DENVER — New COVID-19 boosters that target the most prominent omicron strains of the novel coronavirus currently spreading throughout the country will soon be available in Colorado.
While the current vaccines still offer strong protection against hospitalization and death, immunity against infection has dropped significantly as more immune evasive variants have emerged over the course of the pandemic.
The arrival of the BA.4/5 COVID-19 boosters is good news for those looking for added protection, but how much of it they will create remains to be seen.
Denver7 spoke with Heather Roth, the Colorado Department of Public Health and Environment's immunization branch chief, to talk about their efficacy, how they were approved, what the new boosters mean for families looking to vaccinate their kids as we enter a new school year, and more.
Please note: This interview has been edited for time and clarity.
1. The CDC has approved the bivalent COVID-19 BA.4/5 boosters, meaning the vaccine has components from the wild type strain (the original Wuhan strain of the novel coronavirus) and the BA.4/5 sublineages of the omicron variant.
What do we know about the efficacy of these boosters against severe disease, and, more importantly, against transmission and infection, given that no human neutralization data was submitted and only mice data was used, as it is done with the flu vaccine each year?
I think the important thing to know is that the updated vaccines were developed and manufactured using the same process as the original vaccines, except that they now contain a second component, right? And that is a component targeting the omicron BA.4 and BA.5 subvariants.
In kind of reviewing the data in making this decision, both the FDA and CDC looked at the safety and effectiveness data from the original mRNA vaccines that have been administered to hundreds of millions of people in the U.S. alone. They also looked at safety and immune response from the bivalent booster studies of about 1,400 people that included the original strain and what had been the BA.1 variant. And then, as you mentioned, data from a study of the new omicron vaccines in mice. Based on all of that kind of taken together, the vaccines are expected to increase protection against the currently circulating omicron BA.4/BA.5 subvariants.
2. Many people skeptical of COVID-19 vaccines and the virus itself will say “it’s just a cold” or “it’s just a flu.” First of all, is COVID-19 the same as the flu?
No, they're obviously two different viruses and they cause different severe effects if you end up getting sick.
There's no such thing as “long flu” but there is such a thing as “long COVID,” right? There are two separate things and they're both quite real, and we're heading into the fall; they're both going to be circulating at the same time.
3. Knowing that COVID is not the same as the flu, should it concern people that the CDC is applying a flu-like approach to these boosters before human trial data is complete? After all, flu shots typically aren’t very effective—so wouldn’t we want to know how effective these COVID boosters are going to be before rolling them out?
I think comparing development of flu vaccines to really any other vaccine is like comparing apples to oranges. The science — the data — that kind of the guessing game that goes behind flu vaccine development is very different than what we're talking about with COVID, where we know exactly which subvariants are circulating predominantly in the U.S. and in Colorado right now.
Back to the mice study, you’re asking about how effective these are going to be. Those mice studies suggest that these new vaccines will be about 20 times more protective against Omicron than the original vaccines that we've been having for more than two years now, and about 5 times more protective than the manufacturers’ first attempt at Omicron-specific bivalent vaccines with that BA.1 component.
I will add that human clinical trials are going on right now with the BA.4/BA.5 components and so we'll have more data in another month or two on that particular piece (of the puzzle).
3. When are the updated booster shots arriving to Colorado and when will I be able to get one?
So actually, the first shipment started arriving yesterday and we're going to have about 294,000 doses available on our first two waves of shipments. I think the majority of the doses will be arriving after Labor Day next week.
You'll be able to find a vaccine appointment at many of the same providers that have been offering COVID vaccines, again, for two years now – so your retail pharmacies, your primary care providers, local public health agencies, and then our state-run clinics too – so our mobile buses and our community vaccine sites that will be coming online very soon.
4. Is the state going to host a news conference when these boosters are available or is there going to be some sort of statewide communication via text telling Coloradans that these updated boosters are here and it’s time to go and get yours?
We haven't quite gotten to the point where we'll be doing direct outreach. I can see that happening after the first couple of weeks of rollout as that initial demand might decrease where we do some performed outreach to people to make sure they're aware of this change and this new vaccine.
