Your Questions About The Updated COVID Vaccines, Answered

SciFri producer Kathleen Davis talks with Dr. Kizzmekia Corbett-Helaire, assistant professor of immunology and infectious diseases at Harvard’s T.H. Chan School of Public Health to help answer our listeners’ top questions about the updated COVID-19 vaccines.

This Q&A, which includes questions from our audience members, has been adapted from our interview with Dr. Kizzmekia Corbett-Helaire. It has been edited for clarity and brevity.

If I’ve already had COVID and it wasn’t so bad, why should I even bother with this new booster? 

There’s always a chance that COVID-19 will cause more than the sniffles, or that you could end up in the emergency room—especially for older people. Why take that chance when you have the option to go to your local CVS and, in many cases, get a free vaccine that has been proven to decrease your chances of more severe disease?

My hope is that as time progresses, people become more comfortable with the idea of getting seasonal vaccinations for COVID-19 along with flu.  

Is the new COVID-19 vaccine one shot?

Yes. 

Are these “updated vaccines” different from a booster? 

A “booster” is a casual word, and an “updated vaccine” is a more official term. They are essentially interchangeable. However, a booster means that you would have gotten COVID-19 vaccines previously. But if you haven’t, that doesn’t mean that you can’t go and get your updated vaccines. So, there is a little bit of nuance, but for most people, you can use the terms interchangeably. 

We’ve got the two mRNA vaccines, Moderna, Pfizer, and then we have protein-based Novavax. What are the pros and cons of available vaccine options? —Wanda, Canton, MI

There have been a couple of studies that have looked at responses of mixing and matching various vaccines. Those studies tend to look at very specific antibody responses, and they’re not necessarily gauging on a population level what protection looks like.

So any vaccine that is approved to be a booster in this country, whether it be Novavax, Moderna, or Pfizer is a very, very good vaccine for you to get. The protein vaccines have tended to have less reactogenicity—meaning those little mild side effects, the soreness in the arm, the redness in the arm, the fevers that you get after your vaccine are reduced. But any vaccine is a good one.

Because Noravax is a little bit different, would it potentially offer more protection if you’ve had Moderna or Pfizer shots before? 

No.

The federal Bridge Access Program, which gave access to free COVID-19 vaccinations for uninsured Americans, recently ended. What does this change mean for those who are uninsured? 

I think it is absolutely unfortunate that we’ve come to this point where we’ve almost dismissed what the outcomes of COVID could be from a regulatory standpoint. One of the parallels with inequities in health disparities, particularly with COVID-19 and other diseases, is that access to healthcare correlates with how much income people have. Many uninsured people don’t necessarily have the means to spend something like $150 every season to get their vaccine.

Can I get my child vaccinated at the local pharmacy with me?  

Unfortunately, many pharmacies do not vaccinate children, particularly those under two years of age. Even children under 12 in many pharmacies may have a hard time being vaccinated. If you want to get your child vaccinated, contact your pediatrician or your local publicly subsidized health department, and they will point you in the right direction. 

If I had COVID-19 recently, when is the best time for me to get this new booster to protect against a Thanksgiving and Christmas COVID surge?  —Alan, Boulder, CO

The CDC recommends that if you know that you have had a COVID infection in recent months to wait at least two to three months until getting your vaccine booster.

If I didn’t have COVID-19 this summer, when is the best time to get the booster to protect against a Thanksgiving and Christmas COVID surge?  

For those who didn’t have a COVID infection in the last wave, I like to warn people about restricting themselves on timing so strictly, understanding that Thanksgiving is only a hop, skip and jump away now. If you were to get boosted today, you would have a lot of antibodies waiting to protect you against the COVID-19 virus come Thanksgiving. But optimally, about two to three weeks before any major surge would be the best way to protect yourself.

If I’m over 65, what’s the best time to get the new booster?

Go as soon as possible.

It’s been recommended that people over 65 can get a vaccine twice this year. Is that accurate? 

Previously it has been twice a year. But the CDC and the FDA continuously review the epidemiology and make recommendations in real time. So to say that someone 65 and up may have to get a vaccine in six months from now may not be necessarily true. Keep watch out in six months, but worry about your booster for this fall right now.

Why are vaccines not being advised on a twice a year schedule, because we are currently seeing both a summer and a winter wave? —Michael, New York, NY

Earlier this year, around the time when JN.1 started to circulate, a data review showed that people under the age of 65 were still very well protected against severe disease and some mild disease from their fall 2023 vaccines. And so there was no reason to ask for them to get boosters because their fall vaccine was doing just okay at protecting them against severe disease and mild disease. 

Is it possible to overwhelm or confuse our immune system with too many vaccine doses? 

Every day, your immune system is learning about what you come into contact with. Whether it be the bacteria on your desk, or some virus that someone sneezed on you on the train. So the immune system is great at not being overwhelmed. 

There have been terms thrown around like immune exhaustion, and that does happen. But in this case, it’s not necessarily a thing because you aren’t getting vaccinated every day. You’re getting vaccinated six months to a year apart, depending on your age. That’s enough time to let your immune cells settle down and allow yourself to be boosted again. So overwhelm is not something we should really think about in this case. 

Are the OTC rapid COVID tests still accurate given the number of variants? —Wendy, Sonoma, CA

Yes. COVID tests are regulated heavily, continuously. So if they were not accurate, they would not be on your shelves. 

I have COVID tests at home that are probably about two years old now. Should I honor their expiration dates?

I would check the expiration date. And if one is expired, do not use it. You should always honor expiration dates. (Note: Some manufacturers have extended test expiration dates. Check this page for updates.)

Some people worry about side effects or potential harms of getting COVID vaccines. How can they weigh the potential side effects versus the benefits of getting the booster? 

This is absolutely something that we all need to heed—scientists, healthcare practitioners, and doctors—people really do have this real fear. There are anecdotal, small amounts of rare cases where people have contributed a long term effect, which is a vaccine injury, to the COVID-19 vaccine. Oftentimes it’s something like tingling in your extremities, or some people have said that they are really tired all the time after getting a COVID-19 vaccine. But the cases are very rare and there have been no correlation with any long-term side effects en masse at all.

Overarchingly, these vaccines continue to save lives, and have saved millions of lives. They continue to keep people from getting really severely ill with COVID-19. 

Do not be ashamed if you fear a vaccine injury. But I’d say to lean into that fear in a way that allows you to gather information. Ask questions of trusted sources, ask your doctor and ask your friends about their experiences with the vaccines as well.

Further Reading

• The CDC’s COVID-19 vaccine guidance.
• The FDA’s resources for at-home COVID-19 tests and expiration dates.
• Learn more from the Public Health Communications Collaborative.
• Learn more from “Your Local Epidemiologist,” Katelyn Jetelina.