Future Covid-19 Booster Shot Formulations Will Likely Require New Formulations, As New Coronavirus Variants Continue To Emerge

To be current on COVID-19 vaccinations must have received three to four doses of the same shot. The current boosters use the same formulas as the original coronavirus. They still protect from severe COVID-19, hospitalizations, and deaths. The world needs a long-term strategy to boost immunity as new, more contagious SARS-CoV-2 variants become available.

I am an immunologist and study immunity to viruses. I was part of the teams that developed the Moderna and Johnson & Johnson SARS/CoV-2 vaccines. The monoclonal antibody therapies by Eli Lilly and AstraZeneca were also develop.

People often ask me how often or infrequently I believe they will need COVID-19 booster shots. Nobody can predict which SARS-CoV-2 variant or what future variants of vaccine immunity will emerge next. However, it is possible to look at other respiratory viruses that have plagued humanity for some time and see what the future might hold.

The influenza virus provides one example. It is endemic, which means it is present in all people. Officials try to predict how to make the flu shot that will reduce the chance of serious disease every year.

SARS-CoV-2 is evolving and it is likely that it will become endemic. It is possible that people will need to have booster shots periodically in the future. Scientists will likely update COVID-19 to accommodate newer viruses, just as they did for the flu.

Based On Careful Surveillance, Forecasting Flu Is Possible

SARS-CoV-2 surveillance provides a possible model to track over time how Influenza virus surveillance could work. Flu viruses have been responsible for several pandemics including one that struck in 1918 and killed 50 million people. Each year, flu-like symptoms are report. Officials encourage people to get flu shots.

Every year, World Health Organization’s Global Influenza Surveillance and Response System makes an educated guess about the most likely flu strains to be in the Northern Hemisphere’s flu season. Based on the select flu strains, large-scale vaccine production is then initiated.

Sometimes, the vaccine isn’t a good match with the viruses that are most prevalent. The shot does not work as well in preventing severe illness. Although this prediction process is not perfect, flu vaccine research has been aid by strong viral surveillance systems as well as a coordinated international effort of public health agencies to prepare.

Although the details of influenza and SARS/CoV-2 viruses are slightly different, I believe the COVID-19 community should consider adopting similar surveillance systems over the long term. Researchers will be able to update the SARS/CoV-2 vaccine with current strains by staying on top of new ones.

What Sars-Cov-2 Has Accomplished So Far

SARS-CoV-2 is in an evolutionary dilemma as it spreads from one person to another. While the virus must be able to enter human cells via its spike protein, it can also change in ways that will allow it to evade vaccine immunity. Vaccines are make to your body recognize a specific spike protein. The higher it changes, the greater the chances that the vaccine will not be effective against the new variant.

Plan For The Future

Yes, the SARS-CoV-2 dominant variants may be different than the current omicron subvariants. A booster that is more similar to today’s omicron-subvariants and the immunity people have already received from the first vaccines will likely provide better protection. It may not require as much boosting as the omicron sublineages.

In the coming weeks, the Food and Drug Administration will meet to determine what fall boosters should look like in order to allow manufacturers to make the shots. Moderna, a vaccine maker, is currently testing its booster candidates on humans and evaluating their immune response to new variants. It is likely that the test results will determine what vaccine will be use to prepare for a winter surge or fall.

One possibility is to change the vaccine booster strategy so that universal coronavirus vaccine strategies are includ. Animal studies have shown promising results. Researchers are currently working towards a universal vaccine that would be effective against multiple strains. To increase protective immunity, some researchers are focusing on chimeric surges which combine parts of different coronaviruses into one vaccine. Other researchers are using nanoparticle vaccinations to get the immune system focus on the most sensitive areas of the coronavirus spike.

Secondary And Coinfections Should Be Addressed

The immune system reacts differently in different ways to bacteria and viruses. Antivirals are not effective against bacteria and antibiotics do not work against viruses. To address secondary and coinfections, it is important to understand the mechanisms that the body uses to regulate antiviral as well as antibacterial infections.

My colleagues and I may have a clue. To identify the molecules in cells that were either killed or protected against bacterial infection, we sequenced the DNA from macrophages, a type of immune cell.

We identified Z DNA binding protein (ZBP1). This molecule is already known to regulate how the immune system responds to influenza. ZBP1 is a molecule that detects the presence of influenza viruses in the lungs. It signals immune cells and epithelial cells to self-destruct. This causes cell death and encourages the recruitment of immune cells to the site.

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