Last year, the emergence of the highly transmissible omicron variant of the Covid-19 virus took many by surprise and led to a surge in cases that overwhelmed hospitals and led to deaths. Now we’re learning that omicrons are mutating to better evade the immune system.
Omicron-specific vaccines were approved by the FDA in August and are recommended by U.S. health officials for ages 5 and older. According to a recent KFF poll, only half of U.S. adults have heard much about these booster shots, and only a third say they’ve gotten one or plan to get one soon. In 2020 and 2021, cases of Covid increased between November and February in the United States.
While we don’t know for sure if we’ll see another wave this winter, here’s what you need to know about Covid and updated boosters to prepare.
1. Do I need a covid booster shot this fall?
If you have completed a primary vaccination series and are 50 or older, or if your immune system is compromised, get a Covid booster shot as soon as possible. Forty percent of deaths occur in people age 85 and older, and about 90% in people age 65 and older. Although people of all ages are being hospitalized with Covid, the age of those hospitalizations is increasing.
While still a minority in the US, unvaccinated people are still at the highest risk of dying from Covid. It is not too late to get vaccinated before this winter season. The United Kingdom, whose Covid wave has been spreading to the United States for almost a month, is starting to see another spike in cases.
If you’ve already received three or more Covid shots, are aged 12 to 49, and are not immunocompromised, your risk of hospitalization and death from the disease is significantly reduced, and additional boosters are unlikely to add much protection. .
However, getting a booster shot provides a “honeymoon” period of several months after vaccination, during which you are less likely to become infected and thus less likely to pass the virus on to others. If you’re visiting elderly, immunocompromised, or otherwise vulnerable family and friends over the winter holidays, you may want to get a booster two to four weeks in advance to better protect them against Covid.
You may have other reasons for wanting to avoid infection, such as not wanting to stay home from work because you or your child is sick with Covid. Even if you’re not hospitalized from Covid, lost wages or arranging backup childcare can be costly.
One major caveat to these recommendations: You should wait four to six months after your last Covid infection or vaccination before getting another shot. A dose given too soon will be less effective because antibodies from a previous infection or vaccination will still be circulating in your blood and will prevent your immune cells from being vaccinated and responding.
2. Should children be vaccinated even if they have covid?
Although children are at lower risk of severe Covid than adults, children’s risk is greater than many diseases already recognized as dangerous. Their risk should not be measured against the risk that Covid poses to other age groups but against the risk they face from other preventable diseases. In the first two years of the pandemic, Covid was the fourth or fifth leading cause of death in every five-year age bracket from birth to 19, killing around 1,500 children and teenagers. Other vaccine-preventable diseases such as chickenpox, rubella, and rotavirus killed an average of 20–50 children and adolescents before vaccines were available. By that measure, vaccinating children against Covid is a slam-dunk.
Children with Covid also benefit from vaccination. The vaccine reduces the risk of them being hospitalized and missing school days, while parents may have to stay home with them.
But it’s precisely because the risks to children are high that many parents worry about vaccinating their children. As recently as July, just after the FDA approved the Covid vaccine for children under 6 months of age, a KFF survey found that more than half of parents of children under 5 years of age said they thought the vaccines posed a greater risk to their child’s health than the disease. And in a recent survey, half said they had no plans to vaccinate their children. The rate of covid vaccination among children aged 12 to 17 years is 61% to 2% among children under 2 years of age.
Like influenza, Covid is most deadly to the very young and the elderly. Children are particularly at high risk. They are unlikely to have immunity to infection, and a small proportion have been vaccinated. Unless their mothers were vaccinated during pregnancy or got Covid during pregnancy – the latter of which poses a higher risk of death for the mother and premature birth of the baby – babies are likely not getting protective antibodies against Covid through breast milk. And because children have smaller airways and weaker coughs, they are more likely to have trouble breathing with any respiratory infection, even less severe than Covid.
3. Do I need a covid shot every year?
It depends on the goals set by public health officials to determine whether Covid becomes a seasonal virus like the flu, and how much the virus continues to mutate and evade humanity’s immune system.
If the goal of vaccination is to prevent serious illness, hospitalization, and death, many people will be well protected after their initial vaccination series and may not need additional shots. Public health officials may strongly recommend boosters for elderly and immunocompromised people while choosing whether to boost for low-risk individuals. If the goal of vaccination is to prevent infection and transmission, repeated boosters will be needed after completing the primary vaccination series and several times a year.
