Getting one annual shot could potentially be more palatable to pandemic-weary people, Dr. Russo says. The vaccine rollout has been “haphazard,” he explains, and the public has often been unclear about which COVID vaccines they should get and when.
The thinking goes that, with a simple annual vaccine schedule, people will better understand how to protect themselves—and actually get the shots they need. “‘When do I get my next booster?’ is a very, very common question,” Dr. Schaffner says. This proposed shift will hopefully “relieve the vaccine fatigue that’s out there.”
However, certain folks may still need extra protection each year. The FDA’s document suggested that older and immunocompromised people—two groups who face a higher risk of severe disease from COVID—as well as “the very young,” who may not have had previous exposure to the virus, may need two shots a year, but it’s unclear what this schedule would look like.
During Thursday’s meeting, some committee members expressed hesitation in scaling back. “We need broader protection,” Pamela McInnes, DDS, the former deputy director of the National Center for Advancing Translational Sciences at the National Institutes of Health, said during the discussion, per NBC. “We don’t want to be chasing the virus.”
Dr. Russo says that giving most people one annual shot could, in fact, be risky at this stage in the pandemic. “Immunity—whether from prior infection or vaccination—wanes over four to six months,” he says. “You gain extra protection by boosting in that time frame.” While respiratory viruses generally circulate more during the fall and winter months, COVID-19 cases can rise during warmer months, though the spikes are usually less severe. (For example, cases significantly increased during the summer of 2021, when the delta variant first hit.)
If and when COVID becomes a seasonal illness, the likelihood of dealing with a wave of infections during spring and summer will likely be less of a concern, Dr. Russo explains. That said, the possibility of contracting COVID at any time still lingers, and we now know that long COVID, which can spur potentially debilitating symptoms, can affect anyone who is infected—even those who initially had a “mild” illness.
Will the COVID vaccine formula change as new variants emerge?
The committee members also recommended that the bivalent vaccines be updated this year ahead of the start of the 2023–2024 cold and flu season, so the formula provides the best protection possible as the virus mutates, per NPR. They suggested the FDA meet in May or June of this year to discuss the proposed updates, which would allow for new shots to be available in the fall.
The process of tweaking the bivalent vaccines each year may eventually look similar to the routine we have in place for the flu vaccine, Dr. Schaffner says: “[Global health authorities] update the influenza vaccine twice a year in an organized fashion, [once for] the northern hemisphere and once for the southern.” That’s not currently the case for the COVID vaccines, which “are different and varied” from country to country, Dr. Schaffner says.