Covid-19: Annual flu-like booster approach may not be appropriate, says expert on infectious disease

Mahase, Elisabeth

doi:10.1136/bmj.p196

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…The introduction of novel Covid-19 vaccines and associated communication campaigns likely played a significant role in raising public awareness about the importance of vaccination, potentially contributing to the observed increases. Given the high intent to vaccinate among over 50s in our 2022 survey, the decision to scrap the offer of a seasonal influenza vaccine to over 50s in 2022 [25] may reflect a missed opportunity to secure high adult population vaccination coverage rates and reduce the seasonal burden of influenza in this cohort [26].…”

Section: Impact Of the Pandemic And Policiesmentioning

confidence: 99%

Changing socio-demographic determinants of seasonal influenza acceptance in England during the pandemic and a framework for predicting future acceptance

de Figueiredo,

Paterson,

Lin

et al. 2024

Preprint

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Objective: To assess the current level of seasonal influenza vaccine acceptance in England and establish the evolving socio-demographic determinants of seasonal influenza uptake and intent-to-vaccinate behaviours between 2020 and 2022. To provide a framework for predicting future rates of seasonal influenza uptake at sub-national scales in England. Design: Two cross-sectional online surveys analysed using a Bayesian time-series multilevel model followed by poststratification to re-weight against English census data. Setting: England, September 2020 to July 2022. Participants: 28,748 English adults, 18 years of age and older. Main outcome measures Three response variables: whether an individual was offered a seasonal influenza vaccine on the NHS in the last 12 months, whether this offer was accepted, and whether they would accept a seasonal influenza vaccine in the next 12 months. Results: In the 2021-22 flu season, 56.3% of adults in England were offered the seasonal influenza vaccine, marking a significant increase of 10.7 percentage points compared to the 2019-20 season. Notably, acceptance of the seasonal influenza vaccine saw a marked rise during this period, par- ticularly among individuals aged 50 and over. However, intentions to accept the vaccine in the next 12 months showed a slight decline across the entire adult population between 2020 and 2022 surveys, although there was an increase among individuals aged 65 and over. Socio-demographic traits play a significant role in shaping vaccine behaviours, with age, gender, education, ethnicity, and religion influencing the likelihood of being offered the vaccine, accepting it when offered, and intending to receive future vaccinations. Noteworthy differences were observed across demographic groups, with smaller gaps among individuals aged 65 and over, particularly between Black/Black British and White respondents. Of particular concern is waning intent-to-accept behaviours among Asian and Asian British groups, as well as Hindus and Punjabi speakers. Regional disparities also emerged, with estimates for flu vaccine receipt and future intent being lowest in London, especially inner London. Moreover, forecasts generated from 2022 data regarding future flu vaccine uptake correlated well with the observed UK Health Security Agency-reported uptake in the subsequent 2022-23 flu season. Conclusions: The findings underscore the significant progress made in increasing seasonal influenza vaccine uptake among adults in England during the 2021-22 flu season, particularly among the older population. However, despite these improvements, disparities persist across socio-demographic groups, highlighting the need for targeted interventions to address barriers to vaccine acceptance. The slight decline in intention to accept the vaccine in the next 12 months among the general adult population warrants attention and suggests the importance of ongoing efforts to promote vaccine confidence and accessibility. Furthermore, the regional disparities observed emphasize the importance of tailoring vaccination strategies to address specific geographical contexts. The strong correlation between predicted vaccine uptake and observed data indicates the potential utility of pre- dictive modelling in informing public health interventions. Overall, these findings provide valuable insights for policymakers and public health practitioners to enhance influenza vaccination efforts and mitigate the burden of influenza-related illness in England.

