Who should get it and when?

This transcript has been edited for clarity.

New and improved COVID vaccines are now available, but who can get it, who should get it, and when should they get it? Two improved mRNA COVID vaccines, from Moderna and Pfizer, have been authorized or approved by the U.S. Food and Drug Administration (FDA) for people 6 months of age and older.

Both vaccines target the KP.2 strain of Omicron's JN.1 lineage. Novavax, It is also approved for JN.1, but for ages 12 and up.

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommends the 2024-2025 updated COVID vaccine for everyone 6 months of age or older. This includes people who have never received a COVID vaccine, those who have been vaccinated, and those who have previously had COVID infection.

The big question is when, but the FDA and CDC have set some criteria: For mRNA updated vaccines, patients must wait at least two months after their last dose of a COVID vaccine before receiving the updated vaccine dose.

The wait is even longer if the patient had COVID recently. Patients can wait three months after COVID infection to get vaccinated, but they don't have to. The FDA's instructions for the Novavax version aren't as straightforward. People can get the updated Novavax dose at least two months after their last mRNA COVID vaccination or at least two months after completing the initial series of two doses of Novavax. Those two Novavax doses must be at least three weeks apart.

Patients can customize their vaccination schedule. Protection is strongest during the first few weeks to months after vaccination, after which antibodies tend to wane. It is a good idea to time vaccination to maximize protection around major events such as weddings or major conferences.

If patients decide to wait, they are at risk of contracting COVID-19. Also, consider which variants are circulating and how much activity there is locally. There is currently a large amount of COVID-19 circulating, most of which are related to JN.1, the target of this year's improved vaccine. If patients decide to wait, they should avoid crowded indoor environments or wear a quality mask for protection.

The bottom line is: Most people (over 95%) have some COVID protection, either from previous infection, vaccination, or both. But if you haven't had COVID recently and haven't been vaccinated in the last year, you're still susceptible to disease without up-to-date protection. The best way to stay healthy is to get up-to-date on your vaccination as soon as possible. This is especially true for people who are in high-risk groups or who are around high-risk people.

Two-thirds of hospitalizations due to COVID are in people over 65. The highest rates of hospitalization are in people over 75 and infants under 6 months of age. These infants are too young to be vaccinated, but vaccination of pregnant and breastfeeding mothers helps protect their infants.

COVID-related hospitalizations continue to show racial and ethnic disparities, with the highest hospitalization rates among American Indians, Alaska Natives, and Black people. People who are immunocompromised, have chronic illnesses, and live in long-term care facilities are also at higher risk. Unlike last year, booster mRNA doses are not currently recommended for people over 65, although that could change.

We have made great strides in fighting COVID since 2020, but the fight is still ongoing. In 2023, nearly 1 million people have been hospitalized with COVID and over 75,000 have died. COVID vaccines can help protect us from severe illness, hospitalization, and death.

Let's be honest, we're all suffering from booster fatigue, but COVID is now endemic. This will continue, and it's much safer to renew antibody protection with vaccination than infection. Another benefit of vaccination is that it reduces the odds of long COVID. COVID vaccine coverage was abysmal last year, with only about 23% of adults and 14% of children getting the vaccine.

But this is a new year and a new vaccine. Make sure your patients understand that the virus has changed significantly. Antibodies built from previous infections or vaccinations are not as effective against these new variants. Antibody levels decline over time, so even if you missed your last few vaccinations without getting sick, you should still consider getting this new vaccine. The 2024-2025 updated COVID vaccine is the best way to catch up, renew your immunity, and stay protected.

Additionally, we are now in the season for respiratory viruses, COVID, influenzaNow is the time to get the three vaccinations for RSV and HBsAg, and patients can receive all three at the same time in one appointment if they wish.

Your recommendation as a physician is powerful: Adults and children who receive a recommendation from their health care provider are more likely to get vaccinated.