New COVID Boosters Arrive Amid Rise In Infections

IRA FLATOW: This is Science Friday. I’m Ira Flatow. Later in the hour, we’ll check in on our native bees and stop thinking honey, in this case. And also more information on what made the recent earthquake in Morocco so devastating.

But first, this past Tuesday, the CDC recommended new COVID vaccines from Pfizer and Moderna for anyone over the age of six months. It’s welcome news for some as COVID cases have been ticking up over the summer accompanied by higher hospital admissions and deaths. How should we think about these new boosters? Should we expect to take them every year going forward?

Joining me is Dr. Katelyn Jetelina, adjunct professor at UTHealth School of Public Health and author of Your Local Epidemiologist newsletter. She’s based in San Diego, California. Welcome back.

KATELYN JETELINA: Yeah, thanks for having me again.

IRA FLATOW: It’s terrific to have you back. OK, let’s talk about these new COVID boosters. When are they available? Who should be getting them?

KATELYN JETELINA: Yeah, big news. So earlier this week, the FDA approved the updated vaccines for this fall. And yesterday or on Tuesday, the CDC determined that everyone over six months is eligible for an updated COVID-19 vaccine this fall because the benefits of vaccines completely outweigh the risks across all age groups.

Now, the next step is when are they available is a really good question. Technically, you’re able to get the vaccine today. However, access may be delayed or challenging while we’re waiting for, for example, physicians’ offices to get their supply in. And maybe we can get into this a little more later. But waiting may make sense for some as well. So yeah, great news. Welcome news. And hopefully, it helps our fall and winter.

IRA FLATOW: And there’s a wrinkle in it this time in that they’re not free, right?

KATELYN JETELINA: That’s right. So this is the first time the government is not paying for our COVID-19 vaccines, particularly because we are out of a public health emergency. So that means that Pfizer and Moderna, they’re charging about $120, $129 per dose, and Novavax, I think, is around the same, about $130.

IRA FLATOW: Wow.

KATELYN JETELINA: And for the record, I think this cost of vaccines is absolutely absurd given that we taxpayers funded Operation Warp Speed in the first place. But this is what is happening. Now, the good news is private insurance is going to cover it. Medicare is going to cover it, for example. The biggest challenge will be among the uninsured, which is about 9% of Americans. And the government is working on getting them free vaccines as well.

IRA FLATOW: And is the vaccine designed to prevent COVID? Or like the other ones, you’re going to get COVID, you just won’t get as sick if you get COVID and may avoid a trip to the hospital?

KATELYN JETELINA: Yeah, so I know your audience appreciates nuance. So I’ll get into a little nuance here. The new vaccine or this updated vaccine for this fall has an updated formula. And it targets a specific Omicron subvariant called XBB. And the number one priority for these vaccines is to help prevent hospitalization and death, severe disease, particularly among, of course, the highest risk, which is those over 65 or those people with comorbidities.

But there are secondary advantages to the vaccine like prevention of infection as well as reduction in transmission. But that effect wanes much more quickly. It wanes probably around three or four months. So the main purpose of these is to protect against severe disease.

IRA FLATOW: Now, what if I recently had COVID now, like myself? I just came off of being contagious or giving it to people. I tested negative just, let’s say, a week or so ago. Do I wait a few months because my natural immunity is going to kick in first?

KATELYN JETELINA: Yeah, this is a really good question. And it’s a tricky answer because it’s a bit of a game. We have a very scarce scientific guidance on optimal timing. But what the scientific guidance is telling us is that you should wait at least two to three months after infection.

You don’t have to wait. We won’t exhaust or overwhelm our immune system. But waiting ensures that we broaden our B cells, which is our secondary line of defense. It’s basically our antibody factory. And with this updated vaccine formula, we want this factory update. So wait least two to three months after infection.

The question is on the other end, how long do we wait? And the longer we wait, the more we get out of this vaccine. One study showed that waiting eight months helps, another study showing that waiting 12 months help. But waiting is a gamble, right? So even if vaccine protection sooner is not as good as it could be, it’s better than waiting too long and catching COVID without limited protection, especially among high-risk people.

So all that to say, if you’re over 65 or at high risk for severe disease, I suggest waiting about four months after infection or your previous vaccine. If you’re under 65 and not at risk, I would wait at least six months.

IRA FLATOW: And what if you had a recent booster, like the old booster? You said, well, I’m going to get it, and then this comes out. Should you be waiting also?

KATELYN JETELINA: Yes, I would. The official guidance from the CDC is to wait at least two months. But I would take the similar suggestions that wait– if you’re high risk for severe disease, wait about six months. If not, you can wait a little longer.

IRA FLATOW: Hmm. And how should we be thinking about masking at this point?

KATELYN JETELINA: Well, masking gets everyone’s blood boiling.

IRA FLATOW: Well, well, well, let me preface that by saying there has been a slight uptick in cases, right?

