IN fifth century BC, Hippocrates first reported an illness with “flu-like symptoms” spreading in northern Greece. Years later, in Renaissance-era Florence around 1300 AD, an influenza virus called “influenza di Fredo” hit the Italian city with a vengeance. History shows that we have been fighting the flu for thousands of years, while COVID-19 is a relatively new contagion. Still, experts say, the flu has provided the foundation for how we might respond to COVID-19 in the future.
Rajiv Fernando, an infectious disease expert and fellow at Harvard Medical School, says we’re in a very different place than we were with the virus in 2020, because now about 90 percent of Americans are infected with COVID-19. Many of us have “hybrid immunity,” meaning we’ve been vaccinated against the infection and contracted it. As a result, we are less likely to need vaccines every four months, as we did a few years ago.
Annual booster?
While there’s a lot we don’t know, Fernando says we may be able to act like the flu by looking at the type of flu strain that circulates in the southern hemisphere and changing the vaccine accordingly each year. “It’s reasonable to think that this would also work with the COVID-19 vaccine and that an annual vaccine could be recommended, but the difference is that we have years of data on influenza that we just don’t have yet with COVID-19.” says Fernando.
As new variants emerge, Fernando says, we should be able to adjust accordingly and recommend an updated vaccine when there is a threat. Many vaccine makers have already said they will be able to come up with a new vaccine within 100 days if a dangerous variant rears its head. In this case, a vaccine may be needed more than once a year.
Read more: What new variants of COVID-19 are currently circulating?
Like the flu shot, the highest recommendation for a Covid-19 vaccine would be elderly and immunocompromised patients. However, those who are not immunocompromised may also choose to receive one. But as the data rolls in, we’ll have a better idea of who should get an annual bump. “Either way, we have to be in a position that if someone who is not immunocompromised wants to get the vaccine, they should not be turned away,” says Fernando. Furthermore, he is concerned that as President Biden Revokes COVID Emergency Declarationvaccines against COVID-19 will no longer be free for those who need them most.
The risk of prolonged COVID
But experts don’t fully agree on what the future of vaccines will look like. Grace McComsey, Ph.Dwho led the Long COVID RECOVER study in University Hospitals of Cleveland Health System, agrees that we may need more than one shot per year based on variants. But for her, the bigger concern about COVID-19 is the long COVID.
Read more: What is long-term COVID and what are the symptoms?
While most people are less likely to die from acute COVID-19 at this point, prolonged COVID affects a broad group of patients from all walks of life, she says. There are so many more complications in those who survive COVID-19 compared to the flu, and we are seeing so many new health conditions such as brain fog, lethargy, blood clots, gastrointestinal issues and so many more arising as a result of this illness . “In my opinion, preventing prolonged COVID should be the primary concern and the reason everyone should get an annual immunization, if not more than one,” says McComsey.
There is still much we don’t know about how COVID-19 will affect us in the future as more options emerge and we gain a better understanding of the long run of COVID. All of these will affect who should get an annual vaccine. But what is clear is that COVID-19 is not over and our response to it should not be either. And unlike the flu, surviving COVID-19 doesn’t mean you’re in the clear.
Read more: Can COVID-19 Change Who We Are?