At a meeting to simplify the nation\u2019s covid vaccination policy, the FDA\u2019s panel of experts could agree on only one thing: Information is woefully lacking about how often different groups of Americans need to be vaccinated. That data gap has contributed to widespread skepticism, undervaccination, and ultimately unnecessary deaths from covid-19.<\/p>\n

The committee voted unanimously Thursday to support the FDA\u2019s proposal for all vaccine-makers to adopt the same strain of the virus when making changes in their vaccines, and suggested they might meet in May or June to select a strain for the vaccines that would be rolled out this fall.<\/p>\n

However, the panel members disagreed with the FDA\u2019s proposal that everyone get at least one shot a year, saying more information was needed to make such a declaration. Several panelists noted that in recent studies,<\/a> only about a third of people<\/a> hospitalized with a positive covid test actually were there because of covid illness. That\u2019s because everyone entering a hospital is tested for covid, so deaths of patients with incidental infections are counted as covid deaths even when it isn\u2019t the cause.<\/p>\n

The experts questioned the rationale for annual shots for everyone, given that current vaccines do not seem to protect against infection for more than a few months. Yet even a single booster seems to prevent death and hospitalization in most people, except for the very old and people with certain medical conditions.<\/p>\n

\u201cWe need the CDC to tell us exactly who is getting hospitalized and dying of this virus \u2014 the ages, vulnerability, the type of immune compromise, and whether they were treated with antivirals. And we need immunological data to indicate who\u2019s at risk,\u201d said Dr. Paul Offit, director of the Vaccine Education Center and a pediatrician at Children\u2019s Hospital of Philadelphia. \u201cOnly then can we decide who gets vaccinated with what and when.\u201d<\/p>\n

Offit and others have expressed frustration over the lack of clear government messaging on what the public can expect from covid vaccines. While regular boosters might be important for keeping the elderly and medically frail out of the hospital, he said, the annual boosters suggested by the FDA and the drug companies may not be necessary for everyone.<\/p>\n

\u201cThe goal is to keep people out of the hospital,\u201d he said. \u201cFor the vulnerable, it would be important for vaccines to keep up with circulating strains. But for the general population, we already have a vaccine that prevents hospitalization.\u201d<\/p>\n

Other panelists said the government needs to push research harder to get better vaccines. Pamela McGinnis, a retired official of the National Institutes of Health, said she had trouble explaining to her two young-adult sons why they promptly got sick after venturing out to bars one night only weeks after getting their bivalent booster.<\/p>\n

\u201c\u2018Think how sick you would have gotten if you weren\u2019t fully vaccinated\u2019 is not a great message,\u201d she said. \u201cI\u2019m not sure \u2018You would have landed in the hospital\u2019 resonates with recipients of the disease.\u201d<\/p>\n

Members of the FDA\u2019s advisory committee have been irked in recent months, saying the agency didn\u2019t present them with all the data it had on the bivalent vaccine before it was released in September. And some critics have said<\/a> the FDA should have instructed drug companies to include only the newer strains of the virus in the shot.<\/p>\n

Asked about that Thursday, Jerry Weir, a senior FDA vaccine officer, said his \u201cgut feeling\u201d was that a vaccine matched to a single omicron strain would have performed better than the bivalent shot, which also contains the original covid strain. \u201cBut the real question is where we\u2019re headed,\u201d he said, \u201cand I don\u2019t know the answer.\u201d<\/p>\n

Perhaps the most important presentation Thursday<\/a> was from Heather Scobie, who keeps tabs on covid at the Centers for Disease Control and Prevention. She reported that fewer than half of Americans 65 and older had gotten the latest booster, and that only two-thirds of that age group had gotten even a single booster.<\/p>\n

Yet evidence continues to mount that it\u2019s mostly the elderly who are at serious risk from covid. Death rates from the disease have declined in every age group except those over 75 since April, despite the uptick in new strains. Except for the very old, the death rate has hovered around 1 in 100,000 since April. Earlier in 2022, babies 6 months old and younger were hospitalized and died at relatively high rates. Vaccination levels in the 4-and-under group hover at about 10%.<\/p>\n

While acknowledging the FDA\u2019s desire to regularize its covid vaccine policy, panel members said it\u2019s still too early to know for sure whether covid will surge only in the winter, like flu, respiratory syncytial virus, and other respiratory infections.<\/p>\n