A key adviser to the Food and Drug Administration (FDA) vaccine panel questions whether more covid booster shots are needed for younger, healthier people.
Evidence from the new versions of the vaccines for the omicron variant of the coronavirus, which the FDA approved in August, is «disappointing» and does not show that they are much better than the original injections, said Dr. Paul Offit, a pediatrician who is a leading expert on vaccines and infectious diseases, wrote on Wednesday in the New England Journal of Medicine.
Protecting people against Covid infection with current mRNA technology can be a pipe dream, especially as new strains of coronavirus emerge every few months, Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told NBC News. .
The updated boosters from Pfizer-BioNTech and Moderna are probably best reserved for people at high risk of severe illness or death from Covid: older adults, people with multiple coexisting conditions and the immunocompromised, Offit said.
Asking healthy young people who are at lower risk of serious disease to boost with a variant-specific vaccine, followed by a different variant-specific formulation a few months later, may not be practical, he said.
Offit, who is a member of the FDA’s Advisory Committee on Vaccines and Related Biologicals, wrote in the article: «I think we should stop trying to prevent all symptomatic infections in healthy young people by boosting them with vaccines that contain mRNA from strains that could disappear a few months later.”
The FDA’s vaccine committee is scheduled to meet 26 of Januarywhen the group of external advisors will determine what the next version of the covid vaccines should be.
Offit’s position contradicts the FDA’s Covid vaccine guidelines and the Centers for Disease Control and Preventionwhich recommend that everyone over the age of 6 months be updated on their vaccinations at least two months after the last dose.
In response to the NEJM article, FDA spokeswoman Abigail Capobianco said the data Offit used to support her argument was «selective» and that «we strongly believe that the totality of available evidence continues to support the use of these vaccines.» in all age groups. .”
«Dr. Offit has the right to comment on the effectiveness of bivalent covid-19 vaccines used as boosters,» he said.
Why is there an omicron booster?
Following the surge of the omicron variant in the US last winter, the FDA’s vaccine committee met in June to recommend redesigned boosters that target some form of the omicron virus. Offit and another member voted against changing the vaccines. Subsequently, the FDA endorsed the vaccine panel and authorized a new formulation of the booster shots.
The updated vaccine, called a bivalent, targets the original strain of the coronavirus, as well as BA.4 and BA.5, two subvariants of omicron. which are now largely out of circulation In the USA
At that time, the updated booster shots had not yet been tested in humans and suggested initial data which did not generate a better immune response to BA.5 than the first iterations of the vaccines.
However, data published in the following months by Pfizer and Moderna, as well as a real-world study by the CDC, found that the new vaccines offered greater protection against omicron subvariants, although protection against infection was still low. compared to the protection they once offered against the original strain of the coronavirus.
Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, responded that boosters still reduce the risk of covid infections and serious illness, and in turn reduce the risk of contracting covid for a long time. .
“People who talk about why young people need it miss the point,” he said, referring to the booster. “We don’t just vaccinate to prevent deaths. We prevent serious diseases with vaccines and therefore also prolonged Covid ”.
It is not clear if the new document will influence other members of the FDA panel or the agency’s decision on the next version of the vaccines.
Dr. Ofer Levy, another member of the FDA panel, agreed that the benefit of a booster may be less for younger people than for older adults, but said it’s «not zero.»
Levy, the director of the Precision Vaccines Program at Boston Children’s Hospital, continues to encourage Covid boosters for all who are eligible.
Relatively few people in the US have had upgraded boosters. As of January 4, only about 15% of people over the age of 5 had received them, according to to the CDC.
Dr. Anna Durbin, a vaccine researcher at Johns Hopkins University in Baltimore, said the case for boosting young and healthy people is «weaker» than for boosting the elderly and those at higher risk of severe disease. . However, she said, it is likely that the young will still be infected.
The FDA’s advisory committee is expected to discuss this month whether the first two doses of the mRNA vaccine given to people who are not yet vaccinated should be updated to match the current circulating strains of the virus. Those shots, called the primary series, still target the original coronavirus strain that was identified in Wuhan, China, in late 2019.
