I just read an interesting article in JAMA on this fall’s Covid-19 vaccine. Most of it is from the FDA meeting in June (Rubin R. This Fall’s COVID-19 Vaccines Will Target Omicron XBB Subvariants, but Who Needs Them Remains to Be Seen. JAMA. Published online July 05, 2023. doi:10.1001/jama.2023.10053).
One expert was quoted, indicating that there will be “…an elaborate discussion” at the CDC ACIP meeting about who should get the new monovalent XBB.1.5 vaccine. I don’t see that the meeting is scheduled yet.
There are some other interesting quotes to pass along:
“Back in March and the first half of April, XBB.1.5 represented more than 80% of circulating SARS-CoV-2 in the US, according to CDC estimates. Its dominance began to slip in late April, and as of late June, XBB.1.5 represented little more than a quarter of circulating SARS-CoV-2 variants. By then, though, XBB.1.5 and 9 other XBB subvariants together accounted for a total of 96% of circulating SARS-CoV-2 in the US. Fortunately, members of the XBB family of subvariants are antigenically similar to each other, so a vaccine against XBB.1.5 should protect against the rest of them as well, the WHO committee noted.”
“By the third quarter of 2022, an estimated 96.4% of approximately 143 000 blood donors in a nationwide, longitudinal cohort had SARS-CoV-2 antibodies from previous infection or vaccination or both, according to an analysis published in June in Morbidity and Mortality Weekly Report.
Or, as Sawyer told JAMA, “[t]he whole US has had this virus in one form or another.”
Because of the high prevalence of SARS-CoV-2 antibodies in the population, Paul Offit, MD, in an interview predicted “a focused recommendation by the CDC” regarding who should receive the XBB.1.5 vaccine.”
“Offit said he expects that the CDC will recommend the new monovalent XBB.1.5 vaccine for groups at the greatest risk for severe disease, reflected in continuing hospitalizations for COVID-19. Those groups likely would include people who are 75 years or older, people with severely compromised immune systems, and pregnant people, Offit said.”
“At least for people 60 years or older, the fall vaccine situation will be more complicated than it was a year earlier, Schaffner noted. That’s because at its regular monthly meeting in June, ACIP voted to recommend that this age group have the option of being vaccinated against respiratory syncytial virus (RSV) after consulting with their physician or pharmacist.”
That would mean that there would be 3 vaccines coming in the fall: RSV, Covid-19, and influenza. Sena and I have been doubtful about why a conversation with a physician would be necessary for the RSV vaccine. We don’t know whether that means you couldn’t get it without a physician’s order. There are also questions about coadministration of the RSV and Covid-19 vaccines.
Because the time is coming soon for seasonal vaccines, we’re hoping the questions will be answered soon.
Go Retire Psychiatrist 