[jyl]

The original vaccines and boosters were designed for the original strain of Covid (wild type aka Wuhan). They were very effective in reducing the risk of both infection and severe disease, from the original Covid strain, and still very effective against Delta. Omicron was quite different, and the original vaccines and boosters are less effective in reducing the risk of infection although still quite good at reducing the risk of severe disease.

The plan all along has been for the mRNA vaccines to be rapidly revised to target new Covid strains. But Covid mutated so quickly that the vaccine revision lagged the variants. With the rate of severe disease and death declining, there may have been less perceived urgency, and then Congress slashed the budget for Covid vaccines and antivirals. More people, including in the Federal government, were willing to accept Covid as endemic, something that people may contract once or a couple times a year, like cold or flu.

In the meantime, more data on “long Covid” has shown that it is a significant problem. Long Covid appears to be responsible for very roughly a quarter of the lost workforce, which is part of the inflation problem. Long Covid also appears to be a meaningful risk even if the Covid infection does not cause severe disease (hospitalization). The potential cost for the US healthcare system, labor productivity, and general health is starting to get attention. US life expectancy fell two full years during the pandemic, to levels normally associated with less developed countries. So the idea of Americans getting infected and re-infected with Covid every year is starting to look not so great.

It isn’t clear what the alternative is, to endemic Covid. Masking and distancing is too unpopular, Omicron is very transmissible, and China’s struggle to maintain a “zero-Covid” policy is not something any other country wants to emulate. (Although, Long Covid may give China the last laugh - I’m sure the CCP figures that in 10 years, China’s population will be healthier than the US population struggling with tens of millions of long Covid cases.

But revising the vaccine to restore its effectiveness against the current Omicron variant is something we can do, that may help somewhat, so that is being done. The new boosters are bivalent, meaning they target both original strain and some variant of Omicron.

I’m not sure how many people will get the revised boosters, since the Federal government isn’t going to provide them free any more (I think). Obviously people with insurance or money can get it - I sure will - but vaccines are more effective if most of the population get them, so I wish the Feds were still funding the boosters.

There are trials underway for nasally administered vaccines as boosters to the current injected vaccines. The idea is that Covid enters by initially infecting nasal cells, then moves down the upper respiratory tract to the lungs, and also causing the systemic inflammation and other effects that cause the wide range of damage from acute Covid as well as long Covid effects. If the nasal cells can be primed to react immediately against the initial infection, the infection might not be able to get established further into the body. That’s the idea, anyway. The government isn’t funding this work (at least, not as aggressively as it funded the original vaccines) so the work is going slowly.

Which is a ridiculous situation. Covid doesn’t care if we got bored with it. It is still infecting and mutating to be even more infectious, and unlike cold and flu, Covid is able to damage a person’s health, even be disabling in some cases, for a long time after the initial infection is gone.