COVID-19 UPDATE
Will Flu Shots & COVID Vaccines Be Combined? What Would the Future Look Like? By Alvin Boyd Newman-Caro and Rebecca L. Sanchez, PhD
The idea of combined vaccines is not a new one. There are several examples of combined vaccines currently utilized, such as Pediarix, ProQuad, Kinrix and Pentacel, all which protect against various combinations of diphtheria, tetanus, pertussis (DTaP), hepatitis B virus, poliovirus (IPV), measles, mumps, rubella (MMR), varicella virus (chickenpox) and Haemophilus influenzae type b (Hib).2 Not only have combination vaccines been proven effective, they also have the advantage of being an individually administered shot that protects against multiple diseases. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has produced 33,079,543 cases of coronavirus illness and taken 591,265 lives in the United States.1 When the outbreak began, prompt publication of the viral genome sequence allowed work to begin immediately on a vaccine solution. In groundbreaking fashion, vaccines for COVID-19 were created in less than one year. Up to this point, Pfizer/BioNTech has reported efficacy of 95%, while Moderna has set forth an efficacy of 94.5%.3,5 Nonetheless, it is unknown if current COVID vaccines will be protective against future COVID-19 strains. It is possible that SARS-CoV-2 will persist for some time and will potentially become a seasonal epidemic, like that of past influenza epidemics. Reasons for this are because we have yet to globally eliminate earlier strains of SARS-CoV-2, we are seeing novel viral variants emerge and the long-term protectiveness of current COVID vaccines remains unknown — calling into question the need for booster shots. Similar to the influenza virus, the SARS-CoV-2 viral 26
SAN ANTONIO MEDICINE • July 2021
variants could necessitate a modified yearly vaccine against it. Therefore, the next logical step in vaccine development would be the creation of a combined COVID and influenza vaccine. In addition, discussions involving COVID and influenza combination vaccines make sense right now, especially since the 2021-2022 influenza season is already upon us. During this year’s typical influenza season, cases of influenza infections were significantly reduced. In May, the CDC reported on its website that from September 27, 2020, through May 15, 2021, only 250 (or 0.05%) of the 485,637 specimens tested and reported were positive for influenza viruses at U.S. public health laboratories, and only 1,874 (or 0.18%) of the 1,054,101 respiratory specimens tested and reported were positive for influenza viruses at U.S. clinical laboratories (compared with 10%-19% in recent years).6,7 However, now that mask and social distancing regulations are becoming more relaxed, a rise in both influenza and SARS-CoV-2 cases is predicted for the 2021-2022 season. Infection with influenza, SARS-CoV-2 or influenza/SARS-CoV-2 co-infection, presents a significant future public health threat, making a combination vaccine desirable. While many are just starting discussions about future combination vaccines, Novavax, a biotechnology company developing a SARS-CoV-2 vaccine (NVX-CoV2373), released preclinical data in May 2021 using a combination hemagglutinin (HA) quadrivalent nanoparticle influenza vaccine (qNIV) and their COVID-19 vaccine candidate (NVX-CoV2373).4,5 The Novavax study
