When should I get the omicron booster? Will I need COVID shots forever?
The Washington Post September 19, 2022
The Centers for Disease Control and Prevention is recommending that all teenagers and adults get an updated coronavirus booster shot designed to target both the original virus and the omicron variant circulating now.
The broad protection from these updated shots — called bivalent boosters — could prevent more than 100,000 hospitalizations in the coming months, according to one estimate. But many people still have questions about who should get the new booster, the best timing for the shot and if it would be better to delay the booster until COVID surges again. Here are some answers.
— Should I wait and time the booster for when COVID cases get bad again?
Most experts agree you shouldn’t wait. You’re eligible to get the updated booster shot if you’re 12 or older and it has been at least two months since your initial vaccine or your last booster. Older Americans, those with chronic illnesses and people who are immunocompromised or pregnant should get the updated booster shot as soon as possible.
Even though the number of daily reported cases fell again this week, the virus is still spreading. About 30,000 people are hospitalized with COVID across the United States and 410 Americans on average die each day from the virus.
“I feel that there’s probably a tepid response to the boosters right now because everything looks relatively quiet on the COVID front in the U.S.,” said Peter Chin-Hong, an infectious-disease specialist at University of California at San Francisco. “But, once cases start going up, I bet there’ll be people coming out of the woodwork to go and get it.”
Bob Wachter, professor and chair of the department of medicine at the University of California at San Francisco, said that “timing the market” and waiting for case numbers to rise before you get a booster shot usually doesn’t work.
Wachter said that even if you’re not concerned about contracting a severe case of covid-19, you still need to contend with the possibility of long COVID. “It just makes all the sense in the world” to boost your protection against the long-term consequences of the disease, he said. “The best protection against long COVID is not getting COVID.”
“Everybody in America over the age of 12 should get it,” said Ashish Jha, the White House coronavirus response coordinator in an interview.
Many Americans still have a “decent amount of protection” against serious illness, Jha said, but if you got your booster shot last year or early this year, “you don’t have that much protection against infection anymore.”
“You’re doing it for your family and your friends,” Jha said. “And you’re doing something that’s free and incredibly safe. It just feels like a no-brainer.”
— What are the side effects of the booster shots?
The CDC doesn’t expect side effects for the updated booster shot to differ from those associated with the current vaccines, which include redness and swelling where the shot was administered, as well as occasional fatigue, headache and muscle soreness.
Wachter said there’s a reasonable chance that “you’ll feel crummy for a day or two” after getting the booster shot. But there’s no way of telling whether you’ll have side effects this time around.
— What if I just had COVID?
The CDC says people who recently had a COVID-19 infection should consider waiting three months from their first symptoms, or positive test, before getting a booster shot.
Chin-Hong said those who have contracted the virus in the past few months are walking around with a “force field” for now. But all of that could change if there’s a new variant, and people should keep an eye on the number of coronavirus cases in their community.
Stephanie Langel, an immunologist at Duke University, said that as a 34-year-old healthy adult, she’s not at risk for a severe case of COVID-19, but she’s planning to get the booster because she wants the broader protection it confers.
“I just had omicron a couple of months ago, and it was not a fun time,” Langel said. “What we know from the animal studies, and the human studies, is that an increase in antibodies can lead to a decrease in symptomatic disease.”
— What if I just had rebound-COVID after taking Paxlovid?
If you took Paxlovid, an antiviral drug used to treat coronavirus infections, and tested positive again in a rebound infection, you should start counting three months from the second onset of symptoms.
— What if I recently got the monkeypox vaccine?
According to the CDC, young men who recently got the monkeypox vaccine, called Jynneos, might want to wait four weeks before getting any coronavirus vaccine. The delay is intended to reduce the risk of inflammation of the heart muscle, a rare complication from mRNA coronavirus vaccines that can affect young men.
— How do I know I’m getting the right shot? Should I ask to see the label?
Some experts are concerned the bivalent booster shots look too similar to the vials of primary vaccines from Pfizer-BioNTech and Moderna, which are still in circulation for adults and teenagers who haven’t gotten the vaccine yet. The Pfizer-BioNTech bivalent shot is available for anyone 12 and older. The equivalent booster from Moderna can be taken by anyone 18 and older.
The CDC said you can get either booster shot, regardless of your first set of vaccinations.
Michael R. Cohen, the founder of the Institute for Safe Medication Practices, a watchdog organization devoted to preventing medication errors, said that in the two weeks since the FDA approved the new booster shots, they’ve received more than a dozen voluntary reports of practitioners mixing up the original vaccines and the boosters.
CVS, Kaiser Permanente and Walgreens — three national distributors of the vaccine — told The Washington Post the companies have policies in place to ensure people get the correct shots. CVS is using different colored baskets to separate vaccines and checklists to ensure the staff is administering the correct shot.
Spokespeople for both CVS and Walgreens said people are welcome to ask to see the label of the vaccine before the shot is administered.
William Schaffner, professor of preventive medicine at Vanderbilt University Medical Care, said health care providers should not take it personally if patients ask to see a label. Schaffner suggested broaching the topic about confusion around the old vaccine and the updated booster shots.
Just say, “Do you mind double-checking? I’d be so much more reassured,” he said.
— How long until a booster starts working? And how long will the protection last?
The CDC says it takes two weeks for the booster to take full effect. But some experts, like Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said at least some of the protection from the booster shot should start kicking in within days.
But we don’t know how long the updated booster will provide protection against infection, and a new variant could change how much protection this booster offers. It’s too early to say to what degree and at what rate.
— Can I get a flu shot at the same time?
Yes. You can get the flu vaccine and a coronavirus vaccine or booster at the same time. But some experts said that to get maximum flu protection, you should get the coronavirus booster now and your flu shot in late October or early November. That way, you’re most prepared for the worst of the flu season in January or February.
“If you get vaccinated now and the peak influenza activity isn’t until the end of January or February, you’ll have lost a lot of your protection by then,” Osterholm said.
Jha, the White House coronavirus coordinator, said he got his coronavirus booster and flu shot at the same time on Friday. He doesn’t want people “overthinking it.”
“For a majority of people, it’s so much more important that they get the vaccine than the exact date they get it,” Jha said.
— Are we going to need booster shots forever?
Jha said that it’s hard to predict the future with this virus, but he expects people will probably need another booster in the fall of 2023 as well, “based on everything we know.” In the next few years, Jha said he believes most Americans will only need a booster once a year.
“I can imagine a time down the road — two, three, four, five years down the road — where we decide that we don’t need annual shots,” Jha said.
Laurie McGinley and Lena H. Sun contributed to this report.