Last week, the Food and Drug Administration recommended that the next COVID-19 vaccine be targeted at the XBB.1.5 subvariant. That new shot is expected to come out this fall, leading public health experts to urge everyone to get vaccinated again before the possible fall-winter surge in COVID cases, which may coincide with the holidays and the retreat indoors during colder weather.
“You hope that the winter won’t be bad. We don’t know, and the hope is that this new booster will be available,” Jen Kates, director of global health and HIV policy at KFF, a public health think tank, told Yahoo News. “And then that would give us that protection that we need going into a time when there might be more cases.”
The current COVID situation
COVID-19 is still killing hundreds of Americans each week, according to the most recent data available from the CDC, and the unvaccinated are much more likely to be among them. The “bivalent” COVID vaccine booster shot released last fall combined the original vaccine with one targeted at the subvariants that were widespread at the time, Omicron BA.4 and BA.5. But that shot isn’t designed to specifically block XBB.1.5, the Omicron subvariant now most in circulation.
If you build it, will they come?
Experts say they are hopeful that uptake of the new shot will be high, and that the anti-vaccine misinformation currently being spread by Robert F. Kennedy, Jr., the gadfly Democratic presidential candidate, will not deter people from receiving it.
“I do think there’s going to be a sizable proportion [who get the next booster] — you know, in the last few years, we’ve had a pretty good proportion of people get their flu vaccine,” said Dr. Yvonne Maldonado, a professor of population health at Stanford University. The proportion of the population that has obtained the flu shot has been between 50% and 60% in recent years, according to the CDC.
Only 17% of Americans got the bivalent booster shot, in addition to their primary series of the vaccine, although 43% of people ages 65 and older got the bivalent booster after it was released last fall. (Seventy percent of the population and 94% of the elderly received the complete primary series.) A December 2022 analysis from the health advocacy group the Commonwealth Fund calculated that more than 18.5 million hospitalizations and 3.2 million deaths in the United States were prevented by COVID vaccines.
“Of course the anti-vax groups present a challenge,” said Dr. Jessica Justman, an epidemiologist at Columbia University. “Everyone has to decide where they get their information from: Do they want to get it from their own doctor, who knows their medical history, or do they want to get it from a radio show?”
Who should be getting the bivalent booster shot right now?
The immunity from a vaccine starts to wane after roughly four to six months, and in April, the CDC approved a second booster shot for people of age 65 and over if they are more than four months past their first one, and after just two months for the immunocompromised. Although the bivalent shot didn’t target XBB subvariants, vaccinated and boosted Americans have much lower rates of hospitalization and death from XBB.
“The CDC has set up the recommendation so that people can get repeated bivalent boosters if their doctor feels that they would benefit from it, based on their medical condition,” Justman said. “It’s not one-size-fits-all, and a major message here is: Talk to your doctor.”
Some experts caution that people in these categories might want to wait until the next vaccine comes out in the fall, because a waiting period could be required between your last bivalent booster and your next shot, and because those at high risk should get their OBB shot as soon as it becomes available.
“There’s always been a time break between boosters and any kind of additional dose,” Kates said, adding that if you get a booster, “You may have to wait longer for the next one,” which is likely to be more effective against currently circulating variants.
Who should get the OBB shot this fall?
Everyone. On this, the experts are unanimous. In addition to reducing the risk of hospitalization and death, Maldonado noted, vaccines also lower the risk of long COVID.
“It’s safe, so why not do something that’s safe?” Maldonado said. “People take vitamins, they put their seat belts on — why is this not the same thing? You’re going to be exposed to this virus in the fall, I can guarantee most people will be.”
What should the federal government do?
Experts say the government will need to educate the public about the benefits of the next shot and to underscore the seriousness of the risk of COVID.
“We need to make sure that messaging does get out there about new strains,” Maldonado said. “People have very short memories. You have to keep reminding them, ‘Remember three years ago, when everybody was dying, and you were all lining up and fighting each other to get these vaccines?”