Central Florida providers have begun administering new Pfizer and Moderna COVID-19 “bivalent” boosters that target the currently-dominant omicron BA.5 subvariant, the BA.4 subvariant, and the original virus.
Moderna’s formula is authorized for use as a single booster dose in people 18 years and up. Pfizer’s is for people 12 years and up.
The shots — approved by the Food and Drug Administration in August and then recommended by the Centers for Disease Control and Prevention on Sept. 1 — are advised for almost all fully vaccinated people 12 and up as long as it has been at least two months after their last shot or COVID-19 infection. People who are immunocompromised should talk with their doctor.
This booster, as with the other COVID-19 vaccines, will continue to be offered free regardless of insurance status.
Sanford resident Seth Jestus, 35, booked an appointment as soon as he heard the news because his fiancée has type 1 diabetes, a condition that puts people at increased risk of getting severely ill from COVID-19.
“I try my best to take her health extremely seriously and will do whatever it takes to make her feel at ease and comfortable with the situation that she’s been dealt as a diabetic,” Jestus said.
After getting the shot on Tuesday, he said his symptoms were similar to the ones he had after getting his first three Pfizer shots: headache, fever and vomiting. They cleared up after 24 hours.
Ryan Stotler, who lives in a Tampa suburb, also plans to boost himself and his son to protect both of them against the possibility of severe disease.
“For the last 3 months Florida has been number 1 in the nation for Covid deaths,” he wrote. “Much like I’ve gotten a flu shot every year, this is just another way to mitigate risk.”
Jill Roberts, an associate professor at the University of South Florida College of Public Health, reiterated that almost everyone over 12 who is fully vaccinated should get this shot, even Floridians who have already been infected or double-boosted.
This COVID-19 shot and the annual flu shot can even be scheduled for the same time, one in each arm.
“A vaccine is essentially free immunity. And I say that because it’s free from the side effects of the disease itself,” Roberts said. “There’s individuals already who are trying to figure out how they can get disability and things like that for long COVID, and the more we can limit that, the better.”
The CDC estimates one in five Americans who catch COVID-19 have “long COVID-19,” new chronic symptoms that linger for months or even years after they stop being contagious.
Until now, vaccines have targeted the original strain of COVID-19, even as delta then omicron emerged and became dominant, said Dr. Ashish Jha, White House COVID-19 Response coordinator, at a Tuesday news conference.
“For the first time since December of 2020, these vaccines — our vaccines — have caught up with the virus,” Jha said.
The news comes as BA.5 continues to dominate Central Florida wastewater.
On Aug. 29, the omicron BA.5 subvariant mutation was detected in about 90% of SARS-CoV-2 variant genomes, shed by infected people when they go to the bathroom, according to data provided by Frank Martz, city manager of Altamonte Springs. The Altamonte sewer service area covers parts of Orange and Seminole counties.
Orange County on Thursday reported an 18.5% positivity rate. Florida Department of health data indicated the county has over 3,000 new cases over the last two weeks, though the popularity of at-home tests means many results go unreported; 167 in Orange are hospitalized, according to Department of Health and Human Services data.
Making of the booster
Updates to the original vaccines were recommended amid concerns that their effectiveness to prevent infection waned over time and was very low against new omicron subvariants BA.4 and BA.5, even as the protection they offered against severe disease seemed to hold up.
“We fully expect that the updated bivalent vaccines ... will offer better protection against currently circulating strains than the original vaccines, although it is difficult to predict at this point how much better that protection will be,” said Dr. Anthony Fauci, White House coronavirus response coordinator, this week.
The new vaccine appears to be safe and effective, though human clinical trials are still ongoing. Pfizer and Moderna originally designed this updated booster to target BA.1, the initial version of omicron that caused last winter’s record-breaking COVID-19 surge. When BA.4 and BA.5 developed to be even more infectious than the original version of omicron, the FDA told the drugmakers to change course.
Though there wasn’t enough time to complete clinical trials for this new version before the fall rollout, evidence of the safety and efficacy of the original and BA.1 boosters indicates this booster will also be safe and effective. The new vaccines use the same mRNA technology as the old ones.
“These vaccines are manufactured using the same process,” an FDA news release says.
Clinical trial data from the BA.1 iteration suggests the booster incites mild side effects similar to the shots that came before it, such as arm soreness, fatigue and body aches.
Rarer side effects such as myocarditis may occur after vaccination, however, a CDC analysis of electronic health records from 40 U.S. health systems indicated myocarditis is more common after COVID-19 than it is after vaccination.
Fauci added this shot will potentially usher in a new era of annual COVID-19 shots —tweaked based on the subvariant expected to circulate that year — because the virus likely won’t evolve very far from BA.5.
“You’ve got to put the wildcard of a way-out, out-of-left field variant coming in. If that happens, all bets are off,” Fauci said. “But if we continue to have an evolution of what we used to call and still do call an ‘influenza adrift’ — not a major change, but just sort of drifting along the BA.5 sublineage — I believe that ... we’ll be able to cover what is out there.”
Roberts agreed that drastically different variants will always be a concern for Florida, but are unlikely.
“What’s going to happen is most mutations are going to deviate very, very little from the original,” she said. “And so if that’s the case, the vaccines are still going to have enough activity that it won’t matter.”
A list of nearby sites that offer bivalent Moderna and Pfizer vaccines can be found at vaccines.gov. For now, here’s how and where to get a free appointment as of Friday:
Some local Walgreens have appointments available for both the Pfizer and Moderna boosters, which can be made at the same time as a flu shot appointment. Schedule an appointment at Walgreens.com/ScheduleVaccine or through the Walgreens app.
CVS has appointments available for the updated Pfizer booster at cvs.com/vaccine or through the CVS Pharmacy app. The store allows customers to make an appointment for a flu vaccine and COVID-19 booster in one appointment.
Some Central Florida Publix pharmacies are currently offering both the updated Pfizer and Moderna boosters, which can be booked at the same time as a flu vaccine. Check availability and make an appointment at https://www.publix.com/covid-vaccine.
Some local Costcos offer the Moderna bivalent booster, which is only available to people 18 and over. Check availability and make an appointment at costco.com/covid-vaccine.