The future of COVID-19 boosters – new variants, new formulations?

Current boosters are the same formulations as the first authorised doses which were formulated based on the original strain of the coronavirus. It’s important to note that these formulations still offer protection against severe COVID-19

But as immunity wanes over time and new, more contagious COVID-19 variants emerge, it’s time to think about a long-term booster strategy.

David R. Martinez, an immunologist who formed part of the teams that helped develop the Moderna and Johnson & Johnson SARS-CoV-2 vaccines, recently discussed this topic in an article with The Conversation

Future COVID-19 boosters 

Martinez referenced annual influenza vaccinations as a prospective roadmap for how COVID-19 boosters will be developed in the future. 

“Influenza is endemic in humans, meaning it hasn’t disappeared and continues to cause recurrent seasonal waves of infection in the population. Every year officials try to predict the best formulation of a flu shot to reduce the risk of severe disease.

As SARS-CoV-2 continues to evolve and is likely to become endemic, it is possible people may need periodic booster shots for the foreseeable future. I suspect scientists will eventually need to update the COVID-19 vaccine to take on newer variants, as they do for flu.” he said. 

How influenza vaccinations are forecast and formulated 

Almost every year there are seasonal outbreaks of influenza, and every year we are encouraged to receive our annual flu shots. 

Health agencies including the World Health Organization’s Global Influenza Surveillance and Response System make their recommendations on the flu strains circulating in the Southern Hemisphere about which ones are most likely to circulate in the Northern Hemisphere’s upcoming flu season. Then large-scale vaccine production begins, based on the selected flu strains.

While this prediction process isn’t always accurate, there are years when the vaccine doesn’t turn out to be a great match with the virus strains, the strong viral surveillance systems and a concerted international effort by public health agencies have helped stay on top of influenza year after year.

While SARS-CoV-2 virus is a different ball game altogether, Martinez stated that “The COVID-19 field should think about adopting similar surveillance systems in the long term. Staying on top of what strains are circulating will help researchers update the SARS-CoV-2 vaccine to match up-to-date coronavirus variants.”.

“Current booster shots are simply additional doses of the vaccines based on the outbreak SARS-CoV-2 virus strain that has long been extinct. The coronavirus variants have changed a lot from the original virus, which doesn’t bode well for continued vaccine efficacy. The idea of tailor-made annual shots – like the flu vaccine – sounds appealing. The problem is that scientists haven’t yet been able to predict what the next SARS-CoV-2 variant will be with any degree of confidence.” he said. 

Trials are underway 

As per The Guardian’s recent reporting, the formulation of an updated version of Moderna’s COVID-19 vaccine is well underway which increases antibody levels 8-fold against the Omicron variant (according to early trial results). 

The vaccine is the first “bivalent” formulation to combine protection against Omicron and the original strain of coronavirus, and is the company’s leading candidate for upcoming autumn booster programmes.” the article noted. 

Dr Paul Burton, Moderna’s chief medical officer, said the new vaccine raised antibody levels to such a degree that one booster a year could be enough unless a substantially different variant calls for the vaccine to be redesigned again.

Moderna intends to apply for approval from medical regulators in the coming weeks, including the UK’s Medicines and Healthcare products Regulatory Agency, with a view to supplying the vaccine for the (northern hemisphere) autumn booster programme. 

If the booster does provide year-long protection against COVID-19, this approach to Covid-19 vaccines could be a sustainable strategy for the future.

Opinions or facts expressed within the content have been sourced from various news sources. While every effort has been taken to source them accurately, the pharmacy, its owners, staff or other affiliates do not take any responsibility for errors in these sources. Patients should not rely on the facts or opinions in the content to manage their own health, and should seek the advice of an appropriate medical professional. Further, the opinions or facts in the content do not reflect the opinions and beliefs of the pharmacy, its owners, staff or other affiliates.

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