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New Omicron COVID Boosters Coming Soon: What to Know Now

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Editor’s note: Find the latest news and guidance about COVID-19 at the Medscape Coronavirus Resource Center.

New COVID-19 vaccine boosters targeting new strains of the Omicron virus are expected to roll out to the US in September, a month ahead of schedule, the Biden administration announced this week.

Moderna has signed a $1.74 billion federal contract to supply 66 million initial doses of a “bivalent” booster that includes the original “hereditary” strain of the virus and elements of the Omicron BA.4 and BA.5 variants. The government also decided to order 4 million doses for children, bringing the total contract to $1.8 billion. Pfizer also announced a $3.2 billion agreement with the US for an additional 105 million injections. Both vaccine suppliers have signed options to supply millions more boosters in the coming months.

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According to the CDC, about 83.5% of Americans have received at least one COVID-19 shot, with 71.5% fully vaccinated with the initial series, 48% receiving one booster and 31% two boosters. With about 130,000 new COVID cases per day and about 440 deaths, updated boosters could help curb those numbers by targeting the highly contagious and widely circulating strains of Omicron, officials say.

Federal health officials are still working out the details of guidelines and recommendations on who should get boosters, which are expected to come from the CDC and FDA. For now, the authorities have decided not to expand eligibility for second boosters of existing vaccines – they are now only recommended for adults over 50 years of age and immunocompromised individuals 12 years of age and older. Children aged 5 to 11 years are recommended to receive one booster vaccine 5 months after the first series of vaccinations.

To find out what to expect from the CDC and the FDA, we spoke with Keri Althoff, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Excerpts from this interview follow.

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Q: Based on what we know now, who should get one of these new bivalent amplifiers?

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A: Of course, there is a process for specific recommendations, but it looks like all people will be encouraged to get this bivalent booster, similar to the first booster. And there will probably be a recommended period of time since the last booster.

Right now, we have a recommendation for adults over 50 or adults at increased risk for severe COVID-related illness. [to get] second amplifier. There will probably be a timeline for them that says you should get a booster if you have X months or more after your second booster; or X or more months since the first booster if you only had one.

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Q: What about pregnant women or those who are being treated for chronic diseases?

A: I believe that once this bivalent booster becomes available, it will be recommended to all adults.

Q: And for children?

A: That’s a good question. This is what I’ve been digging into [and] I think parents are really interested in this. It is suggested that most children aged 5 years and older should get a single booster now if X days are left until the first round of vaccinations. Of course, these 6 months to 4.99 years are not yet suitable. [for boosters].

As a parent, I would like my children to qualify for bivalent booster therapy. It would be great if these boosters provided additional protection that kids could access before we send them to school this fall.

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Q: If you have never received a booster and only received a preliminary series of vaccines, do you need to get those earlier boosters before you get a new bivalent booster?

A: I don’t think they are likely to make it a requirement to limit the bivalent booster vaccine to only those who have already received the booster vaccine or have updated their vaccines at the time the bivalent booster vaccine becomes available. But it will depend on [CDC] vaccine advisory committee to make a decision.

Q: Are there any new risks associated with these boosters since they were developed so quickly?

Oh no. We continue to monitor this technology, and with all the mRNA vaccines that have been delivered, you’ve seen all of this monitoring play out to find, for example, different forms of inflammation in heart tissue and who might be affected. So these monitoring systems work, and they work very, very well, so we can detect these things. And we know that these vaccines are definitely safe. Oh no. We continue to monitor this technology, and with all the mRNA vaccines that have been delivered, you have seen how all this monitoring plays a role in detecting, for example, different forms of the virus. inflammation of the heart tissue and who it can affect. So these monitoring systems work, and they work very, very well, so we can detect these things. And we know that these vaccines are definitely safe.

Q: Some health experts are concerned that “vaccine fatigue” will affect the booster campaign. What do you think?

A: We saw this fatigue in the proportion of people who were buffed by the first booster and even buffed by the second. But it’s important to have these earlier boosters along with this new bivalent booster, because essentially what we’re doing is activating the immune system.

