It’s now been more than six months since the bivalent COVID-19 shot was authorized for use in adults in the U.S. The updated formula targets the original virus strain and the highly contagious omicron variant.
But since it’s now been available for a considerable amount of time, many folks who got the shot when it was first offered in September are worried about waning protection, especially since the initial vaccine had a decrease in protection about four months after getting the jab. So do you need another dose to protect yourself from getting very sick?
“This is a good and increasingly common question,” said Dr. Mark Loafman, the chair of family and community medicine at Cook County Health in Chicago.
Earlier this winter, Canada and the United Kingdom updated their vaccine guidance to allow high-risk folks to get a second bivalent booster. And as of April 19, the Centers for Disease Control and Prevention recommended a second bivalent booster for certain at-risk groups — but not for everyone.
What are these new guidelines? And do you actually need a second bivalent booster? Below, experts weigh in on what to know:
So, who can get a second booster dose?
A second bivalent booster dose is available for adults 65 and older under the CDC guidelines.
“If you’re ages 65 and older and received an updated COVID-19 vaccine dose (either Pfizer or Moderna) at least four months ago, you may now choose to receive an additional dose,” CDC spokesperson Kristen Nordlund told HuffPost via email.
People who are moderately or severely immunocompromised also can get additional booster doses, according to the CDC’s new guidance. If you fall into this category, you are eligible for additional bivalent booster shots two months after your last updated vaccine dose (again, either Pfizer or Moderna) with at least two months between each booster. This means immunocompromised people can get multiple booster doses every couple of months, depending on what they decide with their doctor.
“CDC’s updated guidance allows more flexibility for healthcare providers to administer additional doses to their immunocompromised patients as needed, taking into consideration the individual’s clinical circumstances,” Nordlund said.
Why isn’t a second dose available to all?
“Considerations for a second dose arise from studies showing that protective antibody levels from the booster vaccine diminish over time, just as we experienced with the initial COVID mRNA vaccine,” Loafman said.
Experts are still seeing good protection against severe disease and hospitalization in those who got the bivalent booster — meaning most people aren’t at risk for negative COVID outcomes because of the booster’s protection.
Many people think it’s like a light switch, explained Dr. William Schaffner, a professor of preventive medicine in the department of health policy at Vanderbilt University Medical Center in Nashville. They think when they reach six months they’re not protected at all, but that is not the reality. “You still have substantial residual protection,” Schaffner said.
Nordlund of the CDC underscored that the bivalent vaccine does still provide protection for most people — immunocompromised folks and people above 65 are just at higher risk for severe illness.
It’s not clear if a second shot of the current bivalent vaccine will be recommended to all or if a new one will come through instead.
“At the moment, the Food and Drug Administration seems directed at creating an annually updated booster,” Schaffner said. “That’s what they’ve been talking about, that’s what their expert advisory committee has been speaking about and has been supporting. And they’re moving in that direction.”
He added that there may be developments throughout the summer months before fall, which is when experts think there will be a new updated booster available. A new booster would target the dominant strains come fall.
Very few Americans have actually taken advantage of the bivalent booster.
The majority of Americans have not received this updated booster shot, which strongly protects against hospitalization and death. In fact, only 1 in 5 people have received the bivalent booster, according to Loafman.
“From every perspective I can imagine ― science, public health, use of health care resources, compassion, respect for life, getting back to a real sense of normalcy, etc. ― the low rate of booster dose uptake is an epic-level, heartbreaking tragedy,” Loafman said.
“A safe, simple way to stop most of this death and suffering is at our fingertip — and yet so far away. Imagine if only 1 in 5 of us wore a seat belt?” he added.
According to Schaffner, if you compare unvaccinated people with those who got the bivalent booster, you’ll see that unvaccinated people are 17 times more at risk for hospitalization. When compared with people who are partially vaccinated, those who did not finish the vaccine series are 2.5 times more at risk.
If you haven’t gotten your first bivalent booster, you can still get the shot — and it’s currently free, which could change for some folks when the United States’ public health emergency declaration ends in May. There’s an online database you can use to find your nearest vaccination location.
The CDC also announced on April 19 that the original monovalent vaccine is no longer recommended in the United States — meaning, if you do not have the original shot that was first available in 2021, you do not need it before getting the updated bivalent booster shot.
Everyone 6 and older is eligible for a bivalent shot, according to the CDC. This guidance is straightforward for those 6 and over, but it’s a little more complicated for younger children. For additional guidance, reach out to your pediatrician or look at the CDC’s guidelines.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.