There’s a New COVID Booster You Should Probably Get This Fall
Updated COVID booster vaccines are now officially approved and recommended by the FDA and CDC. There is a Pfizer booster for kids aged 12 and up, and a Moderna booster for kids ages 18 and up. The new shots replace the existing boosters for these age groups, and there’s a new set of rules to figure out if you should get them – no more counting how many doses you’ve already received.
The latest step in the process was a meeting of the CDC’s Immunization Practices Advisory Committee on Thursday, where experts discussed the evidence and voted to recommend new boosters for everyone in the appropriate age ranges. The director of the CDC then formally issued a recommendation that bivalent booster doses should be available as soon as pharmacies can get new shots in stock.
Boosters are now bivalent (essentially two vaccines in one)
Vaccines against COVID have not changed their composition at all since they were first tested and then approved. While the virus has mutated into new variants such as Delta and Omicron, all vaccines are still based on what is called “hereditary” SARS-CoV-2. This is changing with boosters this fall.
The new boosters include ancestral spike protein mRNA and Omicron spike protein mRNA. The spike protein is the part of the virus that our immune system can easily recognize, and the mRNA is sort of the blueprint for making that protein.
We have more information on how mRNA vaccines work here , and Gizmodo has more information on the specific formulation being used for this season’s boosters. The variants known as BA.4 and BA.5 have spike proteins that are identical to each other, so you may hear these vaccines being described as being for “BA.4/BA.5” variants.
Having two different mRNAs in the same frame means your immune system will become familiar (or re-acquainted) with both forms of the spike protein. One of the experts at yesterday’s CDC meeting mentioned that our immune system can actually “read” this combination more easily than it would if it encountered each type individually.
If the idea of combining different options sounds familiar to you, it might be because that’s how flu shots are formulated. Each year, several influenza strains are selected for this season’s vaccine. All flu shots available this year are quadrivalent, meaning four different flu varieties are included. COVID boosters cover two variants, which is why they are called bivalent.
It doesn’t matter anymore how many shots you fired.
It’s okay if you forget how many COVID shots you’ve had. It’s gotten pretty confusing: two boosters are recommended for people at risk and one for the rest, plus an extra dose for immunocompromised people… and that’s without regard to age recommendations.
The Centers for Disease Control and Prevention (CDC) is now announcing a “drop reset” of the booster counter. Regardless of how many shots you’ve had in the past, it’s now recommended that you get one bivalent booster dose this season if it’s been two months or more since your last dose. Old boosters will no longer be used in adults. (At the time of writing, the CDC site has not yet been updated with new information, but you can read about planned updates here .)
In short: if you have completed your primary vaccination with or without any number of revaccinations, you are eligible for a bivalent revaccination this fall if at least two months have passed since your last COVID vaccine . This applies to people aged 12 and over; booster updates for younger children are still in development.
Your “core batch” is your initial set of COVID vaccines. That means two doses of Pfizer or Moderna, or one dose of Johnson & Johnson if you’re not immunocompromised.
If you are immunocompromised , your primary series consists of three doses of mRNA vaccine—two doses of Novavax or a dose of J&J plus a dose of mRNA vaccine. Incidentally, you can also ask your doctor about EVUSHELD , an antibody shot that may provide additional protection against COVID for immunocompromised people.
Bivalent injections are not used for primary doses, only for boosters. If you have not yet had your main series, that is, if you have not yet been vaccinated against COVID, you need to do so before you can receive your fancy updated booster vaccine.
Have these boosters been tested on humans?
The initial approvals for the COVID vaccine included lengthy clinical trials in thousands of people. Boosters didn’t go through the same process. There have been studies in mice showing that boosters elicit the same immune system response as the original vaccines. Small human studies also showed that the side effects of the BA.1 vaccine variant were equivalent to the parent vaccines. (Plan BA.1 was eventually canceled in favor of BA.4/5.)
Some experts are potentially concerned about the lack of human data; but others point out that we are not conducting full human clinical trials of the annual flu shot. Once we understand how a vaccine works, small adjustments like these are unlikely to make a significant difference to safety or efficacy. It is worth noting that after this was discussed at yesterday’s meeting of the Advisory Committee on Immunization Practices, members voted 13-1 in favor of recommending a booster.
Ultimately, this change in evidence required is what you’d expect as we transition to treating COVID boosters like flu shots: something that’s updated every year to keep up with the circulating options. If it helps, the evidence is strong enough for me. I plan to purchase one of the new bivalent boosters.
What if I already had COVID?
If you are one of the many, many people who contracted and recovered from COVID this summer, a booster can still help you. But some experts have suggested that you probably have decent protection against this infection, so you don’t need to get a booster right away.
The CDC says you “may consider delaying” any COVID vaccine, including boosters, up to three months after symptoms appear. So if you contracted COVID in July, you may want to schedule a revaccination in October.
Can I get a COVID booster and a flu shot at the same time?
Yes. COVID vaccines can now be given alongside almost any other vaccine. (The monkeypox vaccine is one notable exception; if you are getting the monkeypox vaccine, check with your doctor for timing.)
For COVID revaccination, the timings are listed above: two months or more after your last COVID shot, possibly longer if you had a recent infection. When it comes to flu shots, you usually want to get them done by Halloween so you’re protected well in advance of winter. If these schedules work for you, feel free to get your flu shot and COVID booster at the same time.
The CDC recommends that if you receive a high-dose or adjuvanted flu shot , you should give it in the opposite arm of your COVID vaccine. This is because both injections are capable of causing local reactions such as redness and pain in the arm. It would be uncomfortable if both vaccines were given at the same time in the same arm, and if you have a more severe reaction, it would be good to know which vaccine is causing the problem.