Short Wave - The Latest COVID Booster Is Here. Should You Get It?

Episode Date: September 15, 2023

This week, the Food and Drug Administration approved new COVID vaccines this week. It comes at a time when COVID cases, hospitalizations and deaths are on the rise. It's also the first time that the federal government is not paying for the vaccines. Given this confluence of events, we huddled with our colleagues, intrepid health correspondents Maria Godoy and Rob Stein. They gave us the lowdown on the CDC's recommendations for who should get it, how protective the booster is, how to access it regardless of your insurance status—and even how time this booster with other vaccines that may be on your radar.Check out Rob and Maria's full COVID booster Q&A here. Have health question? Email us at [e-mail] pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey, short wavers, Regina Barber here, with news that there's a new COVID vaccine on its way to pharmacies. The FDA approved the shots this week and a day later, the CDC weighed in on who should get it. So we figured it's time to call up our colleagues, Rob Stein. Hey, Regina. And Maria Gauda. Hey, Chika. And we're here to talk all things booster vaccines, especially this booster.

It was initially developed with the Omicrodod's subvariant, X-Bron. B-B-15 in mind, and in the middle of developing this vaccine, a new sub-variant of Omicron emerged. B.A. 286. Right. And scientists were watching B.A. 286 closely when it popped up in August and continue to keep an eye on it because it contains more than 30 mutations on the spike protein the virus uses to infect cells, which is a level of mutation on par with the original

omicron variant that caused a massive surge. And there has been a surge recently. Yep, hospitalizations have jumped. Some hospitals and schools have reinstated mask requirements or at least actively encourage people to wear them again. But the experts that Rob and I have spoken to have said, so far, this latest sub-variant is not better at evading vaccines. And with that, let's cut to the chase.

Today on the show, Robin Maria give us a masterclass on all things COVID boosters. We talk about how protective the latest booster is. When to get it, regardless of your age or how healthy you are. And how to take a holistic look at your vaccine schedule between COVID, the flu, and RSV shots. You're listening to Shortwave, the science podcast from NPR. Okay, Rob, we know coronaviruses mutate a lot. And since this booster was developed, new Omicron subvariants have emerged. How good is this new booster in protecting against the current field of variants?

You know, the new boosters are targeted at a much more recent version of Omicron than the previous shots. It's known as XBB15, so these new shots should be a much closer match to currently circulating variants than the earlier vaccines. Right. So when I talk to Andrew Peckosch, he's a virologist and immunologist at Johns Hopkins, he said, you know, the updated shots should be pretty protective. And when you get vaccinated, the vast majority of the antibodies your body generate should cross react to the variants that are circulating right now. And that's exactly what laboratory studies have found. that the new shots generate neutralizing antibodies that look like they would do a good job of helping fight off the variants that are circulating now. And are these new boosters protective against the latest sub-variant that experts are watching really closely? That's BA-286. Yeah, that's the good news

that came as a big relief. When it first emerged, B-8-286 set off alarms because it had so many mutations. But a spate of recent lab studies suggest it is no better at evading immunity than other circumstances. variants, and the new COVID boosters should still provide protection. And deep debonitaria, a professor of immunology at the University of Arizona College of Medicine says, You know, there's every reason to expect that people will make decent antibodies against the variants that we know about right now. That's good to know. So for me, the COVID booster is kind of starting to feel like annual flu shots. Yeah, exactly. So the flu vaccine is updated every year to target the viruses that are likely to be circulating in the fall and winter. So in the same way,

officials say getting an updated COVID shot can help bolster people's waning immunity as we head into respiratory virus season. Like Rob said earlier, these new boosters are a much closer match to currently circulating variants than prior COVID vaccines. Okay, so then, Maria, what's the guidance for who should get this vaccine? Well, the short answer is anyone six months and up. That's the recommendation the CDC endorsed this week. But experts like John Moore, he's an immunologist, from Wild Cornell Medical College, they agree that the booster is most critical for people at higher risk of severe disease from COVID.

You know, that's people age 65 and older, or if you're immunocompromised or... If you are in poor health and have an acknowledged pre-existing condition that puts you at risk of severe COVID, then you are a priority group for getting an additional round of protection from a vaccine booster.

Now, Gina, if you're not overresteen or 65 and are pretty healthy. That means you're probably not part of one of those critical groups of people. So it's a bit more of a personal choice, really. Yeah, the last time I talked to my doc, I'm in that lower risk category. What should I consider when making the decision to get the booster or not? So one thing to consider is how recently you got the last booster or COVID for that matter. The CDC says people who've had a recent infection may wait three months to get a booster. But, you know, many of the people Maria and I spoke to, like Peckush, say it's okay to wait longer if you're at low risk, and maybe it actually could be a good idea to wait maybe four to six months to get the best bang for the buck from the new shots.

