Everything You Need to Know About the Bivalent COVID-19 Boosters

Even as cases of COVID-19 level off, that doesn’t mean you should let your guard down.

COVID-19 remains active across the country, with approximately 1.4% of communities experiencing a high transmission level, 17.6% with a moderate transmission level and 81% with a low transmission level, according to the Centers for Disease Control and Prevention’s COVID-19 data tracker as of October 20.

Multiple offshoots of the omicron strain, including the dominant BA.5 and new subvariants, have been shown to stealthily evade immunity and cause mild or no symptoms at all. While some individuals may display common symptoms — such as cough, fatigue, runny nose, headache, shortness of breath, sore throat and fever — others may not be aware that they have been infected.

In fact, in a study published on August 17 in the journal JAMA Network Open, researchers evaluated 210 participants who tested positive for COVID-19 and found that more than half of them (56%) were unaware of their infection. Of those who didn’t realize they had COVID-19, only 10% reported mild symptoms that they attributed to a common cold or other unrelated infections.

To protect against the new strains of the virus, the Food and Drug Administration recently authorized the COVID-19 bivalent vaccine boosters for emergency use.

“The updated COVID-19 bivalent boosters are formulated to better protect against the most recently circulating COVID-19 variants,” CDC Director Dr. Rochelle P. Walensky said in a statement. “They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants.”

The updated boosters, developed by Moderna and Pfizer-BioNTech, are now available at pharmacies and community health centers. Find a local vaccination site near you at vaccines.gov. However, people cannot get a bivalent booster without first completing at least a primary series of the original vaccines.

Let’s tackle the most common questions about how the new boosters work, who should take them and whether they’re safe.

[READ: Long COVID Treatments and Recovery.]

What Are the New Bivalent Boosters?

The bivalent boosters are developed from the same technology as the original monovalent vaccine, which uses synthetic messenger RNA (mRNA) to teach our body’s cells how to fight the virus. However, the updated boosters contain an mRNA component of both the original SARS-CoV-2 strain and a component of the BA.4 and BA.5 omicron subvariants to provide broader protection against newer versions of the virus.

While BA.5 is currently causing most cases of COVID-19, a slew of new variants are expected to drive another wave of cases in the winter. That’s because the virus is constantly mutating and changing to resist treatments and vaccines to help them survive.

“Just like the flu virus changes, the COVID-19 virus alters over time to identify new ways to become more infectious,” says Dr. Doug Harley, program director of the family medicine residency program at the Cleveland Clinic in Akron, Ohio. “As the viruses change, booster shots need to adjust to provide the strongest protection.”

For that reason, health officials said it’s likely that COVID-19 shots will be updated on an annual basis — like the flu vaccine — to target the most common strains circulating in the population.

[READ: What to Know About Flu Shots.]

What Is Different About These Boosters?

The original COVID-19 boosters were called monovalent vaccines because they provided protection against one single strain of SARS-CoV-2. However, the bivalent boosters not only protect against the original SARS-CoV-2 strain, but also against the dominant and more highly transmissible omicron variants BA.4 and BA.5.

“One of the hopes of the omicron-specific boosters is to increase antibodies and prevent even mild infections,” says Dr. Monica Gandhi, professor of medicine and associate chief of the division of HIV, infectious diseases and global medicine at the University of California, San Francisco.

[SEE: 10 Foods That Can Boost Your Immunity.]

Who Should Get the New Boosters?

The CDC recommends that adults and children ages 5 and older receive the bivalent booster if it has been at least two months after completing the primary series dose or a monovalent booster.

The FDA has authorized the COVID-19 bivalent boosters for the following ages:

Moderna bivalent booster: Individuals ages 6 and older.

Pfizer-BioNTech bivalent booster: Individuals ages 5 and older.

“Even if individuals have received several (monovalent) booster shots, it’s important to get the bivalent booster to increase protection,” Harley says.

The CDC no longer recommends the monovalent vaccines as booster doses for individuals ages 12 years and older. This means that if an individual had not previously received a monovalent booster dose, they will now receive the bivalent booster to better protect against the most common COVID-19 strains. However, people cannot get a bivalent booster without first completing at least a primary series of the original vaccines.

Serious complications with COVID-19 increase with age. According to the CDC, people 65 and older who received two doses of the monovalent vaccines showed a 94% reduction in hospitalizations related to COVID-19.

“Based on the data, I am recommending this new booster first for older people, those 65 and older, and those who are immunocompromised who benefit from an ‘antibody boost’ during times of high viral circulation,” Gandhi says. “Certainly, anyone can get this booster and it is now authorized by the FDA down to the age of five, but concentrating our efforts on those most at risk of severe disease is good public health.”

If you have been diagnosed with a condition or are undergoing treatment that weakens your immune system, follow the CDC vaccination guidelines for people who are moderately or severely immunocompromised.

When Should People Get the New Boosters?

If it’s been two months since your last COVID-19 booster, then you are eligible to receive the new bivalent booster. That recommendation applies to individuals who have received one, two or three previous boosters.

If someone has recently been infected with COVID-19, the CDC recommends waiting three months before receiving the new booster from symptom onset or from a positive test that was asymptomatic.

Remember: You can get the COVID-19 boosters at the same time as the flu vaccine. In fact, health officials strongly urge people to get both shots to stay up to date with all their vaccinations in order to reduce the likelihood of getting sick during fall and winter, when COVID-19 and other viruses, such as the common cold and the flu, tend to rise.

Are the New Boosters Safe?

The new boosters were reformulated using the same technology as the original vaccine. When approving the new bivalent vaccines, the FDA considered all the existing studies, including extensive safety and effectiveness data of the original vaccines and the new boosters. Although researchers are still conducting human clinical trials for the new boosters, health officials and experts state that the updated vaccines are safe and effective.

Early data recently released from Pfizer-BioNTech’s clinical trial showed that the updated vaccine booster was highly effective in producing a strong immune response against omicron BA.4 and BA.5 subvariants and was well tolerated with similar mild side effects as the original vaccine.

Individuals who receive a bivalent COVID-19 vaccine may experience side effects commonly reported by individuals who receive authorized or approved monovalent COVID-19 vaccines. These side effects may include:

— Chills.



— Muscle pain.


— Pain, swelling or redness on the arm where the shot was given.

— Tiredness.

What Are the Health Benefits of Getting the New Boosters?

Vaccination is the best way to protect yourself and others from severe, long-term complications, hospitalization and death related to COVID-19, but the protection granted from the primary series of COVID-19 vaccines and subsequent boosters are temporary. Immunity wanes over time, but boosters help the body remember how to fight the virus. That’s why it’s important for people to stay up to date with their shots.

More from U.S. News

10 Foods That Can Boost Your Immunity

9 Myths and Misconceptions About the Flu Vaccine

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Everything You Need to Know About the Bivalent COVID-19 Boosters originally appeared on usnews.com

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