A vial of SARS-CoV2 COVID-19 vaccine in a medical research laboratory
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It’s time to update COVID-19 vaccines in anticipation of a possible infection surge this fall, a federal panel decided Tuesday. Older adults and other at-risk Americans should likely be first in line when these drugs become available, they said.

In a 9 to 2 vote, the panel of advisers to the Food and Drug Administration recommended that new vaccine booster formulas include an omicron component. The aim is to address the worrisome waning efficacy of current vaccines and the continuing threat of new and fast-spreading SARS-CoV-2 strains, they said.

The original vaccines continue to provide protection and should remain in use, some panel members said. But a vaccine that can target omicron’s new subvariants, or even newer virus strains, may help reduce risk of severe disease in those who require the most protection, they noted. 

It will be up to the FDA to OK new vaccine formulas and authorize appropriate drug candidates, they noted.

Complicating the panel’s decision-making were quickly changing omicron subvariants, which new mRNA vaccine candidates made by Pfizer and Moderna do not address. The two drugmakers have developed yet-unauthorized drugs shown to tackle the original version of omicron variant, BA.1. But new omicron BA.4 and BA.5 subvariants now account for over half of all COVID-19 cases in the U.S., and it is unknown how those vaccines would stack up against the new strains.

Omicron immunity in LTC

Most nursing home residents and workers develop signs of new omicron-specific immunity after receiving a third dose of Pfizer-BioNTech’s COVID-19 vaccine, according to one recent study. And another study from Israel found that long-term care residents who get a fourth dose of the COVID-19 vaccine are at a reduced risk of being hospitalized or dying from the disease during an omicron-related surge. But that was before the newer omicron subvariants had become more dominant.

Without the benefit of vaccines that address new variants, even a less-severe new strain could wreak havoc if it’s highly transmissible, potentially leading to a higher rate of deaths, said panelist Mark Sawyer, M.D., of the University of California, San Diego.

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