(CNN) — The US Centers for Disease Control and Prevention (CDC) gave its approval this month to the launch of the updated booster vaccines against covid-19, after authorization by the Administration of US Food and Drug Administration (FDA). These vaccines will replace those previously offered in the US, so for those 12 and older, being “up-to-date” on vaccines means having the new vaccine.
Will the covid-19 vaccine become annual, like the flu? On Tuesday, Dr. Ashish Jha, head of the Biden administration’s Covid-19 Response Team, suggested yes, telling reporters that vaccinations and boosters will likely become “a more routine part of our lives.” “.
Many people have specific questions about whether to get vaccinated now or wait. Who should rush to get the vaccine and who can wait a little longer? Is it worth delaying the vaccine to coincide with the winter holidays? And do parents of children under 12 have to worry because they are not yet cleared for the new booster?
To get our bearings on these questions, we spoke with Dr. Leana Wen, a CNN medical analyst, emergency room physician, and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health“.
CNN: What are your main takeaways from the updated booster?
Dr. Leana Wen: One of the takeaways is that the booster will be an updated formulation that targets both the original strain and the omicron subvariants. This is not unusual: it is what is done every year with the flu vaccine, where manufacturers anticipate which strains will be in circulation and modify the vaccine accordingly.
Another important aspect for me is that the CDC is stopping counting the number of doses of the vaccine and instead saying that people 12 years of age and older are considered up-to-date on their coronavirus vaccines if they have received the original primary series, either two doses of Pfizer, two doses of Moderna, or one dose of Johnson & Johnson, plus this updated booster. That simplifies things a lot.
CNN: Do you think the coronavirus vaccine will now be an annual shot, similar to the flu shot?
Wen: From the time Covid-19 vaccines were first licensed, I and other public health experts have argued that this would be a possibility. We didn’t know if the coronavirus vaccines would be a series of two, three or four shots, after which it would be over, or if they would have to be given at regular intervals. The hepatitis vaccine, for example, is a three-dose vaccine, as opposed to tetanus, which requires regular boosters. And, of course, the flu vaccine is updated every year.
It seems that the coronavirus vaccines are more like the flu shot. Immunity wanes after a while, and there are also new strains that can be targeted with more specific vaccines. Federal health authorities have even indicated that they could move to an annual vaccination rate.
This cadence will be helpful, I think, because Americans are already used to getting a flu shot every year. Especially if the covid-19 booster can be timed alongside the flu shot, that could help improve uptake of both vaccines.
CNN: All of my friends and colleagues have some version of this question: Should they get their current booster shot now? In your opinion, who should rush to receive the booster as soon as it’s available?
Wen: The CDC says everyone over the age of 12 is recommended to get the current vaccine, as long as it’s been at least two months since the last shot. However, for me that does not mean that the urgency is the same for everyone.
I think it is more urgent that people who have not received any vaccine or who have not had covid-19 in 2022 receive the updated booster. This is especially true for the elderly and those with chronic medical conditions. About 30% of people age 65 and older have not received a booster shot. These people should get the updated vaccine now.
Until this latest announcement from the CDC, only people over the age of 50 and those who are immunocompromised could get two boosters. Uptake of the second booster dose has also been low, with only 40% uptake so far among people aged 50 and over. This means that there are quite a few adults who may have had their last shot in the past year. I advise these people not to wait.
If someone has not been vaccinated, they have to be vaccinated first with the primary schedule. That means getting both doses of the original Pfizer or Moderna vaccines (or two doses of Novavax or one dose of Johnson & Johnson). The primary schematic must be completed before receiving the upgraded booster.
CNN: Who would you say could wait a little while to get the updated booster?
Wen: People who have recently recovered from covid-19 can wait to receive the updated booster. CDC guidelines say these people can wait three months from their infection. I think that is good advice. Reinfection is unlikely to occur immediately after recovery, and it may also be beneficial to let the body produce antibodies from the infection.
The CDC also says that people can get vaccinated with the new booster if it has been at least two months since their last shot. I don’t think most people should rush to get vaccinated at exactly two months. Some might decide to wait three or four months for it to be a little later in the fall; in this way, they could have better protection during the boreal winter.
CNN: I’ve heard from some people, as you mention, that they want the booster time around winter break. Does it seem logical to you?
Wen: I can understand why they would want to do this. We know that covid-19 vaccines provide maximum efficacy against infection in the weeks after they are administered. There is sustained protection against severe disease, but efficacy against infection decreases somewhat over time.
However, it is difficult to predict the best time to give the vaccines, because we do not know what will happen this fall and winter. Right now, the covid-19 case count is high in many parts of the country. For some people, especially those who are more vulnerable to serious illness, it makes sense to get optimal protection now. But the case count could also spike later this fall, and other people might decide to wait until a few weeks before Thanksgiving to get their booster.
In general, I would go back to the point of the last vaccination or infection. If you have not been vaccinated in 2022 and have not had a recent infection, I advise you to get the booster vaccine as soon as possible. But if you’ve recently had a booster and/or covid-19, you could probably wait a month or so, to try to be more effective against the infection heading into the holidays.
CNN: Should parents of children under the age of 12 be concerned that they still can’t get the upgrade booster?
Wen: No, and I don’t think the case for reinforcing children is as clear as it is for adults. Most children have already had covid-19. Recovery from infection, plus vaccination, provides a very high level of protection against severe disease. I think it’s okay for parents of younger children to wait until there is an updated booster for this age group.