U.S. Officials Detail Plan to Combat Respiratory Virus Season

With 2023 bringing new tools to fight a common respiratory scourge, U.S. health officials on Thursday offered a preview of the Biden administration’s fall vaccine campaign, while acknowledging that some questions remain unanswered.

“We’re going to be encouraging Americans to get their COVID-19 vaccine, in addition to their annual flu shot, as well as the immunizations for RSV [respiratory syncytial virus] for people who are over the age of 60, as well as for infants,” said a CDC official on a call with reporters, which was conducted entirely on background.

COVID-19 Vaccines

The FDA is currently reviewing manufacturer data on new products for the fall — this time a monovalent vaccine targeting the XBB.1.5 Omicron subvariant — but an official on the call said the updated shots are expected by mid-September. Recommendations for use will be made at a meeting of CDC’s Advisory Committee on Immunization Practices (ACIP) scheduled for September 12.

As COVID cases tick up, it might be best for people at higher risk of severe outcomes to get a COVID shot sooner, explained CDC Director Mandy Cohen, MD, MPH, in a Q&A video released on Friday. However, anyone who gets a currently available bivalent vaccine now may then have to wait before receiving one of the updated products.

COVID hospital admissions surpassed 12,000 over the past week, a notable increase compared with recent months, but this is still far lower than the 40,000 hospitalizations per week this time last year. “We’re in a much different and better place in August of 2023,” said Cohen.

Even though most of the U.S. population has some degree of immunity either from past infection or vaccination, protection from either has been shown to wane.

“Having antibodies is like a shield, but we still need to be cautious, because that protection does decrease over time, and we have to remember that the virus continues to change,” Cohen explained in the video.

Manufacturers say their updated vaccines can successfully neutralize currently circulating variants, including EG.5 or “Eris,” though it is unclear how well they will neutralize BA.2.86, a new and highly mutated variant of concern now in the U.S., though in small numbers. “We’re working as fast as we can to understand this new variant and what impact it might have on how severe the COVID disease will get or how well our vaccines work against it,” Cohen noted.

New Options Against RSV

The first-ever RSV vaccines were approved by the FDA earlier this year, from GSK (Arexvy) and Pfizer (Abrysvo). The ACIP recommended the prefusion F protein-based vaccines for adults 60 and over following a shared decision-making with a healthcare provider.

And on Monday, Pfizer’s shot was approved for use in pregnancy to prevent serious infections in infants; ACIP is expected to weigh in with recommendations for use next month.

That option is likely to soon join nirsevimab (Beyfortus), a recently approved vaccine-like monoclonal antibody recommended for all infants younger than 8 months born during or approaching their first RSV season.

“We urge parents to make sure their newborns — to the extent they’re eligible — are taking advantage of that … especially before we go into the throes of the RSV season,” a CDC official on the call said.

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