Tony's Diary Package — page 1119

A France 52.176 1.136 Bt SSESISOS, ESISISS B . Delta eg f Gamma A BA.1/BA.1.1 Beta I A » BA.3 _* - a Omicron BA2 WA1 BA4 - XBB/XBB.1 0.001 BQ.1/BQ.1.1 405.154 21,196 XBB-specific alterations G339H, R346T Del144 L368, V445P H146Q G446S, N460K Q183E G252V(XBB.1) F486S, F490S V83A R493Q SD15S02 RBD L452R K444T F486V N460K R493Q R346T (BQ.1.1) BA.2 Del69-70 BA.5-specific alterations BQ.1-specific alterations SPO FP Singapore |_| Bg ari LEE EA ILE PEALE ba LE 910 985 1035 1068 1163 1211 HR1 CH CD HRAT Nov. 19, 2022 Rochelle called me up this morning and arranged for a zoom at 10:30 AM to discuss her side of the story of why she wants to simplify the boosting regimen for children less than five and six years old for the Moderna and Pfizer boost. There is a tension between her/CDC and Peter Marks and Larry Horowitz (FDA) regarding whether or not the younger children should all get the bivalent boost or have them finish their primary regimens with the ancestral strain vaccine. Peter and Larry had both called me up previously (couple of nights ago) making it look like the CDC was holding back on wanting to give the most updated boost to the children. Yet, when Rochelle explained this to me this morning it became clear that it is a much more complicated situation than Peter and Larry described to me by phone a couple of nights ago. Ultimately, in January all children of all ages will get a unified vaccine either for the primary series or the boost and that will be the bivalent BA.4/5. Rochelle explained that to insert that bivalent boost into the already complicated regimen for the small fraction of children who have started on their primary series would create an enormous amount of confusion for pediatricians. I tend to side now with Rochelle even though when Peter and Larry explained that in the simplified form it seemed that they were making sense. However, according to Rochelle's explanation I believe she is correct. We will all sort this out on a zoom call with HHS tomorrow (Sunday) evening. Ebola still smoldering in Uganda: