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A new round of updated COVID booster shots have been approved for all people six months and older, the Centers for Disease Control and Prevention (CDC) said earlier this month. But some are pushing back against the nearly-universal recommendation.
COVID hospitalizations have been on the rise in recent weeks, with numbers nationwide creeping back to what they were back in March 2023. The new booster shots—made by Pfizer and Moderna—could help slow this rise as the U.S. moves into the fall.
“People can ask their doctor about receiving their COVID-19 vaccine during the same appointment as their annual flu shot, saving time now and helping to prevent severe disease later when respiratory viruses are at their peak,” Albert Bourla, chairman and chief executive officer at Pfizer, said in a press release.
But even with cases on the rise, some people are suggesting that recommending yet another round of COVID boosters to already-healthy people is unnecessary, or even dangerous.
Paul Offit, MD, a former member of the CDC’s Advisory Committee on Immunization Practices (ACIP) told KFF Health News: “I don’t plan to get it myself.” Offit said he’s received two boosters and had COVID last year, so he doesn’t feel like an additional booster is necessary to protect him from serious disease.
And in Florida, Ron DeSantis’ administration announced on Thursday that it would break with the CDC, and advise that people under 65 avoid the new shots over safety concerns.
According to a CDC report published in June, an estimated 96% of Americans have some COVID immunity. Despite this, experts largely agree with the CDC’s latest decision—all eligible people should get vaccinated for COVID this fall.
“There isn’t any doubt that younger, healthier people obviously are less apt to get serious disease,” William Schaffner, MD, professor of infectious diseases at the Vanderbilt University Medical Center, told Health. “No matter what your age is, whether you’re young and healthy or old and frail, the benefits of vaccination outweigh the decision not to be vaccinated.”
Here’s what experts had to say about the newly-approved COVID vaccines, and why most people should consider getting them soon.
Despite most Americans having some immunity to COVID, there are a few key factors that might explain the CDC committee’s decision to recommend the new Pfizer and Moderna shots almost universally.
For one, this new vaccine isn’t necessarily a booster, Mark Mulligan, MD, director of the vaccine center at NYU Langone, told Health. Unlike the bivalent shots from last year, this new vaccine doesn’t protect against the original strain of COVID or early Omicron strains, such as BA.5.
Instead, the new shot is formulated specifically to target the XBB.1.5 subvariant, which made up a considerable percentage of COVID cases through July. Other Omicron subvariants have emerged since then, but both Pfizer and Moderna say the vaccines hold up against other these other XBB-related. It should also protect against EG.5, which is expected to be the next dominant subvariant.
Even for those who were vaccinated or got the booster in the past, their COVID immunity has likely waned. The new shot is a chance to strengthen it.
This is especially true for those who are immunocompromised, older, or have underlying illness, Schaffner added. In addition to immunity that fades faster, these groups are also most likely to get severely sick if they do get infected, making vaccination all the more important.
For people who are younger or healthier, there are still reasons to get the new shots. There’s evidence that vaccination lowers a person’s risk of developing long COVID, Mulligan said. Plus, getting vaccinated will make someone’s illness less debilitating if they do get infected, Pedro Piedra, MD, professor of molecular virology and microbiology, and pediatrics at Baylor College of Medicine, told Health.
Beyond each person’s individual protection, there’s also a number of more societal or “altruistic” reasons to recommend the shots to everyone, Mulligan explained. People who are vaccinated are less infectious if they do get sick—that keeps the community at large safer, he said.
“Even with mild COVID you can potentially transmit the virus to a vulnerable person around you,” said Mulligan. “It’s a bit of our societal duty to try to pitch in and keep them protected by getting ourselves protected.”
Similarly, cost and accessibility likely played a role in the CDC’s approval, Schaffner added.
“The committee was very concerned about equity,” he said. “They wanted to be sure that everyone in the United States age six months of age and older was covered for this vaccine.”
Most health insurance plans will provide the COVID shots at no charge, and those who are uninsured or underinsured can get free vaccines at pharmacies that participate in the CDC’s Bridge Access Program.
Plus, practically speaking, universal recommendations for vaccines are simply easier to implement than patchwork risk-based recommendations, Schaffner added, making it easier for people to get vaccinated.
It is true that some people may not need to get this new COVID shot right away, experts agreed.
“After you’ve been exposed to the vaccine or COVID virus, the immune system gets heavily activated,” Mulligan said. “You need some time to recover. So a couple of months after your most recent vaccine, and I think a couple of months is plenty after COVID, as well.”
But vaccine experts don’t buy the argument that only certain, more vulnerable people should get the new COVID shot.
“A good example is to think about influenza,” Piedra said. “Influenza has caused major pandemics in the United States and in the world. And then it evolves over time.”
Still, all people over the age of six months are encouraged to get annual flu shots. The goal is to keep immunity high so that the flu doesn’t once again rage out of control—people can think of COVID in the same way, Piedra explained.
As for determining when a person should get their shot, experts agree that it’s best not to put it off.
There’s a fair amount of COVID already circulating, Piedra and Mulligan said, and cases will probably continue to climb as the weather gets cooler. It’s probably simpler—and effective—for a person to get both the COVID shot and the flu shot the first chance they’re available this fall.
Getting vaccinated in “late September into October should carry us over pretty much into March, through that period of time when both influenza and COVID are expected to be circulating the most intensely,” Schaffner added.
Now that the shots are approved and largely available at pharmacies and clinics, the last piece of the puzzle is making sure people actually get vaccinated. This could be a challenge, Schaffner explained.
Almost all American adults got one COVID shot, but only 17% of the total population received the bivalent COVID booster. That number was a bit higher—over 43%—for seniors.
“We have a big job in front of us, and I don’t have an easy answer as to how I can flip a switch, and suddenly have people line up for the vaccine,” Schaffner said. “I think we’re going to have to work very hard.”
This will likely require a shift in mindset to some degree. For the first time, Piedra said, the U.S. now has vaccines for the three major respiratory viruses—COVID, flu, and RSV.
Though the latter isn’t necessary for everyone, almost all people should expect to get a COVID and flu shot each fall going forward.
“COVID is not going to disappear any more than influenza has disappeared,” said Schaffner.