Dual-variant Covid vaccine approved for UK booster programme

A vaccine designed to target two different forms of Covid will be offered as part of the autumn booster programme, after the jab was approved by the UK’s regulator.

Manufactured by the US firm Moderna, the jab attacks not only the original coronavirus – as is the case for vaccines currently in use – but is designed specifically for the Omicron variant BA.1, which fuelled a wave of the virus in the UK last winter.

The UK is the first country to approve the bivalent vaccine, known as “Spikevax bivalent Original/Omicron”, giving the green light for its use as a booster for people over the age of 18.

The UK’s Joint Committee on Vaccination and Immunisation (JCVI) said the vaccine would be used in the planned autumn booster programme. This is expected to begin in September, ahead of what could be a difficult period for the NHS with an expected surge in respiratory diseases, including Covid and flu.

Dr June Raine, the Medicines and Healthcare products Regulatory Agency’s (MHRA) chief executive, said clinical trials had shown the bivalent vaccine provided a strong immune response to the Omicron BA.1 variant as well as the original 2020 strain.

“The first generation of Covid-19 vaccines being used in the UK continue to provide important protection against the disease and save lives. What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve,” she said.

Prof Sir Munir Pirmohamed, chair of the Commission on Human Medicines, which independently reviewed the vaccine data, said the commission agreed with the MHRA’s decision, adding that the jab was able to lead to a broader immune response than the original vaccine.

According to Moderna, trial participants who were given the bivalent booster had antibody levels against BA.4 and BA.5 that were 1.7 times higher than those given the original booster. These subvariants fuelled the most recent Covid wave in the UK, and have caused infections, breakthrough reinfections, deaths and disruption around the world.

However, the difference is small and it is unclear what impact such a rise in antibody levels means clinically in terms of the protection offered by the jab. Nonetheless, the bivalent vaccine is expected to be no less effective than current jabs.

The JCVI said that getting vaccinated is more important than focusing on the jab involved, with existing jabs having offered very good protection against severe disease for all Covid variants to date.

“It is important that everyone who is eligible takes up a booster this autumn, whichever vaccine is on offer. This will increase your protection against being severely ill from Covid-19 as we move into winter,” said Prof Wei Shen Lim, Chair of Covid-19 immunisation on the JCVI.

The autumn booster programme is focused on protecting those at increased risk from Covid, including people over the age of 50 and residents in care homes for older adults, with about 26 million people expected to be eligible for the jab. The Guardian understands the approach is an effort to move away from an emergency response to Covid in favour of a more targeted stance.

The JCVI said it was preferable for a single type of vaccine to be used in the autumn booster programme, but it is not yet clear if this will be the bivalent Moderna jab or the existing booster jabs from Pfizer/BioNTech and Moderna, which the JCVI have also said can be used. In addition, the JCVI have said the Novavax jab can be offered as a booster. This is based on more traditional vaccine technology and can be given to people who cannot have the other booster jabs, for example because of allergies.

Children who require a booster will be offered one of the current Pfizer/BioNTech jabs, at the appropriate dose for their age.

Danny Altmann, a professor of immunology at Imperial College London, suggested the “Spikevax bivalent Original/Omicron” vaccine may not offer huge gains in the fight against the latest Omicron subvariants.

“We lack the certainties we had in early 2020 of which way to go with the vaccines, not least how to keep up with evolution of the variants,” he said.

“BA.5 is highly immune-evasive, so that even boosted people have highly impaired protection. Even exposure to the original Omicron sequence – as used in this, new, bivalent vaccine booster – only gives a rather marginal advantage to the antibody response.”

Altmann said that meant the outlook was complex. “We’re in a terribly vulnerable position heading into the winter, so any booster programme is better than nothing, and this bivalent booster almost certainly an improvement over the first-generation vaccines,” he said.

“My view is that this approach offers a marginal improvement in our battle against BA.5, but actually, we still need to think harder about this and look more broadly at the diverse vaccine candidates. In the meantime, get boosted.”