If you've been infected less than six months ago, you probably don't need the vaccine right now because you've got some strong immunity from that infection. And, you know, people who are young and otherwise healthy, they're not considered to be at high risk of severe. or disease. But even so, a lot of the experts I spoke with, say, getting a booster is still a good idea. So one of them is Dr. Preeti Malani. She's a professor of medicine at the University of Michigan. From my standpoint, I feel that COVID boosters are a good thing for everyone. And the reasons are multiple. One of them is that even if you're not preventing illness, you're going to have milder illness in general. And if you get boosted, it may reduce the chance that you'll pass on the virus to someone vulnerable around you, you know, maybe someone in your own family. And while this

virus causes mild illness for many people, it is still killing others. Yeah, that's a really important point. And it's a big reason for a lot of people, especially if you know you're going to be around vulnerable people. And also, as CDC epidemiologist noted at Tuesday's meeting, there's accumulating evidence that vaccination can also reduce the risk of long COVID among both children and adults. Okay, noted. But how long will the latest booster protect people? That window for boosted immunity starts about two weeks after getting this shot. Now, some people will try to like maximize it. For instance, they want to get more bang for the buck for their protection by, say, waiting until a couple of weeks before they're planning to do something big, like go on vacation or gather with family

for the holidays. But some experts say weeding can be risky, especially if the numbers are all going up right now. But regardless of what date you get the booster, when you do get it, it will give you a boost in protection against severe disease. You know, the kind of scary symptoms that can send you to the hospital, the protection against that sort of thing should last longer. Dr. Robert Wachter, professor and chair of the Department of Medicine at the University of California, San Francisco estimates it will markedly increase your protection against getting very sick for about a year or so. Of course, exactly how long depends on a variety of factors, including your immune system, your health, your age, and your prior exposures to both vaccines and infections.

And for the first time, the federal government isn't paying for the boosters. Can you still get one for free? Will insurance cover it? Yeah, if you're insured, your plan should cover it. That's according to Jennifer Kates. She's a policy analyst I spoke to at Kaiser Family Foundation. Although if you get the shot from a provider who's out of your insurance network, there may be a cost, as there are with other things you get out of network. But, you know, there are an estimated 25 to 30 million other adults in the U.S. who don't have health insurance. Right. And if you're uninsured, the Federal Bridge Access Program will provide free vaccines through the end of 2024. The The CDC vaccine.gov website has information on where to go to get the no-cost shots.

Kate says it's unclear if the program will be able to accommodate every uninsured person who needs a free shot, but it's good to see the government trying to fill in those gaps. Right. Now, uninsured children can still get COVID vaccines and other immunizations for free under the Vaccines for Children program. Paying out of pocket for a vaccine could cost between $120 and $129 a shot. those are the list prices for the Pfizer-Biotech and Moderna vaccines, respectively. Ouch. Ouch, indeed. Yeah, it's not cheap.

Now, COVID doesn't operate in a vacuum. There's also the flu virus and RSV lurking around out there, for example. And RSV is a common respiratory virus. It usually causes mild illness, but it can be serious for young children and older adults. So if people are looking to get multiple shots, can they get, say, the COVID booster at the same time as the flu vaccine or other vaccines? Yeah, the CDC says adults can get a flu vaccine and a COVID shot at the same visit. In fact, they might want to do that just, you know, because it'd be more convenient. Though if you're Peter Hotez, who heads the National School of Tropical Medicine at the Baylor College of Medicine,

while you agree with this guidance in principle, you have to get both XPB and flu vaccine at the same time, it should be absolutely fine. You might choose to maybe stagger them slightly because they can hurt and you don't want to have, you know, painful arms at the same time, or maybe you had a bad reaction to one in the past and you sort of want to give yourself a break. It's really up to you. And it's that personal decision. You can get them together or you can stagger them if you feel more comfortable with that. But most experts we talk to, like Peckosch, they recommended getting the vaccine for RSV separately. So I think the recommendation would be if you're going in, get your flu and COVID shot.

If you're eligible for RSV, maybe space that out by a week or two. theoretically, it should be fine to get all three shots at once, but since the RSV shot is new this year, there's just no data to show that getting flu, COVID, and RSV all at once is fine. But there's no scientific reason to think they wouldn't be, but, you know, scientists like data. We do, we do. Okay, so that's about the timing of when to get these vaccines for adults. But what about my kid? She's a teenager or even younger kids. Should they even be getting these vaccines?

So the CDC recommendation is for everyone six months and up to get it, and these vaccines are okayed for those groups. Now, the fact is that kids are at much, much lower risk of getting really sick or dying from COVID, which is good news, but it still does happen, which is, you know, one reason why these vaccines were cleared for everyone six months and up. Okay, so I'm really glad we took this deep dive into the vaccine. But as we're talking about all this, I'm also wondering, are there? other precautions people should be taking right now, like in addition to the booster? Like, I'm seeing a lot of people bringing their masks back out. Yeah, no, it's funny. I went to the grocery store last night. And for the first time in ages, like half the people in the store were masked. I didn't see that in so long. I mean, I think it depends on a lot of things, personal factors,

like, you know, how strong your immune system is and you know your health history best, so you know your risk better than anybody else. If you can't afford to get sick, don't want to get sick, because even getting it for several days stinks, you know, it's no fun, then, yeah, mask up. But, you know, it is a personal choice. Thank you both for this very thorough look at the current COVID and vaccine landscape. Thank you so much. Oh, it's my pleasure. Sure, anytime.

This episode was produced by Burleigh McHoy, Alejandra Marquez Hanse, and Claire Marie Schneider. It was edited by managing producer Rebecca Ramirez and Jane Greenhalsh. It was fact-checked by Anil Oza. Maggie Luthor was the audio engineer. Beth Donovan is our senior director and Anya Grenman is our senior vice president of programming. I'm Regina Barber. Thank you, as always, for listening to Shortwave, the science podcast from NPR.