For some, securing an updated COVID-19 vaccine amid the summer surge has been frustrating. The distribution of current vaccines is inconsistent as pharmacies await new ones designed to combat the latest variants.

On a positive note, the Food and Drug Administration (FDA) is expected to approve the new vaccines shortly, which will then be distributed to pharmacies in the weeks that follow.

Experts note that the rollout of COVID-19 vaccines tends to align with the annual distribution of flu shots, which typically occurs in the fall. This is done to shield individuals from severe illness during winter flu peaks. However, those well-versed in the disease caution that approaching COVID-19 similarly to the flu has significant drawbacks. This seasonal pattern means that updated COVID-19 vaccines won’t be accessible when summer infections rise.

Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, emphasizes that this timing isn’t ideal.

“COVID is like a two-humped camel,” Schaffner remarked. “It doesn’t just disappear as influenza does. We see rises in cases during the summer, followed by a decline in the fall, leading to a significant resurgence in the winter.”

FDA Sets Goals for Fall Vaccines

The Centers for Disease Control and Prevention (CDC) reports that COVID-19 cases, hospitalizations, and fatalities have been climbing recently. Nine states in the Southeast are experiencing moderate hospitalization rates, and parts of the Midwest are observing rising case numbers. Ohio’s Governor Mike DeWine revealed on Tuesday that he has contracted COVID-19 as the state faces a summer spike.

Since COVID-19 testing does not capture all infections, assessing the virus’s spread can also be done through wastewater testing. The CDC indicates that viral levels are “very high” in 32 states and the District of Columbia.

Although hospitalizations and deaths remain significantly lower than at the pandemic’s onset, the risk of serious illness from infections still exists for many individuals.

Both Pfizer-BioNTech and Moderna are waiting for FDA approval for their updated mRNA vaccines that target current variants. Additionally, Novavax is introducing protein-based vaccines, offering a viable option for those who prefer alternatives to mRNA vaccines or have experienced adverse reactions from them.

Although an FDA representative stated that the agency cannot disclose approval timelines, Carly Pflaum, an FDA press officer, mentioned, “The FDA plans to act swiftly to authorize or approve updated COVID-19 vaccines, aiming for availability this fall.”

In June, a federal advisory panel advised vaccine manufacturers to develop new options targeting the JN.1 variant, which has been circulating this year. The existing vaccines target XBB.1.5 and may not offer sufficient protection against JN.1 and the variants fueling this summer’s surge.

In the early days of the COVID-19 pandemic, the government took charge of vaccine procurement and distribution. However, with the conclusion of the public health emergency, responsibility has shifted to a market-driven model, requiring vaccine manufacturers to estimate demand and pharmacies to purchase vaccines based on projected consumer needs.

The CDC suggests that everyone aged six months and older receive updated vaccines, but by mid-May, only 22.5% of adults and 14.4% of children had received theirs.

As summer progressed and the virus spread more rapidly, manufacturers stopped shipments of current vaccines to accommodate the newer versions awaiting FDA clearance. Some wholesalers still possess doses of the current vaccine, but particular doctors and pharmacy chains may no longer have supplies available. Many consumers have voiced their frustrations on social media regarding their struggles to locate boosters ahead of summer events like weddings.

Certain CVS locations have exhausted their COVID-19 shot supplies and won’t be restocking, yet many shops still have doses available, according to a CVS spokesperson, who recommended customers check their retailer’s website for information on stock levels.

Timing Matters for Boosters

Experts emphasize the importance of booster timing. Dr. Paul Offit, a vaccine specialist and director of the Vaccine Education Center at Children’s Hospital of Philadelphia, explains that vaccine effectiveness diminishes after four to six months. Individuals getting the updated vaccine this fall should have adequate protection throughout the winter. Some may opt to get an additional shot prior to summer to extend protection, Offit noted.

The CDC Advisory Committee on Immunization Practices has talked about strongly suggesting higher-risk groups, including older adults or those with weakened immune systems, to receive a second shot before summer. Schaffner mentioned this recommendation will likely be discussed in their upcoming October meeting.

If the advisory committee opts to recommend summer booster shots for the following year, it might boost manufacturers’ and pharmacies’ confidence in preparation efforts.

Efforts are underway to produce and maintain an adequate supply of COVID booster shots to last throughout the summer, until the new formulation arrives in the fall.

“Right now, finding a COVID booster can feel like a stroke of luck; you might come across a pharmacy, clinic, or other health provider that has the vaccine,” said Schaffner.