Marcio Jose Sanchez/AP Photo
Finley Martin, 14, gets a shot of the Pfizer COVID-19 vaccine at the First Baptist Church of Pasadena, May 14, 2021, in Pasadena, California.
After months of waiting, updated coronavirus vaccines are going to be available soon. The FDA has approved bivalent boosters from both Pfizer and Moderna—meaning they target both the original version of the virus and the BA.5 variant that is currently dominant in most of the world. They will be available for people over age 11 and 17, respectively, as long as they’ve gotten their first two shots at least two months ago (though some scientists also recommend waiting at least a similar period after recovering from an infection). Now that the CDC has signed off, they should be available within days.
It seems likely that COVID-19 is going to settle down into something similar to the flu: an endemic virus that circulates and mutates continually, requiring an annual vaccine to get the greatest protection. Luckily, it is relatively easy to update the mRNA vaccine to match variants as they come out. Everyone should get this shot, and be prepared to do it again regularly in the future.
Recall that in mid-2021, after the initial vaccination campaign, cases, hospitalizations, and deaths fell to their lowest level so far. They rose back again for two reasons: First, new variants arose that were biologically different from the original virus, and hence the immune response trained by the original vaccine became less and less effective—especially against the omicron variant, which had multiple significant mutations. Second, unlike polio or chicken pox, immunity to coronavirus unfortunately tends to fade over time. As people got further away from their date of vaccination, they were still much more protected than the unvaccinated, but steadily more vulnerable to both infection and severe illness.
This process is exactly what happens with the flu, and why you need to get a shot every year. Each year, a different variant (or combination of variants) circulates, and so scientists produce a vaccine targeted at what they think will be around. Their educated guesses are alternatively dead-on or somewhat off the mark, and this often determines a “good” or “bad” flu season. They can do it without expensive, time-consuming clinical trials, because the science around the flu vaccine is so well understood that only data showing adequate immune response is needed. Then, because your immunity from last year’s shot, or a prior flu infection, has faded, you benefit from the latest vaccine.
That process is now largely complete with COVID and its vaccines. The science is understood well enough, and the mRNA vaccine technology proved safe enough, that we can get by with just immune response and data from studies in mice, allowing the shots to be rolled out as quickly as possible. If we have to wait for months to get full-blown human clinical trials, it’s likely that a different variant will be circulating, and the shots will be less effective.
Unfortunately, the public discourse has been badly muddled around COVID vaccines. On the one hand, there is an anti-vaccine propaganda campaign on the right that has cut uptake among conservatives, in the process killing tens of thousands of loyal Republican voters, including a number of right-wing media figures.
This process is exactly what happens with the flu, and why you need to get a shot every year.
On the other, public-health authorities and pundits have carried out a de facto misinformation campaign of their own about the need for regular shots and the supposed danger of the vaccine, especially for children. When the Biden administration was planning its booster rollout in mid-2021, top public-health bureaucrats like Philip Krause, Marion F. Gruber, and Paul A. Offit dragged their feet—and when the administration wisely pressed ahead, Krause and Gruber resigned from the FDA. The three even published a Washington Post op-ed arguing against universal boosters as the omicron variant was first sweeping the country. Offit is still giving quotes to reporters arguing the latest booster needs more delay-inducing trials.
Meanwhile, the FDA and CDC dithered for over a year approving a vaccine for younger kids, including a pointless request for additional data that took months, creating an impression that there was some particular risk for children. That made a toxic combination with previous messaging from writers like Emily Oster, who insisted that children were at little risk from COVID and that it doesn’t spread in schools much (in an obvious attempt to rig up any argument for schools to be reopened).
Even many liberal parents grew convinced that COVID is no big deal for kids, while the vaccine is scary and dangerous for them. Just 60 percent of kids aged 12–17 have gotten two shots, and only 30 percent of 5- to 11-year-olds. A meager 7 percent of kids from six months to four years old have gotten even one dose.
The truth, of course, is that the vaccines are extraordinarily safe—less dangerous than aspirin or Tylenol—while COVID is a serious risk, even for children. According to the CDC, 1,251 people under age 18 have been killed by the virus, which is certainly an undercount, and untold more have suffered serious complications. It’s a safe bet that virtually all of these dead kids were unvaccinated.
Incidentally, Americans are similarly confused about the flu vaccine. In my experience, people greatly underestimate how important it is to get a flu shot—only about half of Americans generally get one. People tend to think (as I did until I started looking into it) that the flu isn’t really that bad, and therefore the vaccine provides only a minor benefit.
In reality, the flu can be a very serious illness, and getting a flu shot is one of the most powerful ways to protect your health and the health of those around you, as it spreads person-to-person. Scientists suspect that a large fraction of annual deaths from heart disease, stroke, and other illnesses are actually flu complications. The actual death toll from the flu may be as much as triple the officially counted deaths—something like 90,000 a year. For people with heart disease, for instance, a flu shot reduces the risk of death by fully 28 percent.
Thanks to vaccines and all the prior infections building up Americans’ immunity, COVID is no longer the monster killer that it was at the start of the pandemic. But even if it actually does settle down into being about as bad as the flu, that is no reason to let your guard down. Get your updated booster, and flu shot while you’re at it, and you might just save your life, or the life of someone you love.
