Will COVID Vaccines Be Given Every Year, Like Flu Shots?

Giving the shot annually would also allow vaccine experts and manufacturers time to update the formula to more closely match the strains of the virus that are circulating, similar to the process followed for the flu shot. “This virus, like the influenza virus, mutates; it changes periodically,” explains Schaffner, who is not a member of the committee that advises the FDA.

Jerry Weir, with the FDA’s Office of Vaccines Research and Review, assured advisory committee members that routinely updating the vaccine does not mean the agency would be chasing variants, which are constantly emerging and fighting for a dominant spot. “None of us think that’s realistic,” he said. “But I think our experience so far with the bivalent vaccines indicates that we can continue to make improvements to the vaccine.”

Research shows that the newly updated bivalent shots — which target the original strain of the coronavirus, plus two recently circulating omicron strains — offer superior protection against severe illness. One study recently published in the New England Journal of Medicine found the bivalent booster to be about 62 percent effective against hospitalization and death from COVID-19, while the original (monovalent) booster is now about 25 percent effective.

Experts seek more answers

The committee of vaccine experts who met to discuss the FDA’s proposal, however, say more answers are needed before adopting a sweeping schedule change, including knowing how long vaccine protection lasts against severe disease and who, exactly, is considered high risk. Though hospitalization and death rates from COVID-19 have plummeted since this time last year, more than 3,700 Americans are still dying each week from the illness, federal data shows.

“We need the CDC to tell us exactly who it is that’s getting hospitalized and dying from this virus,” said advisory committee member Paul Offit, M.D., an infectious disease expert at Children’s Hospital of Philadelphia. “What are their ages? What, specifically, are their comorbidities? If they are immune compromised, in what manner are they immune compromised? Did they recently get a vaccine? Were they treated with antivirals, etc.?”

Another concern that’s been raised: When is the best time to deliver an annual COVID-19 booster? The flu shot is pushed out each year in the fall — by the end of October is the ideal time to be vaccinated, the CDC says, since flu activity typically peaks between December and February. But COVID-19 hasn’t settled into a seasonal pattern yet; waves continue to hit throughout the year.

Still, timing an annual COVID booster with the flu shot might be the best route, Schaffner says, the idea being that people only need to make one trip to the clinic or pharmacy. What’s more, vaccine manufacturers are working to create a combined COVID-flu vaccine, “which would make that much easier because then you just have to get one shot,” he adds.

The committee did not vote on whether to implement the annual booster schedule, but Schaffner says it appears to be moving “in that direction.” Even if it is adopted, Schaffner says we’ll need to remain flexible. If the course of the pandemic changes, vaccine recommendations will probably change too.

Phasing out the original vaccines

The vaccine advisory committee did, however, vote in favor of phasing out the original (monovalent) versions of the COVID-19 vaccines, which are still being used to inoculate people for their initial two shots, while the bivalent vaccines are being used for boosters.

The committee is recommending that the FDA make the bivalent vaccines the only option going forward — both for those initial shots and for boosters. Doing so would “simplify things very greatly,” Schaffner says, both for the public and for health care providers who stock and administer the vaccines.

“There’s so much confusion about these different formulations that I think anything we can do to ease up on that confusion and simplify things is going to be a good thing,” said advisory committee member Archana Chatterjee, M.D., dean of Chicago Medical School.