New Bivalent Covid-19 Boosters: When Should You Get These BA.4, BA.5 Updated Vaccines

In order to stay in sync with the latest Centers for Disease Control and Prevention (CDC) recommendations, it’s time to say bye, bye, bye to the original Covid-19 mRNA booster vaccines. Or perhaps bivalent, bivalent, bivalent. Going forward, bivalent versions of the Pfizer/BioNTech and Moderna Covid-19 mRNA boosters are what’s going to be available, replacing the original univalent ones. That’s because on August 31, the U.S. Food and Drug Administration (FDA) officially announced that they had further amended the emergency use authorizations (EUAs) for both the Moderna and Pfizer-BioNTech Covid-19 mRNA vaccines to now include the bivalent formulations of them. And continuing to get the original univalent Covid-19 mRNA boosters when the bivalent ones are available would be kind of like continuing to purchase one-legged pants when two-legged ones are available. That’s because unlike the original univalent boosters, the bivalent ones give you added protection against the now circulating Omicron subvariants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) such as the BA.5. So when asking for your next Covid-19 mRNA booster remember the prefix “bi-.”

By the way, when should you go by the pharmacy, the clinic, or some other vaccination location to get one of these bivalent vaccines that you don’t have to buy because they should be free? Well, if you want to go by the book, the EUA says that you should wait at least two months after you’ve gotten your last Covid-19 vaccination whether it was from your primary series or your last booster dose before getting either of the bivalent Covid-19 mRNA boosters. In theory, if you’ve only gotten one dose of the Covid-19 mRNA vaccine before, you only have to wait at least three to four weeks before getting another dose in order to give your immune system some time to respond to the first dose. The two-month imposed wait may be in part to make sure that there isn’t a flood of people getting the bivalent boosters in the coming weeks. So check your calendar to see when you got the univalent one. You may want to get the bivalent booster as soon as you are eligible. After all, the Covid-19 coronavirus and the pandemic haven’t gone bye, bye yet. And the BA.5 Omicron subvariant is the alpha-dog of the SARS-CoV-2 right now, comprising around 87% of all Covid-19 cases.

In the word univalent, “uni” refers to “one,” as it does in unitard or unibrow, and “valence” refers to the immune system stimulating items in the vaccine. So a univalent vaccine is designed to stimulate your immune system to protect against a single antigen or single microbe. The original univalent Covid-19 mRNA vaccines included one type of mRNA to serve a blueprints for your cells to produce the spike protein that studded the surface of the original version of the SARS-CoV-2. While this univalent vaccine still offers some protection against the currently circulating Covid-19 coronaviruses, its protection is limited since the viruses spike proteins have changed quite significantly.

By comparison, the prefix “bi” stands for two as is the case with a bicycle, bi-weekly, bigamy, and bipalmitoylation. So the bivalent Covid-19 mRNA vaccines have two types of mRNA that code for two different types of SARS-CoV-2 spike proteins: those of the original virus plus those covering the surface of the newer now circulating BA.4 and BA.5 Omicron subvariants. Therefore, these new bivalent booster should offer the same level of protection as the original booster plus a booster of extra updated protection.

Now the amount of vaccine in these new bivalent boosters should be the same as the univalent boosters: 25 mcg in the Moderna one and 30 mcg in the Pfizer/BioNTecg. So think of the bivalent vaccine as a latte where you’ve decided to go halfsies on the two different types of mRNA.

How old do you have to be to get these bivalent boosters? Based on the amended EUAs you can now get the Moderna bivalent Covid-19 booster if you can buy spray paints and change your name in most states in the U.S. That is, you can get it if you are at least 18 years of age. For the Pfizer-BioNTech bivalent Covid-19 booster, you have to be old enough make a will, be the subject of an Anti-social Behaviour Order (ASBO), or register for a Young Scot Membership, which would be at least 12 years of age.

If it’s been at least two months since your last Covid-19 vaccination and you are old enough, should you wait any longer to get the bivalent Covid-19 mRNA booster? For example, should you wait until it’s closer to the late Fall so that you can make sure that your protection extends throughout a possible Winter Covid-19 surge? Probably not. Predicting when specifically the next Covid-19 surge is a bit like timing the stock market. The colder and drier weather accompanied by more activities moving indoors could increase transmission of the SARS-CoV-2 and make it more likely for a surge to occur. But this surge could start anytime in the Fall, especially if a new more transmissible variant comes along. Moreover, even though protection from the booster may peak six to eight weeks after vaccination, this protection is not like a warranty on your laptop or smartphone. It’s not as if you say one day, Holy Batman, the protection is gone. Instead, your immune protection may gradually wane over time, although the wane manner is not yet completely clear. More and longer studies are needed to determine how long protection from the bivalent boosters will last. Chances are the bivalent booster should offer a good amount of protection through all of the Winter months should you get the booster now.

So as *NSYNC sang, “I’m doing this tonight,” in the song, “Bye Bye Bye,” you may want to get the bivalent as soon as they are available, which should be very, very soon. While the U.S. may be just past the peak of the Summer 2022 wave, there have still been daily averages of 36,347 Covid-19-related hospitalizations and 492 Covid-19-related deaths over the past two weeks, according to the New York Times. And remember, vaccination, while effective, is not like a full-body concrete condom. It doesn’t offer 100% protection. You still should layer on other Covid-19 precautions such as wearing face masks while indoors, practicing good hand hygiene, keep areas well-ventilated, and maintaining a reasonable amount of social distancing especially when you are at higher risk for being exposed to the virus like when you are amongst other people. Covid is not over. No one has been able to say bye, bye, bye to the pandemic emergency just yet.


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