Fall boosters coming soon – now what? UW doctor answers FAQs

The FDA has authorized fall COVID-19 boosters, and now the shots have just received the CDC’s signoff before they can get in the pipeline for widespread distribution. It is expected that they will hit pharmacies within days.

The booster shots will be a mix of the original form of COVID-19, along with omicron subvariants. This allows them to target omicron — especially BA.5, the dominant strain in the U.S. right now — in a way that the previous shots, which were made before omicron came on the scene, were not as able to do. While the previous shots still provide excellent protection against severe illness, these will offer a better shield against catching the sickness in the first place.

“We think it’s really going to provide much better protection,” said Dr. Seth Cohen, medical director of Infection Prevention at UW Medicine.

BA.5 most contagious strain yet, second booster on the way

But if you are one of the many people who just had BA.5 in the summer wave, you may be wondering if you can hold off on the booster for a while. After all, you have some natural immunity now, and there is no major surge coming on yet. Should you let your natural immunity see you through the next few months, and then get the booster as that natural immunity wanes, in anticipation of another winter surge?

Cohen cautions against that approach.

“It’s very hard to time COVID — sort of like timing the stock market,” he said. “And the challenge with waiting is, by the time you feel like you’re in an outbreak, you could be one of those vulnerable patients or you may have had it already.”

And if you do indeed take that risky gamble, end up waiting, too long, and then get caught in a wave without that latest shot, it will take about another two weeks before the booster is able to give you its full protection.

“We really don’t know when that next wave is going to come,” Cohen said. “And, just remembering that it takes a few weeks for boosting to really kick in after you get it, I think it makes sense for most people to go out and get the vaccine, hopefully, sometime in the next couple of months.”

This also goes for those who got the previous boosters over the summer, as the new boosters will offer a different kind of protection, more specific to omicron.

Due to limited supply, it is likely that only older and immuno-compromised people will be able to get the boosters at first, similar to how previous shots were prioritized. Cohen said young, healthy people make up the one group that can afford to wait a little longer for boosters.

“For people who are young, healthy, who otherwise have low risk for complications, if community case rates remain low, it may be okay to not rush out and be the first person to get boosted,” he said.

Boosters and herd immunity?

With the boosters right around the corner, with the majority of Americans already having the previous vaccines, and with most Americans also having COVID — especially after the ultra-contagious BA.5 omicron subvariant sparked a summer wave — is it reasonable to hope we might achieve herd immunity?

Not so fast, Cohen said — though he noted that we do already likely have some level of herd immunity.

“I do think herd immunity is probably responsible in many ways for this most recent variant to feel more mild, because a lot of people have pre-existing immunity, and thankfully, they’re mostly protected against developing severe disease,” he said.

But he explained that amount of herd immunity is not enough to stomp out the virus yet — especially if another new variant comes along this fall.

“I have concerns about the fall,” he said. “It may be that we see a lot of BA.5 or related variant — or it may be that we see a completely different strain or variant that we’re less prepared for.”

While the boosters should offer some protection against future subvariants of omicron, all bets are off if another strain, separate from omicron, begins circulating.

“The biggest concerns from the medical community would be if there’s a completely new variant that’s not omicron, that’s something else that might have a better ability to escape our immune system or our level of herd immunity that we currently have,” Cohen said.

The best way to prepare, he said, is to get the new fall boosters when they come out.

“Getting this new booster in the fall is going to be the best way to make sure that there are no major disruptions to schools, daycares, hospitals, and all the others services we rely on,” he said.

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