FDA looks to improve, simplify Covid vaccinations

Building on flu vaccine model, advisors to consider whether annual boosters are needed to prevent severe Covid and deaths; Study points to significant "long Covid" symptoms after mild Covid illnesses

Although I had planned to publish this newsletter today, I wasn’t expecting it to be right after getting a phone call that said:

“The result of your Covid-19 test is positive. You have Covid-19.”

I managed to evade Covid for three years, and now, this wily virus caught up with me. But it’s very different now from even a year ago. Treatments such as Paxlovid are readily available, and the “bivalent” vaccine provides good protection that reduces severity even among people who do get infected. So, I’ll be fine.

What’s harder is figuring out how to keep reducing Covid hospitalizations and deaths. A vaccine-resistant nation and an ever-changing virus are a bad combination. That’s why FDA advisors are meeting later this week to foster development of new vaccine formulations and a streamlined, simplified schedule.

Widespread infections provide some protection - but not enough

Because the Covid-19 virus keeps evolving and millions of Americans are not getting vaccinated, it’s unlikely that “herd immunity” will ever be reached. However, estimates are that 3 out of 4 Americans have had Covid. That plus the 70% who received the first and second round vaccinations protect against some deaths and severe illness.

But, fewer than 1 out of 5 Americans has gotten the updated “bivalent” booster, which has been shown to be much more effective against omicron and other recent strains. That low acceptance rate is one reason health officials are devising ways to simplify the confusing vaccine schedule.

Making Covid shots more like annual flu shots

When the FDA vaccine advisors meet on Thursday, they will review plans to adapt the Covid-19 vaccinations so that they can be administered once a year, much like seasonal flu shots that are tailored to prevalent strains. Because so many Americans have at least some existing immunity to Covid because they have either had it or been vaccinated, “individuals may only need to receive one dose” of new vaccines to restore or boost immunity for a given time period.

Multiple studies conducted in the United States and Israel indicate that the bivalent boosters are effective against BA.1 and BA.2 strains of omicron. “Hybrid immunity,” from the combination of previous infection and vaccination appears to be strong, though at least one study indicates that three shots of an mRNA vaccine may be the best overall. While this data is not definitive, there is strong evidence supporting the vaccines, even for those who have been infected previously.

Long Covid affects many who had only mild Covid symptoms

Meantime, the reasons to keep trying to avoid Covid-19 infection keep mounting. A comprehensive review of studies from around the world led by Dr. Eric Topol of the Scripps Research Translational Institute in La Jolla, Calif., estimates that long Covid occurs in 10-30% of people who get Covid but don’t require hospitalization. Among the most significant common symptoms are chest pain, coughing, trouble thinking and blood clots.

“Long COVID is a multisystemic illness (that) has already debilitated millions of individuals worldwide, and that number is continuing to grow…. A significant proportion of individuals with long COVID may have lifelong disabilities if no action is taken,” say the researchers in their paper, published in Nature Reviews Microbiology.

A few interesting reads:

Haven't Had COVID Yet? Wanna Bet? (webmd.com)

42% of US adults likely have had COVID, but almost half of them say they didn't | CIDRAP (umn.edu)

The triple threat of Covid, flu and RSV peaked before the holidays - the surge wasn’t as bad as forecast

I hope you find this newsletter helpful. And if you haven’t gotten a Covid vaccination since the summer, it’s time for a booster. Find out more at Covid.gov.

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