COVID boosters have arrived. Here’s what you need to know about them

South Florida pharmacies began receiving the new COVID-19 boosters this week and are accepting appointments for the shots.

Pharmacies like CVS, Walgreens, Publix and Walmart will replace the bivalent booster they previously gave out with a vaccine dose formulated to target the currently circulating COVID strain. Anyone older than 6 months is eligible to get the new shots.

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Federal health officials say the updated COVID shot can help bolster people’s waning immunity as the country heads into fall respiratory virus season. Last fall, the booster provided 80% protection against emergency room and urgent care visits among children. “Even if you’re not worried about severe disease, the vaccine reduces the severity and length of symptoms,” notes Katelyn Jetelina, a public health expert and author of the widely read newsletter “Your Local Epidemiologist.”

On Wednesday Florida’s Surgeon General Joseph Ladapo advised against the shots for anyone under 65, attacking federal public health officials for lack of safety data, allegedly performing bad science, and using Americans as “guinea pigs” for newly approved coronavirus vaccines.

His advice contrasts that of the nation’s top health advisers, many who have spoken out to criticize Ladapo’s advice. On Thursday, Dr. Anand Parekh, chief medical adviser for the Bipartisan Policy Center, noted that multiple scientific agencies and expert researchers conclude the benefits of the boosters outweigh any risks. “The recommendation is that all Americans over the age of six months should get it, but in terms of impact, it’s probably most important for high risk groups such as older adults as well as individuals who are around these high risk groups,” he said.

Florida has the highest COVID hospitalization rate in the country, and cases in the state are rising. Here is what to consider as the boosters reach your pharmacies:

Who has the shots available, and for what ages?

CVS says it will offer either the updated Moderna or Pfizer-BioNTech COVID-19 mRNA vaccines, depending on store location. CVS.com and the CVS Pharmacy app will be updated to reflect active vaccinating CVS Pharmacy locations. All CVS Pharmacy locations are expected to have the vaccination in stock by early next week. Pediatric doses of the Moderna and Pfizer-BioNTech COVID-19 vaccine for ages 5-11 are available at select CVS Pharmacy locations. Parents and guardians should check CVS.com, or the CVS Pharmacy app, to find locations near them with available appointments.

MinuteClinic locations also will begin offering the new COVID-19 vaccine for patients ages 18 months and older in the coming weeks. Pediatric doses of the COVID-19 vaccine for children 18 months through 4 years of age will be available at most MinuteClinic locations.

Walgreens will offer the updated Pfizer and Moderna COVID-19 vaccines. Appointments can be scheduled immediately, with available appointments starting nationwide on Monday. Earlier appointments may be added; inventory is currently on its way to pharmacies nationwide. Pharmacists can administer the updated vaccine to eligible individuals ages 3 years and older. To schedule a COVID-19 vaccination appointment at Walgreens, visit Walgreens.com/ScheduleVaccine, use the Walgreens app or call 1-800-WALGREENS. The online scheduler offers the option to book appointments for up to four people during the same visit.

Publix: Publix will carry the vaccine for ages 12 and up and has begun to accept appointments at Publix.com/vaccines.

Other providers: You can search by ZIP code at vaccines.gov

At home: If you have difficulty with mobility and cannot go to a vaccination site, you may be able to get an in-home vaccination; call 1-888-677-1199 for information.

Who should get an updated COVID vaccine?

Almost everyone should get a booster, says U.S. Health and Human Services Secretary Xavier Becerra.

“You may have been vaccinated several months ago, or vaccinated with one of the previous vaccines, and all of that is good because it provides a level of protection, but if you want to maintain the highest level of protection, you want to get this updated vaccine,” Becerra said during an AARP town hall on Thursday.

Becerra said any individual who hasn’t received a vaccine in the last couple of months, and anyone who contracted COVID more than three months ago, should consider getting the booster, even if you are not in a high-risk category. “We want to go into the holidays being able to kiss and hug our relatives and not affect them,” he said.

Health expert Jetelina is advising a wait time based on your age: People over 65 or at risk for severe disease should get vaccines four months after infection or a previous vaccine. Don’t wait more than six months.

If you’re under 65 and not high risk, wait at least 6 months after infection or a previous vaccine, she says. Ideally, get vaccinated once a winter wave starts taking off. (Getting it by Halloween is a good bet.)

Is the booster shot still free?

The federal government is no longer the supplier of vaccines, but insurance, including Medicare and Medicaid, should cover the cost. This is not the case for the more than 23 million uninsured non-elderly adults in the United States.

