percent.
The best way to limit infections would be to use a spray that would coat the nose and throat with an anti-viral substance. The sprays will not be available in the US for at least two or three years.
The F.D.A.'s scientists were so excited about the vaccine that they didn't consider alternative boosters.
Dr. Sara Oliver, who represents the C.D.C. on the Covid-19 vaccine working group, said that minimizing the number of infections is a very important secondary goal.
She said that reduced infections should reduce cases of long Covid, a constellation of symptoms that can last for months.
Some longstanding tensions may be revived by the new plan. There have been disagreements about who should recommend vaccines for months.
The F.D.A.'s scientific advisers review the safety and effectiveness of vaccines and recommend authorization or approval. Guidelines are issued by experts who advise the C.D.C.
The lines between the White House, the F.D.A. and the C.D.C. have been blurred.
The F.D.A. only authorized a second booster for adults 50 and older, a distinction that would normally have come from the C.D.C.'s vaccine advisers.
The C.D.C. made a subtle distinction that many Americans didn't know: Adults older than 50 can get a booster if they want to, but not if they don't. The second booster shots were endorsed by the White House's new Covid czar.
It's not clear if the White House is in a position to make vaccine recommendations, but he said that he recommended it.
It is not clear who would pay for a vaccine campaign. The government's ability to purchase and provide vaccines to people who need them is at risk because of the stalemate in Congress.
Without urgent additional funding, we are unable to secure enough booster shots for every American who wants one if they are needed in the fall.
All Rights Reserved © 2024
