NEW YORK CITY -- Americans may need to get a single COVID-19 vaccination every year, federal health officials said Tuesday, making clear that the country will be living with the coronavirus for the foreseeable future.
"This week marks an important shift in our fight against the virus," said Dr. Ashish Jha, who is leading the White House COVID-19 Response Team. "It marks our ability to make COVID vaccines a more routine part of our lives as we continue to drive down serious illness and deaths and protect Americans heading into the fall and winter."
Though Tuesday's announcement isn't a surprise -- the Biden administration has been hinting at such a shift since the spring -- it is a significant moment as the government continues to de-escalate its pandemic response.
Jha said the newly authorized updated COVID-19 boosters would be free of charge to all who qualify and want them, but future vaccines and treatments may not be, as funding for the pandemic response dwindles and the government begins to shift therapeutics to the commercial market.
Vaccine experts said the shift to yearly shots signals that COVID-19 isn't going away.
"Our great-great-grandchildren will be getting coronavirus vaccines," said Dr. Gregory Poland, who directs the Mayo Clinic's Vaccine Research Group. "Just like you and I, when we get our flu vaccine this fall, one of the components we'll get is derived from the 1918 pandemic influenza virus, and 100-plus years later, we're still immunizing against it."
Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, said on Twitter that it could be the right time to move to annual boosters if we could answer some key questions, like how well do the updated shots work?
"What do you put in next year's shots?" Hotez tweeted. "What global surveillance mechanisms need to be implemented to identify early strains?"
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Tuesday that although he expects this fall to be the beginning of annual shots for COVID-19, those who have weakened immune systems might need more frequent protection.
"In the absence of a dramatically different variant, we likely are moving towards a path with a vaccination cadence similar to that of the annual influenza vaccine, with annual updated COVID-19 shots matched to the currently circulating strains for most of the population," he said.
Fauci said the latest boosters should continue to protect Americans as long as the coronavirus changes incrementally, drifting away from the currently circulating BA.4 and BA.5 subvariants.
He acknowledged that the plan to give annual shots might need to be revised if the coronavirus makes a significant evolutionary leap, as it did when the Omicron variant surfaced around Thanksgiving. He likened this to an "out-of-left-field curveball."
"There's nothing we can do about that except know that we have vaccine platforms that will allow us to quickly move to address that," Fauci said.
But he stressed that barring any big changes to the virus, the updated boosters should continue to protect in the year ahead and could be updated annually.
Tuesday's announcement marked a shift in how COVID-19 prevention is messaged, too.
"The biggest problem with the vaccines today is that people aren't getting them," said Dr. Robert Wachter, who chairs the Department of Medicine at the University of California at San Francisco.
Only about 1 in 3 Americans ages 5 and up have had a booster, according to CDC data.
In planning the announcement, Wachter said, the White House and CDC were hoping to get more people boosted by taking away some of the uncertainty about when they might need their next shots.
The overall goal, he said, was to make boosters feel more manageable by casting them as something you do every year, like getting a flu vaccine.
"I think it's a really smart way of rebranding and rethinking it," Wachter said.
At Tuesday's briefing, Jha urged Americans 12 and older to take advantage of the updated boosters, stressing that it was the first time the country has had vaccines that match the currently circulating variants.
He also said people should get their flu shots at the same time as their COVID-19 vaccines.
"I really believe this is why God gave us two arms, one for the flu shot and one for the COVID shot," Jha quipped.
Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said "the benefits of being up to date on your COVID-19 vaccines are clear."
BA.5 and BA.4 are the dominant circulating variants of COVID, she said. Although hospitalizations are down 14% since last week, there are more deaths now than in the spring.
"The seven-day average daily deaths are still too high: about 375 per day, well above the around 200 deaths a day we saw earlier this spring and, in my mind, far too high for a vaccine-preventable disease," Walensky said.
Fauci said his message to Americans "is simple: Get your updated COVID-19 shot as soon as you are eligible in order to protect yourself, your family and your community against COVID-19 this fall and winter."