Vaccinations against COVID-19 are at a critical juncture as companies test whether new approaches such as combined injections or nasal drops can deal with the mutated coronavirus – although it is unclear whether changes are needed.
There is already public confusion about who should get a second booster now and who can wait. There is also a debate about whether almost everyone may need an extra dose in the fall.
“I am very concerned about booster fatigue, which is causing a loss of confidence in vaccines that still offer very strong protection against the worst outcomes of COVID-19,” said Dr. Beth Bell of the University of Washington, an adviser to the Centers for Control. diseases in the United States and prevention.
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Despite success in preventing serious illness and death, there is growing pressure to develop better vaccines to prevent milder infections, as well as options to counter the dreaded options.
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“We’re going through a fire drill, it seems every quarter, every three months or so,” when another mutant triggers frantic tests to determine if the shots hold up, Pfizer vaccine chief Catherine Jansen said at a recent meeting at the New York Academy of Sciences. .
Still, looking for improvements for the next round of vaccinations may seem like a luxury for American families concerned about protecting their youngest children – children under 5 who are not yet eligible for vaccination. Dr Jacqueline Miller of Moderna told the Associated Press that her request for two low-dose injections for young children would be submitted to the Food and Drug Administration “soon enough”. Pfizer has not yet reported a third dose of its extremely low dose for young children, after two were not strong enough.
COMBINATION PICTURES MAY FOLLOW
The original COVID-19 vaccines remain highly protected against serious illness, hospitalization and death, especially after a booster dose, even against the most contagious variants.
Updating the vaccine prescription to match the latest variants is risky, as the next mutant may be completely unrelated. So companies are taking the example of the flu vaccine, which offers protection against three or four different strains with one injection each year.
Moderna and Pfizer are testing 2-in-1 protection against COVID-19, which they hope to offer this fall. Each “bivalent” injection would mix the original, proven vaccine with an omicron version.
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Moderna has a hint that the approach may work. He tested a combo shot that targeted the original version of the virus and an earlier version called beta_, and found that vaccine recipients had developed modest levels of antibodies capable of fighting not only beta but also more new mutants like omicron. Moderna is now testing its bivalent candidate targeting omicron.
But there is a deadline. Dr. Doran Fink of the FDA said that if updated photos are released in the fall, the agency will have to decide to change the recipe by early summer.
DON’T EXPECT BOOSTERS EVERY SEVERAL MONTHS
For the average person, two doses of Pfizer or Moderna plus one booster _ a total of three injections _ “prepare” you and you’re ready for what could become an annual booster, said Dr David Kimberlin, CDC advisor at the University of Alabama in Birmingham.
After this first booster, CDC data suggest that an extra dose offers a gradual, temporary benefit to most people.
Why the emphasis on three frames? Vaccination triggers the development of antibodies that can repel coronavirus infection, but naturally decrease over time. The next line of defense: Memory cells that jump into action to make new fighters against viruses if an infection sneaks in. Researchers at Rockefeller University have found that these memory cells become more powerful and can target more diverse versions of the virus after the third injection.
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Even if someone who has been vaccinated gets a mild infection, thanks to these memory cells, “there is still enough time to protect you from a serious illness,” said Dr. Paul Ofit of Children’s Hospital of Philadelphia.
But some people – those with severely weakened immune systems – need more doses in advance for a better chance of protection.
And Americans in their 50s and older are being offered a second booster, following similar decisions by Israel and other countries that offer an extra chance to give older people a little more protection.
The CDC is developing tips to help eligible people decide whether to get an extra injection now or wait. Among those who may want a second booster earlier are the elderly, people with health problems that make them particularly vulnerable, or who are at high risk of exposure to work or travel.
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CAN NOSAL VACCINES BLOCK THE INFECTION?
It is difficult for a shot in the hand to form many antibodies that fight viruses in the nose, where the coronavirus fastens. But the nasal vaccine may offer a new strategy to prevent infections that disrupt people’s daily lives, even if they are mild.
“When I think about what would make me get a second booster, I’d actually like to prevent an infection,” said Dr. Grace Lee of Stanford University, who chairs the CDC’s immunization advisory committee. “I think we need to do better.”
Nasal vaccines are difficult to develop and it is unclear how quickly they will become available. But few are in clinical trials worldwide. One in a later stage of testing, produced by Indian Bharat Biotech, used the chimpanzee cold virus to deliver a harmless copy of the coronavirus protein to the nasal mucosa.
“I certainly don’t want to give up the success we’ve achieved,” said COVID-19, said Dr. Michael Diamond of the University of Washington in St. Louis, who helped create the candidate, who is now licensed for Bharat.
But “we will have a hard time stopping transmission with the current systemic vaccines,” Diamond added. “We’ve all learned it.”
© 2022 Associated Press
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