Some U.S. adults are a step closer to getting updated COVID-19 boosters this fall, as government advisers voted Tuesday that it’s time to tweak shots to better match the most recent virus variants. The Food and Drug Administration must decide on the precise recipe, but it is likely that a combination shot will be used to provide protection against the super-contagious Omicron variant.
Advisers to the FDA voted 19-2 that some version of omicron should be part a fall booster campaign, an effort to blunt an expected COVID-19 surge. We will be behind the eight ball if we delay,” said Dr. Mark Sawyer from the University of California San Diego.
But panelists cautioned that the recommendation doesn’t necessarily mean everyone would get a tweaked booster — they might be urged only for older adults or those at high risk from the virus.
Current COVID-19 vaccines have saved millions of lives globally and those used in the U.S. still offer strong protection against hospitalization and death — especially after a booster dose. But their ability to block infection dropped markedly when the super-contagious omicron mutant emerged.
Pfizer and Moderna tested shots updated to better match the omicron that surged over the winter, but that first mutant has disappeared — replaced by its genetically distinct relatives. These are the two new omicron relatives, known as BA. 4 and BA. 5, together now make up half of U.S. cases, according to the Centers for Disease Control and Prevention.
Only about half of vaccinated Americans have gotten a single booster. And while a second booster that’s recommended for people 50 and older again restores protection, only a quarter of those eligible have gotten one. The authorities hope that a new booster for fall will attract more attention.
What evidence is there for a recipe modification? Among the evidence Tuesday:
— Both Moderna and Pfizer found what scientists call “bivalent” shots — a combination of the original vaccine plus omicron protection — substantially boosted levels of antibodies capable of fighting that variant, more than simply giving another regular dose. The combination approach is preferred by many scientists because it retains some of the vaccine’s proven benefits. This includes cross-protection against mutants created during the pandemic.
Both companies found the tweaked shots also boosted antibodies against BA. 4 and BA. 5 but not by nearly as many.
— Pfizer, along with its partner BioNTech offer an omicron-only shot. The vaccine is also modified to meet the requirements of BA. 4 and BA.5.
— A third company, Novavax, is awaiting FDA authorization of a more traditional kind of COVID-19 vaccine, protein-based shots. Novavax argued that the booster of its existing vaccine will provide a strong immune response to new omicron mutations.
Another problem: World Health Organization advisors recently suggested that omicron tweaked shots could be used as an alternative to first vaccines. They should improve the protection of multiple strains.
“We don’t want the world to lose confidence in vaccines that are currently available,” said Dr. Kanta Subbarao, a virologist who chairs that WHO committee.
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