Tents are set up for COVID-19 testing outside of San Ysidro Health Center's San Ysidro clinic, Dec. 7, 2021. (Zoë Meyers/inewsource)

Additional boosters for COVID-19 might not be available to the general public until fall, as scientists work toward updating vaccinations to better tackle Omicron. Health experts are worried that, as counties across the country continue to see high rates of infection with the spread of new strains, these new doses might be coming too late.

The Food and Drug Administration said last week that it had advised coronavirus vaccine manufacturers to update their booster doses to better tackle the strains, BA.4 and BA.5, which have become the dominant variant of Omicron circulating.

Why this matters

COVID-19 cases across the country are increasing with the spread of new variants. Experts say this might lead to more hospitalizations or deaths.

These new variant-adjusted vaccinations, which will replace the existing booster shots that are available to some currently, will most likely not be ready for distribution until fall, according to scientists, but that timeline is still relatively tentative.

Experts are cautiously optimistic about the efficacy of these new doses being developed in preventing serious complications with the strains of Omicron that have been circulating over the last few months. However, given the timing and the purpose of the vaccine, scientists say this might not impact the levels of transmission seen as counties like San Diego remain in the middle of another surge.

“The variants have gotten too smart and have figured out how to evade the (existing) vaccines,” said Susan Kiene, professor of global health at San Diego State University. “So really we’d be looking into rolling out the newer (variant-adjusted) vaccines, as soon as they’re ready, but unfortunately I don’t think we’re quite there yet.” 

San Diego County health officials are warning the public to be more vigilant when it comes to following public health safety recommendations, given rising levels of transmission across the county.

Current case numbers in the county continue to be high with a modest increase since mid-June. The city has confirmed more than 9,100 cases being recorded the last week of June, although experts believe this number to be an undercount due the increased use of at-home testing.

Last week, county health officials tracked an additional 9,763 cases, with experts saying cases could climb even more following Fourth of July activity.

The newest iterations of the Omicron variant, BA.4 and BA.5, have become the dominant strain of virus seen in the county, accounting for about 77% of the county’s viral caseload according to the latest available data from wastewater sampling

Given their extreme transmissibility and skill at evading antibodies, this number could rise even further as more time passes since people have received a dose of the vaccine, potentially causing more breakthrough cases given that the potency of the shot decreases significantly a few months after administration.

County numbers of hospitalization and death still remain relatively low compared to previous waves — the total number of hospitalizations per day in June has mostly been around 30 cases daily and the number of deaths staying below five. 

As these variants continue to spread, the number of people experiencing these issues might increase with the number of positive cases, according to researchers — potentially peaking before the variant-adjusted vaccine is available.

Experts stress though that even if these updated vaccines were made available to the general public now, it would most likely have little impact on the number of infections seen in the county.

“When we talk about vaccines and boosting, it doesn’t change a lot of what we’re seeing with this particular variant, cause it is so infectious and it gets around immune responses really well,” said Dr. David Smith, chief of infectious diseases and global public health at UC San Diego.

“Vaccines and the boosters have a very small effect on the transmission rate,” Smith continued. “What they really do and what they’re really good at is they decrease the need for hospitalization and death.”

According to experts, the county is seeing an increased number of cases due to more exposure from increased activity. Although transmission is high, they say, the decision-making behind eligibility for the second booster stems from the possibility of preventing these serious complications should someone contract COVID-19, not the overall chance of infection.

Second boosters are currently only available to those older than 50 and those of any age that are immunocompromised based on a pre-existing condition. According to health officials, only about 26,440 people in the county are eligible because they are immunocompromised.

Those 60 and older currently have the highest number of hospitalizations and deaths in San Diego County, compared to other age groups. This age group accounts for 63.4% of hospitalizations and 100% of deaths since May 1. Those between the ages of 20-39 have the second highest number of hospitalizations, making up 17.5% of the total number.

“There’s less benefit to healthy people for a second booster,” Kiene said. “Among the general population of what we would consider young and healthy people, right now, the first booster dose is doing a good job of producing a robust immune response that’s continuing to provide protection from severe disease.”

Studies have shown that this remains to be the case, with older adults and individuals who are immunocompromised seeing the biggest decrease in likelihood for severe complications after receiving the second booster shot.

While the second booster might not be available to the general public since November 2021, first booster administration has largely stalled across the county, with a take-up rate among those eligible for the first booster of about 57.3% as of June 29.

“If people are eligible for boosting now, they should not wait for a vaccine,” said Dr. Robert Schooley, chief of the UC San Diego Health Division of Infectious Diseases. “There is a ton of extremely transmissible virus out there and one can’t assume that it isn’t possible to get infected over the next 3 to 4 months.”

Given the rate of transmission, it will become even more important to be as up to date as possible with vaccination as the virus continues to mutate. What the next iterations of COVID will look like later this year is still largely unknown.

“We’re moving on. The virus is moving on pretty darn quickly,” Smith said. “There probably is gonna be (a new variant) coming. I don’t know if it’s gonna be that much different than Omicron. Only time will tell whether or not another very divergent variant comes up.” 

Experts stress that individuals should continue to take precautions to prevent infection to prevent further spread or developing long-term illness, such as long COVID.

It’s unclear whether the county is considering reimplementing any measures to curb transmission. Nonetheless, health officials say that people should be careful and take steps to avoid the virus, particularly given high rates of reinfection.

The county continues to encourage people to take steps to lower risk of infection by taking measures like wearing a mask, limiting indoor activities, and staying home if an individual is experiencing symptoms.

“COVID transmission continues to be widespread in our community now with increases in hospitalizations,” County Health and Human Services Agency spokesperson, Sarah Sweeney, said in an email. “We continue to encourage people to use proven strategies to protect themselves and others from contracting and spreading the virus.”

Type of Content

News: Based on facts, either observed and verified directly by the reporter, or reported and verified from knowledgeable sources.

Danielle Dawson is a former reporting intern for inewsource through a partnership between the Columbia University Graduate School of Journalism and the Institute for Nonprofit News. Originally from San Diego, she joined the newsroom after graduating from Columbia University with a master’s degree in...