Many Americans may soon be due for a dose of COVID-19 vaccine only once a year, just like an annual flu shot, under a federal Food and Drug Administration plan to simplify immunizations.

Streamlining the schedule is set to be discussed by an FDA advisory panel Thursday, along with whether the country should transition to a single vaccine for both the initial and booster doses that’s updated periodically to target the latest strains of the virus.

Currently, the initial series of COVID-19 shots is based only on the original strain of the virus, while the most recent booster shot is an updated bivalent vaccine that also contains newer versions of the omicron variant but not the latest mutations.

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A document released Monday by the FDA declared “most individuals may only need to receive one dose of an approved or authorized COVID-19 vaccine to restore protective immunity for a period of time.”

But two doses may be needed to offer enough protection against the virus for very young children who have not been exposed to COVID-19, as well as those with weaker immune responses, older and immunocompromised adults.

While there’s been talk before about treating COVID-19 vaccinations more like annual flu shots, the FDA’s move came as a surprise to some experts, including a few members of the agency’s advisory panel, The New York Times reported.

Dr. Eric Rubin, one of the FDA’s advisers and the editor of the New England Journal of Medicine, told the newspaper he’d like to see more data “to try to tell if we’re doing the right thing.”

Rubin also added he’d “definitely be in favor of something simpler, as it would make it more likely that people might take it.”

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Han Kim, a professor of public health at Westminster College in Salt Lake City, said he doesn’t see a lot of downside to going along with the FDA plan even if all the needed data isn’t available yet.

“It’s one of those things, I think you have to be practical. I think a lot of experts and a lot of scientists are trying to just go by the data,” Kim said. “Sometimes you just have to make a call given the realities.”

The FDA is responding to the “quite honestly, abysmal” uptake of the updated COVID-19 booster shots, he said, as well as to the public’s confusion about who needs the shots, and when.

“Given that situation, I think the FDA is saying, ‘Hey, let’s just simplify things. People aren’t getting it anyways. So let’s try something,’” Kim said, adding the new plan should boost vaccination rates even if it’s not “a magic elixir” that convinces everyone to get the shots.

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The Centers for Disease Control and Prevention says just over 15% of all Americans have gotten the updated COVID-19 booster shot, available to children as young as 6 months old, usually at least two months after a previous dose.

Fewer flu shots are also being given across the country despite months of warnings about a “tripledemic” outbreak of flu, COVID-19 and RSV, or respiratory syncytial virus. The flu vaccine is already updated annually to go after specific strains.

There’s even been talk of combining both the COVID-19 and flu vaccines into a single shot to help increase the uptake, although that apparently is not on the FDA advisory panel’s agenda.

The FDA is not bound by its advisory panels, although the agency usually follows their advice. But not always. In November 2021, the FDA recommended COVID-19 booster shots for all even though an advisory panel had said they should be limited to older adults.