Opinion

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Readers continue to ask about the ideal timing of the next coronavirus booster. Here’s the bottom line: While some people have specific circumstances prompting them to get a shot now, most Americans can wait until the updated booster is released in late September to early October.

That’s because the new booster is expected to provide better coverage against currently circulating variants. While covid-19 cases are on the rise now, they are likely to surge even more during the winter months. Given the short duration of the coronavirus vaccines’ maximal effectiveness, it makes sense to time your next shot to last into the winter.

Susan from Maryland writes that her family (two 50-year-olds and a 17-year-old) are going on a cruise soon. “Should we get a covid booster before we leave?” she asks. “We have all been fully vaccinated previously, but none of us have gotten covid since last fall.”

Given their ages, the three people in Susan’s family are unlikely to become severely ill from covid, and they probably have adequate protection because of hybrid immunity from prior infection and vaccination. They do not need to receive a booster ahead of this trip.

My answer is the same for Mollia from Washington state, who is inquiring about her 19-year-old son as he prepares to start his sophomore year of college. He had the original two-dose series of coronavirus vaccines but has not received any boosters. “He contracted covid at the start of his freshman year, and it got college off to an awful start with missed classes, isolation and, while not clinically diagnosed, he felt depressed for some time. I want him to get a booster before school starts, but I’m wondering if he should wait until the newer version is available later in the fall. He is healthy, athletic and has no preexisting conditions.”

Mollia’s son can wait for the updated booster to be released. This is also a good time to check with the college about its testing and isolation guidance, which might be more lenient than it was in 2022.

For some, it’s worth considering getting the current booster sooner. Ed from D.C., a healthy 73-year-old, is leaving for Bulgaria at the end of September. “I will be in with a small tour group of 14 others for the 18-day tour of Thracian ruins and such in various cities and towns. Should I get the ‘regular’ booster in mid-September just to play it safe?

Candace from Virginia has a similar question. She and her husband are both in their mid-70s and will be traveling to Portugal during the last two weeks of September. “Should we go ahead and take the bivalent vaccine that’s readily available now and then wait until the winter and take the new vaccine?” she asks.

I think Ed and Candace could make either choice. If they received the current booster in early to mid-September, they would be eligible for the updated booster five months later, in February. That’s not an unreasonable decision for people older than 65 who have a major trip or high-exposure event before the new booster is released.

On the other hand, people whose high-exposure events are later in the year could delay their booster a bit more. “I had the bivalent vaccine in October 2022 and then covid for the first time in end of April this year,” Glenna from Arizona wrote. “I am nearing 70, take a statin for high cholesterol and have well-managed hypothyroidism. We are doing a Panama Canal cruise in early January. Should I wait to get it three weeks before the cruise to have the best coverage for the trip or get it when it first becomes available?”

I think Glenna could wait because she had covid four months ago and is still well-protected as a result. Moreover, if she gets the booster in late September, the period of optimal effectiveness from infection would be over by the time of her cruise. Getting the updated booster in early to mid-December would provide the best coverage for her trip. If she has holiday plans involving a lot of exposure for Thanksgiving, she could move up the booster to two weeks before that, and it should still provide some protection during her cruise.

Some readers are thinking ahead and asking about the next booster. “I am 74 and am in generally good health,” writes Anne from Maryland. “My second bivalent covid vaccination was in ApriI 2023. I intend to get the updated covid vaccine this October before an upcoming event in November. That booster may be less effective by next spring. Do you anticipate another covid vaccination round to be available in spring 2024 for those of us over 65 folks who plan on travel/family gatherings then? I worry that a yearly shot won’t be enough to protect me.”

Federal health officials have not weighed in about the frequency of boosters for people who are not immunocompromised. In 2023, they allowed a spring booster to “top-up” protection for those aged 65 and older. It’s possible they might do the same in 2024. It’s clear that protection, especially against infection, wanes quickly. Most people eligible for a twice-a-year booster won’t get it, but some will, and I think it’s reasonable to offer the option for those seeking optimal protection.

All of this guidance could change if a new variant emerges that is more immune evasive and causes more severe disease. Until then, most people can wait until the new booster is released, and those most vulnerable to severe illness should take additional precautions and plan to take antivirals if they contract covid.

Have more questions? Please send them and I’ll get to them for next week’s newsletter.