In June, an advisory panel to the U.S. Food and Drug Administration (FDA) recommended that the next round of Covid-19 boosters be targeted against the Omicron XBB.1.5 subvariant. Pfizer, Moderna and Novavax will use the same platforms to manufacture the new boosters as they used for the original vaccines. These new boosters are scheduled to be available in October. However, this booster roll out will not be like prior years. The pandemic emergency authorization has expired, more than two thousand pharmacies have closed, and primary care practitioners are in short supply. I expect the vaccine waits will last into December. However, I also expect fewer people will be seeking vaccination, in the mistaken belief that “Covid is Over.”

Should you wait to get the new booster?

There are three factors at work:

  1. Virus keeps mutating
  2. Requiring new vaccines
  3. The high risk groups


In Favor of Waiting till fall…

  1. Better Match: The new version should be a better match against the versions of the virus that are circulating now and in the winter.
  2. Better Timing: We anticipate a Winter surge. Cold weather forces people indoors where Covid-19 is more easily transmitted. The past three Winters have seen Covid-19 cases surge in the November through February.
  3. Annual habit: The goal of Covid-19 vaccine preparation is longer duration. This year, there have been clinical trials combining Covid-19 with flu vaccine. There are several thousand people more than six months under observation. While the virus can always mutate, the odds-on seasonal vaccination keeps improving. Maybe this is the year.

Why you may want the existing Covid-19 booster now.

  1. You never got fully vaccinated in the first place. That you have managed to avoid Covid-19 to date despite not being fully vaccinated is most likely good planning or dumb luck. Getting vaccinated now to get at least some level of protection. Luck runs out.
  2. You are at significantly higher risk for getting severe Covid-19 and haven’t gotten a Covid-19 vaccine in over half a year. This would be the case if your immune system is substantially weakened from some combination of illness, medications, or advanced age. Your doctor can help make this call because it would entail weighing many different factors.
  3. You think you can avoid the virus. You can try to avoid any SARS-CoV-2 exposure over the next two months. It’s worked so far, right? The problem is people now believe that “Covid is Over” and no longer practice pandemic precautions. It will be more difficult to navigate safely.

What should you do?

Most people can wait until the updated XBB.1.5 Omicron subvariant version of the vaccine becomes available. The vaccine will not be available immediately everywhere. While waiting for the new booster, keep an N95 mask in your pocket, purse, or backpack for those times you find yourself in poorly ventilated indoor spaces with people you don’t know. Happy Hour crowds with people talking over each other are still problems. Testing for symptoms is wise; I have already treated two Covid-19 cases this month.

For those people who are under vaccinated or have poor immune systems, consult your doctor.  – Dr. K

by Dr James Edward Katz, MD MPH

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