“For those who don’t have insurance, we have established a bridge program, which gives people access to vaccines free of charge whether in your neighborhood pharmacy, a federally qualified health center, or a state or local health department,” Becerra said.

As part of the Bridge Access Program, the CDC has contracted with CVS and Walgreens pharmacies to allow them to continue offering free COVID-19 vaccinations to those who do not have insurance. A website has been set up to help people find the providers who are participating in this program. If you go to a pharmacy that does not participate in the Bridge Access Program you may be charged, so be sure to ask in advance.

State health departments will continue to offer vaccines free of charge to eligible children, including those who are uninsured, through the federal Vaccines for Children program.

Are side effects from the new COVID booster different?

“There are people who are having some side effects, but again, side effects are a lot different from dying because you didn’t get a vaccine,” Becerra said. “The best advice is to make sure you are speaking first to your physician. He or she will know best what circumstances you bring to the table.”

Because of side effects, some people may want to wait for the Novavax booster, which uses a different platform than mRNA. Jetelina says high-risk people should not wait for this option if it’s been more than six months since your last vaccine or infection. The Novavax booster is still under FDA review.

Can you get the flu and COVID shots at the same time?

You can get both at the same time, said Parekh, chief medical adviser at the Bipartisan Policy Center. “Many people did that last year and it was convenient. It’s perfectly fine and safe to do so if you wish,” he said.

Experts recommend getting the shots in different arms. Some also believe that getting the COVID booster in the same arm as your previous boosters will increase your immunity.

If want to get the flu and COVID shots at separate times, there is no set amount of time you must wait in between, Parekh said.

He does not advise getting the RSV vaccine and a COVID booster at the same time, saying there has been less research on that combination of shots.

What about mixing the Pfizer and Moderna vaccines?

Jetelina says if you’ve had only an entire Moderna series, you may see marginal benefit from getting a Pfizer booster (and vice versa). But, the science is mixed and isn’t strong. She advises getting whichever brand is most easily accessible.

If COVID shots lose effectiveness, will a booster be needed in the spring?

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The main purpose of these vaccines is to prevent severe illness and death, and the booster should be effective for that through spring, Parekh said. “In terms of preventing symptomatic infection, you’ll likely have a few months’ protection,” he said. “In terms of preventing hospitalizations a little bit longer, and for severe illness and death, you can expect to be protected throughout the season.”

People over the age of 65 or those who are immune-compromised may need a second dose after four months, he said. “Talk to your healthcare provider on whether that is necessary,” he advised.

Will the booster be effective against the new omicron variant BA.2.86?

The new variant, BA.2.86, nicknamed Pirola, is a highly mutated new omicron sublineage.

“We are seeing cases of BA.286 all over the world, but it hasn’t really taken off in a big way,” Parekh said. “Research suggests the new vaccine produces antibodies that are effective against this new variant. It will protect against severe illness, and our current tests and treatments work as well, so there is no need for alarm.”

If you got the initial series but haven’t received boosters, do you need to backtrack before getting the newest booster?

No, you don’t have to backtrack. And in fact, those previous booster doses won’t be available anymore as the new vaccines roll out, experts say.

What can you tell us about the research that went into the latest vaccines? Were they studied in humans?

“In terms of the COVID vaccine, it is the exact same scenario for which we have an annual flu vaccine,” Parekh explained. “Every single year we don’t do new clinical trials of flu vaccines. What we do is we see what are the circulating strains out there in the world and study how to make vaccine that covers those strains. That’s what we do for flu, and that’s exactly what is being done for COVID. The research on the safety is the same. The only thing that is changing is the particular strains that are being targeted.”

Is it worth getting a child vaccinated?

This will be a judgment call for parents, but Jetelina offers these facts to consider:

• More than half of children hospitalized for COVID-19 do not have a co-morbidity, or another illness or condition.

• Behind adults 75 years and older, infants younger than 6 months had the highest rate of COVID-19 hospitalization. The burden of severe illness is lowest among children ages 5 to 17 years compared to other age groups.

• For children, hospitalization rates were lower or comparable to flu. Once hospitalized, though, more kids went to the ICU for COVID-19 than for flu.

• The COVID-19 hospitalization rate for children is higher than other vaccine-preventable diseases

• The prevalence of COVID is highest among young adults.

Cindy Goodman is the health reporter for the South Florida Sun Sentinel. She can be reached at cgoodman@sunsentinel.com, or on Twitter at @cindykgoodman.