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Upgraded Covid-19 Boosters Could Arrive by Fall

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A covid vaccine and testing site set up outside of Yankee Stadium on the opening day of the 2022 MLB season.

A covid vaccine and testing site set up outside of Yankee Stadium on the opening day of the 2022 MLB season.
Photo: Spencer Platt (Getty Images)

It looks like there won’t be a hot booster summer this year. The Food and Drug Administration is reportedly abandoning immediate plans to sanction a second covid-19 booster shot for people under 50, according to the New York Times. Instead, the agency is set to speed along the release of upgraded boosters so that they can be available by early fall.

In late March, the FDA authorized a second booster of the original mRNA covid-19 vaccines for Americans over 50 and those with certain health conditions. But as recently as two weeks ago, the agency was still debating whether to go ahead and extend that availability to younger Americans.

When they were first released to the public in late 2020, the covid-19 vaccines, especially the mRNA shots, appeared to be highly effective at preventing illness and infection from the coronavirus. And to this day, they remain very protective against serious illness and death (one recent analysis estimated that they prevented 20 million deaths last year). But their effectiveness against infection has greatly declined, both as a result of waning immunity over time and, more substantially, the emergence of variants like Omicron that can evade some degree of people’s past immunity to the original coronavirus.

Booster shots have been able to restore some protection even against Omicron. And in people over 50 or at higher risk of severe illness, both the first and second round of boosters have further reduced the risk of hospitalization and death. But the protection against illness in general provided by the first booster seems to be short-lived, and there’s been an ongoing debate within the FDA as to whether a second booster for all would really offer much benefit to the public, at least in its current form.

Meanwhile, vaccine makers Moderna and Pifzer/BioNTech have been conducting trials of a dual booster vaccine, one meant to elicit immunity to the classic coronavirus as well as the Omicron variant. And so far, early indications are that these shots are more effective than the original booster against the strains of the virus now circulating in the world.

On Thursday, the New York Times reported that the FDA has decided to shelve plans to authorize a second booster for everyone else this summer and to go all-in on accelerating the release of these next-generation boosters, following assurances from Moderna and Pfizer.

Previously, it was expected that the upgraded shots would be available by around November or December, but they might now be here as soon as September, according to an anonymous official cited by NPR. These shots are expected to be formulated against BA.4 and BA.5., the lineages of Omicron currently most dominant in the U.S. and world. On Friday morning, it was also announced that the government has secured a deal to purchase 66 million doses of the upgraded boosters from Moderna; a month earlier, the government agreed to buy 105 million doses from Pfizer.

The boosters will still need to be formally authorized by the FDA and CDC. But perhaps the biggest hurdle will be the public itself. Compared to other similar countries, the rate of booster vaccination has been lower in the U.S., with fewer than half of those already vaccinated having obtained them. And should this level of hesitation continue to be present throughout the fall, it will surely cost many lives.

Just this week, an analysis by the Commonwealth Fund estimated how many deaths might be averted with an expanded and successful booster campaign this fall and winter. In their model, they expanded eligibility for a second booster shot to anyone over 5, so long as it was five months after their first booster.

Compared to the baseline rate of new daily vaccinations right now, they estimated that up to 160,000 lives would be saved from August 2022 to March 2023 if 80% of those eligible for a first or second booster shot received them by October. And even in a scenario where booster rates only reached the same level of flu vaccination rates typically seen during the winter (around 50% of Americans), then 100,000 lives still would be saved.

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