Registered nurse Orlyn Grace (R) delivers a COVID-19 booster vaccine to Diane Cowdrey (L) at the COVID-19 Vaccination Clinic on April 6, 2022 in San Rafael, California.
Justin Sullivan | Getty Images
The CDC’s panel of independent vaccine experts has indicated an unwillingness to approve fourth Covid shots for the broader US population until the agency adopts a clear strategy.
The group, in a five-hour meeting WednesdayAnd They largely agreed that deploying boosters frequently to prevent infection is not a realistic goal with the current generation of shots.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices discussed the US vaccination strategy ahead of the expected fall wave of infection. It was the committee’s first meeting since the CDC authorized a fourth dose of Pfizer or Moderna for people age 50 and older in late March, as well as a fifth dose for those age 12 or older with compromised immune systems.
doctor. Sarah Long, a panel member, said public health agencies need to abandon the idea that vaccines can prevent Covid infection. Instead, she said, they should tell the public that the main goal is to prevent severe illness, hospitalization and death.
rainbow chase
“With the vaccines currently available, we shouldn’t be chasing the rainbow hoping that those vaccines will prevent infection, transmission and even mild illness because we knew that wasn’t possible,” said Long, a professor of pediatrics at Drexel University College. of medicine. “We just need to let go of that with these vaccines and focus on preventing severe disease and preventing death.”
Long criticized the CDC for emptying the IV shots of the elderly without consulting the committee, saying the decision caused public confusion and could lead to increased fatigue. She said a full public discussion in the committee about vaccine recommendations would help restore public confidence.
The Pfizer and Moderna vaccines have proven highly effective in preventing hospital admissions for Covid, but protection against infection and mild illness is rapidly declining over time, a challenge exacerbated by the virus’s rapid evolution. Vaccine makers developed the vaccines to target the spike protein of the virus that emerged in Wuhan, China in 2019. The virus uses spike to invade human cells, and since this protein has mutated over the past two years, it has become more and more difficult for it. Vaccines to prevent infection.
65% effective against mild diseases
Data presented by CDC officials Wednesday showed that three doses of Pfizer or Moderna shots were 79% effective in preventing hospitalization and 94% effective in preventing serious illness or death among adults with healthy immune systems during the unprecedented wave of omicron infections during winter season. Three doses were 65% effective in preventing mild disease.
doctor. Beth BellAnd Director of the National Center for Emerging and Animal Infectious DiseasesAnd He said that asking people to get booster doses every four to six months is not a sustainable public health strategy. Such an approach could undermine confidence in the vaccination campaign, she said. Bell said the initial vaccination series of two doses and a booster dose currently provides adequate protection for people with healthy immune systems.
“I am very concerned about our meeting and considering additional doses for a smaller and smaller yield, creating the impression that we do not have a very effective vaccination program,” said Bell, who is also a clinical professor at the University of Washington School of Medicine. Public Health.
doctor. David Kimberlin of the American Academy of Pediatrics said the CDC should adopt a long-term vaccination strategy now to avoid having to respond to the next crisis. Kimberlin said the CDC should make it clear that most Americans need three doses initially and will then need a booster dose once a year to maintain protection from severe disease.
covid long fears
But the head of the committee, Dr. Grace Lee said the United States needs to invest in developing vaccines that are effective in preventing infection, noting that even a mild infection can lead to long-term COVID-19 with devastating health consequences.
“If we focus on hospitalization and death in acute illness, you don’t think about the long-term consequences of Covid and that can happen even in individuals with mild symptoms,” said Lee, a professor of pediatrics at Stanford University School of Medicine. . Missing work or school due to infection, he told me, is a huge challenge, especially for communities that don’t always have easy access to health care.
While three doses may be sufficient for healthy adults, people with weakened immune systems remain at risk of developing serious illness, according to Dr. Camille Cotton is an infectious disease specialist at Massachusetts General Hospital. They are at risk of infection even after full vaccination, and boosting monoclonal antibody prophylaxis, Cotton said.
“In some ways they are the ones who have been somewhat left behind in the pandemic,” Cotton said. “I would just ask that we keep a huge focus on immunocompromised patients,” she said.
FDA meeting
The CDC meeting comes after independent advisors to the Food and Drug Administration met earlier this month to develop a framework for selecting new vaccines that target mutations developed by the virus over the course of the pandemic. Public health authorities expect another wave of infections this fall and are concerned about the emergence of a new type that undermines existing vaccines.
doctor. Peter Marks, who leads the division of the Food and Drug Administration (FDA) responsible for vaccine safety and efficacy, told the drug regulator’s advisory committee that the United States has until June at the latest to select a new vaccine formulation to be ready for fall. Declining immunity from vaccines could leave the United States vulnerable to another surge when people move indoors during the colder months, Marks said. FDA panel members were also skeptical of the broader population asking for a booster so frequently that there was clear data showing that it was necessary to prevent severe disease.
“I think we have a lot in common with the idea that we simply cannot reinforce people repeatedly,” Marks told the committee. “I am the first to acknowledge that this additional fourth booster dose that was approved was an interim measure until we put things in place for the next potential booster in light of emerging data,” Marks said.