Boost Now or Wait for New Vaccine? Many Wonder How to Face COVID’s Next Wave

Gwyneth Paige didn’t want to get vaccinated against covid-19 at first. With her health issues — hypertension, fibromyalgia, asthma — she wanted to see how other people fared after the shots. Her mother was diagnosed with colon cancer.

“At that point, I didn’t care if the vaccine killed me,” she said. “To be with my mother throughout her journey, I had to have the vaccination.”

Paige, 56, lives in Detroit and has received three doses. This leaves Paige with one less booster federal health recommendations.

Like Paige, who said she doesn’t currently plan to get another booster, some Americans seem comfortable with the protection of three shots. Others might wonder what to do. Boost again with one of the original vaccines now, or wait months to get promised new formulations to combat the highly contagious Omicron subvariants BA.4 and BA.5.

The rapidly evolving virus has created a dilemma for the public and a communication challenge to health officials.

“What we’re seeing now is a little bit of an information void that is not helping people make the right decision,” said Dr. Carlos del Rio, a professor of infectious diseases at the Emory University School of Medicine.

Del Rio said the public isn’t hearing enough about the vaccines’ value in preventing severe disease, even if they don’t stop all infections. Del Rio said that each new covid variant forces health officials and advocates to change their messaging, which can lead to mistrust in the public.

About 70% of Americans age 50 and older who got a first booster shot — and nearly as many of those 65 and older — haven’t received their second covid booster dose, according to dataFrom the Centers for Disease Control and Prevention. The agency recommends two booster shot after a primary vaccination series for adults 50 years and older, and younger people with compromised immune system. Last week, multiple news outletsBiden’s administration is working on a plan that would allow all adults to receive second covid boosters.

Officials are concerned about the rapid spread of BA.4 (and BA.5), which can easily spread and can escape immune protection from vaccinations or previous infection. A recent study published in NatureIt was found that BA.5 was four-times more resistant to the mRNA vaccines currently available than earlier omicron subvariants.

Different views from leading vaccine scientists have made it difficult for consistent messaging to be established. Although physicians like del Rio and Dr. Peter Hotez of Baylor College of Medicine see the value in getting a second booster, Dr. Paul Offit, a member of the FDA’s vaccine advisory committee, is skeptical it’s needed by anyone but seniors and people who are immunocompromised.

“When experts have different views based on the same science, why are we surprised that getting the message right is confusing?” said Dr. Bruce Gellin, chief of global public health strategy at the Rockefeller Foundation and Offit’s colleague on the FDA panel.

Janet Perrin, 70, of Houston hasn’t gotten her second booster for scheduling and convenience reasons and said she’ll look for information about a variant-targeted dose from sources she trusts on social media. “I haven’t found a consistent guiding voice from the CDC,” she said, and the agency’s statements sound like “a political word salad.”

The Biden administration released the following information on July 12. its planto manage the BA.5 Subvariant, which it warned would have greatest impact in areas with lower vaccine coverage. This strategy will make it easier for people access to testing, vaccines, boosters, and antiviral treatment.

During the first White House covid briefing in nearly three weeks, the message from top federal health officials was clear: Don’t wait for an omicron-tailored shot. “There are many people who are at high risk right now, and waiting until October, November for their boost — when in fact their risk is in the moment — is not a good plan,” said Dr. Rochelle Walensky, head of the CDC.

Concerns about the BA.5 Subvariant Growing the FDA on June 30 recommendedModerna and Pfizer BioNTech, drugmakers, get to work creating a bivalent vaccine. This will combine the current version with a formula that targets the new strains.

Both companies claim they can make available to the U.S. millions in doses of the reformulated shots by October. Experts suggest that this deadline could slip by a few more months because of the unexpected issues that plague vaccine manufacturing.

“I think that we have all been asking that same question,” said Dr. Kathryn Edwards, scientific director of the Vanderbilt Vaccine Research Program. “What’s the benefit of getting another booster now when what will be coming out in the fall is a bivalent vaccine and you will be getting BA.4/5, which is currently circulating? Although whether it will be circulating in the fall is another question.”

The FDA on July 13 authorized a fourth covid vaccine, made by Novavax, but only for people who haven’t been vaccinated yet. Many scientists believe that the Novavax shot could act as a booster for those who have been vaccinated with mRNA vaccines from Moderna and Pfizer-BioNTech. This is because of its unique design, which could increase the immune response to coronaviruses. Gellin, from the Rockefeller Foundation, stated that few studies have evaluated mix-and-match vaccination methods.

Edwards and her husband received covid in January. She was able to get a second booster last month because she thought it might have been necessary for a Canadian business trip. She stated that she felt a fourth shot was a waste and not very risky. She told her husband — a healthy septuagenarian — to wait for the BA.4/5 version.

People at very high risk for covid complications might want to go ahead and get a fourth dose, Edwards said, with the hope that it will temporarily prevent severe disease “while you wait for BA.4/5.”

Because of the fact that the original strain is known to be fatal, the components of the omicron vaccinations will target it.

Dr. David Brett Major, an infectious diseases specialist at the University of Nebraska, stated that these components will help keep older strains of virus under control. That’s important, he said, because too much tailoring of vaccines to fight emerging variants could allow older strains of the coronavirus to resurface.

Brett-Major said messages about the value of the tailored shots will need to come from trusted, local sources — not just top federal health officials.

“Access happens locally,” he said. “If your local systems are not messaging and promoting and enabling access, it’s really problematic.”

Some Americans are still pondering when or whether to get their second boosters. Experts say that many people had already seen the pandemic years ago and were not aware of the current outbreak.

Dr. Georges Benjamin, executive director of the American Public Health Association, said he doesn’t expect to see the public’s level of interest in the vaccine change much even as new boosters are released and eligibility expands. Parts of the country with high vaccine coverage will remain relatively insulated from new variants that emerge, he said, while regions with low vaccine acceptance could be set for a “rude awakening.”

Scientists aren’t sure how to adapt to an ever-changing virus.

“Nothing is simple with covid, is it? It’s just whack-a-mole,” said Edwards. “This morning I read about a new variant in India. Maybe it’ll be a nothingburger, but — who knows? — maybe something big, and then we’ll wonder, ‘Why did we change the vaccine strain to BA.4/5?’”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. With Policy Analysis and Polling, KHNOne of the three main operating programs at KFF(Kaiser Family Foundation). KFF is an endowed, nonprofit organization that provides information on health issues for the nation.