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Section: Impact Of the Pandemic And Policiesmentioning

confidence: 99%

Changing socio-demographic determinants of seasonal influenza acceptance in England during the pandemic and a framework for predicting future acceptance

de Figueiredo,

Paterson,

Lin

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The recent WHO vaccination guidance against regular boost vaccination for low risk population departs from prior US FDA proposal of annual boost vaccination similar with the flu shot. 11 Such contrasting policies highlight ongoing debates on the effectiveness of regular boost vaccination, 12 partly due to the less than impressive serum neutralization of omicron sub-variants even after administration of omicron-adapted boosters. 13 Nonetheless, the sudden withdraw of booster recommendation might be based on incomplete evidence of the effectiveness and durability of infection-elicited protection against reinfection, 10,14 especially by emerging variants with unpredictable antigenic characteristics.…”

Section: Mainmentioning

confidence: 99%

Humoral immune response to omicron infection in long-term Wuhan-Hu-1-imprinted population

Lǚ

Zhu

Zheng

et al. 2023

Preprint

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Recent WHO vaccination guidance no longer recommends COVID-19 vaccination beyond the first booster in low risk population, citing high population-level hybrid immunity due to widespread omicron infections.1 Although SARS-CoV-2 infection confers durable protection against reinfection,2-4 it may also produce immune imprinting, which skews subsequent immune response to variant antigens toward the first-exposed antigen based on the antigenic distance.5,6 China has the earliest and exclusively Wuhan-Hu-1(WH1)-imprinted population before the 2022 nation-wide omicron outbreak,7 which offers a unique opportunity to study long-term immune imprinting between most antigenically distant strains. Here, we assessed pseudovirus neutralization activity and anti-WH1 receptor binding domain (RBD) antibodies in 4 Chinese cohorts with hybrid or vaccine-only imprinting, or naïve to SARS-CoV-2 prior to omicron BF.7 infection. Both hybrid and vaccine-only imprinting augmented post-infection serum neutralization of WH1 and omicron sub-variants BF.7/BQ.1.1/XBB.1.5 comparing to naïve background. Feedback from pre-existing high-affinity antibodies limited the magnitude of humoral immune response to omicron infection without compromising protection, while antigenic seniority of pre-existing cross-reactive B cells only slightly reduces forward neutralization breadth in hybrid- and RBD vaccine-imprinted participants. Our results support the effectiveness of hybrid immunity against omicron reinfection in long-term imprinted population and provide immunological basis for similar epidemiological findings.8-10

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“…While these vaccinations help those individuals receiving a dose, this level has a negligible impact on the endemic level of cases (decreasing Î from 2% to 1.94% for the nominal parameter values). Many public health agencies have encouraged COVID-19 vaccine updates in the fall (Mahase 2023). For example, vaccination rates in Canada during September-December 2022 were 14 times higher (0.174% of the population per day, an annual rate of 63.5% (Health Infobase Canada 2023)), a rate that substantially lowers the endemic equilibrium level if maintained (from 2% to 1.16% for the nominal parameter values).…”

Section: Introductionmentioning

confidence: 99%

Endemic means change as SARS-CoV-2 evolves

Otto,

MacPherson,

Colijn

2023

Preprint

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SummaryCOVID-19 has become endemic, with dynamics that reflect the waning of immunity and re-exposure, by contrast to the epidemic phase driven by exposure in immunologically naïve populations. Endemic does not, however, mean constant. Further evolution of SARS-CoV-2, as well as changes in behaviour and public health policy, continue to play a major role in the endemic load of disease and mortality. In this paper, we analyse evolutionary models to explore the impact that newly arising variants can have on the short-term and longer-term endemic load, characterizing how these impacts depend on the transmission and immunological properties of variants. We describe how evolutionary changes in the virus will increase the endemic load most for persistently immune-escape variants, by an intermediate amount for more transmissible variants, and least for transiently immune-escape variants. Balancing the tendency for evolution to favour variants that increase the endemic load, we explore the impact of vaccination strategies and non-pharmaceutical interventions (NPIs) that can counter these increases in the impact of disease. We end with some open questions about the future of COVID-19 as an endemic disease.

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Covid-19: Annual flu-like booster approach may not be appropriate, says expert on infectious disease

Cited by 7 publications

References 3 publications

Changing socio-demographic determinants of seasonal influenza acceptance in England during the pandemic and a framework for predicting future acceptance

Changing socio-demographic determinants of seasonal influenza acceptance in England during the pandemic and a framework for predicting future acceptance

Humoral immune response to omicron infection in long-term Wuhan-Hu-1-imprinted population

Endemic means change as SARS-CoV-2 evolves

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