Like the flu, we may need annual shots to protect us from Covid

Just like the flu, Americans may need to get a single Covid-19 vaccination every year, according to federal health officials.

"This week marks an important shift in our fight against the virus," said Dr. Ashish Jha, who is leading the White House Covid-19 Response Team.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that he expects this fall to be the beginning of annual shots for Covid-19.

Jha cautioned that older people and those with health problems may need to get boosted more often. But for most people Jha hopes this latest booster will be the last shot they need for at least another year.

Jha said the newly authorized Covid-19 boosters would be free of charge, but future vaccines and treatments may not be, as funding for the pandemic dwindles and the government begins to shift therapeutics to the commercial market.

The federal government has started rolling out a new round of boosters for the fall: updated versions of the Moderna and Pfizer-BioNTech vaccines targeting both the original coronavirus and the two omicron subvariants that are currently causing most infections.

These vaccines could be tweaked again if new variants become dominant in the future, which is how the flu shot works. 

Every fall, people get a new flu vaccine designed to protect against whatever strains of the virus are likely to be circulating that season. The hope is the Covid boosters will act the same way.

However, some experts have expressed concern about deciding to do an annual Covid booster right away, without even knowing how well the newly updated vaccines work.

Dr. Peter Hotez, dean of the National School of Tropical Medicine, said on Twitter that it could be the right time to move to annual boosters only if we could answer some key questions, like how well do the updated shots work?

"What do you put in next year's shots?" Hotez tweeted. "What global surveillance mechanisms need to be implemented to identify early strains?"

"In the absence of a dramatically different variant, we likely are moving towards a path with a vaccination cadence similar to that of the annual influenza vaccine with updated Covid-19 shots matched to the currently circulating strains for most of the population”, said Anthony Fauci.

Fauci added that the latest boosters should continue to protect people as long as the coronavirus changes incrementally, drifting away from the currently circulating BA.4 and BA.5 subvariants.

He acknowledged that the plan to give annual shots might need to be revised if the coronavirus makes a significant evolutionary leap, as it did when the Omicron variant surfaced around Thanksgiving.

However, Fauci stressed that barring any big changes to the virus, the updated boosters should continue to protect in the year ahead and could be updated annually.

Other experts said that while new strains can be problematic, the main problem is the fact the people are not getting vaccinated.

The biggest problem with the vaccines today is that people aren't getting them," said Dr. Robert Wachter, who chairs the Department of Medicine at the University of California at San Francisco.

According to the CDC, only 34% of Americans over 50 have gotten their second booster.

At the briefing, Jha urged Americans 12 and older to take advantage of the updated boosters, and added that people should get their flu shot at the same time as their Covid-19 one.

Dr. Rochelle Walensky, director of the CDC, said the average daily deaths are still too high: “about 375 per day, well above the around 200 deaths a day we saw earlier this spring and, in my mind, far too high for a vaccine-preventable disease," Walensky said.

The shift to yearly shots points at the fact that Covid is not going away. "Our great-great-grandchildren will be getting coronavirus vaccines," said Dr. Gregory Poland, who directs the Mayo Clinic's Vaccine Research Group.

"Just like you and I, when we get our flu vaccine this fall, one of the components we'll get is derived from the 1918 pandemic influenza virus, and 100-plus years later, we're still immunizing against it”, Poland added.

While European authorities have not said anything about shifting to yearly Covid shots, the EU recently released a document saying countries should start offering boosters to their populations now to contain the wave of infections expected this autumn and winter.

"Vaccination continues to be the most reliable way of avoiding severe disease and therefore reducing mortality from Covid-19," it said, telling the 27 EU states to prepare vaccination campaigns, including shots adapted to new variants.