Should you get a booster shot now or later?

In September 2022, CDC recommended an updated COVID-19 booster shot for people starting at age 12 that targeted two variants of the coronavirus — the omicron variants BA.4 and BA.5. In April, CDC updated the recommendation to include children ages six months and older and "allowed" a second booster shot for people ages 65 and older, provided it had been at least four months since their last shot.

Meanwhile, a new booster shot is expected to arrive this fall, as both Pfizer and Moderna are developing shots aimed at targeting the omicron subvariant XBB 1.5, which is circulating now.

All of this has led many patients to ask whether they should get a booster shot now or wait for the updated shot coming this fall.

"The timing now is a little bit funny," said Abraar Karan, an infectious disease fellow at Stanford University. Currently, the dominant variant in the United States is EG.5, which is not targeted by the current booster nor will be targeted by the one coming this fall.

The pros of waiting for an updated booster

According to Karan, the fall booster will be "closer to that strain than the old shots."

But if you're concerned about rising COVID-19 hospitalizations and are considering getting a booster now, "I would discuss your individual situation with your doctor because it is complicated and for most people, it won't provide much benefit," Karan said.

Preeti Malani, an infectious disease specialist at the University of Michigan School of Medicine, said waiting to get the new booster shot "will provide a better match to the currently circulating variants."

"There might be some very specific scenarios under which we might recommend the bivalent vaccine right now instead of waiting for the newer formulation but for the majority of people, better to just wait and be careful about exposures" and use the familiar strategies like mask-wearing in a crowded indoor setting, Malani added.

If you've already had COVID-19, you're up to date on your shots, and you aren't high risk medically, you're likely fine to wait until the fall, Malani said.

Meanwhile, for children, Adam Ratner, an infectious disease specialist at NYU Langone Health, said parents should talk to their providers about children staying up to date on booster shots and advised that parents ensure their children are vaccinated with the new booster as soon as it's recommended for children.

'A bit nuanced'

However, Malani noted the decision "is a bit nuanced." For example, if you received all the recommended shots but it's been a long time since your last booster and you haven't had COVID-19 and are planning to head out on a trip, Malani said it's not unreasonable to get the current booster shot and then wait a few months to get the new one this fall.

Paul Offit, head of the Vaccine Education Center at Children's Hospital of Philadelphia, said people who haven't had the most recent booster shot and are high risk should talk to their doctor about getting a shot now. While the current booster shots don't match well to current variants, "it's holding up well against severe disease," he said.

Offit also advised that those at highest risk of contracting COVID-19 have tests on hand to use if they develop symptoms. Those in the highest risk category who develop symptoms should test within the first day or two and talk to their doctor to discuss a prescription for an antiviral treatment if their test is positive, Offit said.

Ratner added that families should have conversations about risk tolerance, adding that your family's risk tolerance may be different from other families if you have someone in your family who's immunocompromised or elderly. (Kritz, "Goats and Soda," NPR, 8/11)

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