Top HHS official: COVID-19 could require annual boosters

The director of the federal government’s primary biomedical research agency says the novel coronavirus that has killed more than half a million people in the United States may be so prevalent that Americans will need annual booster shots of vaccines for the foreseeable future.

Gary Disbrow, director of the Biomedical Advanced Research and Development Authority (BARDA), said vaccines against the coronavirus could become as prevalent and regular as those that protect against seasonal influenza.

“Right now we do feel that we will potentially need a boost in the fall for those people, especially those above the age of 65, where you do see a more dramatic waning of immunity than you do in younger people,” Disbrow said in an interview with The Hill. “We’re in the process right now, working with our interagency colleagues as well as the Food and Drug Administration, to determine if we’re going to need potentially annual boosters for any of the potential circulating strains.”

BARDA, which heads federal research and development into vaccines and therapeutics for pathogens both old and new, has played a starring role in the response to the pandemic, and in the development of vaccines that have now fully inoculated more than a third of the American public.

Disbrow told The Hill he sees the agency as a key player in preparing for the possibility of future pandemics. 

He took over the agency in November, after serving as acting director following the abrupt dismissal of his predecessor, Rick Bright. Bright had clashed with top Trump administration officials over the pandemic response, and especially the administration’s focus on hydroxychloroquine, a malaria drug that showed early promise in battling COVID-19.

The Food and Drug Administration (FDA) issued an emergency use authorization for hydroxychloroquine before studies showed it had limited use against the virus and the disease it causes. The FDA and the World Health Organization recommended against using the drug on COVID-19 patients last year.

But even before the coronavirus pandemic swept the world, top BARDA scientists had helped to develop the new mRNA technology at the heart of the vaccines developed by Moderna and Pfizer, two products given their own emergency use authorization by the FDA.

“We had supported Moderna in their technology previously for Zika, helping them scale up, because at the time they were very, very small scale for manufacturing. So even the investments that we made in 2016 for the Zika outbreak for Moderna has assisted them for being capable to manufacture at commercial scale their COVID-19 vaccine,” Disbrow said. 

“We invested very quickly at the beginning of the outbreak, COVID-19 outbreak in January and February, even before BARDA was provided supplemental funding, and the standing up of Operation Warp Speed to invest in multiple technologies because you never know which vaccine technology is going to be the one that provides the highest efficacy against different pathogens,” he said. “In this case it happens to be the mRNA vaccines.”

Pharmaceutical researchers have now turned their attention to the next generation of coronavirus vaccines and COVID-19 therapeutics to treat those who are already infected.

Disbrow said his team is closely monitoring therapeutics that have won emergency use authorizations from the FDA: One is a product developed without federal support by Eli Lilly. The other has been developed by Regeneron, known as REGEN-COV, a drug for use in those with mild to moderate symptoms.

More treatments are on the way, Disbrow said.

“We’re now turning towards antiviral small molecule drugs which are critically important,” he said. Those drugs inhibit the reproduction of a virus, and some have the potential to apply to a “broad spectrum meeting against multiple families. The family of coronavirus is not just SARS-CoV-2.” 

The coronavirus family includes viruses well beyond SARS, MERS and SARS-CoV-2, including several that cause nothing more than the common cold in humans who contract them.

Asked whether the new therapeutics could include a cure for the common cold, Disbrow said: “Potentially, yes.”

As the federal government turns its attention toward preparations for the next global pandemic, a key priority of the Biden administration, Disbrow said he hoped BARDA would become a more prominent player in future planning.

“It seems that BARDA is always brought to the forefront during pandemics,” he said. “It would be really helpful if BARDA had additional funding to establish an emerging infectious disease division within our organization so that we can plan for future pandemics.”