Do I need the new COVID booster? Eligibility, side effects, cost and more

As the United States enters the thick of respiratory virus season and the holidays approach, health officials are urging more Americans to roll up their sleeves and get the new COVID-19 booster.

The updated vaccines are recommended for everyone ages 6 months and older to protect against severe illness this winter, according the U.S. Centers for Disease Control and Prevention.

Unlike the last round of boosters, the new shots for 2023-2024 have been reformulated by manufacturers to target the latest variants.

Since the CDC signed off on the vaccine rollout in September, millions of doses have arrived at pharmacies, doctor’s offices and health clinics around the country.

However, uptake of the new shots has been lagging. As of Nov. 17, only 14.8% of adults and 5.4% of children in the U.S. have gotten the updated vaccine, according to the latest CDC data.

Amid concerns about a winter coronavirus surge, the Biden Administration is encouraging more people to get jabbed.

“As we get into the holidays, we need to protect each other, and too few people have gotten the vaccine so far,” CDC Director Dr. Mandy Cohen said on the TODAY show Nov. 21.

Although the updated COVID-19 vaccines only target one variant, omicron XBB.1.5, the shots are expected to offer protection against more recent strains, including the newly dominant HV.1 variant, EG.5 or "Eris" and BA.2.86 or "Pirola."

The U.S. Food and Drug Administration has approved three COVID-19 vaccine options so far: two mRNA vaccines from Moderna and Pfizer-BioNTech for everyone 6 months and older, and one protein-based non-mRNA vaccine from Novavax for everyone ages 12 and older, NBC News reported.

The CDC recommends everyone who is eligible get least one dose of an updated booster to protect against serious COVID-related outcomes, including hospitalization and death.

Although COVID-19 infections and hospitalizations are trending downward after a late summer surge, experts expect cases to rise again this winter, following seasonal trends in recent years.

What's more, cases of influenza and respiratory syncytial virus are increasing, stoking fears about another "tripledemic" of COVID-19, flu and RSV.

“COVID continues to pose a health threat, but we have more and more tools,” said Cohen. “Getting vaccinated is still the most important way you can protect yourself and your family.”

The initial vaccine rollout hit some speed bumps, including high demand at pharmacies, cancelled appointments and insurance obstacles, the Associated Press reported. Last month, parents reported difficulties getting their children vaccinated as providers struggled to stock up on child-size doses.

However, experts say they do not expect long-term delays in COVID-19 vaccine availability, and the Biden administration says insurance issues for COVID-19 vaccines have largely been resolved.

"They did have some hiccups right at the beginning, but that's all been ironed out," said Cohen.

Here's what else we know about the updated vaccine, availability, side effects and cost so far.

What is the newest COVID-19 booster?

The newest COVID-19 booster is an updated vaccine that targets the omicron XBB.1.5 variant, which was the dominant strain circulating in the U.S. for most of 2023.

Although many are referring to the updated vaccine as a booster, the shot looks different from its predecessors. It may be first of what will become an "annual COVID-19 shot" that gets revamped every year, similar to the seasonal influenza vaccine, Dr. Mark Mulligan, director of NYU Langone Vaccine Center, tells TODAY.com.

Unlike the last round of boosters, the updated mRNA vaccines are monovalent, which means they target one variant. The previous booster rolled out last fall was bivalent, meaning it included two strains — the original SARS-CoV-2 virus and the omicron BA.4 and BA.5 subvariants, says Mulligan. The bivalent vaccine is no longer authorized by the FDA, the CDC said.

In recent months, the XBB.1.5 subvariant targeted in the updated vaccine has been overtaken by new strains including HV.1, EG.5 or "Eris," F.L.1.5.1 (dubbed "Fornax"), and XBB.1.16 or "Arcturus" — which are all descendants of the omicron XBB lineage and close relatives of XBB.1.5, TODAY.com reported previously.

Fortunately, the updated vaccines are expected to provide good protection against the variants currently circulating, the FDA said.

