Category: COVID-19 vaccines

Four Seasonal Vaccines for Older Adults?

There are a number of seasonal vaccines recommended for older adults in the U.S. They include vaccines for influenza, pneumonia, and the newest one is Respiratory Syncytial Virus (RSV).

I noticed that during the recent FDA meeting to decide on approval of another vaccine for the XBB variant of Covid-19, many experts objected to the use of the word “periodic” in the voting question.

Those objecting to it did so because of the implicit suggestion that Covid-19 is a seasonal virus. Not all experts agree on that. I gather it takes time to determine whether or not an infectious agent should be considered seasonal or not.

If the XBB variant of Covid-19, RSV, pneumonia, and influenza are all considered seasonal, then there are 4 vaccines for which older adults would be eligible.

The consensus among most experts is that you can take both influenza and Covid-19 vaccines at the same time. Most of us older adults also get the pnemococcal vaccine as well.

Will the RSV vaccine be added to the list? Should you get all 4 at the same time? Or should they be spaced out? Should you get the influenza and Covid-19 vaccines together and wait a week or two before getting the RSV and pneumococcal vaccines?

The increase in recommendations for vaccinations could be burdensome for those without health insurance. Vaccine uptake will probably continue to be a challenge.

FDA Meeting Today on Strain Selection for Periodic Covid-19 Vaccine

The FDA Vaccines and Related Biological Products Advisory Committee will meet today from 8:30 am-5:00 pm ET to discuss and make recommendations on strain selection for the periodic updated Covid-19 vaccines for the 2023-2024 vaccine campaign.

The discussion topic will be:

“Based on the evidence and other considerations presented, please
discuss selection of a specific XBB lineage (e.g., XBB.1.5 or
XBB.1.16 or XBB.2.3) for inclusion in the 2023-2024 Formula of
COVID-19 vaccines in the U.S.”

The voting question will be:

“For the 2023-2024 Formula of COVID-19 vaccines in the U.S., does the
committee recommend a periodic update of the current vaccine composition to
a monovalent XBB-lineage?”

UPDATE: The committee upvoted the question unanimously. The word “periodic” was removed from the question. A September 2023 time frame was expected for availability of the new vaccine.

CDC Updated Recommendations for Covid-19 Vaccine Use

The Centers for Disease Control (CDC) held a Clinician Outreach and Communication Activity (COCA) meeting to discuss updated recommendations for Covid-19 vaccine use on May 11, 2023. You can view the YouTube recording of the meeting and view presentation slides at this link. The meeting was designed for clinicians.

FDA Meeting June 15, 2023 on Strain Selection for Periodic Covid-19 Vaccine

The FDA Vaccines and Related Biological Products Advisory Committee will meet June 15, 2023 from 8:30 a.m.-5:00 p.m. ET “to discuss and make recommendations on the selection of strain(s) to be included in the periodic updated COVID-19 vaccines for the 2023-2024 vaccination campaign. This discussion will include consideration of the vaccine composition for fall to winter, 2023-2024.”

FDA Update on Covid-19 Annual Vaccine Strategy

On April 18, 2023 the FDA posted an update on the Covid-19 updated bivalent vaccine and the upcoming immunization strategy for this fall. According to the announcement:

“In June, the FDA will hold a meeting of its VRBPAC to discuss the strain composition of the COVID-19 vaccines for fall of 2023. Much like the FDA does yearly with the influenza vaccines, the agency will seek input from the committee on which SARS-CoV-2 variants and lineages are most likely to circulate in the upcoming year. Once the specific strains are selected for the COVID-19 vaccines, the FDA expects manufacturers to make updated formulations of the vaccines for availability this fall.”

Behind the Mask Policy

Tomorrow I’ll get to see how the new Covid-19 face mask policy works at the University of Iowa Hospital & Clinics. It goes into effect today. I’m going to see the dentist, as I have periodically for years, even during the Covid-19 pandemic. Of course, the idea of masked dental patients is ironic.

The rule change about masks being sort of optional is a little confusing.

It’s sort of optional because it looks like it’s not optional for unvaccinated health care employees. They still have to wear masks.

I wrote about this back in May of 2021, “Unmasked Means Fully Vaccinated?” That was back when bandanas were acceptable as face coverings.

