The U.S. has reached an important milestone in the pandemic, according to federal health officials.

Going forward, COVID-19 could be treated more like the flu, with one annual shot offering year-long protection against severe illness for most people.

"Barring any new variant curve balls, for a large majority of Americans we are moving to a point where a single, annual COVID shot should provide a high degree of protection against serious illness all year," said White House COVID response coordinator Ashish Jha at a press briefing Tuesday.

The federal government has started rolling out a new round of boosters for the fall — they are updated versions of the Moderna and Pfizer-BioNTech vaccines targeting both the original coronavirus and the two omicron subvariants that are currently causing most infections.

These vaccines could be tweaked again if new variants become dominant in the future, which is how the flu shot works. Every fall, people get a new flu vaccine designed to protect against whatever strains of the virus are likely to be circulating that season. The hope is the COVID boosters will act the same way.

Jha cautioned that older people and those with health problems that make them more vulnerable to severe disease may need to get boosted more often. But for most people Jha hopes this latest booster will be the last shot they need for at least another year.

Throughout the pandemic, SARS-CoV-2 has been incredibly unpredictable and has been evolving much faster than anyone expected, so officials say they will continue to monitor the virus closely and they are ready to reprogram the vaccines again if necessary.

"You've got to put the wild card of a way-out-of-left-field variant coming in," said White House adviser Dr. Anthony Fauci, at the briefing. If that happens he says the recommendations may change. But, "if we continue to have an evolution sort of drifting along the BA.5 sublineage," he says the annual shot should be able to cover whatever is out there as the dominant variant.

But there is still a lot of debate about just how much of an upgrade the new boosters will really be. Some infectious disease experts are not convinced the updated vaccines will be a game-changer, because they haven't been tested enough to see how well they work.

"I think the risk here is that we are putting all our eggs in one basket," Dr. Celine Gounder, a senior fellow at the Kaiser Family Foundation, told NPR. "We're only focusing on boosting with vaccines. I think the issue is people are looking for a silver bullet. And boosters are not a silver bullet to COVID."

Federal officials are concerned that a low number of people will sign up for the new boosters, following a low demand for the initial booster shots. According to the Centers for Disease Control and prevention only 34% of people over 50 have gotten their second booster.

So, as we head into the winter, the administration is urging everyone age 12 and older to get boosted right away to help protect themselves and the more vulnerable people around them. People have to wait at least two months since their last shot and should wait at least three months since their last infection.

But they can sign up to get a COVID booster at the same time as a flu shot.

Because Congress has balked at providing addition funding to fight the pandemic, the new boosters are likely to be the last COVID shots provided for free. People who have insurance will get them covered through their policies. The administration says it's working to make sure those who are uninsured have access to future COVID-19 vaccinations.

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Transcript

AILSA CHANG, HOST:

The new COVID-19 boosters mark a major turning point in the fight against the pandemic. At least that's what federal health officials have declared. They say their hope is to make COVID shots more like the annual flu shots. To explain more, we're joined now by NPR health correspondent Rob Stein. Hey, Rob.

ROB STEIN, BYLINE: Hey, Ailsa.

CHANG: Hey. So tease out the so-called parallels here between these new COVID boosters and the annual flu shot.

STEIN: Sure. These new boosters are the first COVID vaccines that have been reformulated to match the strains that are currently infecting most people, the omicron subvariant BA.4 and 5. And that's how the flu shots work. Every fall, people get new flu shots designed to protect them against whatever strains of that virus are likely to be out there. And so the hope is that the new COVID boosters will give most people all the protection they need for at least a year. Here's how Dr. Ashish Jha put it at today's White House briefing.

(SOUNDBITE OF ARCHIVED RECORDING)

ASHISH JHA: Barring any new variant curveballs, for a large majority of Americans, we are moving to a point where a single annual COVID shot should provide a high degree of protection against serious illness all year. That's an important milestone.

STEIN: Now, Jha cautioned that older people and people with other health problems may need to get boosted more often. But Jha hopes this could be the last COVID shot most people need for at least another year.

CHANG: Wait. Wait. Wait. But these new variant curveballs he mentioned - haven't we been served a lot of those curveballs within the same year?

STEIN: Yeah, absolutely. You know, this virus has been evolving much faster and erratically - much more erratically than anyone expected. So officials say they will monitor the virus closely and can reprogram the vaccines again if necessary. Here's White House adviser Dr. Anthony Fauci.

(SOUNDBITE OF ARCHIVED RECORDING)

ANTHONY FAUCI: You've got to put the wild card of a way-out, out-of-left-field variant coming in. If that happens, all bets are off, and we change. But if we continue to have an evolution sort of drifting along the BA.5 sublineage, I believe that we'll get into a cadence that, on a yearly basis for most people, we'll be able to cover what is out there as the dominant variant.

STEIN: And that would enable the country to continue returning to something more like normal life.

CHANG: OK. That's vaguely reassuring. So give us a bit more detail about...

STEIN: Yes.

CHANG: ...The shots themselves. Like, remind us. What is so special about these particular new boosters?

STEIN: Yeah. So for the first time, they contain genetic coding that stimulates the immune system to fight off the omicron subvariants. So the hope is that, in addition to boosting waning immunity, these new shots may provide longer-lasting, broader immunity that would work against similar variants that emerge. But, you know, Ailsa, that's unproven at this point. And there's still a lot of debate about just how much of an upgrade these new shots will really be.

CHANG: So some people still aren't convinced that these new boosters are a game-changer.

STEIN: That's right. That's right. Some experts worry that they just haven't been tested enough to know if they're everything they're cracked up to be and worry they'll lull people into a false sense of security at a time when 4 to 500 people are still dying every day and another surge may be about to hit. Here's Dr. Celine Gounder. She's an infectious disease specialist at Kaiser Family Foundation.

CELINE GOUNDER: I think the risk here is that we are putting all our eggs in one basket. We're only focusing on boosting with vaccines. I think the issue is people are looking for a silver bullet, and boosters are not a silver bullet to COVID.

STEIN: But, you know, Ailsa, federal officials are more confident and are urging everyone age 12 and older to get boosted right away as long as it's been at least two months since their last shot. They can even get boosted at the same time they get their flu shots.

CHANG: That is NPR's Rob Stein. Thank you, Rob. Transcript provided by NPR, Copyright NPR.

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