A panel of experts at the FDA is expected to recommend annual COVID boosters, like those offered for the flu. Many believe an annual booster, updated each year with the most common strains of the virus, is the most effective way forward, especially since the majority of people have had some level of exposure to COVID-19, whether in a vaccine or through contracting the virus itself.
"We're dealing with a situation where most people have been exposed to the coronavirus in one way or another and have some memory cells," said Dr. Wesley Long, the medical director of microbiology at Houston Methodist.
The "memory cells" he referred to have to do with the immunity the body creates against a pathogen after being exposed to it. "So the question is how we best tailor those memory cells and their immune response to whatever happens to be circulating this year. The best way to do that is likely with an annual vaccine that is going to be likely updated from year to year."
Long also believes an annual vaccine may simplify recommendations and clear up confusion around when and where to get booster shots, potentially resulting in more people getting boosted who previously have been confused by the recommended booster timeline or found it difficult to have to schedule more than one shot.
Nationally, only around 15% of people report having gotten the most recent bivalent booster. In Harris County, numbers are even lower. Many at the FDA think that perhaps more people will get the Covid booster as a result of increased convenience, since they could get their yearly flu shot and Covid vaccine at the same time. "That way people wouldn't need to find childcare or take off work more than necessary," Long said.
Others worry that a yearly bivalent booster may still offer less than optimal protection, since COVID-19 mutates more quickly than the flu. Offering boosters more than once a year, however, would be costly.
"The boosters have gone up in price as companies are gouging to $130 per dose," said Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine and Co-Director of the Texas Children's Hospital Center for Vaccine Development. This is a substantial cost increase: according to the most recent federal contracts from July, Moderna and Pfizer charged $26 and $30 per dose, respectively.
Beyond just cost, while COVID-19, like the flu, sees the number of infections go up in the winter, places like Texas also saw a summer spike in coronavirus infections. This leads many experts to believe that once a year may be too infrequent for optimal protection, since waves are less predictable than flu season.
Still, Dr. Hotez supports the recommendation of yearly boosters.
"Recommending a yearly booster may offer a compromise between what the science dictates and what's actually realistic from a policy and financial perspective," he said.
Hotez warns that it is still not time to be overly complacent.
"We aren't seeing 2,000 or 3,000 COVID deaths a day anymore, but we are seeing 400 to 500, which is still a lot of deaths," he said.
The booster would likely reduce the severity of the infection (and with it, the probability of experiencing long-term effects from the virus) as well as the likelihood of hospitalization and death.
