Editor's note on Oct. 30, 2023 at 11 a.m.: This article has been modified to include information about the updated Novavax vaccine, which was not yet available to the general public when this article was originally published on Sept. 13, 2023, and includes information from the CDC and the FDA released on Oct. 25, 2023, about the potential risk of stroke in older adults if the updated COVID-19 vaccines and the flu shot are taken at the same time.
DENVER – Coloradans looking to roll up their sleeves for added protection against the novel coronavirus during the upcoming viral respiratory season are now able to get an updated COVID-19 vaccine, including the highly sought-after update to the protein-based Novavax vaccine.
Like the rest of the country, Colorado is seeing an increase in both cases and hospitalizations for COVID-19, even though the fall respiratory season is still weeks away.
Statewide, the number of reported cases has increased by nearly 200% since the beginning of August. COVID-19 related hospitalizations have also seen an uptick since late summer after a few weeks of remaining in lows never before seen since the start of the pandemic. As of Wednesday, 123 people across the state were hospitalized for COVID-19.
Still, respiratory viruses are unpredictable and health officials are not sure what this viral respiratory season will have in store for us over the next few months, so it’s not a bad idea to get added protection ahead of the fall, said Colorado Department of Public Health and Environment (CDPHE) state epidemiologist Dr. Rachel Herlihy.
WHAT'S NEW ABOUT THE UPDATED COVID-19 VACCINE?
The updated COVID-19 vaccine targets only one strain of the SARS-CoV-2 virus this time around, namely the XBB.1.5 strain of the omicron variant which currently makes up only 3.1% of all cases nationwide. Though its prevalence has diminished since first gaining dominance across many parts of the world in the first half of 2023, scientists believe the updated formula will still protect against the strain’s descendant lineages, including the now-dominant EG.5.1 and FL1.5.1 strains, as well as the highly-mutated BA.2.86 strain of the novel coronavirus.
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A side note before we continue: Though not officially sanctioned by any health agency, those strains have been nicknamed “Kraken” (XBB.1.5), “Eris” (EG.5.1), “Fornax” (FL1.5.1) and “Pirola” (BA.2.86) by variant trackers to help the public better understand the wide variety of currently circulating strains of the virus across the world. We will use these naming conventions alongside their scientific names throughout the rest of this article.
WHO WILL BE ABLE TO GET THE UPDATED COVID-19 VACCINE?
The CDC and the CDPHE both recommend anyone 6 months of age or older to get the updated mRNA COVID-19 vaccine from Pfizer or Moderna if it’s been at least 2 months since you last got vaccinated, regardless of whether you had previous doses of an outdated COVID-19 vaccine or no doses at all, Herlihy said.
Novavax’s updated COVID-19 protein-based vaccine – which is made with technology that’s been around since the 1980s – was given emergency use authorization in early October. A single-dose is recommended for anyone 12 years of age or older who has been previously vaccinated with an mRNA vaccine from either Pfizer or Moderna but who hasn't gotten the updated shot from either of those vaccine makers. Unvaccinated individuals will need two doses of the updated Novavax vaccine, given three weeks apart from each other. Anyone looking to get the updated Novavax vaccine should click here to find their nearest vaccination site.
Children 4 and younger who have never been vaccinated may need two doses of the updated COVID-19 vaccine, but Herlihy recommended parents talk to their healthcare provider to make that determination.
People who are immunocompromised may need more than one dose of the updated COVID-19 vaccine, Herlihy said, but she again strongly recommended talking to a healthcare provider before lining up at a pharmacy or going to a doctor’s office in the coming days.
If you’ve been recently infected with COVID-19, Herlihy said, “it’s probably okay to wait a couple of months before you get your (updated) vaccine.” While previous guidance from the CDPHE recommended waiting at least three months before getting vaccinated against the coronavirus, Herlihy once again stressed the importance of talking with your healthcare provider to determine the timing of your next COVID-19 vaccine.
HOW MUCH WILL IT COST TO GET THE UPDATED COVID-19 VACCINE?
Unlike previous years, the updated COVID-19 vaccine won’t be paid for by the federal government this time around.
Those with healthcare insurance will be able to get them through their healthcare provider and at pharmacies, Herlihy said.
Uninsured adults will still be able to get vaccinated against COVID-19 through local pharmacies from the U.S. Department of Health and Human Services’ (HHS) Bridge Access Program for COVID-19 Vaccines and Treatments.
Government-run programs like Medicaid and Medicare are also expected to cover the updated shots, and kids enrolled in the Children’s Health Insurance Program and the Vaccines for Children Program will still be able to get updated COVID-19 vaccines through the end of September 2024, health officials said previously.
