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What to know about the new COVID-19 booster

MARY LOUISE KELLY, HOST:

If it feels like a lot of people you know are getting COVID these days, you are not alone. Cases are on the rise in the U.S. So are hospitalizations and deaths. In better news, new COVID boosters have started to arrive at pharmacies this week. So should you get one? If so, when should you get it? And will you have to pay? Regina Barber from NPR's Short Wave podcast sat down with NPR health correspondents Rob Stein and Maria Godoy to answer those questions and more about the updated vaccines.

REGINA BARBER, BYLINE: OK, 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?

ROB STEIN, BYLINE: You know, the new boosters are targeted at a much more recent version of omicron than the previous shots. It's known as XBB1.5. So these new shots should be a much closer match to currently circulating variants than the earlier vaccines.

MARIA GODOY, BYLINE: Right. So when I talked to Andrew Pekosz - he's a virologist and immunologist at Johns Hopkins - he said, you know, the updated shots should be pretty protective.

ANDREW PEKOSZ: So when you get vaccinated, the vast majority of the antibodies your body generate should cross-react to the variants that are circulating right now.

STEIN: 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.

BARBER: And are these new boosters protective against the latest subvariant that experts are watching really closely - that's BA.2.86?

STEIN: Yeah. That's the good news. And it came as a...

BARBER: Good.

STEIN: ...Big relief. When it first emerged, BA.2.86 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 circulating variants. And the new COVID boosters should still provide protection. And Deepta Bhattacharya, a professor of immunology at the University of Arizona College of Medicine, says...

DEEPTA BHATTACHARYA: You know, there's every reason to expect that people will make decent antibodies against the variants that we know about right now.

BARBER: OK. So then, Maria, what's the guidance for who should get this vaccine?

GODOY: Well, the short answer is anyone 6 months and up. That's the recommendation the CDC endorsed this week. But experts like John Moore - he's an immunologist from Weill 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...

JOHN MOORE: 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.

STEIN: Now, 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 Pekosz, say it's OK 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.

PEKOSZ: 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.

GODOY: And, you know, people who are young and otherwise healthy, they're not considered to be at high risk of severe disease. But even so, a lot of the experts I spoke with say getting a booster is still a good idea. One of them is Dr. Preeti Malani. She's a professor of medicine at the University of Michigan.

PREETI MALANI: 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.

GODOY: 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.

BARBER: 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?

GODOY: 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. But, you know, there are an estimated 25 to 30 million other adults in the U.S. who don't have health insurance.

BARBER: Right.

GODOY: And if you're uninsured, the federal bridge access program will provide free vaccines through the end of 2024. The CDC's 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.

BARBER: Yeah.

GODOY: Now, for uninsured children, they can still get COVID vaccines and other immunizations for free under the Vaccines for Children program. Now, if you have to pay out of pocket for a vaccine, that could cost between $120 and $129 a shot. Those are...

BARBER: What?

GODOY: Yeah. That's what Pfizer, BioNTech and Moderna plan to charge for the shots. Those are the list prices, respectively.

BARBER: Wow. 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?

STEIN: 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. You might choose to maybe stagger them slightly because, you know, they can hurt, and you don't want to have painful arms at the same time. Or maybe you had a bad reaction to one in the past and you sort of want to, you know, give yourself a break. It's really up to you, and it's a personal decision. You can get them together, or you can stagger them, if you feel more comfortable with that.

GODOY: But most experts we talked to, like Pekosz, they recommended getting the vaccine for RSV separately.

PEKOSZ: 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.

GODOY: That's because, 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. There's no scientific reason to think they wouldn't be. But, you know, scientists like data.

BARBER: OK, noted. But how long will the latest booster protect people?

STEIN: You know, you'll get a boosted immunity within a couple of weeks, maybe two weeks after getting the shot, that could reduce your risk of coming down with COVID. And that protection will likely last for a few months.

GODOY: 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 waiting can be risky, especially if the numbers are all going up right now.

STEIN: 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...

ROBERT WACHTER: It will markedly increase your protection against getting very sick for about a year or so.

STEIN: Of course, exactly how long depends on a variety of factors, including your immune system, your overall health, your age and your prior exposures to both the vaccines and infections.

KELLY: That is NPR health correspondents Rob Stein and Maria Godoy speaking with the host of NPR's Short Wave science podcast, Regina Barber.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Regina G. Barber
Regina G. Barber is Short Wave's Scientist in Residence. She contributes original reporting on STEM and guest hosts the show.
Rob Stein is a correspondent and senior editor on NPR's science desk.
Maria Godoy is a senior science and health editor and correspondent with NPR News. Her reporting can be heard across NPR's news shows and podcasts. She is also one of the hosts of NPR's Life Kit.