COVID-19 vaccines tweaked to better match today’s omicron threat are expected to roll out in a few weeks but still up in the air is how much benefit the booster shots will offer, who should get one — and how soon.

Pfizer and rival Moderna both asked U.S. regulators this week to authorize modified versions of their booster vaccine — shots that are half the original recipe and half protection against BA.4 and BA.5, the newest versions of omicron.

The Food and Drug Administration ordered that recipe and now is evaluating what scientists call a “bivalent vaccine,” with a decision expected soon.

Dr. Peter Marks, the FDA’s vaccine chief, said Thursday that once authorized, the tweaked boosters could help right away — while BA.5 infections still are too high — as well as hopefully blunt yet another winter surge.

Marks told the Associated Press that the new boosters could rev up the immune system to prevent not just serious illness but maybe milder infections, too, like the original vaccines did earlier in the pandemic, before super-contagious mutants emerged.

“The hope here is that by better matching things, not only will we get that benefit or even more, but we’ll also have that last for a longer period of time,” he said.

WHY DID FDA ORDER A RECIPE CHANGE?

BA.5 currently is causing nearly all COVID-19 infections in the U.S. and much of the world. Current COVID-19 vaccines match the coronavirus strain that circulated in early 2020. And while those vaccinations still offer strong protection against serious illness or death from COVID-19, there’s little effectiveness against infection from the wildly mutated omicron family.

The first update to the recipe is an an important but expected next step — like how flu vaccines get updated every year. True next-generation vaccines are still in development.

“We need to give a clear, forward-looking set of expectations,” said University of Pennsylvania immunologist E. John Wherry, who compares vaccine tweaks to periodically updating your computer software.

The gamble is that BA.5, or something similar, still will be circulating through the winter. (Vaccines target the spike protein that coat the coronavirus, and the BA.4 and BA.5 spikes are identical although those strains vary in other ways.)

HOW WERE THE MODIFIED SHOTS TESTED?

Pfizer and Moderna both studied an earlier tweak to their vaccines that targets the original omicron, called BA.1, that hit last winter, as well as even earlier variants.

To evaluate the combo shots, FDA is using data from human testing of the BA.1-tweaked doses plus mice tests of the BA.5-targeted version that Marks said show “a very good immune response.”

Human data on the newest tweak will come later in the year, to help assess the value of modified shots — especially whether they offer cross-protection if a new mutant comes along, Marks said. Moderna has started a clinical trial of its BA.5 combo shot; Pfizer and its partner BioNTech expect to open a similar study soon.

WILL THEY WORK BETTER?

No one knows. Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia and an FDA vaccine adviser, said the antibody jump from that earlier BA.1-tweaked candidate was “underwhelming.”

“What the administration is asking us to do is to accept this bivalent vaccine as significantly better” than another dose of today’s vaccine, he said. “It would be nice if there were data to support that.”

But while FDA hasn’t made a final decision, Marks said there’s evidence that the updated boosters are safe and that waiting for more study of their effectiveness would risk another mutant appearing before they could roll out.

They “essentially refresh the immune response,” he said. “Granted, it’s still a bit of a guess how long it will last but, this is doing our best.”

Given how outdated the current shots are, an update makes sense, said Dr. Walter Orenstein of Emory University, a former vaccine director at the Centers for Disease Control and Prevention. While he’d like to see more data, he plans to get the new booster.

WHO SHOULD GET AN UPDATED SHOT?

That’s up to the CDC, which called a meeting of its influential vaccine advisers next Thursday and Friday to help decide.

Pfizer wants to open its updated boosters to everyone 12 and older who’s already had a primary series of today’s vaccine, while Moderna has applied only for adult use. CDC will determine if people at highest risk should go first. Studies of doses for younger children are expected later in the year.

A government rollout plan anticipates that people who’ve already gotten their initial vaccinations would qualify for one of the new combination shots, regardless of how many boosters they’ve already had.

WHEN SHOULD THOSE ELIGIBLE GET THE NEW BOOSTER?

Marks is aiming for a very simple message: “It’s probably going to be everyone who has not had a booster within the past X number of months should go out and get the booster in a timely manner,” he said. Officials still have to decide just how many months, though.

