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It’s been about six months since health officials introduced the updated bivalent COVID-19 vaccine to help boost defenses against the disease that has killed more than 1.1 million Americans, most of whom were 50 or older. Now many are wondering: When’s the next shot?
“That’s actually among the most frequently asked questions at the present time,” says William Schaffner, M.D., a professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine and medical director of the National Foundation for Infectious Diseases.
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Since the COVID-19 vaccines were first made available, in late 2020, older adults have been encouraged to roll up their sleeves for a jab about every six months — first with the original booster, then the second booster, followed by the omicron-specific shot. But that could change going forward.
The Food and Drug Administration (FDA) has proposed simplifying the vaccine schedule and making the COVID booster a once-a-year shot, much like the flu vaccine. Proponents say this more spaced-out schedule could help to bolster vaccination rates, which lagged with the latest bivalent option. Only about 16 percent of eligible Americans have received one, federal data shows.
Plus, on a population level, protection looks pretty good against severe disease, Schaffner says. According to December 2022 data, adults who received the bivalent booster are significantly less likely to be hospitalized with COVID-19 than their unvaccinated peers. And recent research from the Centers for Disease Control and Prevention (CDC) shows the new booster is effective against the now dominant XBB.1.5 variant.
Still, the strength of the vaccine’s protection against infection and illness does wane some over time, studies show. And that can be concerning for people who are immunocompromised or at high risk for severe COVID for another reason.
What is a bivalent booster?
The updated boosters are called bivalent vaccines, meaning they contain not one but two sets of instructions (mRNA) that teach the body to produce antibodies to fight off a coronavirus infection. One mRNA component is from the original strain of the coronavirus. This is “to provide an immune response that is broadly protective against COVID-19,” the FDA says. The other is from more recently circulating strains of the omicron variant.
Waiting on word of a spring booster
Currently, health officials are not recommending that high-risk individuals get a second dose of the bivalent booster. And because the booster is available under emergency use authorization (EUA), doctors and pharmacists are encouraged to practice within the recommendations. This means if you’ve already received a bivalent booster, you probably won’t be able to get a second one right now.
However, William Moss, M.D., executive director of the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health, said in a recent media briefing that it would be “a reasonable consideration” if a recommendation for a second dose of the bivalent booster was made for vulnerable populations whose last booster dose was “some time ago.”
Recent reports have hinted that the FDA could OK a spring booster for some high-risk individuals. In a statement to AARP, an FDA spokesperson said the agency is closely monitoring the emerging data and will base any decision on the data. “Importantly, individuals who have not yet received an updated [bivalent] booster are encouraged to speak with their health care provider and consider receiving one,” the FDA spokesperson said.