Coronavirus: Updated boosters?

The F.D.A. may target fall boosters to Omicron or subvariants.

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By Amelia Nierenberg

Writer, Briefings

Updated vaccines for the fall?

Tomorrow will be a big day for the future of U.S. coronavirus vaccines: A panel of independent advisers to the F.D.A. will recommend whether to update the existing vaccines to take aim at a version of the virus in the Omicron family.

The advisory panel also will probably split between those who believe a fall booster will be broadly necessary and those who would limit additional shots to high-risk individuals.

The policy may depend on funding and resources. "It's very clear we're not going to have enough vaccines for every adult who wants one," said Dr. Ashish Jha, the White House coordinator for the pandemic response.

Either way, cases will most likely rise in the winter. The question is: Would booster shots have an updated formula that targets Omicron — or its subvariants BA.4 and BA.5, which now account for more than one-third of the infections in the U.S.? Or will they be the existing vaccines, which continue to provide robust protection against severe disease, but very little against infection?

Rebooted shots are already in the works: Pfizer and Moderna have both started manufacturing doses, betting that the government would pick an Omicron-targeted vaccine to be the fall booster. And clinical trials of a so-called bivalent vaccine — one that combined the existing formulation with one that targeted Omicron — found that it triggered higher levels of antibodies against Omicron than existing vaccines do.

But outside scientists were not impressed by the less-than-twofold increase. One leading virologist described it as "relatively modest."

And the coronavirus has evolved so quickly that new vaccine formulations may be out of date before trials are even finished. The F.D.A. said that targeting Omicron was "already somewhat outdated."

"Omicron is clearly in the rearview mirror," Dr. Peter Hotez, a vaccine expert with Baylor College of Medicine, said.

Even if the F.D.A. does push for a bivalent vaccine that targets BA.4 and BA.5, it will still be a race to produce the doses by fall, even with accelerated testing. There is also the chance that the virus will evolve and render the updated vaccine ineffective.

"Do we target BA.4 and 5? They will probably peak somewhere in the next month or two," said Dr. John Beigel, a clinical research director at the N.I.H. who has conducted multiple coronavirus vaccine studies. "They may be old news by the time the fall comes."

And neither Pfizer nor Moderna has concentrated on developing such a vaccine, so no one knows for sure how well it would work.

At this late point in the year, using human trials to test such a vaccine, followed by the two months that would be required to manufacture doses, could push the release of any new vaccine well into the next wave of the virus. To make a fall deadline, the companies would have to rely more on laboratory tests and animal trials.

Where to find vaccines for kids

You may not be able to get your child vaccinated at the same pharmacy where you rolled up your sleeve. That's because age requirements vary among the larger pharmacy chains.

A majority of big pharmacy chains are giving Covid vaccines starting at age 3, but some are not. Publix and Kroger, for example, are offering shots starting at age 5.

Here are the policies for some major pharmacy chains:

Even if your pharmacy of choice is not offering shots to your eligible child, the pharmacist there can point you in the right direction.

Some parents have also turned to social media groups and grass-roots networks to find shots. One option: A group of volunteers called Vaccinate Under 5 created a national database of pharmacies and providers administering the vaccine to young children.

What else we're following

  • Congress passed legislation to extend free meals and other food assistance for U.S. children until the end of the summer.
  • In The Atlantic, Ed Yong writes that the U.S. is in a "figure it out yourself" period of the pandemic: "It still claims the lives of hundreds of Americans daily, killing more than twice as many people as die, on average, in car accidents."
  • Only one Broadway show, "American Buffalo," will continue to require masks after Friday.
  • Army National Guard soldiers have until Thursday to get vaccinated, The Associated Press reports. About 13 percent of the force remains unvaccinated.
  • Novak Djokovic will not get a shot, even if it means that he cannot play in the U.S. Open later this summer, The Guardian reports.
  • Ezra Klein talked to Dr. Lekshmi Santhosh, the founder and medical director of U.C.S.F.'s long Covid and post-I.C.U. clinic, about the mysteries of long Covid.
  • Researchers at Imperial College London reported that vaccines saved nearly 20 million lives in the first year, The Associated Press reports.
  • The pandemic enticed more bathers to try "wild swimming" in Beijing's lakes and waterways.

What you're doing

My 2-and-a-half-year-old daughter finally got vaccinated today. Over the last number of months — no wait, years — I have mentally rehearsed what this moment would be like. It was all the sentimental mushy gushy stuff you might expect a pandemic parent to say. But in all honesty, the only sentiment that feels true today: it is about damn time! — Dana Siperstein, East Greenwich, R.I.

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