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In recent weeks, the topic of COVID boosters has been making headlines as updated versions of the mRNA vaccines are being rolled out. With cases on the rise and concerns about new variants, many people are wondering if they should get a booster and when is the best time to do so. In this comprehensive guide, we'll provide you with all the information you need to make an informed decision about COVID-19 boosters.

1. Why do federal health officials think Americans need another round of COVID boosters?

Just as the flu vaccine is updated every year to target the viruses likely to be circulating in the fall and winter, health officials say an updated COVID shot can help bolster people's waning immunity as we head into respiratory virus season. The new boosters are a much closer match to currently circulating variants than prior vaccines, say federal health officials. They're updated versions of the existing Moderna and Pfizer-BioNTech vaccines and have been formulated to target a relatively recent omicron subvariant called XBB.

2. Will they protect against the newest COVID variants?

Though new variants have emerged since the FDA developed the booster, the updated shots are still "very closely matched to all the circulating strains," says virologist and immunologist, Dr. Andrew Pekosz. That includes BA.2.86, a new strain that authorities began tracking in August. Recent lab studies suggest that the new COVID boosters should still provide protection against this variant and other circulating variants. Immunology professor Dr. Deepta Bhattacharya states, "I think there's every reason to expect that people will make decent antibodies against the variants that we know about right now."

3. How long will protection last?

After receiving the booster, you'll experience a boost in immunity within about two weeks, which could reduce your risk of contracting COVID. This protection is expected to last for a few months and may make your case milder if you do get sick. The protection against severe disease, which includes symptoms that require hospitalization, should last longer. The duration of this protection depends on various factors such as your immune system, health, age, and prior exposures to vaccines and infections. For many people, the hope is that COVID boosters can be taken annually, similar to flu shots.

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4. Who should definitely get a COVID booster?

If you're at high risk of severe disease from COVID, experts recommend getting a booster. This includes individuals who are over 65, have weakened immune systems, or have certain medical conditions such as chronic lung disease, obesity, advanced diabetes, or kidney disease. Pregnant individuals should also get the shot. The goal is to keep people out of the hospital, and data shows that most of those hospitalized for COVID since January had not received the previous fall's booster. Vaccination rates for COVID are currently highest for Black and Native Americans and Alaska Natives.

5. If I am healthy and under 65, do I really need to get it?

While the risk of severe illness or death is lower for younger, healthy individuals, experts still recommend getting a booster. Being vaccinated is likely to make any illness you get less severe, and getting boosted may reduce the chance of transmitting the virus to vulnerable individuals around you. COVID is still circulating, and as we're seeing, it's still capable of infecting a lot of people and causing harm. Moreover, vaccination has been shown to reduce the risk of long COVID in both children and adults.

6. What about kids? What's the recommendation for them?

The CDC recommends COVID-19 boosters for kids ages 6 months and up. Although children in this age group are less likely to get severely ill from COVID, they can still experience severe illness, even without underlying medical conditions. Hospitalization rates for COVID-19 are highest for infants under 6 months, who are too young for the shots, and kids ages 75 and older. By vaccinating those around them, we can protect the youngest ones and reduce the risk of school absenteeism and long COVID in children.

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7. When should I get the booster? If I'm healthy, should I wait for the holidays?

Federal health officials recommend getting the booster if it's been at least two months since your last shot. For those at lower risk, experts suggest waiting longer, anywhere from three to six months since your last vaccination or infection. Timing your booster around events like holidays or travel plans when you'll be at higher risk may also be a consideration. However, it's essential to note that predicting when the next wave of COVID will occur is challenging, and waiting too long could leave you vulnerable.

8. What if I recently had COVID, do I still need a booster?

The CDC advises people who have had a recent infection to wait three months before getting a booster. However, for low-risk individuals who have been infected within the last six months, waiting longer may be acceptable, as they likely have some level of immunity from the infection. It's best to consult with your doctor, especially if you are elderly, immunocompromised, or have underlying illnesses.

9. Can I get a COVID booster at the same time as a flu shot – and what about RSV?

According to the CDC, it is perfectly fine to get a flu vaccine and a COVID-19 vaccine during the same visit. However, some experts suggest getting them separately to minimize potential side effects. Regarding the respiratory syncytial virus (RSV), it is recommended to space out the RSV vaccine by a week or two if you are eligible for it. Pediatricians should be consulted about scheduling the COVID, flu, and RSV vaccines for children.

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10. Do I have to pay for the booster?

If you are insured, your plan should cover the cost of the booster. However, if you receive the shot from a provider out of your insurance network, there may be a cost. For uninsured individuals, the federal Bridge Access Program offers free vaccines through the end of 2024, but its coverage may be limited. Uninsured children can still receive COVID-19 vaccines and other immunizations for free under the Vaccines for Children Program. The list price for the Pfizer-BioNTech and Moderna vaccines for those paying out of pocket is between $120-$129 per shot.

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COVID boosters are recommended for various population groups, including those at high risk of severe disease and individuals who want to reduce their chances of contracting and transmitting the virus. While the vaccines are closely matched to currently circulating variants, it is important to consider the timing of the booster and consult with healthcare professionals for personalized advice. Stay informed and protect yourself and those around you by making an informed decision about COVID-19 boosters.

Additional Resources:

NC DHHS

NPR

NY TIMES