How long to wait after your last vaccine dose or an infection is a critical decision, immunologists agree. That’s because if you still have a lot of antibodies in your bloodstream, they’ll counteract the brand new antibodies that the vaccine dose is supposed to produce.

So if you already got a booster in July or August and then seek the new combo shot in September, “you’ll receive very little additional boosting from that,” Penn’s Wherry said. He recommends waiting four to six months.

The CDC also will weigh in after after considering how many doses will be available in early September versus later in the fall. The Biden administration has purchased more than 170 million doses.

WILL PEOPLE ROLL UP THEIR SLEEVES AGAIN?

Americans have been reluctant to keep up with COVID-19 vaccinations. While three-quarters of Americans 12 and older have gotten their initial vaccinations, only half got a first booster shot — deemed crucial for the best protection against variants. And just a third of people 50 and older who were advised to get a second booster when omicron arrived did so.

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Every night when the clock strikes midnight, my neighbors, who live in the mobile home on my right, come out to sit on their porch and smoke marijuana. Ordinarily, I would consider it rather romantic that Cinderella and her Prince, sit side by side every night, on their broken lawn chairs, holding hands while getting baked. Their four kids were playing in the street at that late hour, mindful of the fact that they should be in their beds sleeping because they have to be in school early the next morning.

But, as luck would have it, just as soon as they light up their first roll, the wind changes direction, and the smoke that wafts out of their mouths and nostrils travels straight to our house and into our lungs. While they enjoy their weed, we bathe in the disgusting, putrid, and unpleasant smell of their, let’s say, excrement, to put it mildly.

Marijuana has a horrible smell, for those of us who don’t much care for this mind-altering drug. It is a drug, no matter how much people tout its benefits—medical or otherwise—and no matter if it is legal or not. People who smoke it somehow get the arrogance to say that it is their right to smoke it in our faces because it is now legal. As if being legal somehow makes its use safe and harmless. As if being legal for them then takes away my rights regarding secondhand marijuana smoke.

It’s not just my neighbors who are so addicted. Some people live across from my business, who have no job or any work to do, who spend the whole day smoking it. I have customers who come wreaking of marijuana, even though it is illegal to smoke and drive, and when they leave, the smell stays behind for a very long time. We are always forced to use heavy-duty air fresheners to make the air at least pleasant for our non-marijuana smoking customers, even though it may not otherwise be breathable. I also have some employees who use any opportunity they can get, while on the clock, to get a hit or two.

I am extra sensitive to marijuana smell, and smoke. I get an instant headache when there is the overpowering stench of marijuana and that of its smokers. People like me suffer as a collateral casualty of the greed shown by our politician to harvest tax dollars from the dealers, without any regard to the long term adverse effects of this substance on those who abuse it and on those who happen to be within the vicinity.

Cigarette smokers at least have the decency to be mindful of secondhand smoke passing to bystanders, and they do the gentlemanly thing and smoke away from people and even away from buildings. Marijuana smokers don’t show any consideration for others; as a matter of fact, they take pride in flaunting their nasty habit, as if it is a badge of honor to be an addict.

The worst part is that marijuana, along with e-cigarettes, is being heavily used by youngsters and teenagers. Schools are struggling to cope with the number of students who smoke pot. Study after study highlights the dangers of this drug. Marijuana affects the development of the brain in kids still growing; its use results in lower IQ and its abuse leads to behavioral problems.

My neighbor is young, probably in his twenties, as is his wife. They have four children, who are also awake at that late hour, I am sure because of the terrible stench. That stench then draws some other neighbors to join them, and soon we have a party going on every night with noise and nuisance as part of our punishment for being their neighbor.

My neighbor is such a heavy user that he suffers from a condition called cannabinoid hyperemesis syndrome, characterized by severe nausea, vomiting, and abdominal pain. Many times, we see an ambulance outside their home to take him to the emergency room. Each time he is kicking and screaming due to severe pain. But does he stop? No. Does he care how it affects his kids? No. Does he care how heavily our dog objects to his habit, by barking throughout the night? No.

He doesn’t even have a job. He spends his days sleeping in, while his wife works part-time. The amount of marijuana that they consume, and of course, the amount of alcohol that they drink, makes me wonder: How much money are they getting from the welfare? My tax dollars are working against me by financing their nasty habit that then ruins my nights. It’s a wonder that my family, my dog, and I haven’t become addicts yet.

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