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Covid-19: Annual flu-like booster approach may not be adequate, infectious disease experts say


Dear Editor

I read your news item (1), which covers questions expressed by experts about the need for an annual flu-like booster approach to COVID. I welcome and support the call to strengthen pandemic preparedness. He points out potential differences between COVID and flu vaccines. However, he agrees that getting a boost is important, but today’s science doesn’t tell us how often we should get a boost.Each country uses established systems and processes. to develop and implement his COVID vaccination policy for 2023. In the UK, the Joint Committee on Immunization and Immunization (JCVI) has provided interim advice (2) on COVID to the government. -19 vaccination program in 2023. Final advice on the spring booster program is coming soon. According to JCVI, “COVID-19 vaccination programs continue to reduce severe illness across the population while helping protect the NHS.”

The U.S. Food and Drug Administration (FDA) has announced a publication titled “Future Vaccination Regimens to Address COVID-19” (3) that is being considered at the Vaccines and Related Biologics Advisory Committee meeting on January 26, 2023. released a briefing document. Briefing documents provide the rationale for periodic population growth proposals. Data from vaccine efficacy studies “provide preliminary real-world evidence to support the use of bivalent mRNA boosters. The beneficial effects associated with reduced hospitalization and mortality in these studies are , most prominently in the elderly, but younger people also appear to benefit from reduced symptomatic illness and healthcare utilization. It is a widely accepted intervention in individuals aged 6 months and older” (3).

This paper discusses the difficulty and complexity of coordinating and agreeing on changes in vaccine strain composition. These include the lack of a well-established and highly coordinated infrastructure and governance for semi-annual vaccine composition evaluation and recommendation that currently exists for influenza vaccines. Moreover, the diversity of vaccine manufacturers and complex global vaccine supply chains further hinder coordinated global efficacy. One of the key issues that the US committee will address is what to do with routine routine strain selection procedures.

Dire consequences of delaying boosting include risk of infection, ongoing disease spread, increased prevalence, morbidity, hospitalization, and mortality. Statistical modeling (4) indicates that initiating regular population-wide booster vaccinations updated to the dominant variant may significantly reduce COVID-19. Another argument put forward for periodic boosting is that it partially suppresses infection and circulating virus levels, thereby reducing the risk of emergence of subspecies. Modeling results further indicate that boosting at least once a year significantly reduces long-term risk of infection. We also need to consider the costs and logistics of implementing population-based interventions. A yearly booster with proper updates may be our best chance to keep the virus at bay and protect our population and healthcare system.

There are competing priorities and varying interests due to the huge amount of capital required. The US government has spent his $30 billion on COVID vaccines (5). Developed and wealthy countries are more likely to adopt a periodic boost approach, bringing the masses with us to ensure maximum coverage to ensure the best value for taxpayers. It is imperative that there is a scientific and political consensus to follow.

Dr. Padmanabhan Badrinath, former consultant in public health medicine
[email protected]

Disclaimer: The views expressed here are the professional views of the author and do not represent the views of any organization with which the author is or was previously associated.


1. Mahase E. Covid-19: An annual flu-like booster approach may not be appropriate, says infectious disease expert BMJ 2023.
Available from 380 :p196 doi:10.1136/bmj.

2..GOV.UK. JCVI recommends fall COVID-19 vaccine booster. JCVI will make interim recommendations to the government.
2023 COVID-19 vaccination program. UKHSA [Internet]. [cited 2023 Jan 25]Available from .…

3. FDA Briefing Document Future Immunization Regimens to Address COVID-19. FDA [Internet]. [cited 2023 Jan 25]. Available

4. Townsend JP, Hassler HB, Dornburg A. Alternating frequency of infection with SARS-CoV-2 and boosting with mRNA vaccine. J.
Med Vilor. January 5, 2023. doi: 10.1002/jmv.28461. Epub before printing. PMID: 36602045.

5. Kates J, Cox C, Michaud J. How much could the US cost after commercializing a COVID-19 vaccine? KFF [Internet]. [cited
2022 Dec 7]Available from .…
Cost after commercialization/




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