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We’re trying to speed up the process of boosting people’s immune systems so that when a virus gets in our way – as we know it will because [of] these Omicron strains that are highly contagious and really spreading through our communities – we can get the highest level of herd immunity, you won’t end up in the hospital.

Q: What other problems do you see in convincing Americans to get another batch of boosters?

A: One of the things I’ve heard a lot about and I’m really nervous about is people saying, “Oh, I got a full shot, I got a boost or didn’t get a boost, and anyway I had COVID, and it’s really nothing, it didn’t feel like anything special to me, and therefore I’m not going to level up anymore.” We have not yet reached the point where these guidelines are being rolled back in any shape, form or form. There are still people in our communities who are very vulnerable to severe illness and death, and we see hundreds of deaths every day.

There are consequences, even if it is not the severity of the disease, that is, hospitalization and death. And let’s not let the actual quality of the vaccine be so successful that it could keep you out of hospital. Don’t mistake this for “I don’t need another one.”

Q: Unlike the flu shot, which changes every year according to the circulating strains, the new COVID boosters provide protection against both old and new strains. Why?

A: It’s all about creating a broader immune response in humans so that as more strains emerge, which is likely to happen, we can create a broader population immune response. [to all strains]. Our individual bodies see the differences in these strains thanks to vaccination, which helps everyone stay healthy.

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Q: These new mRNA boosters have not been clinically tested. How strong is the evidence that they will be effective against emerging Omicron variants?

Answer: There have been some studies – some excellent studies – looking at things like neutralizing antibodies that we use as a surrogate for clinical trials. But this is not the same as examining the outcome of interest, which might be hospitalizations. So part of the challenge is to be able to say, “OK, this is what we know about the safety and efficacy of previous vaccines… and how we can relate that to the results of these new boosters at an earlier stage.” [before] clinical data available?

Q: How long will the protection of new boosters last – do we already know?

Answer: This time is still an issue, but of course what strains of COVID are circulating plays a big role in this. If we prepare these Omicron-specific boosters and then we have something completely new… we have to be more nimble because the options are ahead of what we can do.

It turns out to be something like a probability game – the more infections we have, the more the virus replicates; the more replications, the more opportunities for mutations and subsequent variants.

Q: How about a combination influenza and COVID vaccine? is it on the horizon?

A: My kids, who, like most kids, don’t like vaccines, always say to me, “Mom, why can’t you just put the flu vaccine and the COVID vaccine in one shot?” And I’m like, “Oh, from your mouth to the ears of some scientist.”

At a time like this where mRNA technology has completely disrupted what we can do with vaccines, in such a good way, I think we should be pushing the boundaries because that would be incredible.

Q: If you received a COVID vaccine that does not contain mRNA, such as vaccines made by Johnson & Johnson and Novavax, should you also receive an mRNA booster?

Answer: Right now, the CDC guidelines say that if your primary vaccine series did not contain an mRNA vaccine, then an mRNA booster is OK and is actually encouraged. So with a bivalent booster, nothing will change.

Q: Can I get a flu shot and a COVID boost at the same time, as recommended by the CDC for past vaccines?

A: I don’t expect there to be recommendations against this. But I would also advise keeping an eye on the recommendations coming out this fall on bivalent boosters.

I hope in the advice that the CDC is giving regarding COVID boosters, they will say that you should also consider getting the flu vaccine. You can also get a COVID booster first and a flu vaccine by October.

Q: After full stimulation, is it safe to stop wearing a mask, maintain social distancing, avoid crowded areas, and take other precautions to avoid COVID-19?

A: The virus will do what it does, which is to infect everyone it can and make them sick. So if you see a lot of transmission in the community – you know who’s sick with COVID in your kids’ schools, you know in your workplace and when people go out – it still signals some increase in virus circulation. So, look at this to understand what your risk is.

If you know someone or have a colleague who is currently pregnant or immunosuppressed, consider how you can protect them by wearing a mask, even if you are just having one-on-one meetings behind closed doors with that person. . .

So your mask question is an important one, and it’s important that people continue to hold on to these masks and wear them, for example, a week before you go to grandma’s to further reduce the risk of you not bringing anything here. .

The high level of public risk across the country is now high. Covid is here.

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