Biden Has Called for Yearly Booster Shots for COVID-19. But is That Even Possible

Biden Has Called for Yearly Booster Shots for COVID-19. But is That Even Possible?

Although the Biden administration seems eager to adopt an annual COVID-19 booster strategy, the coronavirus and its numerous variants present challenges.

In October, when President Joe Biden rolled up his sleeve to receive the COVID-19 booster, he made a promise that most Americans would only require one coronavirus shot per year.

“For most Americans, one COVID shot each year will be all they need,” Biden said at the White House. “And if you get it, you’ll be protected. And if you don’t, you’re putting yourself and other people at unnecessary risk.”

He has also spread the idea on Twitter, saying: “Most people will only require one dose of the updated COVID vaccine, according to national experts, to remain protected all year. Once a year, a single shot. Just like flu.”

A number of Biden’s top health officials have reaffirmed the thesis.

“It is becoming increasingly clear that, looking forward with the COVID-19 pandemic, in the absence of a dramatically different variant, we likely are moving toward a path with a vaccination cadence similar to that of the annual influenza vaccine, with annual updated COVID-19 shots matched to the currently circulating strains for most of the population,” leading infectious disease expert Anthony Fauci said in September.

A COVID-19 booster shot should be administered annually, but more than three months after the Biden administration first suggested it, no official policy has been announced due to unanswered questions and obstacles.

One reason is that creating a shot that precisely matches the COVID-19 variants that are in circulation is challenging; this is a problem the flu vaccine encounters every season. Both the original coronavirus strain and the updated bivalent vaccines were included in the design of the updated bivalent shots. The variant scene has changed since the shots began to roll at the end of August, as is to be expected.

While XBB.1.5 now leads the variant pack and is responsible for over 40% of COVID-19 infections in the U.S., BA.5 was the predominant strain circulating in August. last week, according to estimates from the Centers for Disease Control and Prevention It’s been called the “most transmissible subvariant that has been detected yet,” and it’s unclear how well the updated booster shot will stand up to it.

This indicates that while public health officials believe the updated boosters will still provide increased protection against serious illness, hospitalization, and death from XBB.1.5, the shots aren’t a perfect match to the omicron subvariants that are causing the majority of infections.

It serves as a sobering reminder of how quickly the alternative scene can shift. The Biden administration has acknowledged that a new variant can appear at any time, which is one of the biggest drawbacks of switching to an annual COVID-19 booster cycle.

“The wild card of a way-out, out-of-left-field variant coming, if that happens, all bets are off and we change,” Fauci said of the annual booster idea.

However, this strategy has other problems besides variants. Additionally, the Biden administration would have to choose when to administer the shot, which might be trickier than it seems.

Officials from the administration have compared the COVID-19 booster campaign to the flu shot, which is advised in the fall to maximize protection during the winter, when the flu season typically surges.

However, the coronavirus has not yet developed a seasonal pattern; it still experiences spikes in the summer, fall, and winter.

“We know that the vaccine is protective, but you want to have that right before there’s a lot of transmission in your community because it’s most effective soon after it’s administered,” says Keri Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

The issue is that the COVID-19 vaccine’s ability to produce antibodies wanes over time, with prior research indicating that the first three months see a significant decline. However, each person’s situation is unique, and immunity to serious illnesses typically lasts longer than immunity to infections.

“When we talk about waning antibodies, we have to remember that this is not a switch,” Althoff says. “It doesn’t mean that after six months, all of a sudden, you have no protection left from a vaccine.”

Additionally, experts concur that the solution is not to administer a booster shot every three to four months as the antibodies from the prior shot deteriorate.

“Are we going to be in a situation where we’d recommend a vaccine every three or four months just because antibodies are waning?” No, Althoff says, “but we are likely going to be in a situation where if we see an annual vaccine for COVID, we will want to think through the timing of that to ensure the greatest protection conveyed during the times we anticipate the highest levels of transmission in our communities.

At an upcoming Food and Drug Administration meeting in late January, a committee of vaccine experts will specifically be debating these issues. Among other things, they will talk about “how and whether the composition and schedule for booster doses should be adjusted moving forward.”

“Since the initial authorizations of these vaccines, we have learned that protection wanes over time, especially as the virus rapidly mutates and new variants and subvariants emerge,” FDA’s Peter Marks said in a statement announcing the meeting on Jan. 26. “Therefore, it’s important to continue discussions about the optimal composition of COVID-19 vaccines for primary and booster vaccination, as well as the optimal interval for booster vaccination.”

Marks said that he is “hopeful this upcoming discussion will provide us with the optimal path forward for COVID-19 vaccines, ensuring that the public is as well-protected as possible from virus variants that are constantly changing.”

The Biden administration has already widely publicized its aim of a yearly COVID-19 booster campaign, so the agency’s outside experts face a difficult task. The agency’s ability to conduct an objective discussion about the ideal vaccination schedule may be hampered by this public objective.

William Schaffner of the Vanderbilt University Medical Center says that the Biden administration is in a tough spot because it “needs to point the population in a certain direction that gives them a sense of where we’re going and heading.”

“I empathize with political leaders because they’re in a delicate position,” he says. “I always wanted them to say, “I hope we’re moving in this direction, but we haven’t decided yet.'”

Public health officials will likely face a difficult fight against vaccine fatigue if the campaign for the updated boosters was intended to test the feasibility of switching to annual shots.

Approximately 15% of Americans over the age of four have received the shot, according to the CDC, a much lower rate than experts had anticipated given that the shots were authorized in late August.

“The vaccine hasn’t been accepted as widely or enthusiastically as any of us in infectious diseases and public health had anticipated, expected and hoped for,” Schaffner says.

“It’s been a particular challenge this season because we’ve asked people to really roll up their sleeves to get not just one vaccine but two: the updated COVID booster as well as the routine seasonal influenza vaccine,” Schaffner continues. “And we aren’t performing nearly as well as we would like in the acceptance of both of those vaccines.”

He does, however, hold out hope that efforts to combine the COVID-19 vaccine with the flu vaccine will be successful in addressing the uptake issue.

“That, of course, would be much more acceptable to the general population than having to get two shots,” Schaffner says.

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