COVID shots still work but researchers hunt new improvements

COVID-19 vaccinations are at a critical juncture as companies test whether new approaches like combination shots or nasal drops can keep up with a mutating coronavirus — even though it’s not clear if changes are needed.

Already there’s public confusion about who should get a second booster now and who can wait. There’s also debate about whether pretty much everyone might need an extra dose in the fall.

“I’m very concerned about booster fatigue” causing a loss of confidence in vaccines that still offer very strong protection against COVID-19’s worst outcomes, said Dr. Beth Bell of the University of Washington, an adviser to the U.S. Centers for Disease Control and Prevention.

Despite success in preventing serious illness and death, there’s growing pressure to develop vaccines better at fending off milder infections, too — as well as options to counter scary variants.

“We go through a fire drill it seems like every quarter, every three months or so” when another mutant causes frantic tests to determine if the shots are holding, Pfizer vaccine chief Kathrin Jansen told a recent meeting of the New York Academy of Sciences.

Yet seeking improvements for the next round of vaccinations may seem like a luxury for U.S. families anxious to protect their littlest children — kids under 5 who are not yet eligible for a shot. Moderna’s Dr. Jacqueline Miller told The Associated Press that its application to give two low-dose shots to the youngest children would be submitted to the Food and Drug Administration “fairly soon.” Pfizer hasn’t yet reported data on a third dose of its extra-small shot for tots, after two didn’t prove strong enough.

COMBINATION SHOTS MAY BE NEXT

The original COVID-19 vaccines remain strongly protective against serious illness, hospitalization and death, especially after a booster dose, even against the most contagious variants.

Updating the vaccine recipe to match the latest variants is risky, because the next mutant could be completely unrelated. So companies are taking a cue from the flu vaccine, which offers protection against three or four different strains in one shot every year.

Moderna and Pfizer are testing 2-in-1 COVID-19 protection that they hope to offer this fall. Each “bivalent” shot would mix the original, proven vaccine with an omicron-targeted version.

Moderna has a hint the approach could work. It tested a combo shot that targeted the original version of the virus and an earlier variant named beta — and found vaccine recipients developed modest levels of antibodies capable of fighting not just beta but also newer mutants like omicron. Moderna now is testing its omicron-targeted bivalent candidate.

But there’s a looming deadline. FDA’s Dr. Doran Fink said if any updated shots are to be given in the fall, the agency would have to decide on a recipe change by early summer.

DON’T EXPECT BOOSTERS EVERY FEW MONTHS

For the average person, two doses of the Pfizer or Moderna vaccine plus one booster — a total of three shots — “gets you set up” and ready for what may become an annual booster, said Dr. David Kimberlin, a CDC adviser from the University of Alabama at Birmingham.

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