Uptake of new boosters targeting variants of omicron is slowly increasing, in a change from the days when getting a COVID-19 vaccine appointment felt like a competitive sport.
When the original shots rolled out in early 2021, a crush of eager recipients overwhelmed the limited supply. The situation was less extreme when third shots were authorized that fall, but there was still a dash for shots that tapered off relatively quickly.
It’s a different situation with the new boosters, said Heather Roth, immunization branch chief at the Colorado Department of Public Health and Environment. In September, the state was averaging about 6,000 boosters per day, but that’s increased to an average of 10,700 each day this week, she said.
“I think people are starting to learn about this vaccine and how it’s different,” she said. “I do think the pattern we’re seeing with increased doses each day is a promising sign.”
The new shots expose the immune system to the spike proteins from both the original version of the virus and from the BA.4 and BA.5 variants, which have the same spike. The spike is what allows the virus to latch onto cells, and antibodies specific to a particular spike can disrupt that process. About 90% of COVID-19 samples sequenced in Colorado in the week of Sept. 18 — the last one with data — contained BA.5.
The state health department estimated about 9% of all eligible people have received one of the omicron-specific boosters. Among people over 65, it was 20%.
The state hasn’t released demographic data from the updated shots, but the group that has received any type of booster is disproportionately white, female and older.
Nationwide, about 14.8 million people, or just under 7% of eligible people 12 and older, had received an updated booster as of Wednesday. Children between five and 11 only became eligible for boosters this week.
That’s a slower pace of uptake than during the first booster campaign, according to Reuters. More than 20 million people received third shots in the first six weeks after they became available, even though they were only authorized for those over 65 and people who had chronic conditions.
Roth said she hopes uptake will accelerate ahead of the holidays, when people may be exposed to the virus while traveling or gathering indoors. It’s a good idea to get your COVID-19 and flu shots before Halloween, to allow the immune system time to mount its defenses, she said.
“We’re trying to get as many people as possible who are eligible to go out and get it,” she said.
On Friday, the state health department started sending text messages and emails to people between 50 and 64 whose immunization records showed they might be due for a booster. Those over 65 already received messages in a previous round of texting. While younger people can also get the updated booster, reaching older people is a higher priority because of their increased risk of severe illness.
Anyone over five who completed their original vaccine sequence (two doses of Pfizer or Moderna’s shot, or one dose of Johnson and Johnson’s) is eligible if they had their most recent shot at least two months ago. The Centers for Disease Control and Prevention also advises that people wait three months after recovering from a COVID-19 infection, to maximize their immune response, though that’s not a hard line, Roth said.
There’s been considerably less promotion of the updated shots than in previous campaigns, though the federal government is still doing outreach targeted at older people and under-vaccinated communities. A poll conducted by the Kaiser Family Foundation in September found about one in five adults said they had heard “nothing at all” about the updated boosters. Young and middle-aged people, Republicans and those who are unvaccinated reported less knowledge of the new shots.
The Biden administration has staked out a position that most people should get an annual shot, though older people and those at higher risk may need more frequent boosts. Only about a third of people over 50 have gotten a second booster shot as fatigue set in, making the prospect of an annual shot potentially more attractive.
But some scientists have raised concerns that there isn’t much evidence for a yearly vaccination campaign, since COVID-19 doesn’t have the same seasonal pattern as flu, and some people may need boosters more or less frequently. And experts and people working on the booster campaign privately expressed doubt that more than 30% of Americans will get the updated shots, according to Politico.
About 5% of people in the Kaiser Family Foundation poll said they had already gotten the new shot, 27% said they intended to do so as soon as possible and 18% said they would wait and see. The rest either didn’t intend to get the shot, or aren’t yet eligible because they remain unvaccinated.
The Commonwealth Fund estimated about 745,000 fewer people could be hospitalized by the end of the year and 75,000 fewer might die if Americans get the new boosters at about the same rate as they get annual flu shots — assuming the new boosters are about as effective at preventing deaths as the third shots were. About half of people who are six months or older get vaccinated for the flu in a typical year, according to the CDC.
Early data shows the Pfizer shot increased the level of antibodies against the BA.5 variant of the virus. (Moderna hasn’t released antibody data yet, but its previous shots have performed about the same as Pfizer’s.) Unlike the original shots, the updated ones weren’t tested extensively before their rollout, following a process similar to what’s used for seasonal flu shots, so their full effectiveness will only become clear as more people get them.
Roth said she hopes that more people will opt to get the shots as efficacy data becomes available, but their side effects are comparable to the previous version of the vaccine, and it’s likely they’ll provide strong protection against BA.5.
“The only difference is that they have another strain,” she said.