The conundrum, from the Reuters article:
vaccine makers are pushing for a flu-like model that would allow them to nimbly retool their shots to combat new variants.
but…
regulators do not have enough experience with COVID vaccines to match them to circulating strains without clinical trials.
I would think that the Biden administration would push for the “nimble” path for vaccination updates.
It may technically be an emergency approval, but I doubt the FDA will be in any emergency-style rush. Seems more likely that they’re looking to get on a fixed schedule, as for seasonal flu, maybe every six months.
You obviously don’t understand FDA EUA timelines etc. - they are not meant for a fixed schedule in this case
I don’t know how long after a new flu variant comes into existence that it takes to modify the vaccines against it, but the variants have to exist first. The annual flu shots protect against the four variants most likely to cause an epidemic in the fall-winter flu season. Sometimes they’re right, sometimes they’re wrong, but the response is very “nimble” in terms of development time.
I would hope that the future holds just one covid vaccine per year, but we’re not there yet. We’re still in an emergency situation, where modifications to the current vaccines, which have been shown to be safe, need to be approved very rapidly. (EUA = emergency use authorization)
i understand how American politics are likely to affect future booster approvals.
No, vaccines can protect against new mutations so long as they’re not too different. The first round of Covid vaccines were highly protective against infection by Alpha, Beta, and Delta, and even for Omicron they still provide strong protection against hospitalization and death.
Yes, that was true for early versions of Omicron but evidently not the most recent ones, at least in terms of antibody protection. The flu can also mutate just before the annual decisions are made for the flu shots, and in that case the response has to be “nimble”. Let’s hope things eventually work out that way with covid vaccines so that we need only one inoculation per year. Best case scenario would be if it could be combined with the annual flu shot.
The existing vaccines offer little or no protection against infection by Omicron variants because they’re very different, with over 50 mutations.
If SARS-CoV-2 continues mutating at the rate it has to date (and why would it not?) one booster a year likely won’t be enough.
You can’t generalize as it depends on the sub-mutants. The current vaccines gives actually good protection against omicron BA1/2 (4-6 months) but afterwards the efficacy is waning but that also happened against non-omicron variants
The current vaccines obviously give little or no protection against infection by any Omicron variant. That was clear to me in December, when an acquaintance had a big family reuinion where everyone had to show proof of vaccination and booster, and all but one got it. That’s why the January spike was so insanely huge.
How much efficacy wanes in real-world terms, well,
They don’t give currently protection against infection because many people got their shots 6+ months ago, If a large majority of people would have gotten their last shots 2-4 months ago we wouldn’t see the rise in infection even with omicron. The diminishing protection against infection over time is also not specific for omicron but would similarly happen with delta etc. Read the Nature paper
And the spike in January wasn’t because of missing protection against omicron infection but people weren’t willing to get their booster shots (we are still at 31% in the US) and so their last shot was 6+ months out
No, in December, all the people at that reunion had gotten their boosters within the previous two months.
Some of them were asymptomatic. Note that the Qatar studies count only symptomatic cases. The most recent study found boosters are 52% effective against symptomatic infection. The other 48% could simply be asymptomatic, which is likely given the number of asymptomatic cases detected at hospitals in recent months when people have been admitted for other reasons.
This is the problem I have with all studies and reports involving only reported/detected symptomatic cases.
Nevertheless, based on essentially all recent discussion that I’ve read, I agree with the UCSD infectious disease specialist who, in the same LAT article, is quoted as saying:
“Getting COVID right now — if you’re vaccinated up and you’re reasonably healthy — is more of a nuisance than it is a life-threatening event for most people” (italics mine)
That’s about as positive an outlook as one can have about covid at this point.
That’s great for “most people.”
This is a useful, comprehensive list.
BA5 is coming
“Even if you had some immunity from prior infection like BA.1 you are still at high risk of getting reinfected with these variants. They potentially find a way around immune response also in cause of infection. This is why they outcompete the dominant strain. Because they are more transmissible and can get around the immune system,” said Abraar Karan, Infectious Diseases at Stanford University.
BA.4 and BA.5 are already dominant in California.
BA4 based on mutation profile is less of a concern. BA5 is the one which kind of combines omicron with delta. The question is if we are willing to take updated booster shots without clinical trials
I wonder if any of the available rapid tests are reliable for BA.5.
Since BA.4 and BA.5 only emerged recently, it has not yet been possible to include the variants in a rapid antigen detection test (RADT) evaluation study.
So far I’ve found only press releases from two test manufacturers claiming theirs are.
