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The Food and Drug Administration is considering a major shift in the nation's COVID-19 vaccine strategy.

The goal is to simplify vaccination against COVID and perhaps adopt an approach similar that used for the flu vaccine, with annual updates to match whatever strain of the virus is circulating. This is according to a federal official who spoke under the condition of anonymity because they were not authorized to speak publicly.

NPR reported the proposed shift early Monday morning, and later Monday the FDA outlined it publicly in a set of documents released in advance of a meeting Thursday of the agency's Vaccine and Related Biological Products Advisory Committee (VRBPAC). The committee will vote on the agency's proposal.

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Lengthening the time between a COVID-19 infection and inoculation improves a person's immunity, according to a study published Jan. 26 in the Journal for Clinical Investigation Insight.

Portland-based Oregon Health & Science University studied 96 "generally healthy" employees who have hybrid immunity — vaccination followed by a breakthrough infection or being vaccinated after contracting COVID-19. Those who are better protected align with longer intervals between vaccination and infection.

"Anti-SARS-CoV-2 antibody responses undergo continual maturation following primary exposure by either vaccination or infection for at least 400 days after last antigen exposure," the OHSU researchers wrote.

The study's findings could carry weight in the FDA's future decisions on the COVID-19 vaccine schedule, which so far has been determined by how, when and how much the virus mutates. On Jan. 26, an FDA advisory panel discussed the possibility of a COVID-19 vaccination campaign similar to flu shots, but most disagreed with an annual model because the virus does not mutate on a 12 month schedule.

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interesting study. Also read recently that hybrid immunity is better than either just having a vaccine or just getting covid in terms of reducing %infected and %hospitalized. Another small study, and maybe wishful thinking. Maybe by the time kids get to be our age they will have no susceptibility at all ...

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The temporal aspects of COVID-19 immunity, particularly from repeated vaccination and infection, are less well understood than short-term vaccine efficacy

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The researchers cautioned that the immune response was measured in relatively healthy people, and boosters may be advisable on a more frequent basis among vulnerable people who are older or are immunocompromised.

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On Jan. 26, an FDA advisory panel discussed the possibility of a COVID-19 vaccination campaign similar to flu shots, but most disagreed with an annual model because the virus does not mutate on a 12 month schedule.

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Concerns about vaccine-associated adverse events when immunizations were performed at short intervals led to revision of the tetanus/diphtheria vaccination schedule in 1966 to once every 10 years for patients >6 years of age [4, 5].

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Abstract
Background. Many adult immunization schedules recommend that tetanus and diphtheria vaccination be performed every 10 years. In light of current epidemiological trends of disease incidence and rates of vaccine-associated adverse events, the 10-year revaccination schedule has come into question.

Methods. We performed cross-sectional analysis of serum antibody titers in 546 adult subjects stratified by age or sex. All serological results were converted to international units after calibration with international serum standards.

Results. Approximately 97% of the population was seropositive to tetanus and diphtheria as defined by a protective serum antibody titer of ≥0.01 IU/mL. Mean antibody titers were 3.6 and 0.35 IU/mL against tetanus and diphtheria, respectively. Antibody responses to tetanus declined with an estimated half-life of 14 years (95% confidence interval, 11–17 years), whereas antibody responses to diphtheria were more long-lived and declined with an estimated half-life of 27 years (18–51 years). Mathematical models combining antibody magnitude and duration predict that 95% of the population will remain protected against tetanus and diphtheria for ≥30 years without requiring further booster vaccination.

Conclusions. These studies demonstrate that durable levels of protective antitoxin immunity exist in the majority of vaccinated individuals. Together, this suggests that it may no longer be necessary to administer booster vaccinations every 10 years and that the current adult vaccination schedule for tetanus and diphtheria should be revisited.

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Although many countries, including the United States [8] and Canada [9], continue to recommend booster vaccination every 10 years, the United Kingdom recommends no adult booster vaccinations after the initial 5-dose childhood immunization series [10]. The safety and success of more moderate European vaccination programs with longer intervals between booster vaccinations [10–13] indicate that the current 10-year booster vaccination schedule should be reexamined.

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Public health strategies often end up being a compromise recommendation that the general public can understand and follow.

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And they may change based on new information.