Many people wonder: Does this mean that everyone will need an annual Covid-19 amplifier? Do we need reinforcements even more often? Will it be combined with the flu vaccine? Will new vaccines be developed targeting new variants? And should they wait to receive the boost if they are eligible or get it now? Dr. Leana Wen: We do not know yet. There are many variables here, and only time – and constant research – will show it. First, we do not know how long immunological protection from the vaccine and the first aid will last. There are many indications that the first aid is very important. During a time when Omicron was the predominant variant, the effectiveness of three doses against severe disease remained high at 94%, according to a study by the US Centers for Disease Control and Prevention. If this protection starts to decrease substantially, it would be a sign that another amplifier is needed. Second, there may be new variants that develop over time. The flu vaccine is given annually after being reshaped each year for new mutations. Current vaccines work well against Omicron subtypes, but if there are future variants that avoid vaccine-induced immunity, that is another reason for additional vaccinations. Third, we need to monitor how widespread Covid-19 is. At the moment, it is still rampant all over the world, but if it ends up fading, regular booster doses may not be needed. As Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, told CNN, “Will it eventually reach such a low that we may not even need a boost every year?” This is possible, but we do not know yet. Fourth, we need to see if there is clear seasonality in future Covid-19 outbreaks. Other coronaviruses that cause the common cold are more common in the winter, as are other respiratory viruses such as RSV (respiratory syncytial virus) and the flu. It is possible that SARS-CoV-2 is also present, and there have been increases during the winter months. This piece, however, we still have to see in the coming autumn and winter season. Finally, there are accounting factors to consider. Adding an annual vaccine is a big undertaking. The absorption of the flu vaccine is already low. only about half of Americans get it each year. With the misinformation and polarization surrounding Covid-19, encouraging this frequency level will be a big undertaking. CNN: At the moment, a second amplifier is allowed four months after the first one, which means that the current frequency is higher than once a year. Could amplifiers be needed even more than once a year? Wen: It’s possible. I want to emphasize that there is a lot we do not know, simply because we do not have the ability to predict the future. There are a few different scenarios that could happen. One is that some groups of people may need more frequent vaccinations. Remember that people who are moderately or severely immunocompromised are advised to take extra booster for months. It is possible that in the future, some more vulnerable populations may be advised to get vaccinated more frequently than the general population. In addition, they will also need to be unexpected if a new variant emerges that avoids the previous immunity. There should be the possibility of developing, manufacturing and rapidly distributing vaccines for specific variants. If this happens, the frequency may end up being more than once a year for a certain period of time. From now on, we need to look at the availability of other treatments and mitigation measures. For example, Evusheld is an antibody infusion that, when given to immunocompromised individuals, is very effective in reducing their chances of developing a serious illness. Antiviral pills and monoclonal antibodies are effective treatments when given early in the course of the disease. And there are other precautions, including coverage and pre-merger testing, that can also reduce the risk. CNN: If the Covid-19 vaccine were to be given annually, would it make sense to combine it with the flu vaccine? Wen: Theoretically, yes, but we just do not know if the Covid-19 vaccine should be annual. There are other vaccines that last longer. Tdap (tetanus-diphtheria vaccine), for example, requires a booster every 10 years. The polio vaccine is a four-dose vaccine – you take four doses and you are done. Hepatitis B is a three-dose vaccine. It is possible that Covid-19 could be three or four doses, and we are done, or may need to be updated more often like the flu. Again, we just do not know yet. If it turns out to be something that is annual and the seasonal pattern looks similar to the flu, then it would make sense to get a combined vaccine – or at least, do it at the same time as the flu vaccine -. CNN: Why are there no vaccines for specific variants that target Omicron? Wen: Scientists are working on these vaccines now. They are testing Omicron-specific vaccines and boosters to see if they could be even more effective than the original vaccines, which targeted previously dominant variants. One thought is that additional variants may occur, and scientists need to consider whether the Omicron-specific vaccines or the original vaccine – or a combination – will be more likely to be effective against possible variants in the future. That was one of the many topics discussed by US Food and Drug Administration advisers at their meeting this week. CNN: If people are eligible for amplifiers now, should they receive them or wait? Wen: It depends on the individual’s medical condition and how much he is willing to give up to avoid Covid-19, as I told CNN Q&A last week. Someone over the age of 65 and / or immunosuppressed should probably take the extra booster now. On the other hand, someone between the ages of 50 and 65 with no medical problems and recently had an Omicron infection could probably wait. Some people may postpone an additional reminder as long as they are well protected from serious illness. Others want to avoid any infection, even mild and asymptomatic infections. These are all personal decisions that should be made in consultation with your doctor. CNN: What is your advice for people under 50? Do people need to get their first booster? And go for their second? Wen: Everyone should get their first boost if they are eligible. The issue of the second amplifier is more complicated. If the person is under 50 years old and is moderately or severely immunosuppressed, they should also receive their second reminder. Another group that should receive their second booster, even if they are under 50, are those who have received two doses of the Johnson & Johnson vaccine and at least four months have passed since their last dose. All other teams under the age of 50 are not eligible to receive their second souvenir at this time and should not make their second.
