Vaccine booster shots may have a future role in protecting long-term care residents against new coronavirus mutations, industry observers say.

The Food and Drug Administration on Monday pledged fast-tracked approval of drugs that will strengthen COVID-19 vaccine protection against the virus variants that have health officials concerned, according to the Wall Street Journal. The B117 variant, for example, reportedly is on its way to becoming the dominant strain in the United States after it contributed to new waves of infections in Europe.

Although it is too early to say definitively, those added shots could also ensure effective protection for long-term care residents, said Kevin W. O’Neil, M.D., FACP, CMD, chief medical officer of ALG Senior. 

The problem with viruses is that “the bugs are smarter than the drugs,” said O’Neil, borrowing a line from an infectious disease expert friend. And coronavirus vaccines may require modifications just as influenza vaccines do each year, he said. “[T]hat certainly will impact residents in senior living and long-term care communities, as the older adult population is among the most vulnerable to the severe consequences of this disease,” he told McKnight’s Clinical Daily. 

If boosters are shown to be needed and safe in older at-risk adults, long-term care pharmacists surely will support their use, concurred Chad Worz, PharmD, BCGP, CEO of the American Society of Consultant Pharmacists.

“I think it is early to begin to be concerned about the need of a booster, but I also think research is forthcoming that will clarify that potential need and also clarify other aspects of vaccination like the use of a single dose, or a single dose in those with documented COVID-19-positive history across age and risk groups,” Worz said.

A COVID-19 booster shot could also help to resolve some occasional quirks in the ongoing coronavirus vaccination process, where individuals experience interrupted dosing schedules or test positive for COVID-19 between doses, Worz said. The emergence of a booster to address residents at high risk from variants or who need something to complete their series would be welcomed — assuming the research data meet federal requirements for safety and efficacy in these populations, he added.  

Encouraging yet another shot

If booster shots become a reality, ALG Senior’s O’Neil is looking for a “consistent and universal” federal rollout that reduces the variability of supply and administration among the states. “This would make it much easier for senior living providers like us with communities in multiple states,” he said. “Hopefully, science, not politics, guides these decisions.” 

As to how the company would encourage yet another COVID-19 shot among its staff members and residents, education and optimistic messaging is key, O’Neil said. “We would do a lot of education, such as videos, town hall meetings, and one-on-one conversations about the variants,” he said.

And there are more COVID-19-fighting possibilities on the horizon that may simplify administration and improve protection, O’Neil added. These include single-shot vaccines (like Johnson & Johnson’s), and a double flu-coronavirus vaccine. There’s also the possibility of a pan-coronavirus shot, designed to protect against variants that don’t yet exist; an idea recently promoted by Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, and colleagues, O’Neil said. 

The FDA, meanwhile, appears to be trying to stay a step ahead of the variants in a variety of ways. Acting FDA Commissioner Janet Woodcock said that the agency is seeking “efficient ways to modify medical products that either are in the pipeline or have been authorized for emergency use to address emerging variants,” the WSJ reported. 

The agency also is encouraging makers of diagnostic tests and monoclonal antibody drugs to adapt their products to the strains becoming prevalent in the U.S., the news outlet wrote.

Vaccinations aren’t over yet

There is plenty of work to be done in long-term care while those solutions remain in the lab or on the drawing board, said the American Health Care Association/National Center for Assisted Living.

“We’re focused on getting all of our residents and staff vaccinated with the two doses they need now,” the advocacy group said in response to a McKnight’s query. “We’ll continue to look to the CDC on whether additional shots or other steps may be needed down the road.”