The New COVID-19 Booster: Updates & Changes You Need to Know

Dr. Turck:
You're listening to COVID-19: On The Frontlines on ReachMD. I'm Dr. Charles Turck. And joining me today to talk about the new COVID-19 vaccine booster is Dr. Bill Schaffner, who is a Professor of Medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee. He's also the Medical Director of the National Foundation for Infectious Diseases.

Dr. Schaffner, welcome to the program.

Dr. Schaffner:
Always good to be with you, Charles.

Dr. Turck:
Well, thank you. Now, to start, Dr. Schaffner, would you give us some background on what led to the FDA approval for the new COVID-19 vaccine booster?

Dr. Schaffner:
Well, several things happened. First of all, let's talk about the virus. The virus changed, right? We encountered the Omicron variant and then that virus went into subvariants, and the most dominant viruses out there today are labeled BA.4 and BA.5, so the virus itself changed and deviated from the antigens that were in the original vaccine. Number two, we anticipate that there will be an increase in COVID over the wintertime. That's happened twice before. We don't know whether this will be a mild, moderate or large surge, but we do anticipate an increase. Number three, for many people it's now been several months since they have received their last booster, and so their immunity may be waning, and so the Food and Drug Administration worked with the manufacturers to create an updated vaccine. This is kind of like the influenza vaccine, right? Each year we update it because the virus itself has changed. We seem to be taking the first paths along those lines. And so they have created a new bivalent vaccine. It will contain the same antigen that we've been using all along in the vaccine plus antigens that will work against BA.4 and BA.5, so we have an updated vaccine similar to the updated influenza vaccines we get each year.

Dr. Turck:
Now, the CDC recently announced which patients should receive the vaccine booster. With that in mind, Dr. Schaffner, how would you go about determining if a patient of yours is a good candidate?

Dr. Schaffner:
Well, we're talking about people age 12 and older will be eligible for the Pfizer vaccine and 18 and over for the Moderna updated vaccine. Now, among those folks, there are really two criteria. One, you have to have had at least the primary series. You can't start from scratch with this updated vaccine. It wasn't tested for that, and so the FDA has not given it an emergency use authorization. It is a booster. Now, if it's been at least two months since your last vaccine dose, whatever it is, part of the primary series or one of the boosters, but at least two months, then you're eligible for one of these updated vaccines. And number two, if you've recovered from COVID, wait three months before you are a candidate for one of these updated vaccines. So, two months since your last booster or your last vaccine dose or three months since you have recovered from COVID if that happened more recently.

Dr. Turck:
For those just tuning in, you're listening to COVID-19: On The Frontlines on ReachMD. I'm Dr. Charles Turck, and I'm speaking with Dr. Bill Schaffner about which of our patients should have receiving the new COVID-19 vaccine booster.

So, Dr. Schaffner, once you've determined your patient is a good candidate for a vaccine booster, should they wait to receive the new one or should they opt for the one most readily available?

Dr. Schaffner:
Now that the updated vaccine is available, what the Food and Drug Administration has done is removed the emergency use authorization from the other boosters, and so the only booster that's now available is this updated booster. That is for adults, as I said, age 12 and up. The children, that's a separate story, but for persons age 12 and up really the only booster that's now going to be available. Now, will every single location adhere to those instructions? There will probably be some variation. But that's the deal. The booster that will be available going forward will be the updated booster.

Dr. Turck:
And do you have any strategies for counseling patients who may be hesitant to receive the new vaccine booster?

Dr. Schaffner:
As usual, Charles, it will take some persuasion. I think there is a segment of the population that watches these changes very, very intently, they're up-to-date, and they were in the line asking for this updated booster the day after it became available. On the other hand, there's a large number of people who have to be persuaded. You and I recognize that there's a lot of vaccine fatigue, COVID lethargy out there. People want to put it behind them. So we'll really have to remind them that this is very important for them, for their families and their communities. The vaccines are designed to keep you out of the hospital. That's what they do best, to prevent the severe manifestations of disease, and so it will continue to be important.

You know, going forward, this virus, the COVID virus and all of its manifestations, is not going to disappear. If we're going to manage the impact of this virus, vaccines will continue to be fundamental to do that. The White House has said they're a little bit ahead of their skis but they have said that, you know, this is beginning the road of getting an annual COVID booster similar to our influenza vaccine updates each year. That hasn't been officially decided yet by the Food and Drug Administration and the CDC's Advisory Committee, but most of us think they're right, that we're starting down that road.

Dr. Turck:
Before we close, Dr. Schaffner, do you have any final thoughts you'd like to leave with our audience today?

Dr. Schaffner:
Well, you know, we're about to enter influenza vaccination season also. So here we have two nasty respiratory viruses, a vaccine for each. Both of them are recommended essentially for all, certainly all adults, and influenza vaccine all the children also, so we're going to have to persuade people to roll up both their sleeves, once for influenza vaccine and once for the COVID booster. If you like, you can get them both at the same time. There's no contraindication. But I think we healthcare professionals are going to have to be very persuasive to get our patients to accept 2 vaccines this year before the winter starts.

Dr. Turck:
Thank you for providing those fantastic insights, Dr. Schaffner. And as we come to the end of today's program, I want to thank you for sharing your expertise on the new COVID-19 vaccine booster. Dr. Schaffner, thank you for speaking with me today.

Dr. Schaffner:
Always good to be with you.

Dr. Turck:
For ReachMD, I'm Dr. Charles Turck. To access this and other episodes in our series, visit Reachmd.Com/COVID-19 where you can be Part of the Knowledge. Thanks for listening.