February 27, 2023

Urgent Need for Next-Generation COVID-19 Vaccines

This article from JAMA January 3, 2023, Volume 329, Number 1, p. 19-20 argues that relying on variant-specific vaccine boosters is insufficient as a long-term strategy to address COVID-19 globally. Instead, a new generation of SARS-CoV-2 vaccines is needed to provide longer protection and greater coverage against potential variants. The effectiveness of these new vaccines would need to be ascertained through large randomized clinical trials. To be considered a significant advancement, these new vaccines should ideally protect against a wide range of potential variants, provide at least 75% effectiveness in preventing illness, offer durable protection lasting at least one year, and be suitable for use in all age groups. The ultimate goal is to produce vaccines that offer broad and long-lasting immunity.

The full article from JAMA can be found here: https://jamanetwork.com/journals/jama/fullarticle/2799600

Urgent Need for Next-Generation COVID-19 Vaccines - Page 1 - Highlighted Text: Continuing along the current path of the generation and administration of variant-specific vaccine boosters is inadequate as a long-term strategy for addressing COVID-19 in popu- lations globally. Serious consideration therefore needs to be given to the development of a distinctly improved generation of SARS-CoV-2 vaccines offering longer protection with greater scope. Therefore, unless corre- of SARS-CoV-2 vaccines offering longer protection with greater scope. lates of protection that are strongly associated with duration of protection against COVID-19 can be identified, it is likely that rather than relying on immunobridging to infer vaccine effectiveness, large ran- domized clinical trials similar to the initial trials of the currently authorized or licensed vaccines for COVID-19 will be required to ascertain the effectiveness of these new vaccines.
Urgent Need for Next-Generation COVID-19 Vaccines - Page 2 - Highlighted text: So what would define success for these new vaccines? To truly represent a significant advance in this area, the protection pro- vided by vaccination would need to apply across a wide range of potential variants that might emerge. In terms of the actual level of effectiveness, the minimum expectations for such a vaccine might be adopted from the criteria used in the search for an accept- able “universal” influenza vaccine. The National Institute of Allergy and Infectious Diseases defines the threshold for influenza vaccine as at least 75% effectiveness in preventing influenza-like illness, achieving durable protection that lasts at least 1 year, and suitability for use in all age groups.6 Aiming even further, the vaccines would ideally not only protect against hospitalization, death, and sympto- matic disease leading to increased health care use but would also reduce viral transmission. Even using the criterion for success of a moderate 40% to 60% reduction in transmission is predicted to have a notable positive impact on outbreak control. an attempt to produce vaccines that lead to broad long- lasting immunity is clearly needed.