A Pfizer COVID-19 vaccine booster shot is administered as the...

A Pfizer COVID-19 vaccine booster shot is administered as the Mount Sinai South Nassau Vaxmobile vists Freeport High School, Tuesday, Nov. 30, 2021. Credit: Newsday/Steve Pfost

This fall, new COVID-19 boosters are expected to be available that are designed to protect against Omicron subvariants, which led to virus surges later in the pandemic. These are some answers to your questions about when and if you should roll up your sleeve.

When are the new boosters expected to be approved and available?

It is not clear when they will be available – it could be in a few weeks, or a few months, medical experts on Long Island said.

The Biden administration says it is aiming for a rollout next month. Dr. Sharon Nachman, chief of the division of pediatric diseases at Stony Brook Children's Hospital, said she is confident that will happen – perhaps mid-September.

But Dr. Bruce Hirsch, an infectious disease specialist at Northwell Health, said he is not so sure of the timeline. “A number of us are a little bit skeptical about this” September rollout, he said. Still, he expects it to be available sometime in the fall.

Nachman said that while her prediction is somewhat optimistic, data on the new vaccine is already available and the vaccine has been tested. Much of the timeline will also depend on how quickly the vaccines can get delivered to pharmacies, she said.

How are the new boosters designed to combat the BA.5 variant?

They are using a “bivalent” approach, meaning they have two components – one that attacks the original COVID-19 virus and another that attacks the latest subvariants, BA.4 and BA.5.

One concern is that some of the subvariants such as the BA.5 are especially good at evading the vaccines, Hirsch said. The strains “are kind of wily.”

 “It is hoped that having a more targeted vaccine will be able to increase the efficacy and increase the immune defense against these newer variants,” he said.

Will the new booster be effective?

Hirsch said he expects them to be effective at helping to prevent serious illness, hospitalizations or death. Even the original vaccines still in use are effective at that, he said.

The vaccines and the new booster do not prevent infection – they prevent the worst outcomes in most cases, Hirsch and Nachman said.

“There is no reason for us to expect it would not be an effective vaccine,” Nachman said. “The choice of not getting it all is a poor choice."

Who should get the new boosters?

Anyone who is eligible, the experts said. In fact, people should in general get all the vaccines and boosters they are eligible for – that is best way to prevent serious illness, hospitalization or death. Nachman said she expects that the new booster eventually will be made available to everyone.

The CDC is expected to meet next month to decide eligibility guidelines but last week the agency said it "anticipated" the new vaccines would only be authorized as a single dose to those who completed a primary vaccination series and may be initially authorized for people 12 and older for Pfizer-BioNTech and for those 18 and older for Moderna. 

When should you get a third booster if you’ve already received two?

Typically doctors recommend waiting four or five months between boosters, but there are still unknowns about the new vaccine. Nachman said it could be a six to eight week wait between a second booster and the new vaccine. Federal health and drug officials will specify those details when the new vaccine is approved, she said.

Since the vaccine should be ready some time in the fall, Nachman said that is a great time to get it, since the winter is expected to be a rough time for COVID-19. She said people should talk to their primary care physician about specific times.

Experts do not recommend waiting for the new booster to come out if you are still eligible for the first two boosters – or even the initial sets of vaccine. They say get whatever you are eligible for. 

“There’s no guarantee when these new boosters are going to be available,” Hirsch said. “And these are not magically fantastic advances over the good protection that we’re having right now.”

“COVID has been very, very surprising and it is still active, and who knows about the next variant. One of the future possibilities is that there will be a new, more dangerous variant for which these vaccine strategies need to be completely rethought.”

What can be done to combat booster fatigue?

Nachman and Hirsch said the best motivation is to remember that one million people have died of COVID-19 – in the U.S. alone. COVID-19’s latest variants, while less lethal than the original strain, still kill hundreds of people a day in the U.S.

“I think the answer to fatigue is to be grateful that those of us who are alive now, are alive to really try to honor as much as possible those people who were unable to survive the epidemic,” Hirsch said.

Nachman noted that the vaccines have prevented millions more deaths. “It’s hard to say, ‘Get another shot, get another shot,’” she said. But people should remember the start of the pandemic, when there were no vaccines and hundreds of people were dying every day in New York State alone.

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