So does being masked mean “not vaccinated?” It’s confusing because if masking is optional for patients and visitors, why are health care workers the exception? I’m not sure how anyone would enforce the policy.

If you can wear a mask just because you want to do that, how does that separate you from the unvaccinated person?

If masks are optional, then why are the entrance and exit policies not changing, including screening of patients, visitors, and staff? I didn’t see the guidance about what to do if anyone says they are symptomatic or unvaccinated and prefers not to wear a mask, other than to offer a mask (which is free!).

If it’s disrespectful to ask a patient or visitor to put on a face mask, why is it not disrespectful to require an unvaccinated health care worker to do so? There is one bullet point in the question-and-answer section about whether you can ask anyone to wear a face mask which says you can’t ask anyone, including “employee, colleague, patient, visitor, etc.” In the same section is the statement: “Whether or not to wear a mask is a personal decision that each person must make for themselves and for their own reasons.” Does that apply to getting a Covid-19 vaccine as well?

That said, I’m a staunch supporter of everyone getting a Covid-19 vaccine, if they don’t have medical or other exemptions. They don’t make you magnetic!

And I don’t think the recent Cochrane Review results on face masks really means they’re useless, which some news stories tend to convey. I think the Cochrane review does what most such reviews do, which is point out the problems with some controlled studies. And the reviews themselves may have unintended biases.

What’s the most important part of all this? Well, maybe the predicted snowstorm coming to Iowa tomorrow will prevent my dentist from getting to the clinic. And if that doesn’t work, maybe I could just exercise my right and privilege to wear my mask as a barrier to any nefarious procedures.

FDA VRBPAC Discussion Topics Today

The FDA VRBPAC 178th annual meeting on future Covid-19 vaccine regimens includes two main discussion topics:

“Future periodic vaccination campaigns:
Simplification of COVID-19 vaccine use:

  • Immunization schedule: Please discuss and provide input on simplifying
    the immunization schedule to authorize or approve a two-dose series in
    certain young children, and in older adults and persons with compromised
    immunity, and only one dose in all other individuals.
    Periodic update to COVID-19 vaccines:
  • Vaccine composition: Please discuss and provide input on the
    consideration of periodic updates to COVID-19 vaccine composition,
    including to the currently authorized or approved vaccines to be available
    for use in the U.S. in the fall of 2023.”

Among the members attending the web conference is University of Iowa Professor Stanley Perlman, MD, PhD, Departments of Microbiology and
Immunology, Professor of Pediatrics, Mark Stinski Chair in Virology.

The meeting is today from 8:30 AM to 5:30 PM ET.

Update: Dr. Stanley Perlman MD, PhD from the University of Iowa will be the acting voting chairman of today’s meeting.

Update: Dr. Jerry Weir gave a clarifying and practical bird’s eye view of the issue at hand which began at 2:30 PM on the live play today (the meeting is being recorded). The questions and comments for Dr. Weir by Offit, Levy, and Chatterjee were also helpful to hear.

Update: Voting Question is:

“VRBPAC Voting question
Simplification of current COVID-19 vaccine use:

  • Vaccine composition: Does the committee recommend harmonizing the
    vaccine strain composition of primary series and booster doses in the U.S.
    to a single composition, e.g., the composition for all vaccines administered
    currently would be a bivalent vaccine (Original plus Omicron BA.4/BA.5)?”

Voting Result: Unanimously upvoted.

Reminder: FDA Advisory Committee Meeting Thursday January 26, 2023 on Future of Covid-19 Vaccination Regimens

Remember, the 178th Annual Meeting of the FDA Advisory Committee on the future of Covid-19 Vaccination Regimens is this Thursday from 8:30 AM-5:30 ET.

The details so far include the voting question:

“Simplification of current COVID-19 vaccine use:

  • Vaccine composition: Does the committee recommend harmonizing the
    vaccine strain composition of primary series and booster doses in the U.S.
    to a single composition, e.g., the composition for all vaccines administered
    currently would be a bivalent vaccine (Original plus Omicron BA.4/BA.5)?”

FDA Advisory Committee Meeting to Discuss Future Covid-19 Vaccine Regimens

The FDA 178th Meeting of the Vaccine and Related Biological Products Advisory Committee will meet in open session January 26, 2023 to discuss future Covid-19 vaccination regimens. The meeting will run between 8:30 AM-5:30 PM ET.