KATELYN JETELINA: There is. We are currently in a wave right now. And that is because of behaviors changing during the summer. Masks work. I will go on record saying that that they reduce the amount of articles you inhale and reduce the amount of viral particles you exhale.

And so if you are looking for more layers of protection, which I think is a fantastic idea during a wave, then wearing a mask will help you. It’ll help protect against infection, which means also protect against long COVID, and will reduce viral load.

So I don’t know. The way I think about it is when we start getting high up into a wave kind of like we’re right now, I start masking in really indoor crowded areas like when I’m traveling on airplanes.

I think it depends on risk tolerance of certain individuals. And some people are more willing to take a risk to get infected than others. And I think that this is, for better or for worse, individualized decisions in the United States. And it’s challenging to navigate as individuals as well.

IRA FLATOW: Should we expect that– we’re now entering the holiday season. Should we expect the typical uptick in cases and to be extra careful then?

KATELYN JETELINA: We are. We are expecting an uptick in COVID-19 this winter, particularly because coronaviruses even beyond COVID thrive in winter. They thrive because of changed weather. They thrive because we’re changing our behaviors. They thrive because of the changing humidity in the air. So all signs point to that we’re going to have a wave. Of course, COVID is not predictable yet. So we do not know what it has up our sleeve. But I think that’s a safe bet that we should expect an uptick.

IRA FLATOW: All right. Now, let me throw in the flu season, getting a flu shot and a COVID shot. Should I get them at the same time? Same arm? Different arm? Space them out? What’s the feeling on that?

KATELYN JETELINA: Yeah, so you can get a flu vaccine and other routine vaccines in COVID-19 at the same visit. It is recommended to administer in different arms. But there have been a lot of studies showing the safety and effectiveness of coadministration. And I think that getting them at the same time also reduces the burden of going to the pharmacy or going to the doctor’s office two times, which for busy people is a helpful reprieve.

IRA FLATOW: And let’s zoom out from COVID. Let’s talk about the flu season, which we have. And you mentioned other illnesses and vaccines. What about the RSV vaccine? Can we throw that in at the same time?

KATELYN JETELINA: Yeah, so I think you’re highlighting an important theme this fall is that it’s the first time that we are going to have vaccines for all three of these big respiratory viruses, which is huge. And one of those tools is the RSV vaccine for older adults. Those over 60 can have an RSV vaccine. These RSV vaccines are very effective. And they do not wane as quickly as COVID-19 or flu. So I suggest getting RSV vaccine as soon as possible. It’ll last throughout this season and even maybe into next season. We’re waiting on data on that.

IRA FLATOW: Well, so you should not be fearful of going into your doctor or your pharmacy and getting all three at the same time? Or should we space them out a little?

KATELYN JETELINA: So that is a question we do not have scientific data on about getting all three of them at the same time. We know that getting COVID and RSV at the same time is safe. And we know that COVID and flu getting at the same time is safe. And so we assume that getting all three at the same time is safe. And I would highly suggest this, especially if it’s challenging, for example, an older American to get to a pharmacy or doctor’s office. But you can also space them out.

IRA FLATOW: RSV is kind of new to the public, isn’t it? We haven’t heard about this in many past years.

KATELYN JETELINA: I think it’s new to the majority of the public. RSV is not new to parents like me because RSV is one of the most dangerous viruses that our little ones can catch, especially before the age of one. But it is, I think, a new disease on the radar of older Americans because it’s not typically talked about previously. But there is a substantial burden on older adults. And so that’s why I think that this vaccine will bring some reprieve.

IRA FLATOW: Is there anything else you think that would be important to talk about that we haven’t heard about in larger conversations about the boosters, about vaccines, and maybe just about vaccination itself? Because there’s still a lot of people who are afraid to get vaccines, aren’t there?

KATELYN JETELINA: There is. There’s a lot of hesitancy. I think beyond hesitancy, us epidemiologists are really focused on how this respiratory season is going to play out. The biggest concern is if RSV, flu, and COVID all peak at the same time, our health systems will not be able to handle that. Even prepandemic, our hospitals would be overwhelmed during a bad flu season. And now we have this new repertoire in our threats.

So I think it’ll be very interesting to watch how this unfolds. And I would not be surprised if, for example, hospitals and nursing homes reinstated mask requirements because of just the high risk of people visiting these places and the amount of protection we’re trying to do for our hospital systems.

IRA FLATOW: That’s a really interesting case that you make. We have more than one virus to be aware of now. Start masking up. Dr. Jetelina, thank you for taking time to be with us today. Great stuff.

KATELYN JETELINA: Yeah, thank you for having me.

IRA FLATOW: Dr. Katelyn Jetelina, adjunct professor at UTHealth School of Public Health, author of Your Local Epidemiologist newsletter. And if you want to learn more about the new boosters and where you can get yours, head over to vaccines.gov.

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