More than three years after the pandemic began, the question is still important. Is it time to get another COVID-19 vaccination?
While summer is in full swing, the virus is still out there, lurking at low levels, and people continue to get sick. And when colder weather comes, it’s going to be crucial to stay protected.
Health officials are expected to roll out a new shot in the fall but advise that everyone right now be “up to date” on their vaccinations.
Here are the current recommendations of the US Centers for Disease Control and Prevention, and comments from some experts who believe the CDC advice may in some cases be too cautious.
The CDC says that everyone ages 6 and up should get an updated, bivalent booster vaccine. It’s as simple as that.
Forget about what type of vaccine you got previously. It doesn’t matter how many shots you received so far. There’s no need to play catch-up before you get the bivalent shot. The original shots and boosters from Moderna, Pfizer, and Johnson & Johnson are no longer even authorized.
The CDC recommends that everyone get the bivalent shot, which was first offered to people in September, “regardless of whether they previously completed their [monovalent] primary series.”
In Massachusetts, the state Department of Public Health says about 2.1 million people got boosters after Sept. 1, 2022, nearly all of which were the bivalent shots. That’s about 30 percent of the state’s population of about 7 million. Nationally, about 17 percent of people have gotten the bivalent shots, the CDC says.
People who are 65 and older can also get a second bivalent shot, and people who are immunocompromised can receive even more, according to the CDC.
Children from 6 months to 5 years old should get at least one bivalent shot, and maybe more depending on the number of original shots they’ve received previously, the vaccine types, and their age, the CDC said.
Dr. Philip Landrigan, director of Boston College’s Program for Global Public Health and the Common Good, said people should follow the CDC guidelines. And he suggested that people 65 and older and people who are immunocompromised sign up for their additional bivalent shots.
“It’s important to remind people that even though you can get a respiratory infection, the big thing about the COVID-19 vaccines is they keep you out of the hospital and they keep you alive,” he said. You may get sick, he said, but “you’re going to be alive to work and play next week.”
While it’s steamy outside now, “as soon as the weather gets chilly and people start moving indoors ... we’re going to have an uptick in infections so it’s good to get vaccinated before that time comes,” he said.
(While on the topic of avoiding COVID-19, he noted that “everybody’s tired of masks,” but they continue to be useful. If you have a cough or a cold or are going to be around someone with a cough or a cold, or are in a crowded public place, “slip on a mask,” he said.)
Other experts said their current advice on booster shots would vary from the CDC’s.
They pointed, among other things, to the current low levels of the pandemic, widespread immunity in the population, and the arrival of what’s expected to be a better vaccine, possibly as soon as September.
Federal regulators last month advised vaccine manufacturers to reformulate their COVID-19 shots to target an Omicron subvariant to provide the best protection as the weather turns colder and more people gather indoors. Pfizer, Moderna, and Novavax have said that updated vaccines could be developed and manufactured in time for a rollout in the fall.
Dr. David Hamer, a professor of global health and medicine at Boston University, said that he didn’t think that people who got the first bivalent shot needed to get the second. “I favor having my patients wait until either the new booster is available and/or there is a new wave of SARS-CoV-2,” he said by email.
“My current advice is wait,” he said. “It makes sense to get this vaccine closer to the time there’s actually an outbreak.”
Hamer also said that many people who have gotten their original shots and boosters don’t even need the first bivalent shot, “although the exception would be those who are at high risk based on advanced age, serious underlying immunocompromising conditions, etc.”
Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital, said people who’ve gotten the first bivalent booster don’t need a second one “unless they’re over 80, medically fragile, or immunocompromised.”
Like Hamer, he said he would recommend a first bivalent shot for those at high risk of severe disease, such as older people or those with comorbidities. But for younger, healthy adults, he said, the first bivalent shot may not be needed.
He cited a hypothetical case of a completely healthy 25-year-old man who has had three shots and had COVID-19 twice already. “Does it really make sense to have him get an extra vaccination now? It really doesn’t,” he said.
In the fall, “the monovalent vaccine that will likely be recommended should be a better match to the circulating variants,” he said. “Also, while COVID is still very much circulating — just saw another person with it today — disease levels are lower than they’ll likely be in the fall and winter, which has been the case the last three winters.”
The decision to get a bivalent shot should consider a person’s age, their immune status, and their previous exposure to COVID-19, either through shots or infections, he said.
“People who are highly vulnerable should choose to be maximally vaccinated,” he said. But for “intermediate-risk people, it depends on degree of immunity.”
If people have questions, they should contact their doctors, he said, because it’s not easy to “figure this out from the guidelines.”
The bivalent shots were formulated to protect against both the original virus strain and the Omicron strain. The new shots this fall will be monovalent again, targeting a single Omicron subvariant.
The US Food and Drug Administration told vaccine manufacturers last month to develop shots tailored to fight the XBB.1.5 subvariant, after experts determined that the subvariant appeared to be the best target for future vaccines. The CDC is expected to update its vaccine recommendations in mid- to late September once FDA approves the shots.
Early studies have shown that vaccines targeting XBB.1.5 also help protect against other XBB subvariants, such as XBB.1.16 and XBB.2.3.
Jeremiah Manion of the Globe staff contributed to this report. Material from Globe wire services was also included.
Martin Finucane can be reached at email@example.com.