The Future of COVID-19 Vaccine


Tina Tan, MD, and Sean O’Leary, MD, discuss the future of COVID-19 vaccines and the possibility of a combination vaccine.

Tina Tan, MD: Where do you think we’re headed with regards to COVID-19 vaccines and pediatrics? Do you see maybe the COVID-19 vaccine being combined with other viral vaccines that can be given at the same time to provide protection for these kids?

Sean O’Leary, MD: Great question. I think this is where we’re getting into a lot of uncertainty. I’ll just start for example, with pregnancy. It’s unclear. Is it going to make the public health sense to vaccinate every pregnant woman, and every pregnant person with COVID-19 vaccine during pregnancy to protect the infant? We think there’s probably some additional protection there, but they may already have some preexisting immunity, and they may even be without that additional vaccine. So that, for example, is being explored. In terms of pediatrics, I mentioned the issues around the age group for the primary series and whether we are going to continue the primary series in the entire population. Since your prevalence is so high when we do the studies, do they do the modeling and look at the data? Does it make sense to continue doing primary series in people who have not been vaccinated, in older age groups, or just select populations like immunocompromised? Do we move forward with a booster? I think we also need to continue to track hospitalizations and deaths in children to understand what the risk is going forward.

One of the more powerful parts of the ACIP [Advisory Committee on Immunization Practices] presentations over the last several years would be these benefit-risk calculations. This is when we’re talking about things like myocarditis. For every million adolescents who are vaccinated, this many will develop myocarditis, this many hospitalizations are prevented, or these many deaths are prevented are all statistics that could be calculated. I think we need to continue to do that as a society going forward so that we are continuing to do what is in the best interest of children. For now, that looks like getting your booster doses in the primary series, particularly for young kids. But it’s something that’s going to be continually evaluated as we move forward.

Tina Tan, MD: They’re already talking about possibly a COVID-19/influenza booster and so that’s going to be very interesting if we really feel that you need to get a COVID-19 vaccine on a regular basis.

Sean O’Leary, MD: Exactly. I saw that the manufacturers think that probably won’t be ready for adults this year, but maybe in the coming years. Pediatrics is usually a little bit behind with those types of things, which is the other thing with COVID-19 becoming more of an endemic virus. I think we can say it’s endemic at this point with the number of times children are getting infected, we need to understand those hospitalization risks going forward, and we need to understand the long COVID-19 risks going forward. Because it may turn out, in fact, that kids of a certain age don’t need annual boosters. That’s not where we are right now. But we may be headed there.

Tina Tan, MD: This is a very interesting concept because if they want to make a combination vaccine, it might be the fact that you have to change the antigens in the COVID-19 vaccine in order to keep up with all the evolving subvariants that are coming out.

Sean O’Leary, MD: The other thing I would add is how it is based on the current technologies. Although, given what we saw happen with mRNA vaccines so early on in the pandemic, and how quickly they came to be and get rolled out, we may have a better vaccine going forward. This could be a universal vaccine or something along those lines. There’s a lot of progress in flu vaccinations as well, which has been decades in the making. It’s not going to happen tomorrow. But in the coming years, we very well may have even better technology than we do now.

Tina Tan, MD: No. That’s fabulous. Well, Sean, I want to thank you so much for this rich and informative discussion. You provided a lot of great information to our audience. I want to thank our viewing audience for tuning in and if you’ve enjoyed this content, please subscribe to our E-newsletter to receive upcoming peers and perspectives and other great content right in your inbox.

Transcript edited for clarity

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