The new COVID vaccines are finally here—and, with them, a ton of questions about who should get vaccinated. Last week, the United States Food and Drug Administration (FDA) approved and authorized updated Moderna and Pfizer vaccines that target the KP.2 strain, an Omicron variant that has caused a wave of infections this summer.

Food and Drug Administration. FDA Approves and Authorizes Updated mRNA COVID-19 Vaccines to Better Protect Against Currently Circulating Variants. August 22, 2024.

Centres for Disease Control and Prevention. COVID Data Tracker: Variants & Genomic Surveillance. August 28, 2024.

 

The reasoning? The new vaccines provide stronger protection against severe outcomes, such as hospitalization and death, according to the FDA.

Food and Drug Administration. FDA Approves and Authorizes Updated mRNA COVID-19 Vaccines to Better Protect Against Currently Circulating Variants. August 22, 2024.

While mortality rates have dropped since the start of the pandemic, the country is currently experiencing an increase in test positivity rates, COVID-related emergency room visits, hospitalizations, and deaths.

Centers for Disease Control and Prevention. COVID Data Tracker. August 28, 2024.

 

The best way to stay safe, data repeatedly shows, is to get vaccinated.

World Health Organization. COVID-19 advice for the public: Getting vaccinated. December 5, 2023.

COVID is here to stay, and for many people, “these vaccines can be the difference between severe illness with hospitalization versus a bad cold,” Bernadette Boden-Albala, MPH, DrPH, Founding Dean of the UC Irvine Joe C. Wen School of Population & Public Health, tells MDLinx.

 

 

Who should get the updated shot first, and why?

 

The CDC is recommending that everyone six months and older should get the new vaccine.

Centers for Disease Control and Prevention. Staying Up to Date with COVID-19 Vaccines. July 3, 2024.

“As a public health expert, I generally recommend that everyone six months and older should get the new booster dose,” Dr. Boden-Albala says. It’s especially important for individuals who are over the age of 65; have an underlying medical condition that puts them at risk; or have never received a dose of the previous vaccines to receive an updated vaccine as soon as possible.

Centers for Disease Control and Prevention. People with Certain Medical Conditions and COVID-19 Risk Factors. June 24, 2024.

 

One report found that the vaccines continue to provide strong protection against severe outcomes for six months; however, their effectiveness against infection drops by about 20 to 30 percentage points by the six-month mark.

Feikin DR, Higdon MM, Abu-Raddad LJ, et al. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. The Lancet. 2022;399(10328).

 

“Boosters are recommended to maintain high levels of protection, especially against severe illness that causes hospitalization,” Dr. Boden-Albala says. In general, public health experts view the COVID shots as being similar to annual influenza vaccines. “A booster vaccine once a year should be adequate coverage,” says Dr. Boden-Albala.

Furthermore, as the virus evolves and mutates, it becomes better at outsmarting the old vaccines.

Malik JA, Ahmed S, Mir A, et al. The SARS-CoV-2 mutations versus vaccine effectiveness: New opportunities to new challenges. Journal of Infection and Public Health. 2022;15(2):228–240

Because the older shots don’t target the latest variants, the virus is able to dodge our immunity and infect our cells. The latest shots from Moderna and Pfizer target more recent dominant variants, which can help minimize this risk. Another perk: Being up-to-date on your vaccinations reduces the chances of spreading the virus to other people.

Oordt-Speets A, Spinardi J, Mendoza C, et al. Effectiveness of COVID-19 Vaccination on Transmission: A Systematic Review. COVID. 2023;3(10):1516–1527.

 

 

When should patients get vaccinated again?

 

The big question is when people should get their next dose. The country is in the middle of a surge; however, public health experts also know, from previous years, that another big wave tends to strike in the winter.

Wiemken TL, Khan F, Puzniak L, et al. Seasonal trends in COVID-19 cases, hospitalizations, and mortality in the United States and Europe. Scientific Reports. 2023;13(1).

 

 

Nikhil Bhayani, MD, FIDSA, an infectious disease specialist and Assistant Professor in the Department of Internal Medicine at the Burnett School of Medicine at Texas Christian University, says that people have two options. The first is to get the new shot as soon as possible to avoid getting sick during the current wave, which is expected to continue. The second option is to get the COVID vaccine mid-October to build immunity in time for rising cases between late fall and early winter. “The holiday season,  as we know, will be here quickly [and] will lead to an increase in viral illness as everyone will be traveling for holiday gatherings,” Dr. Bhayani says.

People who are at risk, such as pregnant people or immunocompromised individuals, should get vaccinated as soon as possible, according to Amesh Adalja, MD, FIDSA, a Senior Scholar at the Johns Hopkins Center for Health Security and an infectious disease expert. “Activity of the virus is high and immunity has most likely waned in most individuals,” he says.

Another thing to consider is when you were last vaccinated. If it’s only been a couple months, it’s worth holding out until October so that you have sufficient protection for the winter months.

Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. August 23, 2024.

But if it’s been months—or years—since your last shot, now may be a good time to get boosted. “Boosters are usually recommended several months after the previous dose to maintain immunity,” Dr. Boden-Albala says.

 

The new shots do a great job at preventing infection—something that can’t be said of some of the older shots, Dr. Adalja notes. “If a lower-risk person wants the updated vaccine to protect against infection, it’s better to get it now before the virus changes,” he says.