This summer, a highly mutated new variant called BA.2.86 or “Pirola” gained global attention after health experts thought it was more adept at bypassing immunity from vaccination and prior infection than other variatns. However, new data suggests BA.2.86 may not be as immune-evasive as initially thought and that the updated COVID shots are likely still effective against the strain.

Moderna said its updated COVID-19 vaccine prompts a strong immune response against BA.2.86 and generates neutralizing antibodies against other variants, including EG.5, and FL.1.5.1. Pfizer also announced that its reformulated vaccine produces an antibody response against the various omicron sublineages in circulation.

“The new vaccine is targeting subtypes of the omicron variant that not all of us have been exposed to yet ... so it’s not quite a booster. This is trying to give us immunity against a different version of the virus,” Dr. Priya Sampathkumar, infectious disease specialist at the Mayo Clinic, tells TODAY.com.

Vaccines work by training the immune system to recognize a virus and fight it off before you get infected, says Mulligan.

About 95% of the population already has some degree of immunity from prior infection or vaccination, he adds. However, this protection has waned over time, and the virus has mutated. The new COVID vaccine will act to "update" the body's immune memory so it can respond faster and stronger to the virus, Mulligan explains.

"Receiving an updated COVID-19 vaccine can provide enhanced protection against the variants currently responsible for most infections and hospitalizations," the CDC said.

“The virus has changed, so you want the most updated protection you can get,” Cohen said.

Is the new COVID booster available?

People can get the new COVID-19 vaccines from Pfizer, Moderna, and Novavax right now. The new boosters have already arrived to pharmacies, doctor's offices, health departments and clinics around the country, and doses will continue to arrive in the coming weeks and months.

"There is plenty of supply of vaccines for COVID," said Cohen.

The experts still encourage people to call their pharmacy or doctor's office ahead of time to make sure they have the shots in stock before making an appointment, especially if they want one from a specific manufacturer.

Another important change is that the CDC is no longer printing COVID-19 vaccination cards. Existing cards are still valid, but otherwise people can get their vaccination records from the pharmacy that administered their shots or state immunization registries, the Associated Press reported.

Am I eligible to get an updated COVID vaccine?

According to the FDA, the following people are eligible to get the following updated COVID-19 vaccines this fall and winter:

• Individuals 5 and older (previously vaccinated or unvaccinated) are eligible to receive a single dose of an updated mRNA vaccine from Pfizer or Moderna at least two months after receiving their last dose of any COVID-19 vaccine.

• Children ages 6 months through 4 years who have previously been vaccinated against COVID-19 are eligible to receive one or two doses of an updated mRNA COVID-19 vaccine.

• Unvaccinated children ages 6 months through 4 years are eligible to receive two doses of the updated Moderna COVID-19 vaccine or three doses of the updated Pfizer-BioNTech vaccine.

• Previously vaccinated individuals ages 12 and older are eligible to receive one dose of the Novavax COVID-19 vaccine adjuvanted 2023-2024 formula, at least two months after their last dose of the original vaccine or bivalent booster.

• Unvaccinated individuals ages 12 and older are eligible to receive two doses of the Novavax vaccine, given three weeks apart.

• Immunocompromised individuals ages 12 and older are eligible to receive an additional Novavax dose, administered at least two months after their last dose of any updated 2023-2024 vaccine.

The new vaccines are safe and effective, the FDA said, and its assessments have demonstrated the benefits outweigh any risks.

Who should get the updated COVID booster?

The CDC recommends everyone 6 months and older get the new COVID-19 booster.

While the risk of COVID causing severe illness, hospitalization and death is highest among people ages 65 or older and immunocompromised individuals, it can cause hospitalizations and deaths among young and healthy people as well, Mulligan stresses.

“While the vaccine is pretty good at preventing infection in the first couple of months after you get it, it’s very good at preventing severe disease, hospitalization and deaths many months after you get it,” Dr. Kawsar Talaat, co-director of clinical research at the Johns Hopkins Institute for Vaccine Safety, tells TODAY.com.

