Bivalent Covid booster shots became available in late 2022 that target the original omicron variant, and some other variants, of Covid-19. The American Medical Association states only 17 percent of the U.S. population received the bivalent booster shots, which raised its concern about how many people will opt to take a new Covid booster shot expected to be available in the fall.
Dr. Joe Thompson, MD, MPH, President and CEO of Arkansas Center for Health Improvement, said in a telephone interview that the low intake of the bivalent vaccine is a contributor to the number of people now being infected. He recommends that people who want to be protected get the current bivalent vaccine—if they haven’t had it already—and get the updated booster when it is available this fall.
Some people who were initially strongly in favor of Covid vaccines have decided against the fall booster because of reactions to earlier shots that had side effects such as fatigue, headaches and joint pain. Thompson said that while he can understand that reaction, in general Covid vaccines have had very low rates of side effects, fewer than many other vaccines historically provided.
“Overall, these are very well tolerated vaccines, and they do provide you the protection against the Covid infection,” Thompson said. “Individuals are going to have a choice much like with the flu shot, the shingles shot or vaccines for any preventable illnesses. If you want to use the vaccines available to keep from being infected, it is a safe pathway.
“While some people have a minor case of Covid, others get long haul Covid which can cause so many things like fatigue, brain fog, diabetes and cardiovascular problems. And these boosters are not just your protection, but to protect your family and friends around you. With the infectiousness of this virus, the vaccine booster coming is going to give individuals and families one more tool to protect themselves.”
One woman, who had the first four shots, caught Covid when she attended an Easter event at her church in northern California. About 40 people caught Covid at this event, and she noticed that people who hadn’t received the bivalent booster fared just as well as those who did.
“I had my first four Covid shots and I will be passing on any more,” she said.
However, that experience is anecdotal evidence. The Centers for Disease Control and Prevention states people who received the updated Covid-19 bivalent booster were 14 times less likely to die compared with those who received no vaccine. People were also three times less likely to die compared with those who received only the primary series of Covid vaccines, the CDC report stated.
A recent study authored by Paul A. Offitt, MD, in The New England Journal of Medicine is titled “Bivalent Covid-19 Vaccines — A Cautionary Tale.” The articles states that on October 24, 2022, David Ho and colleagues released the results of a study examining levels of neutralizing antibodies against BA.4 and BA.5 after receipt of a monovalent or bivalent booster dose. They found “no significant difference in neutralization of any SARS-CoV-2 variant,” including BA.4 and BA.5, between the two groups.
“One day later, Dan Barouch and colleagues released the results of a similar study, finding that “BA.5 [neutralizing-antibody] titers were comparable following monovalent and bivalent mRNA boosters,” Offitt’s article said. “Barouch and colleagues also noted no appreciable differences in CD4+ or CD8+ T-cell responses between participants in the monovalent-booster group and those in the bivalent-booster group. Neither research group found the bivalent boosters to elicit superior immune responses. The results are now published in the Journal.”
Offit said the most likely reason that the strategy for significantly increasing BA.4 and BA.5 neutralizing antibodies failed is imprinting.
“The immune systems of people immunized with the bivalent vaccine, all of whom had previously been vaccinated, were primed to respond to the ancestral strain of SARS-CoV-2,” Offitt, who is a member of the Food and Drug Administration Vaccines and Related Biological Products Advisory Committee, said. “They therefore probably responded to epitopes shared by BA.4 and BA.5 and the ancestral strain, rather than to new epitopes on BA.4 and BA.5.”
Offitt concludes that although boosting with a bivalent vaccine is likely to have a similar effect as boosting with a monovalent vaccine, booster dosing is probably best reserved for the people most likely to need protection against severe disease — specifically, older adults, people with multiple coexisting conditions that put them at high risk for serious illness, and those who are immunocompromised. “In the meantime, I believe we should stop trying to prevent all symptomatic infections in healthy, young people by boosting them with vaccines containing mRNA from strains that might disappear a few months later,” Offitt wrote.
The CDC had this to say about vaccines:
- Everyone aged 6 years and older should get one updated Pfizer-BioNTech or Moderna COVID-19 vaccine to be up to date. People aged 65 years and older may get a second dose of updated Pfizer-BioNTech or Moderna Covid-19 vaccine. People who are moderately or severely immunocompromised may get additional doses of updated Pfizer-BioNTech or Moderna Covid-19 vaccine.
- Children aged 6 months–5 years may need multiple doses of Covid-19 vaccine to be up to date, including at least one dose of updated Pfizer-BioNTech or Moderna Covid-19 vaccine, depending on the number of doses they’ve previously received and their age.
- People aged 65 years and older may get one additional dose of Covid-19 vaccine four or more months after the first updated Covid-19 vaccine. People who are moderately or severely immunocompromised may get one additional dose of updated Covid-19 vaccine two or more months after the last updated ovid-19 vaccine. Talk to your healthcare provider about additional updated doses.
- Covid-19 vaccines available in the United States are effective at protecting people from getting seriously ill, being hospitalized, and dying. As with other vaccine-preventable diseases, you are best protected best from Covid-19 when you stay up to date with the recommended vaccinations.