Late COVID Booster

August 2, 2023 1:09 PM

I didn’t get the bivalent COVID booster last year for pregnancy-related reasons. Now that I’m emerging from the newborn fog and preparing to go back to work, I was going to get the shot next week. However, I’ve learned there will be a new monovalent booster this fall targeting a more recent variant. What should I do?

My inclination is to go ahead with the currently available bivalent shot AND get the new booster later for broadest antibody coverage. Are there any reasons I can’t/shouldn’t do that (e.g., minimum number of months between shots)?

Bonus question: Any idea what combination of shots I should expect or advocate for when my infant is old enough to be vaccinated in a couple months?

YANAD / YANMD. Thanks!

posted by findabair to Health & Fitness (19 answers total)

I would ask my doctor for their advice. If I was intent on getting a booster, seems to me that your plan, to get both, makes sense. I too am not a doctor, but I don't think it can hurt. The one concern I would have is if the child was breast feeding. I would follow the recommendation of my team of doctors on what to do if child is breastfeeding.
posted by JohnnyGunn at 1:13 PM on August 2, 2023

Best answer: I had to make a similar decision (get the booster as soon as I'm 6 months past my last one, i.e., next week, or wait for the new XBB [or whatever] booster) and decided to get the shot that's available as soon as I'm eligible. "This fall" could technically be any time before December 20, and I'm both high-risk as defined by Ontario's paxlovid-eligibility guidelines and a front-line education worker. I decided that there was no sense putting myself at greater risk for the next up-to-4.5 months in order to hold out for a maybe-better-maybe-not updated vaccine.

If you're nursing your baby, that's more reason to get boosted now, because there's some evidence that antibodies are passed to the baby through milk and will give your baby a bit of protection before they are eligible for their own vaccination sequence.
posted by heatherlogan at 1:21 PM on August 2, 2023 [11 favorites]

There's a surge happening as we speak and it's expected to get worse as kids go back to school. In your place, I'd get the available booster ASAP and update when the new one arrives.
posted by quince at 1:26 PM on August 2, 2023 [10 favorites]

I got a booster yesterday, one day past my six month mark from the last one. The advice from the nurse was very much to wait a couple of months to have maximum coverage during the fall infection season.

That makes sense, but I chose to go ahead with the booster anyway, despite their recommendation. I was already in the chair waiting, and to give that up for an appointment [some other time down the road], who knows what the situation will be like then, or even if I would remember. Trying to game out my maximum coverage -- I'm not up for that.

The recommendation was to wait. I chose constant coverage instead -- getting shots as soon as available has worked for me so far (as far as I know). For me, I don't think there was a wrong answer, but your newborn changes things and your doctor can give you the best answer for you.
posted by Capt. Renault at 1:29 PM on August 2, 2023 [2 favorites]

I'm waiting because the recommendation is usually at least 4 months between them and they may come out by the end of this month. But check with your doctor (if they are up to date on any of this info.) My concern is not being able to get the updated one because it's too soon to the last one. (ETA my last was Oct.) YMMV.

Everyone should wear an N95/KN95 around others, regardless of your vax status.
posted by Crystalinne at 1:32 PM on August 2, 2023 [2 favorites]

I wanted to add that, at least in Ontario, the recommended minimum interval between shots is 3 months (though up to this July they had been recommending a 6-month interval for people who aren't high-risk).
posted by heatherlogan at 1:32 PM on August 2, 2023

Thanks for asking this question, I was going to post something very similar myself. I have international travel coming up in about 2.5 weeks, and I was thinking of getting my booster now before we fly (my most recent booster was 12 months ago). I'm not sure if it will even help? Does it work that way?

Hope you don't mind me piggybacking on your post, OP. :)
posted by MiraK at 1:41 PM on August 2, 2023

We did this last year, got regular shots in the spring and early summer and then got the bivalent one in September because we took a trip in October.

Mira, I believe that immunity builds up over something like 10-14 days after the shot, so yes now is a good time. Even if it takes a bit longer than that, it is still working as soon as you get the shot, just not at 100 percent effectiveness.
posted by soelo at 1:54 PM on August 2, 2023 [2 favorites]

Ontario guidance has changed. It now reads:

Effective July 7, 2023, individuals aged five years and older should consider delaying their COVID-19 booster dose until Fall 2023. Receiving a booster dose in the fall, as respiratory season commences, will maximize protection against COVID-19 outcomes when peak circulation of the virus is expected along with other respiratory viruses.

The decision to receive a booster dose prior to Fall 2023 may be appropriate for certain individuals based on their unique health status and personal situation. Individuals are encouraged to speak with a health care provider to determine if this makes sense for you.

Recommendations for fall booster doses will be available closer to Fall 2023.
posted by yyz at 2:22 PM on August 2, 2023 [1 favorite]

Please consider the Novavax shot for yourself. It may be hard to find, but the extra legwork could be worthwhile.

It's currently only available in ages 12+ but I don't know if that's just because the trial in smaller kids is running a bit late or was unsuccessful.

