The Covid Boosters in the Post-Pandemic Age: Would Covid Be the New Flu?
(Thursday, September 14, 2023)
The FDA approval and the CDC endorsement of the latest Covid booster vaccines were received with a generally lukewarm reception. The CDC, FDA, and other government agencies presented the Covid booster vaccines as akin to the annual flu vaccine having followed a process to identify the prevailing strains of SARS-CoV-2 virus similar to that used for the annual flu vaccines. Hope is that the Covid boosters will become an annual ritual like the flu vaccines. That may be tough.
It is amazing how within a short span of about 3 years, we seem to have lived through what took flu decades to achieve. We saw worldwide infections and millions of deaths prior to developing a vaccine, then saw a steep drop in both the infections and deaths with the vaccines that were effective for an unprecedented >95% in the vaccinated individuals leading to the reasonably rapid end to the pandemic, and now in the post-pandemic stage, we have already reached the vaccine fatigue, all in the span of about 3 years! Less than 20% of the adults in the US have received or are willing to receive the Covid booster vaccines. These rates are below that for the flu vaccines where about 50% of the adults get it every year. So, would the US population be willing to take two vaccines, one for flu and one for Covid, annually, instead of one?
Covid is much more deadly than flu or at least it was in the pre-vaccine stage. The pandemic took more than 1.12 million lives and infected more than 103 million people in the US over the last three years, with most of them happening in the first year of the pandemic. Compare that to about 300-500,000 hospitalizations and 20-50,000 deaths due to flu infections each year over the last decade. Still, the good news for the Covid vaccines is also the challenge for the acceptance of the continued vaccinations. The two dominant Covid vaccines from Pfizer and Moderna are the most effective vaccines ever invented by mankind not only in preventing infections but also preventing serious illness with opportunistic infections. For the last two years, the message about the effectiveness of Covid vaccines has been drilled so well in the minds of the general population that there is little acceptance that one needs further vaccinations. It’s a case of the initial message being so well received that the subsequent message has a low impact.
So, the likely scenario is that Covid boosters will be used widely by high-risk populations of geriatric adults and young children but not so much by the rest of the population. Additionally, individual organizations such as hospitals and schools may require annual boosters with rules similar to those for the annual flu vaccinations. For the general population, the pleas for booster vaccines will likely fall on deaf ears.
A silver lining is the news this week that Moderna’s RNA-based flu vaccines met the primary endpoints of its Phase 3 clinical trials. So, it should be possible to create a flu-Covid combined vaccine, which would likely be much more acceptable to the general public compared to the two-vaccine regimen. Once that happens, the conventional flu vaccination may be replaced by the combined vaccine. Till that happens, Covid will find it tough to be the new flu.
Dr. Mukesh Kumar
Founder & CEO, FDAMap
Linkedin: Mukesh Kumar, PhD, RAC