What’s next for COVID-19 vaccines, boosters?

With an effective COVID-19 vaccine developed and out in the world, the next step for scientists is to “fine tune” booster shots.

Current COVID-19 vaccine efficacy wanes over time, leading experts to say it’s likely Americans will need annual booster shots as virus activity continues. But if studies currently underway turn out to be successful, it’s likely coronavirus booster shots will be given at the same time as annual flu shots, said Dr. Pat Winokur, executive dean of the University of Iowa Carver College of Medicine and Vaccine Treatment and Evaluation unit director.

“The next vaccine studies that we’ll be watching are the ones that combined flu with the coronavirus vaccine, because that would be the perfect strategy,” she said.

Pharmaceutical companies Moderna and Novavax are studying the effectiveness of a vaccine that combines the seasonal influenza vaccine with the COVID-19 boosters.

The challenge, however, will be determining which coronavirus strains to use in each year’s vaccine. Winokur noted this is the same challenge with determining each year’s flu vaccine.

Scientists — including those at the University of Iowa — are studying the effectiveness of vaccines that specifically target coronavirus variants, such as delta or omicron.

“The one thing that you do with vaccines is we add adjuvants to try and stimulate a different type of immune response,” Winokur said. “A lot of those studies that are still in the works (are) in understanding how the mRNA vaccines are stimulating that cellular immune response, which is really important.”

In the meantime, it’s important Americans stay up-to-date on their coronavirus vaccines and booster shots to reduce virus activity, Winokur said. Scientists still are working to understand what the coronavirus’ natural patterns will be over time, which will help experts better target vaccine distribution.

Coronavirus activity continues to ramp up in Iowa, driving up new weekly COVID-19 cases and hospitalizations statewide in recent weeks. Johnson County has maintained the highest positivity rate in the state for the past month, with the county reporting 480 positive tests per 100,000 residents this past week.

Winokur recommends that those who qualify get a COVID-19 booster shot as soon as possible, especially given the transmission rates in Eastern Iowa.

“I would get it now because there’s a lot of virus circulating again,” she said. “We have seen a significant uptick. The good news is that not as many people who have been vaccinated are ending up in the hospital.”

Last week, the U.S. Food and Drug Administration authorized the first COVID-19 booster shot for children ages 5 to 11. With this authorization, children in this age group who received their second shot at least five months ago are eligible to receive a third dose of the Pfizer-BioNTech vaccine.

Second booster shots have been approved for adults 50 and older, and for those 12 and older who are moderately or severely immunocompromised.

It’s unclear when or if second booster shots will be recommended for the rest of the population.

Federal health officials currently recommend one booster shot of either the Pfizer or Moderna COVID-19 vaccine for those 12 and older. A booster shot should be given at least five months after the final dose of the primary vaccine series, or three months for those who are immunocompromised.

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