Thread that links many studies, with explanations:
https://nitter.net/SocialFuzzer/status/1631400203629785088#m

An argument in favor of Novavax, with anecdotes in comments:
https://donford.substack.com/p/the-benefits-of-novavax-explained

If my own anecdote is helpful, I had achy, feverish reactions to Pfizer and Moderna, but not the slightest issue at all with Novavax as a booster. I was very much exposed to the virus about 2 weeks after my Novavax. Someone I trusted had not been as careful as they thought, and everyone else I know of in this exposure had all been vaxxed and boosted with mrna only, all tested positive, and were bedridden for days. I was the tiniest bit sniffly (it was also allergy season), and tested daily, but I never tested positive.
posted by Former Congressional Representative Lenny Lemming at 5:00 PM on August 2, 2023 [2 favorites]

I would absolutely go ahead and get the current bivalent booster, especially as it is unclear whether the guidelines for the next booster will be open for all.

An expert has said he “expects that the CDC will recommend the new monovalent XBB.1.5 vaccine for groups at the greatest risk for severe disease, reflected in continuing hospitalizations for COVID-19. Those groups likely would include people who are 75 years or older, people with severely compromised immune systems, and pregnant people,” according to the JAMA Medical Journal, via the excellent Pandemic Roundup from Violet Blue.
posted by KatlaDragon at 7:15 PM on August 2, 2023 [1 favorite]

Definitely ask your doctor. It may depend on where you live - since it sounds like you have a choice, getting a bivalent now and the next booster in 3-4 months if allowed where you live would still give you a booster in late fall/early winter, which would still be useful for the fall/winter respiratory illness season in the northern hemisphere.

Where I live, they seem to have dropped down to only allowing one booster per year, in the fall, for everyone not considered high risk. Hopefully the roll-out of this year’s fall boosters won’t be too delayed/will actually happen! And they set the minimum time between boosters as some number of days that is closer to six months. If that is more like your situation, maybe waiting a month or so would be better? In any case, your doctor would likely have good advice.
posted by eviemath at 8:14 PM on August 2, 2023

I went through almost the exact same decision process for the same reasons and got the bivalent booster a couple of days ago. The nurse who gave me the shot listened to my explanation and gave me Pfizer rather than Moderna, so that I could get the next shot in three months rather than four if an update for the new variant becomes available. Not sure if your local health authorities are following the same guidelines but it might be worth asking about.
posted by rpfields at 8:40 PM on August 2, 2023 [2 favorites]

Best answer: Epidemiologist/vaccine developer here. The answer is always 'get what's available to you now.' In a risk assessment and mitigation sense, the idea is that any hedging of bets is an unneccessary calculation. Your individual potential level of protection doesn't matter in population dynamics. What matters is the number of doses administered throughout the population.

This can be a counterintutitive message when we're all deeply programmed to maximize our protection. But if I could ask for your trust in public health, you (and your little one!) will always be very well served by rolling up to the counter when it's time and saying, gimme what you got!
posted by late afternoon dreaming hotel at 4:56 AM on August 3, 2023 [10 favorites]

Mod note: Comment removed. We ask, per the Content Policy, that if you don't have good knowledge of the OP's question that you refrain from answering, thanks!
posted by Brandon Blatcher (staff) at 6:54 AM on August 3, 2023

Get what’s available now. Echoing Capt. Renault, I’ve also chosen “constant coverage” -- getting shots as soon as available has worked for me, and my family of 4, so far (none of us have ever tested positive and all have N-95 masked consistently in public and have avoided* Covid ::*well, as far as we know, anyway::).
posted by edithkeeler at 8:38 AM on August 3, 2023

Just read a post from Katelyn Jetelina suggesting that, in general, people should delay fall boosters for at least six months. (...) (Actually, on reread, this aside in her post may be specific to people who have been recently infected!)

Yeah it's definitely the latter. That is, delaying the booster makes sense if you've just had an infection.

Quote
Does this* mean I’m in the clear for Winter?
Maybe. Data from the UK shows that, on average, people get 1-2 infections yearly. You’ll have good protection going into the fall respiratory season. (I would delay a fall booster by at least six months; more on this later).

*This question following a bunch of questions about dealing with an infection.
*On average, people get 1-2 infections yearly = people don't usually get reinfected within the first six months so "you'll have good protection going into the fall season".


I really think you ought to make whichever decision will best protect your family. Sure, I will buy that that may lead to worse outcomes for society overall. But you can mail the invoice for that problem to Rochelle Walensky.

I think this is misunderstanding the advice.
We are encouraged to engage in public health protection measures to the benefit of society and ourselves. You shouldn't sacrifice your personal health but we all benefit (including individuals who engage in said measures). And conversely, we all suffer consequences for not doing it so the invoice is sent to all of us including the asker.

Regarding breastfeeding
CDC recommends that people who are breastfeeding get vaccinated and stay up to date with their COVID-19 vaccines, including getting a COVID-19 booster shot when it’s time to get one.
posted by M. at 11:45 PM on August 3, 2023 [1 favorite]

Mod note: A couple more deleted. Misinformation, and lack of focus on the OP's actual questions. If you want to complain about Covid public health efforts, maybe make a Mefi post for that discussion. In Ask Metafilter, we ask that people focus on the Op's specific situation with helpful up to date info, or pass up the question otherwise.
posted by taz (staff) at 10:46 PM on August 5, 2023 [3 favorites]

Response by poster: Thank you everyone! I decided to go ahead and get the bivalent shot now.

I found this link which (if I’ve read it correctly) says the CDC only required two months between shots last time in the US, so I’m hoping that I’ll still be able to get the new shot by mid- to late October. But even if that doesn’t work out, the advice to have extra protection now made sense to me. I also liked the thought of providing antibodies to my baby until we can both be fully up to date with our vaccinations.
posted by findabair at 2:53 AM on August 11, 2023 [1 favorite]