Health

Since you already have the flu, why not one for Covid?


As the coronavirus transforms into a stubborn and unpredictable aspect of everyday life, scientists and federal health officials are focusing on a new strategy to immunize Americans: a campaign to immunize Americans. This fall, perhaps with a dose tweaked to combat the intended version of the virus. circulated.

The plan would borrow heavily from the books to distribute annual flu shots, and could become the template for arming Americans against the coronavirus in the years to come.

But some experts question how well a pandemic-weary public will receive a new round of vaccinations, whether doses can be rolled out quickly enough to reach those who need them most. no – and whether most Americans need additional injections.

On June 28, the Food and Drug Administration’s scientific advisors will meet to determine the coronavirus variant that is most likely to spread in the United States when temperatures are cool. That will give manufacturers time to decide if the vaccine’s composition needs to be modified and ramp up production, hopefully enough to produce hundreds of millions of doses by October.

FDA scientific advisers say they will prioritize switching to a new version of the vaccine if there is compelling evidence that current vaccines are no longer effective and the modified version is proven to be better.

The idea is that eligible Americans will be encouraged to seek immunizations against coronavirus and flu at the same time this fall, and in similar places: pharmacies, doctors’ offices, clinics aisles and the like. Some important details — like who will be eligible — will be arranged next month at meetings of scientific advisers for the FDA and the Centers for Disease Control and Prevention.

This plan will mark a departure from the current sequential authorization of booster shots for different age groups. But the shortcomings of the annual method have been obvious to flu researchers for many years.

Scientists and federal health officials typically decide to develop a flu vaccine in the spring, six months before flu season. They guessed which version of the flu virus would reach the United States by looking at what was circulating in the Southern Hemisphere, among other factors.

But in some years, “by the time the vaccine is made, the strains have changed and then you might not have a good match,” says Dr Ofer Levy, director of the precision vaccine program at Hospitals. Boston Children’s Hospital and an FDA advisor. , speak.

Among the contenders for fall Covid footage is an intensifier designed for Omicron, the weird new avatar of the coronavirus, and the combinations that comprise it. Moderna’s top booster candidate contains 25 micrograms each of the original vaccine and one tailored for Omicron, said Dr. Paul Burton, the company’s chief medical officer.

Pfizer is also testing an Omicron-specific vaccine, but won’t make a decision on a fall candidate until June, according to Jerica Pitts, a company spokeswoman.

Even if the vaccine combination isn’t perfect, boosting immunity will provide some protection against any new variants in the fall, much like the flu vaccine.

The number of Americans choosing to get a booster shot has been steadily decreasing with each new recommended shot. While 90% of American adults have received at least one dose of the Covid vaccine, 76% chose the second dose and only 50% for the third dose.

Dr Matthew Daley, senior investigator at Kaiser Permanente Colorado, who leads the CDC’s vaccine working group, said: “Looking at additional doses for increasingly small gains is making the impression. Imagine that we don’t have an effective vaccination program.

Daley and other advisers warned at a committee meeting last month that a nationwide campaign for another vaccine would exhaust pharmacists, providers and public health workers. strength.

And experts fear that ramping up doses of the supplement this fall, when the risk of severe illness and death is likely low for most Americans, could cut immunization readiness. collective later if a new variant emerges and the public urgently demands it.

Repeat vaccinations can even reduce the effectiveness of the vaccine. For example, people who get vaccinated against the flu for one year develop stronger immunity than people who get vaccinated two years in a row, says Florian Krammer, an immunologist at the Icahn School of Medicine at Mount Sinai. New York, note.

Despite the doubts, federal officials are preparing for a fall campaign. Peter Marks, director of the FDA’s Center for Biological Evaluation and Research, said pairing the Covid vaccine with the flu every year is the simplest way to convince Americans to line up for a vaccine.

“It saves people time,” says Dr. Marks. “And it could mean more people getting both vaccines, which would be a good thing.”

Agency scientists are actively debating the best ingredients for fall vaccines with the World Health Organization, National Institutes of Health and vaccine manufacturers, Dr. Marks said. .

The FDA favors providing near-identical Pfizer-BioNTech and Moderna vaccine formulations, to avoid confusing people. If not, “I worry that could really cripple a vaccine campaign, when the most important thing is for people to get healthy,” Dr. Marks said.

However, if the flu vaccine were any indication, many Americans would forgo another Covid shot. The Omicron variant has made it clear that preventing all infections is an unattainable goal and many people consider themselves to be at little risk of serious illness or death.

However, Dr. Marks notes that flu campaigns also aim to prevent loss of productivity, not just medical consequences.

Before the Omicron variant emerged, administration officials said the Covid vaccine was intended to prevent all symptomatic infections, but they have since backed away from that stance.

While the Covid vaccine reduces the spread of earlier variants by up to 70%, “that is clearly not true for Omicron,” he said. “It would be great if there was something that did a better job.”

Some experts say that, rather than another round of injections, the best candidate to limit infection would be a nasal spray that coats the nose and throat with antibodies to block the virus at its entrance. its. But those sprays won’t be available in the United States for at least two or three years.

Until Omicron came along, FDA scientists were so excited about an mRNA vaccine that they didn’t consider alternative boosters, Dr. Marks added: “We may have been temporarily overwhelmed blinded by light.”

Still, minimizing infections whenever possible is “clearly a very, very important secondary goal,” said Dr. Sara Oliver, who represents the CDC on the Covid vaccine working group. -19, said.

In addition to limiting the spread of the virus and social disruption, reducing infections will reduce persistent cases of Covid, the group of symptoms that can persist for months, she said.

The new plan could revive some long-standing tensions. Disagreements over who should recommend a vaccine, and to whom, have stirred these agencies for months.

Generally, FDA scientific advisors review vaccine safety and effectiveness and recommend licensing or approval. The CDC consultants will then issue guidance on who should get the vaccine and when.

During a pandemic, the lines between the White House, the FDA, and the CDC are often blurred. “Right now, one of the challenges is that we have so many voices talking about vaccination policy, and historically we’ve only had one voice,” said Dr. Daley.

For example, when the FDA authorized a second booster shot, it only applied to adults 50 years of age and older — a distinction typically made by CDC vaccine advisors.

The CDC also makes a subtle distinction that many Americans have lost: It recommends that adults over 50 can get a booster shot if they want, but that they shouldn’t. But the new White House Covid tsar, Dr Ashish Jha, endorsed the second booster shots.

Dr. Camille Kotton, an infectious disease physician at Massachusetts General Hospital and scientific adviser to the CDC, said of Dr. Jha.

It is unclear who will pay for a fall vaccination campaign. The impasse by Congress over funding for Covid-19 jeopardizes the government’s ability to procure and deliver vaccines to those most in need.

“Without additional emergency funding, we cannot guarantee a booster shot for every American who wants it if they need it by the fall, and we cannot guarantee a newer, more effective vaccine.” to protect against new variants,” said Sarah Lovenheim, assistant secretary for public affairs at the Department of Health and Human Services.



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