What you need to know about getting the new COVID-19 booster

The change in season is coming with a change in COVID-19 vaccines. Last week, the Food and Drug Administration (FDA) authorized the use of another round of boosters, with the Pfizer-BioNTech shot green lit for people 12 years and older and the Moderna shot for people 18 and older. The shots can only be received after at least two months following the primary vaccination series.

Unlike previous doses, the new booster is a bivalent vaccine which includes an updated formula containing the mRNA of the original SARS-CoV-2 strain to broadly protect against COVID-19 infection, as well as the mRNA of the more recent Omicron BA.4 and BA.5 variants. As of September, the BA.5 variant is currently the dominant variant circulating in the United States, making up 88.6 percent of cases.

Infectious disease experts are bracing for another surge of cases in the fall and winter, but they are cautiously optimistic that the new COVID-19 boosters will provide immunity against severe disease and illness. These vaccinations will be available soon—here’s what you need to know before you get one.

When can I get the new boosters?

By the end of the week. The White House COVID-19 Response Team said in a September 6 press briefing that they have already shipped millions of doses once they received the FDA’s authorization on August 31. They announced that by Friday, September 9, “over 90 percent of Americans will live within five miles of these new updated vaccines.”

You can visit Vaccines.gov to find sites carrying the new boosters. Appointments at pharmacies such as CVS and Walgreens will become available this weekend with a majority of slots opening up next week. You can also contact your primary care provider or local health clinic to see if they are taking vaccine appointments and which booster they are carrying.

Should I go with the Moderna or the Pfizer-BioNTech booster?

Michael Chang, a pediatric infectious disease specialist at UTHealth Houston and Memorial Hermann Hospital, says there’s not much evidence to suggest one is better than the other. However, he says pre-clinical data showed little difference between the two and both were effective in preventing illness and hospitalization. 

Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, recommends trying for a mix-and-match strategy this time around. “If you’ve gotten Pfizer as your primary series, it’s a great idea to swap out and go for the Moderna booster and vice versa.” She says because the vaccines are formulated a little differently and there’s more research to suggest that mixing and matching gives you an extra boost of immunity, you’re likely to have a higher degree of protection.

I already had a COVID booster. Do I need this one?

Yes. The Centers for Disease Control and Prevention (CDC) says you’re not up to date with your vaccines until you’ve finished your primary series and the most recently authorized booster. Even if you received a booster earlier this year, Chang says these new shots are better at targeting Omicron strains. “It will better cover the currently circulating variants and potentially provide broader immunity against future variants,” he explains. Since the newer boosters are more effective, they will replace the previous boosters, which will not be offered anymore to people over the age of 12, Chang adds. 

[Related: Omicron boosters are the future of COVID vaccines in the US]

Chang says if you received your booster even three to four months ago, your antibody levels are probably falling. Both he and Nachman agree that getting the bivalent vaccine will raise the country’s collective immunity and provide as much protection as possible going forward. As the US transitions from pandemic to endemic mode, the priorities have shifted towards learning how to live with? and manage the virus. 

“COVID is here to stay,” adds Nachman. “It’s going to be part of our lives and I suspect we’ll have annual dosing like the flu vaccine every year.”

I just recovered from COVID. How long can I hold off on getting a booster?

Yes, you can wait, but not for too long. Fighting off a recent battle with COVID temporarily gives you antibodies to avoid catching another infection. The CDC advises delaying your booster shot for no more than three months from when your symptoms first emerged or when you received a positive test result. 

Studies measuring antibody levels after each strain of infection shows a lot of variation with naturally acquired protection, Nachman explains. In some cases, she says antibodies lasted a couple of months while others saw levels dropping sooner than that. “Would I run and get the booster a day [after testing negative]? No,” she says. “Would I wait six months? Absolutely not.”

When is the best time to get the bivalent booster?

If you recently recovered from infection and delay the dose for three to four months, Chang says you’ll likely have your highest antibody levels during the winter, a time when infectious disease experts expect to see a surge in cases after the holidays. “You will probably have peak antibodies within two weeks or so [after immunization].” Chang also recommends waiting three to four months for people who received a booster in the summer or in the last two weeks.

Nachman says that in an ideal world, people would wait until October or November to get the booster to prepare for a bad winter. But if you have underlying immune issues or are living with someone with multiple medical problems, she recommends getting the vaccine immediately. If you’re planning on traveling outside of the country, she says it’d be ideal to get your vaccine a month before to protect yourself against a potential outbreak in another country. “There’s no one right answer,” she cautions. When in doubt, Nachman highly recommends speaking with your doctor about the right timing for you to get the booster shot.

[Related: China approves world’s first nasal COVID-19 vaccine booster]

Will the booster have any side effects?

Yes. Both experts say you should expect to see similar side effects as your previous vaccines such as low-grade fever, muscle soreness around the injection site, and fatigue. Though Chang is hopeful that the side effects won’t be as severe as prior vaccinations. “In some cases with people who had vaccine side effects, we’re seeing a little less side effects with each booster.”

To prepare for the side effects, experts recommend getting a full night’s rest, gently moving your body to help with fatigue and muscle aches, and staying hydrated throughout the day. Nachman does not recommend taking pain relievers such as aspirin, Tylenol, or Motrin prior to vaccination. Instead, she says it’s better to take Tylenol a couple of hours after.

When will boosters be available for kids from 5 to 11?

There’s no clear timeline on when boosters will become available for kids between 5 to 11 years. Both experts say Moderna and Pfizer-BioNTech are already starting the groundwork to conduct studies on the appropriate dosage for this age group. 

Chang says the process toward authorizing boosters for kids should not take as long—he could even see more developments before the end of the year. Nachman’s prediction is a bit more grim. She says parents should not expect COVID booster eligibility for younger age groups until late winter 2023. The CDC recommends children 5 to 11 years old get a monovalent—containing only the original strain—booster dose in the meantime.