FDA expert panel to discuss the future of COVID vaccines

• The Vaccines and Related Biological Products Advisory Committee last met on COVID in June. At the time, the committee recommended an Omicron-specific update to COVID boosters.
• "The vaccination program until now has been developed and revised on the fly," said Jason Schwartz, an associate professor at the Yale School of Public Health.
• "I think this meeting, at the start of 2023, signals that it's the right time for the FDA to really take a top-to-bottom appraisal of how they're going to think about COVID vaccination for next year and beyond," he added.

Details: The expert panel will evaluate the evolution of variants and the efficacy of current monovalent and bivalent vaccines to examine what the best course of action is for vaccinations moving forward.

• Paul Marks, director of the FDA's Center for Biologics Evaluation and Research, said in a press release that since vaccine protection wanes over time, "it's important to continue discussions about the optimal composition of COVID-19 vaccines for primary and booster vaccination, as well as the optimal interval for booster vaccination."

What's next: Following the advisers' meeting, the FDA itself will then consider whether it'll recommend adjusting current vaccine authorizations, and also consider what is the most efficient process to select strains to include in primary and booster shots.

Don't forget: Health officials have said they believe that COVID shots could potentially start following an annual schedule, similar to the flu.

What they're saying: The FDA's meeting announcement was similar to a "routine flu press release," said Andrew Noymer, associate professor of population health and disease prevention public health at the University of California, Irvine.

• "It just shows that COVID is becoming like the flu. In the sense that we've been talking about basically constantly tweaking the formulation of the vaccine. It's part of the normalization of COVID," Noymer added.

Between the lines: Earlier this month, researchers from the University of Texas Medical Branch found that while the updated booster shots were effective against the BA.4 and BA.5 variants, they did not have a robust response against the BQ.1.1. subvariant, which the CDC says now accounts for 38% of cases in the U.S.

• On the other hand, BA.5 makes up only 10% of cases.

What we can expect: The FDA is looking to get input from the committee on how to better handle variants, as well as to potentially learn other strategies the U.S. can deploy "as we move from pandemic to endemic," Paul Offit, a member of the FDA committee and director of the Vaccine Education Center at Children's Hospital of Philadelphia, told Axios.

• "Whether you have a multivalent vaccine that's different to the bivalent vaccine, whether you have a nasal spray vaccine. ... I suspect we'll be looking at a number of things," Offit said.

The intrigue: The U.S. has reached a state where most of the population is ready to move past the pandemic.

• COVID restrictions are slowing, people are gathering indoors, vaccination rates are low — and the FDA knows it has to come up with a way to handle the virus in those circumstances.
• The pandemic is over but the virus is still around, "so how are we going to protect those who are most vulnerable moving forward?" Offit said, suggesting that the panel might focus on figuring out how to protect those that are more prone to severe disease, instead of outright prevention, as its goal.