Is it time to give another Covid-19 booster vaccine? Many people ask their doctors this question, especially after what happened last weekend. The US Food and Drug Administration changed their authorization to allow a second bivalent boost for those most susceptible to severe Covid-19 outcomes. The US Centers for Disease Control and Prevention then approved the FDA's updated and added clinical considerations for healthcare providers and patients.
I have a lot of questions. Who is eligible to receive the second bivalent boosters? Does the booster have the same composition as before? Can someone who receives a booster now get another booster next fall? What if a person is not in one of the high-risk groups but lives with someone who is? How has the advice changed for those who haven't received their first booster shot yet and those who are still unvaccinated
Leana Wen, CNN's medical analyst, was able to provide me with some answers. Wen is a professor of health management and policy at George Washington University Milken Institute School of Public Health. She is also an emergency physician. She was previously Baltimore's Health Commissioner.
CNN: Could you please bring us up-to-date on the latest updates? Who is eligible for the second bivalent booster now?
Dr. LeanaWen: Two groups are now eligible to receive a bivalent booster.
The first group is people 65 years and older. We've known since the very beginning of the pandemic that older people are more susceptible to severe Covid-19 outcomes. If it has been at least four months since the first bivalent booster, these individuals can now receive their second one.
Second, immunocompromised individuals. According to the new CDC guidance, anyone aged 6 or older who has moderate or severe immune compromise can receive a bivalent booster if at least two month have passed since their last one. Consult their doctors; depending on the specific circumstances of their medical condition, they may only need to get a bivalent booster every two months.
CNN: Does the booster have the same composition as before?
Wen: I'm talking about the bivalent booster, which is an updated booster first available in the fall of 2022. It targets both the original coronavirus strain and the BA.4/BA.5 subvariants. This booster is effective in reducing the severity of illness, according to studies. The bivalent booster would be given to those newly eligible for a second shot. There is no option to choose the monovalent shot and there are no other boosters available.
CNN: Can someone who receives a booster now get another booster at the end of the year?
Wen: There's a possibility that a new version of booster will be available in the autumn that targets dominant variants more specifically. The people newly eligible for the second bivalent boost are those who are most vulnerable. They are also the first groups that will be eligible to get another Covid-19 in the fall. This is all to say people shouldn't be discouraged from getting a booster because they think it will prevent them from receiving another vaccine in the future.
CNN: What happens if a person is not in one of the high-risk groups but lives with someone who is?
Wen: This person is not eligible. The Covid-19 vaccines reduce the risk of hospitalization or death in the person getting vaccinated. It reduces infection risk for a brief period of time. However, this effect is temporary and muted. The federal health officials have decided not to allow family members and caregivers of individuals at high risk to receive the second bivalent vaccine. I believe this decision is based on science.
Other ways exist to reduce the risk of contracting Covid-19 or spreading it to a close relative. These methods include regular testing and wearing a mask when in crowded spaces.
CNN: What has changed in the guidelines for those who haven't received their first booster and those who are still unvaccinated.
Wen: There have been a number of changes. The CDC has made several changes to the vaccine recommendations in order to simplify them.
The bivalent vaccine will be the only vaccine available to begin with. Even for people who are not yet vaccinated, the original monovalent will no longer be used. It will simplify the administration of vaccines, since pharmacies won't need to stock both types.
Unvaccinated children and adults aged 6 years or older who have received only one dose of the bivalent booster from Pfizer BioNTech, Moderna, will also be considered up-to-date. This is because the majority of unvaccinated individuals in this age range have already contracted Covid-19 and one dose is enough to provide additional protection.
Prior coronavirus vaccinations are not enough to keep vaccinated individuals up-to-date. They will need to receive at least one dose bivalent booster. Even if a person has received three doses or more of the monovalent vaccines they will not be considered up-to-date unless they have received at least one dose of bivalent booster. It is important to note that CDC data shows that less than 1 in 5 people who are eligible for the first bivalent vaccine have received it. This means that, under their new definition, fewer than 1 in 5 Americans were previously considered to be fully vaccinated.
CNN: What is the bottom line? Should people who are newly eligible for boosters get them immediately?
Wen: People who are newly eligible for the vaccine should talk to their doctors about what is best for them. The CDC has issued a recommendation that is known as permissive, meaning that people are free to choose whether or not they want an additional booster. A 65-year old who has recently received Covid-19 may choose to wait until fall before getting another booster. A 65-year-old with kidney disease, a history stroke or heart attack, and who cannot take Paxlovid antiviral therapy, might want to get the booster.
This permissive attitude towards additional boosters, in my opinion, is consistent with the current situation of the Covid-19 Pandemic. People should select the level of protection that best suits their medical needs.