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COVID-19: New strategies to protect people against coronavirus

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Despite the fact that COVID-19 vaccinations have been successful in preventing severe disease and death, there is an increasing push to find Coronavirus vaccines that are better at preventing milder diseases, as well as options to combat terrifying variants.

There’s already some uncertainty among the public regarding who needs a second booster now and who can wait. There’s also a disagreement regarding whether or not everyone will require an additional dose in the fall.

However, for American families concerned about protecting their young children — under the age of five who are not yet eligible for shots – pursuing improvements for the next round of vaccinations may appear to be a luxury.

Dr. Jacqueline Miller of Moderna told The Associated Press that the company’s application to deliver two low-dose shots to the youngest infants would be filed to the FDA “fairly soon.” Pfizer hasn’t released results on the third dose of its extra-small tots’ shot after the first two didn’t work.

Possibly next are combo shots

Even against the most contagious strains, the original COVID-19 vaccinations remain highly protective against severe disease, hospitalization, and death, especially following a booster dose.

Updating the vaccine mix to match the most recent mutants is dangerous because the next mutant could be completely unrelated. As a result, firms have adopted a hint from the flu vaccine, which protects against three or four different strains in a single shot every year.

Moderna and Pfizer are currently testing two-in-one COVID-19 protection that they aim to make available this fall. Each “bivalent” dose would include the original, well-proven vaccine as well as an omicron-targeted variant.

Moderna suggests the strategy might succeed. Combo vaccines targeting the original virus and an early variant called beta were studied and shown to produce modest amounts of antibodies that could resist both beta and recent mutations like omicron. Moderna is currently putting its omicron-targeted bivalent candidate to the test.

But there’s a deadline approaching. Dr. Doran Fink of the FDA said the agency would have to decide on a recipe modification by early summer if any modified shots are to be delivered in the fall.

We have to trust the next line of defense

Dr. David Kimberlin, a CDC expert from the University of Alabama at Birmingham, said that two doses of the Pfizer or Moderna vaccine plus one booster — a total of three shots — “gets you set up” and ready for what may become an annual booster.

Following the initial booster, CDC research suggests that a second dose provides a modest, transient improvement to the majority of persons.

Why is there such a focus on three shots? Vaccination stimulates the production of antibodies that can protect against coronavirus infection, but these antibodies naturally fade with time. Memory cells are the next line of defense, springing into action to create new virus-fighting cells whenever an infection is detected. After the third shot, Rockefeller University researchers discovered that memory cells became more effective and capable of targeting more different strains of the virus.

Even if someone who has been vaccinated catches infection, those memory cells provide “plenty of time to protect you against severe illness,” according to Dr. Paul Offit of Children’s Hospital of Philadelphia.

However, certain people, particularly those with severely impaired immune systems, require higher dosages up front in order to have a better chance of protection.

And Americans 50 and older are being provided a second booster, following Israel’s and other countries’ decisions to provide the additional shot to provide elderly people with a little more protection.

The CDC is working on recommendations to help folks who are eligible decide whether they should get an additional shot now or wait. The elderly, persons with health problems that make them particularly vulnerable, and people who are at high risk of exposure from work or travel are among those who may need a second booster sooner.

Nasal spray or vaccines

It’s difficult for an injection in the arm to produce a large number of virus-fighting antibodies inside the nose, which is where the coronavirus resides. A nasal vaccine, on the other hand, could provide a new technique for preventing diseases that affect people’s daily lives, even if they are minor.

“When I think about what would make me get a second booster, I actually would want to prevent infection,” says Dr. Grace Lee of Stanford University, who chairs CDC’s immunization advisory committee. “I think we need to do better.”

Nasal vaccinations are difficult to create, and it’s unclear when they’ll be ready. However, several are undergoing clinical testing around the world. One under late-stage testing, developed by Bharat Biotech in India, employs a chimp cold virus to deliver a harmless copy of the coronavirus spike protein to the nose lining.

Dr. Michael Diamond of Washington University in St. Louis, who helped develop the candidate that has now been licensed to Bharat, said, “I certainly do not want to abandon the success we have had” with COVID-19 doses.

But “we’re going to have a difficult time stopping transmission with the current systemic vaccines,” according to him. “We have all learned that.”

Image credit: Getty

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