Bivalent booster protects against omicron mutations ahead of winter

The new bivalent booster specifically targets the omicron variants of COVID-19 that have dominated the pandemic for much of the past year, but most Washington state residents have not yet rolled up their sleeves.

A chart on the Washington State Department of Health’s (DOH) website shows only 16% of eligible people in Washington have gotten the new shot.

Health officials say this is a risk as we get into the fall and winter. The past two COVID winters have seen cases spike as colder weather brings people indoors and new variants emerge.

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

If you are one of the many people who had COVID in the BA.5 wave over the summer, you may wonder if you should wait three months to get the booster to maximize your immunity from prior infection before getting your booster immunity. However, one healthcare professional believes the time of year we are in — just weeks before the busy holiday season — makes that a gamble.

“A lot of people ask about whether they should wait for 90 days after infection,” said Dr. Seth Cohen, Medical Director of Infection Prevention at the University of Washington Medical Center. “It’s probably more important to get boosted before holidays or before travel or before being in large gatherings, rather than just crossing your fingers and sticking it out for the full 90 days.”

What is certain, Cohen said, is that if you’ve already had coronavirus and have now gotten the booster, you’ll be wearing a suit of armor going into any fall or winter COVID wave.

“That immunity [from infection] lasts a month or two, but when they get that booster, they really get a very, very nice bump in their antibody levels,” he said. “And so people who have had prior infections and then get boosted are actually in a very good spot from an immune standpoint.”

At a media briefing on Thursday, Department of Health officials warned that we should prepare for another tough COVID winter, especially as healthcare facilities still struggle with staffing shortages.

“This is going to be a challenging time for the next few months, and let’s hope that, by the time spring comes back around and the weather gets better, we will be in a better place. But, of course, we can’t guarantee that,” State Health Secretary Umair Shah, Ph.D., said.

Already in October, New York City is seeing rising hospitalizations as the BQ subvariants of omicron take hold. The XBB omicron subvariant, being called the “nightmare variant” by some due to its contagiousness, is causing waves in other parts of the world.

However, Cohen said that people should not stress about every new variant and subvariant that comes out.

“There is always going to be a new variant. There’s just a lot of alphabet soup with all these newer ones,” Cohen said. “I think until we really start to see one particular lineage take off locally, it’s hard to keep track of all these and it may not be necessary.”

While it is difficult to predict with any certainty what variants we may see this winter, the good news is, the bivalent booster is likely to protect against any mutations that derive from omicron — which are currently the forms spreading.

“I would expect that for most offshoots related to omicron, there would be some cross-protection offered by these vaccines,” Cohen said. “Though, of course, there may be some variant in the future that could escape some of the immunity.”

If you are scheduling your booster now, it is always good to plan for a day or two of side effects following the shot. Those effects are usually mild, such as body aches, fatigue, a low fever, and soreness at the injection site. Cohen said having been previously infected with coronavirus does not necessarily mean you will see stronger side effects from the booster.

If you start experiencing any of these side effects after your booster, it is perfectly fine to take an over-the-counter pain medication like Advil or Tylenol.

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“I usually tell people to plan on, the 24 hours following your booster, you may feel like your immune system is acting up, and you may just feel a little bit off,” Cohen said. “And that’s completely normal. But I think it’s probably good to plan for that just in case.”

And Marissa Baker, professor at UW’s Department of Environmental and Occupational Health Sciences, said if you feel crummy after your shot, you should feel empowered to take a day off work.

“Really, you are doing your coworkers a favor by being vaccinated, you are doing your employer a favor,” she said. “It’s better to take one sick day upfront than it is to need to take 10 or more when you get the flu or COVID.”

She said that it might be a good idea for workplaces that offer flu and COVID vaccine clinics to spread their clinics out across a few days, so that a whole group of employees does not have to call out sick on the same day. However, she noted, better to do without that group of employees for one day than for a week or more if there is a workplace COVID outbreak.

“You’re preventing subsequent cases of flu or COVID-19, which could take folks out of the workplace for a week or multiple weeks,” she said.

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