Will updated COVID shots be too late?

CHENNAI: Roseann Renouf, 77, has grown tired of the current generation of coronavirus shots. Having “never been one for a lot of vaccination,” she decided to forgo the latest round of boosters after watching vaccinated friends contract COVID-19, even though the doses offer a critical extra layer of protection. “It’s just taking another same booster,” Renouf, a retired nurse anaesthetist from Fort Worth, said. “They haven’t done anything different with them to cover new variants.”

But her gripe about the COVID vaccines may soon be settled. American regulators committed last week to updating the 2020 vaccine recipes for this fall’s booster campaign with new formulas meant to defend against the ultra-contagious Omicron subvariants, offering Renouf and other holdouts a fresh reason to change their minds. The Biden administration is betting that the new cocktails, the centrepiece of an effort to drastically speed up vaccine development, might appeal to the half of inoculated Americans who have so far spurned booster shots, a key constituency in the fight against future COVID waves.

Vaccine updates are becoming more urgent by the day, many scientists said. The most evasive forms of Omicron yet, known as BA.4 and BA.5, appear to be driving a fresh surge of cases across much of the United States. The same subvariants have sent hospital admissions climbing in Britain, France, Portugal, Belgium and Israel. COVID deaths in the United States, which had been hovering for months near their lowest levels of the pandemic, are rising again. In the worst case, epidemiologists have predicted some 200,000 COVID deaths in the United States within the next year.

“We’re hoping that we can convince people to go get that booster,” said Dr. Peter Marks, who oversees the vaccines office at the Food and Drug Administration, “and help mature their immune response and help prevent another wave.” Many scientists believe that updated boosters will be critical for diversifying people’s immune defenses as subvariants eat away at the protection offered by vaccines. Catching up with a virus that has been so rapidly mutating may be impossible, they said. But it was far better to be only a few months, rather than a couple of years, behind the pathogen. Omicron is so different that, to me, it seems pretty clear we’re starting to run out of ground in terms of how well these vaccines protect against symptomatic infections,” said Deepta Bhattacharya, an immunologist at the University of Arizona. “It’s very important that we update the shots.”

Now, the question is whether those modified boosters will arrive in time. In a bid to match the latest forms of the virus, the F.D.A. asked vaccine manufacturers to tailor their new shots to the BA.4 and BA.5 subvariants, rather than to the original version of Omicron from last winter.

Virologists said that a subvariant vaccine would generate not only the strongest immune defenses against current versions of the virus, but also the type of broad antibody response that will help protect against whatever form of the virus emerges in the months ahead. But building a fall booster campaign around vaccines at the forefront of the virus’s evolution could also come at a cost. Pfizer and Moderna said that they could deliver subvariant vaccine doses no earlier than October. Some F.D.A. advisers warned in a public meeting last week that the timeline could be slowed even further by any number of routine delays.

In contrast, a vaccine targeting the original version of Omicron is closer at hand: Moderna and Pfizer have already started making doses tailored to the original form of Omicron, and Moderna said that it could start supplying them this summer. Whether the benefits of a newer subvariant vaccine outweigh the drawbacks of having to wait longer depends on when exactly it arrives and how much havoc the virus wreaks before then, scientists said. They said that having some form of an updated vaccine by the fall was crucial.

Mueller is a journalist with NYT©2022

The New York Times