Will anyone ever be fully vaccinated against COVID?

In recent weeks, vital GP services, such as routine health checks for the over-75s, have been curtailed to allow the delivery of the booster program. Chancellor Rishi Sunak has reportedly raised the eye-watering sums involved in several high-level COVID meetings, warning that a regular booster regime could soon start to affect national spending. It has been estimated that additional boosters, should they be required every three to six months, could cost an additional £5 billion ($9.2 billion) a year.

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While some sort of annual COVID booster for the vulnerable – similar to the flu jab – appears inevitable, Professor Adam Finn, a member of the JCVI, hopes that the wider population will in time be spared.

“While it is always hard to predict the future, I would say it is not going to go on being like this,” says Finn, a professor of paediatrics at Bristol University. “We will generate more immunity and the evolution of the virus will stabilise.”

The lesson of previous pandemics, he says, is that the virus remains “highly unstable” for a period, mutating into new strains before eventually settling down. And, as he points out, we are also adding more tools to our armoury.

‘We will generate more immunity and the evolution of the virus will stabilise.’

Professor Adam Finn, member of the JCVI, UK

On Wednesday, it was announced that the British government had increased its order of antivirals five-fold, signing contracts for 4.25 million courses of pills for vulnerable patients, to stave off severe COVID symptoms. The move was in response to criticism the government had only ordered 250,000 courses of the new Pfizer “wonder pill”, which has been shown to cut hospitalisations and deaths by nearly 90 per cent.

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As we discover more about the virus, the potency and effectiveness of the vaccines themselves should also improve. There have been reports that military scientists at the Walter Reed Army Institute of Research in the US will shortly announce the discovery of a new, highly adaptable vaccine which has been two years in the making and will be effective against all SARS and COVID variants, including Omicron.

Early in the New Year another US-made vaccine, the two-dose Novavax, will be rolled out across Europe after being granted approval. The UK has ordered 60 million doses of the jab, which delivers proteins, along with immunity-stimulating adjuvants, directly to a person’s cells and in studies has been shown to be 90 per cent effective.

Currently, we are largely relying on two mRNA vaccines in the guise of Moderna and Pfizer, which, while successful at boosting immunity, do wane over time. Finn anticipates we will diversify into reformulated vaccines that may offer longer-lasting immunity. The measles, mumps and rubella jab, for example, was originally introduced in 1988 as a single shot but from 1996 was offered over two doses to provide better protection. “At the moment, we are just using one tool and that is probably not the best way to run things in the long term,” he says.

Then, of course, there is our natural immunity which, as infections currently surge beyond 100,000 cases a day in the UK, will also continue to build an effective force field. Indeed, one of the reasons that South Africa appears to have fared better than feared against Omicron is the high level of naturally acquired immunity in the population from previous waves of the virus (albeit one gained at an extraordinarily high price of more than 250,000 excess deaths).

‘We are not going to be doing lateral flow tests for the rest of our lives because we got a cold.’

Professor Robin Shattock, Imperial College London

Researchers are currently attempting to unpick exactly why those who have already been infected with COVID have a stronger immune response after being vaccinated than those who have never been infected. This so-called “super immunity” is believed to be, in part, due to memory B cells in the body, which are triggered by infection and are extremely effective at producing new antibodies. Meanwhile, a study published in The Lancet this month found that vaccines are already producing long-lasting T cells (a type of white blood cell that determines our bodies’ immune response to antigens) likely to be effective against current and future strains.

Last week, researchers at Cape Town University released data that appeared to validate the potency of cell memory against Omicron. It showed that samples of people who had been double-vaccinated with Pfizer produced a T-cell response which remained 70 to 80 per cent effective against the new variant.

Future waves of the virus are inevitable, says Shattock. And until we effectively vaccinate the world, we run the risk of new variants coming our way. But the increased sophistication of the weapons at our disposal and natural immunity building offer a “running jump” out of a seemingly interminable cycle of boosters.

“What one would hope is that, in subsequent years, for the majority of the population, COVID will be like getting a bad cold,” he says. “We are not going to be doing lateral flow tests for the rest of our lives because we got a cold.”

The Telegraph, London