New vaccines for COVID-19 and RSV on the horizon

illustration of a woman getting vaccinated
COVID-19 vaccines

Federal health officials are asking Pfizer, Moderna and Novavax to create a new COVID-19 vaccine in time for the fall. Instead of another bivalent shot (which Moderna and Pfizer introduced last year), the U.S. Food and Drug Administration’s (FDA) advisory committee wants all three companies to produce a monovalent vaccine that targets only the XBB.1.5 Omicron subvariant.

The FDA’s advisory committee (VRBPAC) last week voted unanimously for the monovalent update, citing data showing the current bivalent vaccine (targeting the original strain plus Omicron BA.4/BA.5) is much less effective against the XBB subvariants currently circulating. The XBB sublineage includes XBB.1.5, XBB.1.16 and XBB.2.3 strains, which are similar enough that a vaccine with a single target (XBB.1.5) could provide good protection against all XBB subvariants. Additionally, the original COVID-19 strain is, by all accounts, no longer circulating.

Pfizer and Moderna COVID-19 vaccines will continue to use mRNA technology, and the Novavax vaccine will continue to be a non-mRNA vaccine. Learn about the differences here.

Notably, although the bivalent vaccine’s effectiveness against infection from current variants wanes fast, we have not seen a notable increase in severe illness or hospitalizations related to COVID-19.

“The bivalent booster still provides significant protection against hospitalization from COVID-19,” said Dr. Paul Cieslak, OHA senior health advisor and medical director, Communicable Diseases and Immunizations program. “Nevertheless, COVID-19 is still out there, and Oregonians are still being hospitalized by XBB variants. People at high risk could benefit from an updated booster.”

Details and a video of VRBPAC’s meeting can be found here.

After a new updated COVID-19 vaccine is developed and then authorized by the FDA, the Centers for Disease Control and Prevention (CDC) will weigh in and recommend who should get it. This could happen around September, and eligible people should be able to receive the vaccine sometime this fall.

This fall may mark the start of an annual COVID-19 vaccine regimen, like we have long had with the flu vaccine, but it’s too early to say for sure.

Respiratory syncytial virus (RSV) vaccines

Oregonians age 60+ may be able to receive an RSV vaccine this fall. The FDA approved two RSV vaccines for older adults last month, one from Pfizer and one from GlaxoSmithKline, and the CDC’s advisory committee voted yesterday that people age 60+ may receive a single dose of RSV vaccine, after discussing it with their health care provider. Evidence presented to the CDC shows the vaccines to be 80% effective at preventing RSV infection in the adults studied. It is not yet known how long that protection will last, and whether people will need a booster year after year.

“RSV hospitalizes 60,000 to 80,000 adults a year in the United States. Older adults, and particularly those with underlying medical conditions, are at high risk,” Cieslak said.

It will take some time to manufacture and distribute the vaccines. According to statements by the two companies, we expect the vaccines to be available later this year, likely in the fall before the start of RSV season.

RSV vaccines are also being studied to see whether they can be given to pregnant people to protect their newborns. RSV is the most common reason that infants get hospitalized; 2% to 3% of all infants in the U.S. are hospitalized because of it. The FDA has reviewed it and is expected to decide toward the end of the summer whether to approve it.

RSV is a mild, cold-like infection for most people, but it can be especially dangerous for babies and older adults.