EKPA: Everything we need to know about the new booster doses of vaccines in five questions and answers

The Doctors of the Therapeutic Clinic of the School of Medicine of the National and Kapodistrian University of Athens Theodora Psaltopoulou, Yannis Danasis, Rodanthi Syrigou and Thanos Dimopoulos (Chancellor EKUA) summarize frequently asked questions and answers about updated vaccine booster doses according to the guidelines of the US Centers for Disease Control (CDC), and epidemiologists Keri Althoff and Andrew Pekosz from Johns Hopkins University.

• Who is suitable for the new bivalent vaccines?
The CDC has approved the new Pfizer/BioNTech bivalent vaccines for Americans 12 and older and Moderna for those 18 and older, as long as they have received a full course of vaccines or boosters at least 2 months previously. The new vaccines are designed to protect against BA.4 and BA.5 strains. The new bivalent vaccines are not currently approved for children under 12 years of age. However, the recommendation to vaccinate children over 5 years of age with the basic series of vaccines and a booster dose is still valid.

• How do the new bivalent vaccines differ from the previous ones?
The new vaccines use the same mRNA technology as the previous Moderna and Pfizer/BioNTech vaccines, and booster doses have been upgraded to target the newer Omicron strains. The new vaccines contain the S spike protein of both the original (ancestral) strain of the virus and the more contagious Omicron strains (BA.4, BA.5). It is also possible – but not yet clear – that the new vaccines will offer protection against newer but less common strains such as BA.4.6 and BA.2.75.

• Do I need to be vaccinated if I have previously had a booster dose or if I have been ill?
The answer is yes. Even if you have had COVID19 in the past year and/or have received the full series of primary and booster vaccines, you should receive the new Omicron bivalent vaccine. This will lead to broader immunity against SARS-CoV-2 and help limit the emergence of new variants. Booster vaccines are most effective when given after a period of time has passed since the last dose. A waiting period of 2 to 3 months is the minimum, but some evidence suggests that extending it to 4 to 6 months may be an appropriate time. There are no specific guidelines regarding the waiting period after SARS-CoV-2 infection. But if you have been infected with the virus in the past 8 weeks, you may wait 8 weeks before receiving the bivalent booster to allow your immune system to get more benefit from the vaccine. It is also noted that the bivalent vaccine is approved for use as a booster dose and not as a primary vaccine series dose.

• If I am unvaccinated, can I only have the booster vaccine?
Booster vaccines contain a lower dose of mRNA compared to the vaccines used in the primary vaccine series. The new boosters, which target the original Omicron strain and sub-variants, are now the only boosters available for people 12 years of age and older. Booster doses can be given regardless of the type of vaccine used during the primary vaccination.

• Can I be vaccinated at the same time as the flu shot and the COVID19 booster?
The answer is yes. It’s especially important to get a flu shot this year because some experts believe we could see a parallel outbreak of the flu and COVID-19 this fall — a phenomenon some call a “didemic.” Getting a flu vaccine and a SARS-CoV-2 booster – at the same time, if possible – is especially important if you are in a high-risk group. People who are prone to serious complications from COVID19 – such as the elderly, people with weakened immune systems and chronic conditions – are also particularly vulnerable to serious complications from the flu.

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