Does anyone need an annual Covid-19 booster?

CNN
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More people can now get a second Covid-19 booster shot Announced by federal health authorities They allow a wider group to receive a fourth dose of the two messenger RNA Covid-19 vaccines produced by Pfizer / BioNTech and Moderna.

Adults over the age of 50 who have previously received three mRNA doses can receive a second booster at least four months after the first dose. People who have been vaccinated twice with the Johnson & Johnson vaccine can also receive additional mRNA 4 months after the last boost.

Many are wondering: does that mean everyone needs an annual Covid-19 booster? Need booster shots more often? Are you planning to combine it with a flu shot? Are new vaccines planned to target new variants? And if they qualify, should they wait to get a booster or should they get it now?

To answer these questions, I spoke with CNN Medical Analyst Dr. Linawen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She also said,Lifeline: Doctor’s Journey in the Battle for Public Health.. ”

CNN: Does everyone need Covid-19 shots every year?

Dr. Liana Wen: Still do not know. There are many variables here, only the time and ongoing research can be seen.

First, we don’t know how long the vaccine and the first boost immunization will last. There is a lot of evidence that the first booster is very important. When Omicron was the predominant mutant, the efficacy of the three doses for severe disease remained high at 94%. Study by Centers for Disease Control and Prevention.. If this protection begins to weaken significantly, it indicates that another booster is needed.

Second, there may be new variants that develop over time. Influenza vaccine is given annually after being reconstituted annually for new mutations. Current vaccines work well against Omicron submutants, but if there are future mutants that circumvent vaccine-induced immunity, that is another reason for additional vaccination.

Third, we need to monitor how popular Covid-19 is. Currently, it is still rampant around the world, but if it becomes declining, regular booster immunization may not be necessary.As Dr. Anthony Fauci“Is it going to be so low that it doesn’t even need to be boosted every year in the end?”, President Joe Biden’s chief medical adviser told CNN. It’s possible, but I’m not sure yet.

Fourth, we need to see if there is a clear seasonality in future Covid-19 outbreaks. Other coronaviruses that cause the common cold are common in winter, as are other respiratory viruses such as RSV (respiratory syncytial virus) and influenza. SARS-CoV-2 is likely to be the same, and it is increasing rapidly during the winter. However, this part should also be seen in the upcoming autumn and winter seasons.

Finally, there are logistic considerations to consider. Adding an annual vaccine is a big job. Influenza vaccine intake is already low.That’s it About half of Americans Get it every year. Encouraging this level of frequency will be a big task due to the misinformation and polarization around Covid-19.

CNN: Currently, the second booster is already allowed four months after the first booster. In other words, the current frequency is more than once a year. Can boosters be needed more than once a year?

Wen: That is possible. I would like to emphasize that there are many things we do not know just because we do not have the ability to predict the future.

There are several different scenarios that can occur. One is that certain groups of people may need more frequent vaccines. Recall that people with moderate or severe immunodeficiency are advised to take additional boosters for several months. In the future, it may be recommended that certain more vulnerable populations be vaccinated more frequently than the general population.

In addition, contingencies must occur when new variants emerge that evade previous immunity. You should have the option to develop, manufacture, and rapidly distribute mutant-specific vaccines. If this happens, the frequency can be more than once a year for a particular time period.

In the future, the availability of other treatments and palliatives should also be considered. for example, Evusheld is an antibody injection It is very effective in reducing the likelihood of progression to a severe illness when given to a person with immunodeficiency. Antiviral drug When Monoclonal antibody It is an effective treatment when given in the early stages of the disease. There are also other precautions, such as pre-gathering masking and testing, that can reduce the risk.

CNN: If The Covid-19 vaccine will be given annually, does it make sense to combine it with the flu vaccine?

Wen: In theory, that’s the case, but I’m not sure if you need to get the Covid-19 vaccine each year.

There are other vaccines that will last longer. For example, Tdap (tetanus-diphtheria vaccine) requires booster immunization every 10 years. Polio vaccine is a four-dose vaccine. Inoculate 4 times and you’re done. Hepatitis B is a three-dose vaccine.

Covid-19 can be given in 3 or 4 doses and may need to be completed or renewed more often like the flu. Again, I don’t know yet. If it becomes yearly and the seasonal pattern looks like flu, it is wise to have a combined shot or at least get it at the same time as the flu shot.

CNN: Why are there no mutant-specific vaccines targeting Omicron?

Wen: Scientists are currently working on these vaccines. They are testing Omicron-specific vaccines and boosters to see if they are even more effective than the original vaccines that previously targeted the predominant variants.

One consideration is that additional variants may occur. Scientists need to consider whether the Omicron-specific vaccine, the original vaccine, or some combination will be most effective against potential variants in the future.This was one of many problems US Food and Drug Administration Advisor It was discussed at their meeting this week.

CNN: If people are now qualified as boosters, should they get them or should they wait?

Wen: It’s the medical situation of the individual and I’m our Last week’s CNN Q & A.. People over the age of 65 and / or immunocompromised probably need to get additional boosters right now.

On the other hand, people between the ages of 50 and 65 who have no medical problems and have recently been infected with Omicron can probably wait. Some people may postpone additional boosters as long as they are well protected from severe illness. Others want to avoid any infections, even mild and asymptomatic infections. All of these are personal decisions made in consultation with your healthcare provider.

CNN: What’s the booster advice for people under the age of 50? Do people need to get the first booster? And should they go second to them?

Wen: If you qualify, everyone needs to get the first booster. The problem with the second booster is more complicated. If the person is under the age of 50 and has moderate or severe immunodeficiency, he or she should also receive a second boost. Another group that needs a second booster, even under the age of 50, is the group that received the Johnson & Johnson vaccine twice, at least four months after the last dose. All other groups under the age of 50 are not currently eligible to receive a second booster and should not go to a second booster.