New booster vaccines are accelerated to September. What does that mean for people considering getting boosted?

Yesterday, the administration announced that they expect new vaccines for COVID-19 to be available in September, earlier than the October to November timeline that had been previously announced. One thing that was missed by many in the news accounts was the fact that these vaccines may be different from the boosters that everyone was expecting. 

Let me first go through the differences between these new vaccines and the original, then give people guidance as to what they should do concerning getting vaccinated right now.

First, the new COVID-19 vaccines, as expected, involve messenger RNA for the spike (protective) protein from more than one type of SARS-CoV-2/COVID-19 virus. The vaccines were expected to contain the original RNA from the Wuhan virus and the RNA from the first Omicron variant. It now appears that the booster will focus on the most recent Omicron variants, BA.4 and BA.5. This is a surprise for several reasons.

• First, this variant has only recently become dominant in the United States, and is now causing most of the infections here. Producing a vaccine for this variant within two to three months is remarkably fast.

• Second, the speed with which BA.4 and BA.5 has spread through our population shows that it is remarkably contagious. This suggests that the BA.5 “wave” of infections will be resolving in the U.S. about the time this vaccine becomes available.

Therefore, the booster may not be much help in preventing infections with BA.5. Basically, the government is making a guess that future variants will be closer to BA.5 than prior Omicron variants. It is a reasonable bet.

The good news is that it may not matter. Studies in populations most at risk show that the original vaccine is still good at boosting immunity and protecting people from serious illness and death from COVID-19, even with the BA.5 variant.  Therefore, the added RNA from these new viruses is just a bonus.

Given all of this, what should be the considerations about when to or who should get these new boosters?

If you are at risk because your age is greater than 50 or you have a significant medical problem, you should certainly consider getting these vaccines as soon as they are available. However, if you’ve been infected with Omicron/COVID-19, or have already gotten a booster vaccine in the past few months, you need to wait at least six months to ensure that the booster will work. Otherwise, the immunity from your infection or the prior booster will simply neutralize this dose of vaccine.

Some data suggests that a recent infection from COVID-19 may serve as another booster. That is still an open question, but certainly if you are within about six months of having been infected, you need to delay having a booster.

Younger people should also consider at least getting a single booster to lock in their immunity. Most of these people have been excluded from the current booster vaccine and are more than six months out from their initial series of two shots. They should get this vaccine along with their flu vaccine this fall.

The one thing that’s clear at this point is that no one should get the current booster vaccine that is available now. You should not get two boosters within a couple of months, and receiving a booster now with the current vaccine will likely negate the effectiveness of the new booster in the fall.

To summarize, the new boosters may have some broader protection and will be available in September, earlier than thought. This means protection from a winter COVID wave will be available in plenty of time and removes the need for anyone to receive a shot of the current booster vaccines.