Health First Colorado, the state’s Medicaid program, and Child Health Plan Plus (CHP+) will also continue to cover COVID-19 vaccines at no charge for members.
HOW EFFECTIVE IS THE VACCINE AGAINST NEWER VARIANTS?
Though the vaccine’s effectiveness against infection is “extraordinarily short-lived,” according to former White House Coronavirus Response Coordinator Dr. Deborah Birx, you will still want to get it if you’re concerned about the risk of developing long-lasting and sometimes devastating lingering effects from even a mild COVID-19 infection, more commonly known as Long COVID, for which there is currently no treatment or cure.
About 650,000 Coloradans — or about 10% of the state population — currently suffers from Long COVID, though health experts warn that number could be vastly underestimated.
“That is just another additional reason to be vaccinated with this updated vaccine,” Herlihy said, noting that “there is demonstrated effectiveness with these vaccines in preventing Long COVID and that has been the case of previous vaccines, and we expect that to be the case going forward.”
Officials at Moderna have claimed the company's updated COVID-19 vaccine generated a nearly nine-fold increase in antibodies against the BA.2.86 (Pirola) variant. That follows a release from mid-August in which the biotech and pharmaceutical company claimed their updated COVID-19 vaccine generated “a robust immune response” against the EG.5.1 (Eris) and FL1.5.1 (Fornax) variants.
In its own news release earlier this month, Pfizer claimed that a recent preclinical study in mice “showed that our updated monovalent XBB.1.5 vaccine elicited a strong neutralizing antibody response against a number of Omicron variants, including EG.5.1 and BA.2.86.”
The U.S. Centers for Disease Control and Prevention (CDC) said at the end of last month the updated COVID-19 vaccine “will likely be effective at reducing severe disease and hospitalization,” against the BA.2.86 (Pirola) variant.
Though scientists were originally concerned with a significant reduction in our body's ability to fight off an infection from the Pirola variant due to the more than 30 different mutations in the strain's spike protein – the mechanism the virus uses to infect human cells and what our immune system uses to identify it – preliminary data from multiple investigators “suggest similar antibody activity against BA.2.86 as compared to other currently circulating viruses," according to the CDC.
“CDC and other experts are reassured by these research findings that support the effectiveness of this type of immunity against this variant. Additionally, based on CDC’s experience with past SARS-CoV-2 variants, people will likely have protection against severe disease mediated by both cellular and antibody immunity,” the agency wrote.
The CDC did warn, however, that it was still too soon to know how transmissible the variant is and how much previous infection or vaccination will help stunt its spread.
Preliminary studies – which have not yet been peer-reviewed by other scientists – show BA.2.86 (Pirola) isn't better than XBB.1.5 (Kraken) at getting past our body's defenses, which is good news. The bad news? The EG.5.1 (Eris) and FL.1.5.1 (Fornax) variants, which currently make up 36% of all cases in the U.S., are better able at breaking through those same defenses than Kraken — from which the updated vaccine formula is derived.
The silver lining? Other preliminary studies – which, again, have not yet been peer-reviewed by other scientists – have shown the updated COVID-19 vaccine “has the potential to provide protection against these emerging variants and support the Covid-19 vaccine update in 2023-2024.”
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“Vaccines are obviously an incredibly important strategy and are really our first line of defense in protecting ourselves against these respiratory viruses, but there's also a lot of other things that we've learned in the last couple of years and new strategies or tools that we have now,” Herlihy said.
Seeking out treatment and staying home if sick are “really important strategies going forward,” she said, as are wearing a high-quality mask like an N95, KN95 or KF94 in poorly ventilated indoor settings, avoiding large gatherings, moving gatherings outside wherever possible, ventilating indoor spaces if gathering inside, practicing proper hand hygiene, and following CDC quarantine guidance if you've been exposed or test positive for the virus. Taken together, all of these things can help Coloradans reduce their chances of becoming infected and from passing the virus on to other people in the community, health experts say.
The upcoming viral respiratory season, Herlihy noted, “does remind us that now is a great time, as we're seeing this increase in transmission, to think about getting those vaccines and we're talking about, of course, the COVID vaccine, but also vaccines for protection against influenza and RSV for individuals where it might be relevant.”
Older adults looking to get vaccinated for the upcoming viral respiratory season should consult with their doctor or pharmacist if thinking about getting the updated COVID-19 vaccine and this year's flu vaccine at the same time, as doing so may slightly increase the risk of strokes caused by blood clots following vaccination, according to a new study.
Coloradans looking to get the updated COVID-19 vaccine should contact their healthcare provider, pharmacy, or doctor’s office to make sure it’s available before heading out the door. The state also has a website where residents will be able to find the updated COVID-19 vaccine at their nearest pharmacy, hospital, clinic or vaccine site.
