Will We Need a Yearly COVID-19 Vaccine?

Will we need a yearly COVID-19 vaccine?

Paul Offit, MD: Hi, my name is Paul Offit. I'm speaking to you today from the Vaccine Education Center at the Children's Hospital of Philadelphia. It is Thursday, December 1st, 2022. I think one question parents want to know is, are the COVID vaccines that we're giving going to start to be similar to the flu vaccines, which are given every year? Or said another way, can we expect that there will be a yearly COVID vaccine?

It's hard to know the answer to that question, but let me explain the differences between these two viruses. Every year we give an influenza vaccine, and the vaccine that we make is very much strain specific, meaning we need to correctly predict what strains of influenza are going to come into this country.

Every year, the FDA Vaccine Advisory Committee sits down in March and picks strains for what is going to be a vaccine that comes out in September, because it's a six-month production cycle. If we're right, if we're right in picking those strains, then we can dramatically reduce the instance of hospitalizations and deaths caused by that virus. But if we're wrong, if we miss, then we don't because it's really strain specific.

So, for example, a few years ago we missed on one of the strains, the so-called H3N2 strain. And so, the H3N2 strain of influenza that came into the United States was not contained in the vaccine, and you had 0% protective efficacy. It's as if you never got the vaccine in terms of protecting against that strain. That's really not true with coronaviruses. The coronavirus strains that are circulating now are still susceptible to the vaccines that are that were given, the original vaccines, the original mRNA vaccines, are still very good at protecting against severe disease. Not as good at protecting against mild disease, but very good at protecting against severe disease, which is the goal of the coronavirus vaccine. Frankly, it's the goal of every vaccine. In this case, keep people out of the hospital, keep them out of the intensive care unit, and keep them from dying.

And so, you don't really miss because right now the vaccines that we have still protect against serious disease. It's been through all the variants — the alpha variant, the delta variant, the omicron variant, the BA.4, B.A5 variant; the new variants, the B.7 variants, the B.Q1, the BQ.1.1 variants, are still susceptible to protection against severe disease from vaccination, so it's not quite the same story as influenza.

So, I don't think you are necessarily going to need a yearly COVID vaccine. It's certainly not for the general population. There are groups who may specifically benefit, like those who are immune compromised, those who are elderly, those who have a variety of comorbidities that put them at higher risk. But for right now, that may well not be true, but time will tell.

Thank you.