San Francisco Chronicle, Monday, Sept. 5, 2022

Sunday, Sept. 11, 2022

It’s official. Both the FDA and the CDC have approved the first COVID vaccine to target specific Omicron variants BA.4 and BA.5 in addition to the original virus the vaccines were designed for in 2020. But we continue to see conflicting information about when to get the new vaccine, which the CDC press release calls, “updated COVID-19 boosters.” Note that these are actual boosters, designed to be given after the initial series of two doses.

Public authorities urge every one who’s eligible to get the new booster as soon as possible. “If you are eligible,” says CDC Director Dr. Rochelle Walensky, “there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.” The Biden administration has issued a plan to get Americans vaccinated this fall, recommending that Americans get their flu shot and COVID 19 shot at the same time. The White House FACT SHEET (see below) states that new vaccines can now be updated annually to target the current variant.

Expert opinion reported in the media is more nuanced. On NPR, Dr. Anthony Fauci recommended that we time our updated booster for two months after our last COVID shot or three months after having come down with COVID, as he did (and I did) in June, 2022. Dr. Michael Osterholm suggests waiting a little longer than two months after your last shot, but preferably not more than four months. As with the flu vaccine, local spread should be taken into account. It makes sense to get your shot sooner if the incidence of COVID is increasing in your area.

Reasonable to expect a winter surge in 2023? Graph from USA Facts, Sept. 6, 2022

A recent article in STAT points out that the flu vaccine loses effectiveness after about four months, so if you get it too early you may not be as resistant for the worst part of the flu season, which can last through March. There is no guarantee that COVID has a predictable seasonal occurrence, according to Dr. Osterholm. It’s true that we have experienced summer surges as well as winter surges, but, remembering the Delta surge of winter 2020 and the Omicron surge of winter 2021, I think it’s reasonable to expect a winter surge in 2022.

If you, like me, monitor multiple sources, the different vaccination timeframes can be confusing. While the White House report speculates that we may migrate to annual vaccinations for COVID as we do for influenza, there is no reason to believe that the COVID vaccination lasts a whole year or that the virus is limited to one season, like the flu. What we have seen is that new variants arise which are sometimes contagious enough to replace the old ones. Now, for the first time, we have a mechanism for modifying the vaccine to target new variants.

Variants replace variants in an ongoing process. CDC Data Tracker showing the last three months.

Still, there is much to be said for simplicity, according to Noel Brewer, who studies health behavior at the University of North Carolina (see the STAT article). If agonizing over the optimal timing discourages people from getting the vaccine at all, the whole effort turns counterproductive, especially when you consider the benefits of keeping incidence down in the population as a whole.

If you decide to get the flu and/ or the COVID vaccine, and you had a reaction to either one in the past, you might want to get them at separate times so that you have a better idea of what to expect. As for me, after all this reading and investigation, I might just get both at the same time in October.

Simplicity sounds good.

Today’s Notable Headlines

“Push to double up on Covid booster and flu shot may have a downside, experts caution,” STAT, Sept. 9, 2022. https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/

“New Boosters,” NPR with Judy Woodruff and Dr. Anthony Fauci, Sept. 2, 2022. https://www.youtube.com/watch?v=BNkCP_bvx04

“Osterholm: ‘Stay current’ on upcoming COVID booster shots,” MPR News, Sept. 1, 2022. https://www.mprnews.org/story/2022/09/01/osterholm-stay-current-on-upcoming-covid-booster-shots

“The new COVID booster could be the last you’ll need for a year, federal officials say,” NPR, Sept. 6, 2022. https://www.npr.org/sections/health-shots/2022/09/06/1121289835/the-new-covid-booster-could-be-the-last-youll-need-for-a-year-federal-officials-

“US COVID-19 cases and deaths by state,” USA Facts, Sept. 6, 2022. https://usafacts.org/visualizations/coronavirus-covid-19-spread-map

Additional Sources

“CDC Recommends the First Updated COVID-19 Booster,” CDC Media Statement, Sept. 1, 2022. https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html

“FACT SHEET: Biden Administration Outlines Plan to Get Americans an Updated COVID-⁠19 Vaccine Shot and Manage COVID-⁠19 this Fall,” The White House, Sept. 8, 2022. https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/08/fact-sheet-biden-administration-outlines-plan-to-get-americans-an-updated-covid-19-vaccine-shot-and-manage-covid-19-this-fall/

“Waning Vaccine Effectiveness Against Influenza-Associated Hospitalizations Among Adults, 2015–2016 to 2018–2019, United States Hospitalized Adult Influenza Vaccine Effectiveness Network,” Clinical Infectious Diseases, IDSA, HIVMA, Aug. 15, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499703/pdf/ciab045.pdf

Noel Brewer, PhD. Gillings School Directory, University of North Carolina. https://sph.unc.edu/adv_profile/noel-brewer-phd-2/

CDC Data Tracker, https://covid.cdc.gov/covid-data-tracker/#variant-proportions

Why am I doing this?

The coronavirus pandemic is a classic watershed historical event. People will be referring to “before the pandemic” or “after the pandemic” for decades to come. Since March 11, 2020, this blog has examined the modern pandemic experience, drawing on my background as a medical technologist, a historian, and an ordinary person living through an extraordinary world crisis. My sources, both primary and secondary, are documented with links for easy reference.

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