Should you get the new COVID booster? A Mayo doctor weighs in

INTERVIEWER: Thinking about getting their reworked COVID booster shot to battle the variants that continue to infect millions of Americans? Appointments to get the booster shots are open at the state run vaccine site at the Mall of America. The state sites in Duluth, Saint Paul Midway, Rochester, and Moorhead will start taking appointments next week.

The White House coronavirus coordinator said yesterday that the new Omicron boosters, which are set to be released this week, might become part of our health care routines, along with our yearly flu shot. Tell us more about the science behind the vaccines and how they work is Dr. Abinash Virk. She's an infectious disease specialist at Mayo Clinic. Doctor, welcome to the program.

SUBJECT: Thank you. Glad to be here.

INTERVIEWER: Could you explain how these vaccines work?

SUBJECT: So these are similar to the prior boosters, except that these are called the bivalent boosters that means that they have very similar mRNA to the initial vaccines, but also have the mRNA spike protein for the BA.4 and 5, which are the more common variants that we are seeing in the US now. So these are different from the boosters that were recently given earlier this year.

INTERVIEWER: And these vaccines have stirred discussion of durable immunity. Can you talk about that concept? What does it mean exactly?

SUBJECT: It means how long will the immunity actually lasts. So what we saw with the primary series and also with the boosters, the previous boosters and the emergence of new variants, particularly the BA.4, BA.5 was that the immune responses and the protection against infection did go down. And the protection against severe disease also went down to some extent.

And so, the question is, will these bivalent new boosters provide a good immunity? And how long will this be good for. This is something obviously we will have to see as we go into the future. Based on what we know from previous boosters and vaccination, we should at least have good six months or more of protection from these bivalent boosters.

INTERVIEWER: So that should get us well into the fall and through the winter, perhaps.

SUBJECT: Through the winter, yes.

INTERVIEWER: So then, should folks wait till later in the fall to get this new shot alongside their flu shot? Should they try to get one as soon as possible?

SUBJECT: So I think timing is a difficult thing, right? We know from previous two years that the cases started going up in November and peaked in early January. And that, I think, it would be helpful for people to make sure that they have their boosters before November. But you really can't be too perfect because you could be imperfect, and it could be that we have a wave earlier than that, and you may miss that.

So in general, we're recommending that people should just go ahead and get them. Because we, potentially, may have another wave of a different variant or even continuing BA.4, BA.5, that it's good for people to just go ahead and get the vaccine whenever they get it available to them.

INTERVIEWER: As you know, booster recommendations were based on the number of vaccines received. For example, adults 50 plus were supposed to have two vaccines and two boosters. And for some people, that was getting confusing. Does this booster help clarify what's meant by being up-to-date in COVID vaccines?

SUBJECT: Yes. So being up-to-date with COVID vaccines was a moving target, as you know, because we had the primary series then. We had the boosters. But going forward, we will, hopefully, only have one booster a year, similar to influenza, based on what's the prevailing variant that's globally present and present in the US. And that, hopefully, we won't have to have multiple and different types of boosters as we go forward. So it is a change from where we were. And hopefully, the future will be just cleaner in terms of what boosters we get.

INTERVIEWER: And I wonder how might that description, that message resonate with those who might have been hesitant to get the shot to begin with.

SUBJECT: I think what we can, at least, reassure people is that we have seen through the primary series, as well as the boosters and now with the bivalent new booster, that we have been able to decrease hospitalizations, deaths, severe disease. And people should continue to get these boosters. If they've had their primary series, definitely go ahead and get this new bivalent booster.

If they haven't had any vaccination at all, we still urge people to go ahead and get started with your primary series, and then get these bivalent boosters two months after they finish the primary series. There's lots of data to show that these vaccines have been very effective in decreasing the burden of disease in the United States and globally.

INTERVIEWER: Is there any evidence to show that these-- of course, you don't know about the boosters at this point, as you say. But what about long COVID? Does it lessen the potentiality of developing long COVID?

SUBJECT: What we have seen so far is that people who've had vaccination are slightly less likely to have long COVID. And so, again, that's another reason to recommend vaccination for people who have never had it.

INTERVIEWER: As you know, uptake has not been great in this country. And I wonder, if this booster doesn't increase uptake and offer broader protection, does that allow the virus to keep mutating?

SUBJECT: It it does because there'll be more infections. And as we have more infections, there's more likelihood of mutations. And again, every mutation may present the virus to be different. It could be more infectious. It could be more lethal. And so, that's the other reason why we need to continue to prevent these infections and decrease the burden of disease by getting vaccinations.

INTERVIEWER: That is important. I wonder about still mask-wearing in some instances, especially in areas that have a high infection rate. So mostly, people are not masking anymore, as we see day-to-day life. I think, in general, we are still recommending people who are at increased risk of severe disease to be masked, particularly when they are in crowded locations or indoor locations, especially as we are going into the fall and winter.

People who are elderly, particularly who have multiple comorbidities, like diabetes or other additional diseases or people who are immune suppressed, I think-- we know that they don't mount as good as an immune response as people who are immune competent. And so, you do need to layer your protection with masking, and hand hygiene, and some degree of social distancing if you can.

INTERVIEWER: And as a physician, as a person, who has studied this, what are you to be watching for here in the next few weeks?

SUBJECT: We will be watching for, hopefully, increased uptake of the vaccine, of the bivalent booster. We are also continuing to monitor the levels of infections, as well as hospitalizations in the country to get a sense of, how is this winter going to evolve? We are obviously also-- The state is monitoring the wastewater viral presence as well to know where is a higher prevalence of infection.

INTERVIEWER: And before you go, there's so much happening in your field of study. Not only do you have COVID, but we're talking about monkeypox, and there's been some polio outbreaks. What's this time like from where you sit as an infectious disease specialist?

SUBJECT: It's completely unprecedented. I've been doing this for 28 years, and I feel that we are definitely in an era of change. And if you really think back from 2009 onwards, there have been quite a number of outbreaks, and the number of outbreaks seem to be increasing. What is this related to? Is this related to global travel? Is this related to other economic and climate change issues? There's just a lot of change happening.

And of course, in parallel, there are a lot of additional human factors that are contributing to these increases in these outbreaks, namely things like, vaccine hesitancy, and distrust, and medical information and also misinformation. And so, I think, there's a lot of factors that are going into the presence and evolution of these new infectious disease outbreaks that we're seeing.

INTERVIEWER: Interesting times Dr. Virk, thank you for the conversation.

SUBJECT: Absolutely. Thank you, Kathy.

INTERVIEWER: We've been talking to Dr. Abinash Virk. She's an infectious disease specialist at Mayo Clinic in Rochester.