What this man's third vaccine dose says about the future of fighting COVID
When Ian Haydon walked into the research clinic in downtown Seattle, he was less stressed than usual about the injection to come - after all, it was his third COVID-19 vaccine.
The first time he'd shown up to voluntarily roll up his sleeve for an experimental shot had been almost exactly a year earlier.
That shot? Was made by a company called Moderna. Back before the American company was a household name, Haydon was one of the first people in the world to volunteer to help test its experimental dose that, in the past 12 months, has gone from concept, to large-scale clinical trials, to authorization in countries around the world, to an unprecedented global rollout.
Now he's rolled up his sleeve again, as the company begins a new trial of a shot designed to target the variant that first emerged in South Africa. It could even eventually be an annual booster. Think a flu shot, but for COVID-19.
Once again, we sort of had to be OK with stepping into that unknown and really seeing what is going to happen, which is, of course, the whole point of this study," Haydon said, referring to the volunteers who signed up to come back and help test a booster.
Moderna isn't alone in having boosters on the brain. Most of Canada's vaccine suppliers are testing new versions against the new variants that have emerged around the world, though questions about whether they'll be needed remain.
The prospect of a third dose, even an annual shot, was revived Thursday when new comments from Pfizer chief executive Albert Bourla were made public by CNBC, in which he said people will likely" need a third dose of the vaccine within 12 months and could need one every year.
Both Moderna and Pfizer - the first two shots to be authorized in Canada - have said protection from their doses lasts at least six months, and they continue to study that in volunteers, such as Haydon, who were dosed early last year.
But some experts worry that even if immunity lasts longer new virus strains could evade the protection provided by the current slate of vaccines, necessitating new doses.
Canada's procurement minister says she is in the midst of negotiating new vaccine contracts to nail down supplies of vaccine booster shots if they're needed next year.
We are actively planning for 2022," Anita Anand said in a recent interview.
Health Canada has also initiated a plan to authorize boosters without the same extensive testing required to approve the original vaccines, similar to how flu shots are authorized each year after being adjusted for the new strain of flu virus believed to be dominant.
The prospect of vaccines tailored to variants is great news, says Colin Furness, an epidemiologist and assistant professor at the University of Toronto.
Of particularly concern is the E484K mutation, which has been found to have tweaked the spike protein on both the South African and Brazilian variant, which could affect how well the vaccines work against it.
But he questioned whether we'll ever need an annual shot, arguing that we'd only need it if COVID-19 continues to circulate at high levels - spawning variants - or if immunity wanes after a certain period, which would be unusual.
You get a new flu shot every year not because the old one stopped working, but because each winter brings new strains, he says. But the flu virus mutates much faster than the coronavirus.
Once COVID stops raging, mutations will slow right down," he said.
For now, Haydon is happy to be able to be part of making sure a future dose is safe. Because he's now been vaccinated for a year, he's part of the first group of already-vaccinated volunteers who is helping Moderna figure out if a booster shot is safe.
Eventually, later stages of the trial will sort out things such as whether they work against variants.
This time last year, Haydon was a participant in the Phase 1 trial of the Moderna vaccine. This was the first phase of human testing, in which the vaccine was given to a few hundred people and the shot was still relatively unknown.
He was given a dose that was stronger than the one that is now in use, and ended up having to go to the emergency room with a high fever, nausea and a headache.
This time was much better," he said - he had about a day of muscle aches to deal with.
The dose he got this time around is actually lower than what is currently being used around the world, as Moderna is also trying to figure out whether less vaccine would still keep people protected.
They're also not sure yet what a booster would look like, and Haydon's latest shot was a cocktail that combined a bit of the original vaccine with a new formula targeted specifically at the variant.
Getting a third shot has prompted him to think back to last year, when the virus was still novel, deaths were rising, and he knew very little about the shot he'd volunteered for. He'd walked into a clinic last year bracing himself for failure.
We had no idea, myself included, whether it was going to be safe, and certainly whether it would work; and there was plenty of reasons to think it wouldn't work at all. There was a bit of a sense that it could maybe all be for nothing," he said.
Since getting his first dose of vaccine, he's had blood samples drawn, spent several hours donating white blood cells and even had his genome sequenced as researchers have worked to figure out the effect of the vaccine. They'll continue to follow him for another year.
He watched the roll out of the vaccine eagerly, proud of the role he'd played in making sure it was safe.
It was really that moment when I saw nurses, doctors, physician's assistants, people in the health care setting, posting, I just got my Moderna vaccine,'" he recalled.
That's when it hit me that this experiment that I had started participating in so many months ago had reached people on the front line who needed it the most. That was a really incredible moment."
Alex Boyd is a Calgary-based reporter for the Star. Follow her on Twitter: @alex_n_boyd