USA TODAY International Edition

Panel: Next shot should aim at variant

Federal advisers say focus on XBB. 1.5

- Karen Weintraub

This fall’s COVID- 19 vaccine should target the XBB. 1.5 variant and for the first time not take aim at the original virus, a federal advisory committee recommende­d Thursday.

The vaccine’s protection against infection fades over time, and the virus has changed enough that if there’s another outbreak this fall or winter, as there has been the past three years, many people will not be well- protected, experts told the committee.

The best way to prevent infections will be to reconfigure the vaccine to target an XBB variant, officials said during the daylong Vaccines and Related Biological Products Advisory Committee meeting.

Since earlier this year, the XBB- lineage has dominated infections across the United States and the world, starting with XBB. 1.5 and now, seemingly evolving toward XBB. 1.16 and XBB. 2.3.

Government officials and vaccine manufactur­ers said data shows targeting an XBB variant will provide better protection than current shots. Targeting more than one variant isn’t necessary, they said, because the current XBB variants are so similar.

Three manufactur­ers, Pfizer- BioNTech, Moderna and Novavax, can all make XBB vaccines widely available in September, they said. The World Health Organizati­on and the European Union also are looking at XBB vaccinatio­n, simplifyin­g global supplies.

Why no bivalent vaccine?

Last year, the vaccine was changed to target both the original variant and the BA. 4/ BA. 5 variants, but data shows this bivalent vaccine has lost effectiven­ess against current variants.

The original Wuhan variant has not been in circulatio­n since 2021 and so no longer needs to be part of the vaccine, experts told the panel. Wuhan was included in the current vaccine because protection against it seemed to also work against other variants.

The current pace of change suggests that XBB. 1.6 will be the dominant variant in the U. S. by the fall, but that XBB. 2.3 and other XBB sublineage­s could continue to increase. The three variants do not differ much in their spike protein, which is the target of the vaccines, so a vaccine targeting any should be effective against all three, experts told the panel.

All three companies have examined the impact of vaccines targeting three XBB variants and found that one aimed at XBB. 1.5 seems to be most protective.

The committee’s decision still needs to be ratified by the FDA commission­er. Another panel of outside experts will consider how the vaccine should be used, and the director of the Centers for Disease Control and Prevention will need to ratify their decision.

With the current vaccine providing only limited effectiveness, FDA officials promised to talk with their counterpar­ts at the CDC about encouragin­g people to wait for the new vaccines.

Boosters for older people

It also remains unclear whether healthy people younger than 70 or 75 will need regular boosters. Data from studies suggests that although neutralizi­ng antibodies against the virus fade within four to six months, another arm of the immune system, called T cells, continue to provide protection.

Since only immunocomp­romised and older people are at high risk for severe disease if infected, they benefit the most from repeated boosting.

But studies do show that several boosters provide more protection than a single shot and that a combinatio­n of infection and vaccinatio­ns provides even better protection. According to the WHO, about 90% of people worldwide have been infected with SARS- CoV- 2, the virus that causes COVID- 19.

About 95% of Americans older than 50 have received at least one vaccine dose, with lower levels among younger people: 82% of those over 18, 72% of those 12- 17, 40% of children 5- 11, 11% of those 2- 4 and 9% of those under 2.

Children were less likely to need emergency care for COVID- 19 if they were vaccinated, according to a study released this week by Epic Research. Although hospital visits were rare for children of all ages, for those aged six month to four years, vaccinatio­n reduced the risk of a COVID- related ER visit by 80%.

Contact Karen Weintraub at kweintraub@ usatoday. com. Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competitio­n in Healthcare. The Masimo Foundation does not provide editorial input.

 ?? KELLY WILKINSON/ USA TODAY NETWORK ?? Registered nurse Jessica McAfee gives Vincent Baker a COVID- 19 booster vaccine dose in 2022 in Indianapol­is.
KELLY WILKINSON/ USA TODAY NETWORK Registered nurse Jessica McAfee gives Vincent Baker a COVID- 19 booster vaccine dose in 2022 in Indianapol­is.

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