If you don’t think there is worldwide coordination of illogical and criminal pandemic responses, here is the evidence: Canada, UK, Europe and US all authorize nouvelle boosters simultaneously for a threat that has evaporated.

As
the nation braces for another possible surge in COVID-19 activity as
schools resume and cooler weather brings people indoors, vaccine
advisers to the Centers for Disease Control and Prevention (CDC) today
recommended two updated COVID-19 boosters that target the circulating
BA.4/BA.5 Omicron subvariants.

Moving forward with the new boosters

Scientists
from the companies that make the two boosters said the Omicron variant
is the most distant antigenically from the original SARS-CoV-2 virus and
that adding Omicron alongside the original virus in a bivalent
(two-strain) vaccine has the potential to broaden protection, based on
data so far. BA.4 and BA.5 share the same spike protein.

The
action comes just a day after the Food and Drug Administration (FDA)
authorized for emergency use bivalent boosters from Moderna and
Pfizer-BioNTech. The Moderna booster was authorized for people ages 18
and older and the Pfizer booster for those ages 12 and older.

After
discussions today, which included extensive presentations from CDC
experts, scientists from Moderna and Pfizer, as well as comments from
the public, the CDC’s Advisory Committee on Immunization Practices
(ACIP) passed the recommendation with 13 yes votes and 1 no vote for
both boosters in separate votes.

No data from human studies yet

Several
ACIP members aired reservations about the lack of clinical data
specifically on the BA.4/BA.5 version of the booster, while
acknowledging that waiting would delay the boosters a few more months.
Clinical trials are under way, and the FDA based its EUA authorization
on clinical data from the Omicron BA.1 bivalent booster, which has been
approved in Europe, and preclinical data on the BA.4/BA.5 version. The
updated Omicron boosters are made with the same method as earlier mRNA
vaccines and contain the same antigen load.

ACIP member Pablo J.
Sanchez, MD, an Ohio State pediatrician, voted no for both boosters,
saying he would rather wait for the results of clinical trials—those
involving people. “We really need the human data,” he said.

Still,
he said he thinks the bivalent vaccines will have the same safety
profile as current mRNA COVID vaccines made by Pfizer and Moderna and
says he will likely receive one of the new boosters.

The boosters
will be given at least 2 months after primary vaccination or the last
booster dose. CDC officials said to simplify the process, vaccinators
will focus on the time since the last vaccine dose was given, not the
number of earlier booster doses people have received.

Hopes for robust uptake, similar to flu vaccine

Federal
officials are putting high hopes on uptake of the updated boosters as a
way to blunt an expected surge in the fall and winter. Levels of BA.5
activity are still high in many parts of the country, and the
proportions of BA.4.6 subvariant are low but have been slowly rising,
especially in a handful of Midwestern states.

Though about 77% of
adults have had their primary COVID-19 vaccine series, booster uptake
has been lukewarm so far. Only about half of eligible adults have
received a booster shot, and only 34% of adults ages 50 and older have
gotten their second booster doses.

Sara Oliver, MD, MPH, who leads
ACIP’s COVID-19 vaccine group and is a medical officer in the CDC’s
National Center for Immunizations and Respiratory Diseases, said the CDC
estimates that 200 million people will be eligible to receive the
updated booster, with 171 million doses available for fall and beyond,
which she said is a “sufficient but finite” supply.

She said CDC
polling conducted in August with the University of Iowa suggests that
72% of respondents would definitely or probably receive the updated
booster and 63% would be extremely or somewhat willing to get both the
flu vaccine and the updated COVID booster.

From modeling
projections, she said the CDC estimates that broad uptake of the updated
booster early this fall could prevent more than 100,000
hospitalizations, compared to a later or more limited rollout, and save
billions in direct medical costs.

Given that the updated booster
rollout will occur alongside seasonal flu vaccination, CDC experts today
covered vaccine co-administration and acknowledged the complexity for
vaccinators, which in some instances includes similar-looking vaccine
vials. Elisha Hall, PhD, RD, with the CDC’s vaccine task force, said
both vaccines can be given at the same time, with temporary reactions
similar or slightly highly higher. She said the CDC will be providing
resources to help healthcare providers navigate rolling out both
vaccines.

Next steps

Both Moderna and Pfizer have said
they have scaled up manufacturing to be ready to deliver doses this
monh. Immunization with the updated shots can begin as soon as the CDC
director formally accepts ACIP’s recommendation.

Moderna’s
representative said today that the company expects to apply to the FDA
for emergency use of the vaccine in children ages 6 though 17 in late
September. Yesterday, Pfizer said it hopes to submit an application for
kids ages 5 though 11 in early October.

EMA green-lights updated boosters

The European Medicines Agency (EMA) today backed emergency use of updated bivalent boosters targeting Omicron BA.1 from Moderna and Pfizer-BioNTech.

In a snapshot
of COVID activity in the Europe, the European Centre for Disease
Prevention and Control said all countries have now passed their BA.5
peaks, but activity remains relatively high. And the latest surveillance update
from the United Kingdom said most COVID markers have declines, but
hospitalizations remaining highest in those ages 85 and older.

Elsewhere,
officials in the Chinese city of Chengdu—home to 21.2 million
people—ordered a lockdown, as it launches a 4-day mass testing effort,
according to Reuters. Chengdu is in southwestern China. The lockdown, part of China’s “zero COVID” policy, is the largest since the spring.