Updated boosters could help better fight COVID this winter

The European Commission is urging member states to prepare for COVID-19 waves this autumn and winter through the distribution of newly approved omicron-fighting vaccines.

On Monday, just days after recommending a pair of boosters aimed at the older BA.1 omicron variant, the European Medicines Agency (EMA) also recommended updated boosters for the BA.4 and BA.5 omicron subvariants.

They are the most dominant SARS-CoV-2 variants in Europe and more infectious than previous strains, partly because they can better evade the immune system. 

In general, infections from BA.4 and BA.5 are less severe than other variants, and the number of patients with serious illness has decreased compared to the previous delta wave, said Torsten Feldt, head of Tropical Medicine at the University Hospital Düsseldorf, this week.

"Nevertheless, new patients come every day," he said in a statement. "Between 20 and 30 infected people are currently in our normal wards, about five to 10 in intensive care units."

Bivalent vaccines

The updated boosters are bivalent vaccines, meaning that their mRNA has two parts, one for the original SARS-CoV-2 strain and another shared by both the BA.4 and BA.5 variants.

They are expected to provide better protection against the main circulating omicron variants and have similar safety profiles and side effects as previous COVID-19 vaccines from Moderna and Pfizer.

Who should take them and when?

The European Centre for Disease Prevention and Control (ECDC) and the EMA recommended that the new boosters first be delivered to those at higher risk of developing severe illness.

That includes people aged 60 or older, those who live in or receive care from nursing homes, health workers, nursing and social care staff and those who have immunodeficiency or other chronic conditions that increase their risk of severe disease, like hypertension, diabetes, cardiovascular disease and chronic respiratory disease, according to the ECDC.

Beyond that, every EU country will decide individually how to roll out the updated boosters.

It is still unclear when the vaccines will become available in Germany and for whom, but Federal Health Minister Karl Lauterbach said he expects the country's vaccination committee to come to an agreement on how to proceed on Thursday, according to Reuters news agency.

"We need a recommendation for the adapted vaccines, that is quite clear," he said. "And I think we will get that."

For those who have previously been infected with COVID-19, the recommendation of how long to wait until getting a booster varies from agency to agency.

Many agree that you should wait at least four weeks to get a booster after an infection, while others like the Australian Department of Health and Aged Care recommend three months.

A need for updated vaccines

The original COVID vaccines are less effective against newer variants because the antibodies they help produce have a harder time recognizing the mutated BA.4 and BA.5 spike proteins.

Although the original vaccines are still effective at preventing severe COVID-related disease, hospitalization and death, the changes in the spike protein of these variants call for an updated version of the vaccines.

Late last month, the US-based Food and Drug Administration (FDA) approved the emergency use of updated boosters from Moderna and Pfizer specifically targeting the BA.4 and BA.5 variants. The Moderna vaccine is approved for anyone older than 18 and Pfizer for anyone older than 12. Both are delivered as a single dose.

Edited by: Clare Roth