Influenza is a seasonal virus that typically causes infection and disease in the winter, but scientists don’t know if Covid will settle into a similar, predictable pattern. In the first three years of the pandemic, the United States experienced waves of infections in the summer. But if the Covid virus becomes a winter virus, public health officials may recommend an annual booster. The Centers for Disease Control and Prevention recommends that people 6 months and older get a flu shot every year, with very rare exceptions. However, as with the flu, public health officials may still place special emphasis on vaccinating high-risk people against Covid.
And the more the virus mutates, the more often public health officials can recommend boosting immunity to a new variant. Unfortunately, this year’s updated Omicron boosters don’t seem to offer significantly better protection than the original boosters. Scientists are working on variant-proof vaccines that can retain their potency in the face of new variants.
4. Are more covid variants on the way?
The Omicron variant exploded into an alphabet soup of subvariants. The BA.5 variant released earlier this year remains the dominant variant in the US, but the BA.4.6 Omicron subvariant may be poised to become dominant in the US. It now accounts for 14% of cases and is increasing. The BA.4.6 Omicron subvariant is superior to BA.5, which evades human immunity from both prior infection and vaccination.
In other parts of the world, BA.4.6 has been crossed BA.2.75 and BF.7 (descendants of BA.5), which account for less than 2% and 5% of US Covid cases, respectively. The BA.2.75.2 Omicron subvariant caused a wave of infections in South Asia in July and August. While the United States has yet to see much in the way of another variant descending from BA.5 – BQ.1.1 – it is growing just as quickly in other countries. UK, BelgiumAnd Denmark. The BA.2.75.2 and BQ.1.1 variants may be the most immune-evasive Omicron subvariants to date.
BA.4.6, BA.2.75.2, and BQ.1.1 All avoid Evushield, a monoclonal antibody used to prevent Covid in immunocompromised people who do not respond to vaccination. Although another drug, bebtelovimab, is active in the treatment of covid from BA.4.6 and BA.2.75.2, it is ineffective against BQ.1.1. Many scientists worry that EVUSHEELD will be useless by November or December. This is worrisome because the pipeline of new antiviral pills and monoclonal antibodies to treat Covid is drying up without guaranteed buyers to secure a market. In the past, the federal government has guaranteed that it will buy large quantities of vaccines, but funding for that program has not been increased by Congress.
Other Omicron subvariants on the horizon include BJ.1, BA.2.3.20, BN.1, and XBB, all descendants of BA.2.
It is difficult to predict whether one omicron subvariant or another variant will dominate this winter, and hospitalizations and deaths will again increase with US vaccination rates, and prior infection experience will vary around the world and even within the US, meaning that different versions of omicron are on different playing fields. Is it out.
While this may all sound scary, it’s important to remember that Covid booster shots can help overcome immune evasion by major omicron subvariants.
5. What about long covid?
Vaccination reduces the risk of prolonged covid, but by how much is not clear. Researchers don’t know if the only way to prevent long-term Covid is to prevent infection.
Although vaccines can reduce the risk of infection, few vaccines prevent all or nearly all infections. Additional measures – such as improving indoor air quality and wearing masks – will be needed to reduce the risk of infection. It is not yet known whether prompt treatment with currently available monoclonal antibodies and antiviral drugs such as paxlovide reduces the risk of developing prolonged covid.
6. Do I need a flu shot too?
The CDC recommends that anyone 6 months of age and older get an annual flu shot. The ideal time is late October or early November, before the winter holidays and usually before influenza hits the U.S. Like Covid shots, flu shots only provide a few months of immunity against infections and infections, but are better than the initial flu shot. No flu shots. Influenza has already spread to parts of the United States.
It’s especially important for people age 65 and older, pregnant women, people with chronic medical conditions, and children under 5 to get their annual flu shot because they are at the highest risk of hospitalization and death. Although young adults may be at low risk for severe flu, they may serve as vectors for influenza transmission to high-risk people in the community.
The high-dose flu vaccine, also called the “adjuvanted” flu vaccine, is recommended for people age 65 and older. Adjuvants strengthen the immune response of a vaccine.
It is safe to get vaccinated for Covid and flu at the same time, but you may experience more side effects such as fever, headache or body aches.
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