A retooled single-dose Covid “booster” shot is expected to hit pharmacy shelves just as cold and flu season is ramping up. This week, the Food and Drug Administration (FDA) authorized new shots for emergency use, and a panel of experts at the Centers for Disease Control and Prevention (CDC) recommended nearly everyone in the US get one.
But just how soon should people in the US head to their local pharmacies for the new vaccine? And, after so many people have already been vaccinated or sickened by Covid, how urgent is it to get another dose? Below, we fill in details of the agencies’ latest recommendations.
What exactly did the FDA authorize?
The FDA authorized updated versions of the Pfizer and Moderna mRNA vaccines. As Covid continues to circulate, the virus mutates, a lot like the influenza virus. For that reason, pharmaceutical companies have developed a booster to target one of the most widely circulating strains of Covid-19 this season, the XBB. 1.5 variant.
This fall is the first time adults will be able to get the flu, respiratory syncytial (RSV) and Covid-19 shots, all of which protect against commonly circulating respiratory illnesses. This year’s Covid booster is targeted to the XBB. 1.5 variant.
Who should get the new booster shot?
When the FDA authorizes a new vaccine, the CDC makes recommendations on who should get them and when. In short, the agency recommended this booster for everyone older than six months – with a couple of caveats.
Anyone who recently had Covid-19 can wait three months to get the updated booster, and anyone who was recently boosted should wait two months before getting the new shot. The agency’s expert panel placed special emphasis on some groups getting the new shot.
“The most important are those at greatest risk for severe illness,” said Dr Peter Hotez, a vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas.
The people at highest risk are those older than 65; with health conditions such as obesity, diabetes, high blood pressure, chronic lung or heart disease; and those who may be immune-compromised, such as those on immune suppressant medication and people who are pregnant.
If I am already vaccinated or had Covid, why should I get another shot?
Even though most people in the US will have some immunity to Covid-19 through prior infection or vaccination, the likelihood of catching Covid again increases over time as new variants circulate and immunity from prior vaccines wanes.
The agencies hope that providing updated vaccines will help prevent serious illness, the sort that might lead someone to go to the hospital or even lead to death. In addition, data shows getting a Covid-19 vaccine can help reduce the chance of getting so-called long Covid, in which symptoms of fatigue and fog can drag on for months. As a result, the agencies have recommended broad swaths of the American public get the shots.
“I’ll be first in line,” to get the updated shot, said Hotez, who supports the CDC’s broad recommendation. “Even though the amount of hospitalizations will not come anywhere close” to the waves of 2021 and 2022. “In terms of making an individual health choice, I think there’s still vulnerability there.”
How long does immunity from the new shot last?
Peak protection should come a couple weeks after the dose, and last a few months. After that time, immunity declines, either because of new circulating variants or because of waning vaccine efficacy (according to materials from this week’s meetings, it’s difficult for experts to parse the exact answers in the available data).
Do all experts agree with the CDC’s recommendation?
Although a panel of CDC experts voted in favor of the new recommendations, not all experts agree on the strategy. Dr Paul Offit, a virology and immunology expert at the Children’s Hospital of Philadelphia and a member of the FDA’s expert panel on vaccines, argues the government should focus on the nation’s most vulnerable groups.
In 2022, just 43% of people older than 65 – a group at high risk of hospitalization from the disease – got a booster dose. That group in particular should be the focus of a booster campaign, he said.
“My feeling on this, and it’s a feeling that is shared by health advisers in many other countries, is the goal of this vaccine is to prevent serious illness,” said Offit. “Then, the question becomes who is most likely to suffer serious illness? Who is at greatest risk?”
The people at highest risk are those older than 75, with underlying health conditions (such as those mentioned above) and the immune-compromised, according to CDC data. With narrow exceptions, such as nursing home workers and those living with the immune-compromised, the “best strategy is to target those of greatest risk”, said Offit.
Will I have to pay for the new vaccine?
Probably not. Health insurance will cover the cost of the booster dose for most Americans. For those who do not have health insurance – about 27 million Americans, according to the CDC – the federal Bridge Access Program will cover the cost of shots through 2024. For those who pay cash, Pfizer and Moderna have set the list price of their vaccines at $120 and $129 respectively.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.