Remember last winter? It was the worst our area has experienced of COVID-19. Hospitals were overwhelmed, local schools and businesses struggled with staff and student absences, and over two dozen Carroll County residents died.
We’re better equipped to handle COVID going into this winter. Most Americans are vaccinated, and most of the rest have some immunity from a previous infection. Paxlovid and other effective treatments are readily available, and we have bivalent boosters that directly target Omicron and vaccines for kids under 5.
Still, we’re starting to see cases rise again, and epidemiologists are predicting another wave in November or December. One way we can make sure this winter is less tumultuous while getting back to normal is to take full advantage of these tools.
Bivalent booster: Who, When, What and Why?
Who? Everyone age 5 and older should get the bivalent booster.
When? Right now, or two months after your most recent COVID vaccination or booster shot. If you recently had COVID, you may consider delaying your next vaccine dose by 3 months from when your symptoms started. It is safe to get the booster at any time once you have recovered.
What is it? The bivalent booster targets the dominant Omicron variants, BA.4 and BA.5, as well as the original strain of COVID-19. They are likely to also protect against the emerging strains that are on their way to becoming dominant, BQ.1 and BQ.1.1, since both of those descended from BA.5.
Why get it? Previous boosters reduced the risk of infection against Omicron by about 50% for several months, and were shown to strengthen and lengthen the protection against severe disease. This booster is the first one that’s been updated to protect against COVID variants so it’s likely to provide event better protection. This fall, if Americans get boosted at the same rate we usually get the influenza vaccine, the CDC projects it will avert 101,000 deaths, 1,028,000 hospitalizations, and 24.9 million infections.
“It’s important to get the bivalent booster because it’s going to provide the best protection possible against the current strains of COVID,” said Josie Lamb, APRN. Medical Director Deborah Cross, APRN, agreed. “The bivalent booster actually covers the way the virus has changed at this point. Even if you’re previously vaccinated, those vaccines are not as effective at this point since the virus has changed. It was great in the beginning, but now we need to stay updated and get the new booster to stay ahead of the virus.”
Lamb added, “We’re still seeing a lot of people with persistent cases of long COVID that affect quality of life and it’s worth doing everything possible to avoid being in that position. We have patients who contracted COVID early in the pandemic, or even several months ago, who have persistent fatigue, shortness of breath, or cardiac symptoms, and it has a big effect on quality of life. I see enough patients with long COVID that it definitely stands out as a significant reason to still take prevention very seriously.”
Getting a booster is especially important for those 50 and older who are most at risk. Older people have less robust immune response, with protection against serious illness fading faster than for younger people. A CDC review after the last booster shot was released this spring showed that for people over 50, it reduced the risk of death from COVID by a factor of 4.
Even if you’ve had COVID recently, Lisa Cushing, PA says it’s definitely worth getting the booster. “The level and length of antibody protection your body develops varies, especially with the new variants. And getting vaccinated after COVID gives you added protection.”
The amount of immune response after infection varies hugely and seems to depend on a few factors, including how severe your illness was and how old you are. Vaccination and subsequent booster shots create more consistent and broader immunity.
Vaccines for kids
Children are less likely to have severe illness when they contract COVID, but it’s still important to make sure they’re up to date on their vaccines. Lamb explained, “It’s worth it for kids to have protection. Kids have a high level of exposure to COVID because they’re in classrooms, which are crowded settings, every day. Sometimes kids will have a more mild illness but they’ll bring the illness home and they can get elderly or more immune compromised people sick, causing some serious problems.”
“Kids can so often be the harbors of infection,” said Cross. “Especially with younger kids, they’re going to be in your close personal space, so if they’re shedding virus, you’re going to get it from them. So that’s a big reason we want to get kids vaccinated, to help prevent the spread of the disease. They might not get as sick, which is great, but they can spread it so fast.”
The vaccine is especially important for kids under 5. The Advisory Committee on Immunization Practices (ACIP), the CDC advisory group, presented data at their most recent meeting showing that kids 6 months to 4 years old currently have a much higher hospitalization rate for COVID than 5-11 year olds or 12-17 year olds. Children under 2 especially are more at risk of serious complications for COVID than older children.
There’s no vaccine for infants under 6 months old yet, but expectant parents can help protect their infants by getting boosted while pregnant. Infants 0 to 5 months old have the second highest COVID hospitalization rate of any group, with only people 65+ surpassing them. Only 24% had an underlying health condition, usually prematurity.
During Omicron, the data presented showed that infants under 6 months whose mothers were vaccinated were 60% less likely to be hospitalized with COVID. Vaccination has been shown to be very safe during pregnancy. COVID infection is less so, and increases the risk of complications including miscarriage, preeclampsia, and still birth. A booster dose in the latter half of pregnancy can confer some antibody protections to your infant in their first six months of life.
Treatment for COVID
We now have treatments that are very effective in reducing the chances of hospitalization and death for people who are more likely to get very sick. Treatment is recommended for those over 50, people who are unvaccinated, and people with certain medical conditions, such as chronic lung disease, heart disease, or a weakened immune system. Paxlovid and other antiviral treatments have to be started within days after your symptoms start. Talk to your provider if you contract COVID and have any risk factors.
Where can you get vaccinated or boosted?
Most local providers and pharmacies have the bivalent boosters and vaccines for all eligible ages, although pharmacies may not offer vaccination for the youngest children. Call your provider to ask about getting a vaccine or booster for yourself or your child.
White Mountain Community Health Center is offering COVID vaccination and boosters to the whole community, with many appointments available throughout the week. We have both Moderna and Pfizer for both boosters and vaccines, including vaccines for children 6 months and older. COVID shots are free of charge. Call (603) 447-8900 for an appointment.