Outlook poses tough questions for next steps on COVID-19 vaccines

“Theoretically, repeated exposure to an older variant formula may drive our immune system to concentrate too much on old features and not on new features,” Katelyn Jetelina, an assistant professor at University of Texas Health Science Center, wrote in her Substack newsletter. “But despite some truly surprising evolutionary leaps of the virus (like Omicron) we have not seen any convincing evidence of OAS among humans, which is great news.”

There’s also disagreement in the medical community about whether more COVID-19 shots of any kind are necessary for the broader public beyond the elderly and high-risk. The debate has muddled the message on already confusing booster recommendations.

“The FDA and CDC have kind of come out with, like, a lukewarm, ‘Yeah, you can do this,’ as opposed to, ‘Run and do it now.’ And you know, that’s going to leave most people confused,” said Jen Kates, Kaiser Family Foundation director of global health and HIV policy.

Waning public interest

Health officials are also wrestling with what levels of infection and severe disease should be considered acceptable as the pandemic continues. Booster rates are trailing initial vaccination rates, and public interest in getting more shots will likely continue to decline.

“What really keeps me up at night, it’s the knowledge that we can’t keep boosting, and we’re going to have vaccine exhaustion,” Peter Marks, director of the FDA Center for Biologics Evaluation and Research, said at last week’s advisory meeting. “I’m not talking about immune exhaustion, I’m talking about physical exhaustion of people going to get boosted.”