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Fall outlook on COVID-19 vaccines, variants, monkeypox

As we head into the fall, many Americans are concerned about two emerging viruses, the highly transmissible BA.5 SARS-CoV-2 Omicron subvariant and monkeypox, which the White House has declared a public health emergency in the US – building on that of the World Health Organization Declaration that monkeypox is a public health emergency of international concern.

COVID-19 cases have increased again with BA.5. The good news is that most of the country has been exposed to the virus, either through infection or vaccination, resulting in a reduction in hospitalizations and deaths, noted virology expert Peter Hotez, MD, PhD, who helped develop the Corbevax coronavirus vaccine has contributed.

Still, COVID-19 remains the fourth leading cause of death in the United States. And not enough people are taking advantage of the opportunities offered by medical science — they either choose not to get the primary vaccine, skip booster doses, or avoid getting their children vaccinated, said Dr. Hotez, an AMA member. He is Dean of the National School of Tropical Medicine and Professor of Pediatrics, Molecular, Virology and Microbiology at Baylor College of Medicine and Texas Children’s Hospital in Houston.

In an episode of “AMA COVID-19 Update,” Dr. Hotez vaccination strategies to fight COVID-19 and monkeypox – and why people shouldn’t wait until the fall to get their SARS-Cov-2 vaccine booster dose.


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Second COVID-19 Vaccine Shot: Answering Patient Questions

dr Hotez admits he has mixed feelings about the launch of a bivalent vaccine targeting BA.5. “By the time it’s ready in the fall, BA.5 could be past us and we could be onto something completely new,” he said.

Given that the mRNA booster doses didn’t prevent transmission of omicron subvariants as hoped, this may not be the best strategy, he added.

It might be time to look at other booster approaches. Scientists are considering longer-term strategies to develop a universal coronavirus vaccine that uses alternative delivery mechanisms via mucosa or skin, he said.

This is not a quick fix, he acknowledged. Such technologies are still a few years away and there is currently no funding for them.

“We still need a strong interim strategy,” said Dr. Hotez.

Read more about answering patient questions about second COVID-19 vaccine booster doses.

The boosters now available offer the best defense against COVID-19. dr Hotez, who has contracted SARS-CoV-2 and experienced first-hand what it’s like to experience COVID-19, feels fortunate to be vaccinated and fully refreshed.

For people over 50 who received both of these boosts, “it makes the difference between working at home or doing what you want to do and being sick in a hospital bed or in an intensive care unit.”

People shouldn’t wait until the fall to get an updated booster shot, he urged. Maybe you wait until December. With BA.5 transmission so high, people should do everything they can to protect themselves and avoid hospitalization.

Although he had a rebound infection after receiving Paxlovid, Dr. Hotez that eligible people should take it when they get sick.

With COVID-19 antiviral supplies now plentiful, swift action is key.

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What doctors wish patients knew about monkeypox

Although it causes less serious illness than COVID-19, monkeypox is on a worrying path, said Dr. Hotez.

The disease most likely spreads through close, personal contact, although the scientific community is divided on whether it is aerosol transmitted. Cases are rising, and reported numbers likely underestimate the magnitude of prevalence, he said.

“Unless we get a handle on this and really start fighting it back with vaccines, it’s going to spread throughout the US population,” he said, in addition to Europe and Latin America.

Find out why we must learn from the past when fighting monkeypox.

The virus could become a fixture if it enters animal populations. The next thing that happens is a pandemic, which is why ramping up production of the Bavarian-Nordic Modified Vaccinia-Ankara (MVA) vaccine is so important, he said. An older, more common vaccine used to eradicate smallpox could prove useful if there’s a way to safely mix and match it with the MVA vaccine, he suggested.

Find out what doctors wish patients knew about monkeypox.

Get the latest news on the COVID-19 pandemic, vaccines and variants, and more reliable information direct from experts and leading physicians with the AMA COVID-19 Update.

You can see each episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version.

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