Many of our readers have asked us about booster recommendations. So this week’s newsletter is dedicated to answering them.
Alan, from New Jersey, wrote that he and his wife are both 87 years old. His last coronavirus vaccination was the bivalent vaccine last April. “Should I buy a booster this spring?” he asked.
Similarly, Andrew and his wife are American citizens and retired to Ecuador. “We received the first two COVID-19 vaccines (Pfizer) in the United States and the first two booster vaccines (AstraZeneca) in Ecuador. We have not received boosters for the past two years. No, neither of us has ever been infected with the coronavirus. We will be returning home for a month in May. Do we need to get the latest booster?”
The answer to both is yes. They have not been vaccinated with a monovalent vaccine targeting the XBB.1.5 subvariant. This is a vaccine that became available last fall. Alan, Andrew and their wives need to get this shot as soon as possible.
The CDC has published a compelling analysis showing why. Vaccine efficacy against COVID-19-related hospitalizations was 52% during the first 7 to 59 days after monovalent vaccination. This decreased to 43% by two to four months after vaccination.
This means that people who receive the monovalent vaccine can significantly lower their risk of hospitalization if they become infected with the virus. Healthy young people who have hybrid immunity from vaccination and previous infection are already much less likely to develop severe disease. However, older adults and people with chronic health conditions are still at risk and should not hesitate to get the monovalent vaccine if they have not already received it.
Only 42 percent of Americans 65 and older have received their first monovalent vaccine. Some in this group are anxiously awaiting the CDC’s decision and are ready to get vaccinated in the spring, but there are caveats. They don’t want their ability to get future boosters to be jeopardized.
“My spouse and I (ages 76 and 69) have received all COVID-19 booster shots and our last shot is in September 2023,” Terry, from Virginia, wrote. “We are planning to travel to Europe by plane and cruise ship in October, so we planned a booster for mid-September. If I get a booster now, is there a risk that I won’t get one in September?”
Barbara, from Rhode Island, also wants to get a booster now, but worries it will be harder to get additional boosters in the fall. “What should I do?” she asked.
Federal health officials expect a new round of vaccinations to begin in the fall. Vaccine compositions will likely be reformulated to best target variants that may be in circulation next winter. Vulnerable people should not delay getting vaccinated now. Vaccination in the spring does not preclude the ability to obtain new formulations in the fall.
In fact, postponing it can create timing issues. The CDC recommends waiting at least four months between doses, so people who need a booster shot in the fall probably shouldn’t wait until summer to get the next one.
One of the main reasons to postpone is if someone has just had the coronavirus. Bill, from Ohio, is “79 years old and on his way” and has just recovered from COVID-19. Gary, from California, whose girlfriend is 78 years old, is in a similar situation. Need a recommended booster now?
The CDC says people who have recently been infected with the coronavirus can wait at least three months for their next coronavirus vaccine. I think you can probably wait longer because you have a strong immunity to infection.
That means Gary and Bill will be able to receive their spring booster in early June. That way, they can receive the newly developed vaccine in October or November. They could probably wait for the September vaccination and skip the spring booster shot. Because their recent infection was essentially that “booster shot.”
Some readers wanted to know what to do if they are not yet 65 years old. “I have been diagnosed and treated twice for unrelated cancers,” Marisol from Oregon wrote. “Right now, I’m only being followed up if it comes back. Am I still considered high risk for COVID-19? I’m still in my 50s, should I seek vaccination in the spring?”
“What about people who are immunocompromised?” asked Ann from Indiana. “I have an autoimmune disease and am on high doses of steroids. Why can a healthy 65-year-old give her a new booster but not me?”
In fact, Ann is eligible for the spring booster. The CDC recommends vaccination for everyone age 65 and older, but is also allowing booster shots for younger people. Anne, like Marisol, needs to discuss the details of her medical condition with her doctor. If Marisol has had cancer in the past and is currently not receiving treatment, she is probably not at high risk, but there may be other factors in her medical history that could make her more vulnerable to coronavirus. there is.
And of course, anyone considering a spring booster shot because they’re worried about serious illness should make sure they have easy access to antiviral treatment in case they contract the virus.