Bloomberg interviewed 13 vaccine specialists, infectious disease physicians and public health experts about the latest recommendations from the Centers for Disease Control and Prevention (CDC)son how to get the new booster shots Moderna Inc. and that of Pfizer Inc. and BioNtech SE. Not even half of respondents fully endorsed the latest CDC guidelines. Some said people should consider waiting longer than the recommended two months between doses, while others said only people most at risk should get another vaccine at this time.
These ideas are likely to surface in discussions between health regulators and independent consultants next month, when they meet to decide whether vaccine and booster recommendations should change as the pandemic evolves.
The current sentiment marks a shift from optimism around last year’s third dose, when cases soared with omicron and immunity from the first round of vaccines had declined. When Bloomberg polled 15 experts last December on boosters, 93% said everyone who qualifies should get one.
“The situation is more like the flu in that vaccine efficacy is modest and efficacy is primarily against severe disease,” said Stanley Plotkin, a vaccinia doctor and professor of pediatrics at the University of Pennsylvania. “However, it’s not trivial as covid can be fatal.”
The poll was conducted before the CDC released data on Friday showing modest benefits of the new boosters in young adults. The bivalent boosters were 73% effective at preventing covid hospitalizations in older adults compared with those who received two or more injections of the parent vaccine. But in those 18 years and older, the new vaccines were only 38 percent effective in preventing hospitalization compared with those who received at least two doses.
Part of the problem is that covid mutations are appearing so fast that they are outpacing vaccines.
In the past year, drugmakers have moved towards developing vaccines that target the most frequently circulating mutations in the virus. US regulators have backed the strategy, which tracks how flu vaccines are developed each year. However, public health experts say there are still many open questions about using multiple boosters a year to stop the pandemic.
Variant-specific enhancements are “inadequate as a long-term strategy,” said Peter Marks, chief of the Food and Drug Administration’s Center for Biological Research and Evaluation, writing this month in the medical journal JAMA. Updating prescribed vaccines to cover the new variants “is not likely to provide the depth and breadth of protection needed to disrupt viral transmission for an extended period.”
winter worries
Hospitalizations and deaths from covid are rising again, especially among the elderly. Some think boosters should be reserved for these high-risk populations, similar to approaches taken by regulators in the UK and France. Australian health officials have taken a stronger position, recommending that not all booster doses be given to most healthy children under the age of 16.
As of now, the CDC says everyone over the age of six months should get the latest omicron-targeted shot because it can help prevent serious illness, hospitalization, and death during the winter months. However, not many people heed this advice. Despite a renewed recall push from the White House, which was approved by the U.S. men’s soccer team, just 14 percent of people ages five and older have received the recall since it came out in September, CDC data show. .
The new boosters “should help protect against serious illness and death, but they may not be strong enough to prevent advanced infections,” said Kirsten Lyke, a senior research scientist at the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine. .
The problem is that progressive infections can cause you to lose faith in boosters. And the growing number of variants seems to make advanced infections more likely.
Recommend or
All of which has left experts wondering whether it’s okay to recommend up-to-date boosters to your family members or even if they should apply one themselves.
Monica Gandhi, an infectious disease doctor at the University of California, San Francisco, told her parents to get vaccinated because they are 87 and 82 years old. Their children, aged 12 and 14, received only their first two vaccinations. Gandhi, 50, received two booster shots before the latest vaccines came out, but she doesn’t currently expect to receive an updated booster.
If people plan to take the booster again, she recommends waiting at least six months between injections, because studies have shown boosters work best when more time has elapsed, she said.
Pablo Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, also did not receive the new booster. He would like the CDC to publish data on how long three doses protect healthy people from hospitalization and death.
Drugmakers have said they are working on next-generation Covid vaccines that last longer and don’t have to be changed every time a new variant emerges, but it’s unclear when they will be ready.
“Investing in new and better vaccination strategies is critical,” said Plotkin, a professor at the University of Pennsylvania. “We are in the iPhone 1 of vaccines. This is unacceptable.”
