Fourth COVID-19 shot could be suggested this fall, as officials ‘constantly’ review emerging data – CBS Baltimore

(CNN) – As the world nears the second anniversary of the World Health Organization’s declaration of a COIVD-19 pandemic, on March 11, many countries are launching – or are discussing the possibility – a fourth dose of coronavirus vaccine for their most vulnerable. In the United States, top public health officials say they are monitoring “very carefully” if or when a fourth dose may be needed.

Israel was the first country to roll out a fourth dose, announcing in December that adults 60 years of age and older, healthcare workers and people with weakened immune systems are eligible for an additional shot if at least four months have passed since the third dose.

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More recently, Public Health Agency of Sweden announced Last week, a second booster dose was recommended for all people 80 years of age and older in the country. The The UK Department of Health and Social Care has announced Second, an additional dose of the coronavirus vaccine will be made available in the spring to adults 75 years of age and older, residents of aged care homes, and immunosuppressed individuals aged 12 years and older. above.

In the United States, health officials emphasized late last year that a fourth dose was not yet needed and said it was too early to discuss a potential fourth dose of a coronavirus vaccine for most people.

Now, the U.S. Food and Drug Administration “is actually constantly reviewing emerging data on the pandemic and variations in the U.S. and abroad to assess potential uses and ingredients.” of the booster dose,” FDA spokesman Alison Hunt wrote in an email to CNN on Friday.

She confirmed that although Dr. Peter Marks, director of the FDA’s Center for Biological Evaluation and Research, has noted that there is still a lot of uncertainty about how the pandemic could progress further, Mr. also indicates a possible fourth dose. recommended as we move into fall.

The fall timeline coincides with the flu shot, which can be convenient for everyone and makes scientific sense because respiratory viruses – like coronavirus and flu – tend to peak during the off-season. winter later.

“As more data become available on the safety and effectiveness of the COVID-19 vaccine, including the use of booster doses, we will continue to evaluate the rapidly changing science and inform the public,” Hunt wrote. “Any decision that a booster dose is needed will be based on the data available to the agency.”

If or when the FDA allows the public to get a fourth dose, the next step would be for the US Centers for Disease Control and Prevention to review the data before making recommendations for use, as the agency has done. for other coronavirus vaccine recommendations.

The US has seen significant improvements recently in COVID-19 cases, hospitalizations and deaths. As of Friday, cases were down 44% from the previous week, hospitalizations were down 26% and deaths were 13% lower, according to Johns Hopkins University data.

Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said: “Immunizations and boosters will be crucial in maintaining that downward trajectory, especially when you are talking about sugar. red curve of serious illnesses that lead to hospitalization. White House COVID-19 Task Force Brief Wednesday.

The “potential future request” for a fourth booster or booster shot of the Pfizer/BioNTech or Moderna mRNA vaccine or a third dose of the Johnson & Johnson vaccine “is being watched very carefully.” in real time,” Fauci said. “And recommendations, if needed, will be updated with the data as it evolves.”

The CDC does not have a recommendation for a fourth dose of the coronavirus vaccine for the general public, but the agency updated its guidance in October to note that some people with moderate or severe immunodeficiency may receive the vaccine. fourth dose of Moderna or Pfizer/BioNTech vaccine.

“For immunocompetent individuals, a single booster shot continues to provide a high level of protection against serious disease caused by Omicron,” says Fauci. “This should not be confused with the fact that for many immunocompromised individuals, a second booster shot – specifically a fourth dose of mRNA – has been recommended because of what we know about the response. their inferiority to the original regimen.”

Meanwhile, vaccine manufacturers continue to study the fourth dose in broader populations.

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Pfizer announced in January that it was studying the safety and effectiveness of a fourth dose as part of its ongoing research on the Omicron-specific coronavirus vaccine among healthy adults aged 18 to 55 years.

For that study, participants were divided into three groups. A population of 600 people received three doses of the Pfizer/BioNTech coronavirus vaccine before enrolling in the study. As part of the study, they will receive either a fourth dose of the current vaccine or one dose of an Omicron-based vaccine.

“Although current research and real-world data suggest that boosters continue to provide a high level of protection against severe illness and hospitalization with Omicron, we recognize the need to be prepared in the event of a protective layer This fades over time and could potentially help resolve Omicron and Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer, said in the company’s announcement of the study.

ONE Research published by CDC last week showed that protection against COVID-19 hospital admissions and emergency room visits or urgent medical visits was much higher after the third dose of the vaccine than the second, but that protection was lost. gradually over time.

With the Omicron variant predominating in the US, the vaccine’s effectiveness is 87% for Covid-19 emergencies or urgent medical visits and 91% for hospitalizations two months after the second dose. father. The data show that efficiency drops to 66% and 78%, respectively, by the fourth month.

“However, the 78 level is still a good defense area,” Fauci said Wednesday.

Dr Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, told CNN on Friday he thinks the fourth dose makes “very little sense” right now – but there could be makes more sense in the coming fall or winter.

“Because Omicron is going away,” he said, “immunity at the third dose weakens, and the fourth dose is likely to weaken as well. So we want to time the fourth dose push when there is a new variant or for next winter. So I think right now, unless you’re immunocompromised or you’re older, unless you have some personal risk, that doesn’t make much sense. ”

Research showing some weakened immunity after a third dose has led to much discussion about whether or when a fourth dose may be needed.

“As with everything else, health departments review this published data and await guidance from the CDC and from drug manufacturers. Drug manufacturers have been monitoring the effectiveness of vaccines,” Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials, told CNN Friday.

The timing of the fourth dose depends not only on weakened immunity “but also on whether we see any more variations emerging and what we discover in terms of supplemental efficacy.” addition of the vaccine to any emerging infections,” says Freeman.

If a fourth dose is needed, “health departments will switch to a prep mode to administer the fourth dose the way they did the previous doses,” Freeman said. However, the greater concern of local public health officials is the slow – and declining rate – of people completing their third dose, she said.

About 65% of the US population is fully immunized with at least their initial series of shots, and about 28% of the population has received a booster dose, according to the CDC, as of Friday. But the rate at which the booster dose was used fell to one of the slowest.

“Over time, if a fourth dose was needed, we went after those who took the third dose,” says Freeman. “So all of a sudden, we can have a sizable portion of the population that isn’t up to date on vaccines because they’re two doses behind, potentially and more people could get sick.”

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Jake Nichol

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