5. The updated boosters are only available for people 12 and older (Pfizer) and 18 and older (Moderna). When will kids under the age of 12 be able to get these updated boosters?
I think that the manufacturers have said that it's going to be another month or two before they have the data that they would need to submit an application to the FDA for omicron-containing booster doses for kids under the age of 12.
6. Should parents wait until they’re approved, or should parents get their kids a booster from the original COVID-19 vaccine instead, even though the variant currently circulating in the state right now is omicron?
The guidance that has been in place for a long time hasn't changed. If you are due for a booster dose now, you should get it now. There is still some protection offered, particularly against severe disease and severe outcomes that come through the original vaccine for those younger age groups.
So if you’re due I would get it now, knowing that something's coming along the way and in a month or two that you would be eligible for as well.
7. Where do we stand as far as children and their overall vaccination requirements. We saw the vaccination rates fall at the start of the pandemic for children. Has that percentage increased? If not, is the state looking at any programs to increase overall vaccination rates?
So you're right that COVID has disrupted just kind of our routine wellness child visits, our routine regular vaccine visits, and we've seen some increases over the last couple of years where we've kind of climbed out of that valley and out of that decrease.
But we are seeing continued, sustained decreases in other vaccines, in other age groups. One of the things the Colorado Department of Public Health and Environment has done recently is actually doing direct text and email outreach to families whose children are overdue for you know, required school vaccines for example, making sure that they're aware that their kids are missing one or more vaccines, and then linking them up with resources to get them back on track.
8. Should there be any hesitation about combining shots (i.e.: COVID and flu shots or COVID and monkeypox)?
I would say overall, no. If we're talking about flu and a new omicron dose, now is a perfect time to actually roll up both sleeves and get the flu in one arm, your omicron dose in the other, and that really has to do with timing: September and October are the best months to get your seasonal flu vaccine, it gives your body enough time to build protection before that flu virus is circulating widely and it's completely safe and effective to get multiple vaccines on the same day.
There are some special considerations for monkeypox. I don't have the data at hand, but I know it has to do with monkeypox and COVID mRNA vaccines and the theoretical risk of increased myocarditis or pericarditis if those are given on the same day.
(Editor's note: Myocarditis is an inflammation of the heart, whereas pericariditis is an inflammation of the pericardium - a two-layered, sac-like membrane that surrounds the heart.)
9. What about whooping cough (also known as pertussis). There’s reports that cases are on the rise in certain parts of the country. Are we seeing a rise? What is the real concern? Should people get vaccinated against whooping cough?
I don't know what our pertussis case rates look like right now. I'm unaware of any concerning equal increases, but I can say that based on data that we collected from schools and childcare centers for last school year, that we have seen some decreases in vaccine uptake that prevent pertussis from spreading.
Pertussis is a really contagious communicable disease and we want to make sure that we keep our rates high, to keep that out of out of communities and out of schools.
Editor’s note: Pertussis is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. The illness is known for uncontrollable, violent coughing which often makes it hard to breathe. A CDC fact sheet states pertussis can affect people of all ages, but can be very serious, even deadly, for babies less than a year old.
10. The BA.5 variant is the predominant in Colorado, but infections, hospitalizations and the state’s positivity rate are all trending downward. The COVID-19 modeling team even estimates immunity from infection and hospitalization has increased over the past two months: Colorado has upwards of 60-65% immunity against infection and around 85-90% immunity against severe disease. Is it worth getting the BA.4/5 booster at this point for the fall if immunity from the BA.5 variant is this high?
I think it's a personal decision that someone can make and have conversations with their healthcare provider, but as the virus has evolved, so has the vaccine.
This is really exciting that we have science kind of closer to where variants are, that we're not chasing variants quite as much as we have been over the last couple of years. It's the latest and greatest vaccine that's available and getting this updated vaccine is really the safest and easiest way to be protected at maximum levels through the fall and winter.
Those wanting to get the bivalent omicron COVID-19 boosters should get them at least two months after their most recent dose of the COVID-19 vaccine. If you were recently infected, the CDPHE says you should wait at least three months after your SARS-CoV-2 infection before getting a BA.4/5 booster.
