The World Health Organization (WHO) has recommended in a statement that future COVID-19 vaccines no longer include the original SARS-CoV-2 virus, but instead a different version that closely matches circulating variants.
The WHO’s Technical Advisory Group on COVID-19 Vaccine Composition on May 18 suggested including the XBB.1.5 variant, which is responsible for most new infections worldwide. The updated vaccine should focus on a single XBB variant rather than multiple versions.
Although not binding, this recommendation serves as a foundation for national vaccine decisions. Some experts have advocated for including multiple virus strains in the next shot, akin to the annual flu shot’s approach. The WHO group highlighted that slight differences exist among existing XBB variants and alternative formulations or platforms that generate strong neutralizing antibody responses against XBB descendent lineages may be considered.
The latest U.S. COVID-19 booster is bivalent, targeting the original SARS-CoV-2 version and two Omicron variants (BA.4 and BA.5). While these shots and previous vaccines remain effective against severe illness, hospitalization, and death, they offer less protection against infection as antibody levels decline over time. Updating the COVID-19 vaccine is crucial to address waning effectiveness, provided the strains in the vaccine closely match circulating ones. Targeting a single version of the virus may reduce the chances of achieving this alignment.
The WHO’s recommendation will be considered by the U.S. Food and Drug Administration (FDA) when its vaccine experts meet in June to discuss the strains to include in the next COVID-19 vaccine. The FDA’s VRBAC committee is moving towards endorsing an annual single shot for most individuals, with additional doses for the elderly and immunocompromised.
The FDA announced in April that previously unvaccinated Americans can now receive a single dose of either the bivalent Moderna or Pfizer mRNA vaccines. However, this change does not allow individuals to choose between one or two doses to be considered fully vaccinated. The CDC has also made a decision regarding international travelers flying into the U.S., stating that they will be considered fully vaccinated two weeks after receiving a single dose of either the Pfizer or Moderna mRNA vaccine, given any time after August 16, 2022, when bivalent formulations were first available. However, a recent decision by the White House has rendered this announcement irrelevant by eliminating vaccination requirements for arriving travelers.
In practice, these policy changes are unlikely to have a significant impact as they are unlikely to sway the approximately 30% of Americans who have consistently refused COVID-19 vaccines for various reasons. Additionally, few international travelers, especially foreigners, would have only received a single dose of a bivalent mRNA vaccine.
Since the rollout of mRNA vaccines in late 2020, the standard primary series has always consisted of two doses, which is the legal definition of being “fully vaccinated.” The CDC continues to recommend multiple doses of mRNA vaccines, depending on age and health status. The sudden decision by the FDA and CDC to consider one dose of bivalent vaccines sufficient for unvaccinated individuals raises questions about the underlying data and decision-making process. Unfortunately, there is a lack of concrete data and transparency in this regard.
FDA official Peter Marks, MD, PhD, has mentioned the simplification of vaccine administration as the driving factor behind the recent change and believes that allowing unvaccinated individuals to receive a single dose will encourage future vaccination. Marks also refers to the high percentage of the U.S. population that has either been infected or vaccinated, suggesting that an unvaccinated person may only require a single dose to enhance immunity from prior infection.
A major study published at the Journal of Infectious Diseases that comes more than three years into the Covid pandemic concedes what critics of the global pandemic response and vaccine mandates have been saying all along: Natural immunity from prior infection is superior to vaccinated immunity in nearly all aspects for the majority of people.
The medical study titled, “Protection from COVID-19 mRNA vaccination and prior SARS-CoV-2 infection against COVID-19–associated encounters in adults during Delta and Omicron predominance,” was peformed by dozens of accredited medical researchers and was accepted for publication in the Journal of Infectious Diseases this past week.
The lead author Catherine Bozio, PhD. , is a member of the Centers for Disease Control and Prevention COVID-19 Emergency Response Team in Atlanta, Georgia. The study was funded by the CDC.
Natural immunity, or postinfection immunity, was shown to provide 76 percent protection against Covid-19-associated hospitalizations during the Omicron surge, the researchers found. The Moderna or Pfizer vaccines, both using mRNA technology, provided just 39 percent protection for those without a prior infection.
Natural immunity also lasted longer than mRNA vaccination plus boosters, according to the study. During the Omicron surge, natural immunity protection against hospitalization was 74 percent for 150 or more days after infection. A primary vaccine series without prior infection provided just 39 percent protection beyond 149 days after the final shot. Three doses initially provided 81 percent protection but this faded to just 31 percent after 150 or more days following the last shot.
The CDC in its study conceded that scientific data and analysis of natural immunity during the Covid pandemic was “limited.” However, Dr. Marty Makary of Johns Hopkins University in October 2021 undertook research on natural immunity showed that natural immunity was superior to vaccinated immunity against Covid-19.
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OPINION: This article contains commentary which reflects the author's opinion.