So even if you do still get COVID-19 after vaccination, the experts note that it’s much more likely to be mild.

“We know the risk of long COVID increases with each infection of COVID, and there is increasing data ... that suggests vaccination can reduce the risk of long COVID,” says Sampathkumar, adding that this is another reason for young, healthy people to get vaccinated.

"People are still getting long COVID symptoms from the virus even if you get a mild case," Cohen noted.

Additionally, vaccination also helps produce herd immunity, which protects vulnerable individuals. "If I am a young healthy person who is vaccinated and either doesn't get COVID or only has mild COVID, I'm less likely to transmit it to people around me," says Mulligan.

When is the best time to get the new COVID booster?

Right now, the experts say. "Get your appointment. It's never too late to get vaccinated,” said Cohen.

High-risk individuals should not hesitate to get the shot, experts note.

However, if you've recently recovered from a COVID-19 infection, the experts recommend waiting a few months to get the updated vaccine. The CDC has previously said people with a recent infection should consider delaying vaccination by three months.

"You (want) the immune system to go back into its resting state. ... In order for the updated vaccine to be most effective, you want to have mostly recovered from prior infection," says Mulligan.

If you recently got the original COVID-19 vaccine or the bivalent booster this summer, the FDA recommends waiting at least two months before getting the updated vaccine.

Individuals who are high risk and recently received the previous bivalent booster or recovered from infection should talk to their doctor about the best time to get the updated shot, the experts note.

It is safe to get the updated COVID vaccine and the seasonal flu shot at the same time, says Mulligan, who recommends knocking out both shots during the same appointment. "People are busy and it's efficient, so having the option of a 'twofer' is a great thing," he adds.

Last week, Pfizer announced that its candidates for a new combination shot targeting both COVID-19 and the flu will move to final-stage trials following positive initial results from earlier stages.

A new RSV vaccine is available for pregnant individuals (to prevent RSV in newborns), and individuals ages 60 and older. It is also safe to get all three vaccines at or around the same time, experts note.

Side effects of new COVID vaccine

Side effects from the vaccine can vary from person to person and dose to dose, the experts note. According to the CDC, the most common side effects from COVID-19 vaccination include:

• Pain, redness or swelling at the injection site

• Fatigue

• Muscle aches

• Headaches

• Chills

• Low-grade fever

"Most of us have had several prior doses of the COVID vaccine, so it's anticipated that the side effects will be similar to what you had with the prior doses," says Sampathkumar.

Side effects will typically go away within a day or two, Mulligan notes, and these can be managed at home with supportive care like rest, fluids and over-the-counter pain relievers.

"If there's concern about the side effects or feeling bad for a day or two, what I recommend is to get the vaccine on a Friday or the weekend," says Mulligan.

The good news? Although side effects can be unpleasant, they are actually a sign that the the body's immune system is responding and the vaccine is working, experts note.

Is the booster free or will it cost money?

Since 2020, the cost of COVID vaccines was covered by the federal government, and every person in the U.S. was able to get jabbed for free regardless of insurance coverage.

When the federal public health emergency ended in May 2023, vaccine purchasing shifted to the private sector, Cohen noted. The updated vaccines will not be provided by the government — fortunately, the majority of Americans will still be able to get the shots for free, the CDC said.

Most private and public insurance plans, including Medicare, will cover the cost of the updated vaccine, says Mulligan. However, people may need to visit an in-network provider to avoid out-of-pocket costs.

Pfizer and Moderna have said they are pricing each vaccine dose at over $100, NBC News previously reported.

If your health plan does not cover the cost of the vaccine, or you are one of the approximately 30 million uninsured Americans, there are still options. According to the CDC, these individuals can get a free vaccine at local health clinics, state, tribal, or territorial health departments and participating pharmacies.

How many COVID boosters will we need?

Barring the emergence of a significantly more contagious variant in the near future, the FDA said it anticipates that the COVID-19 vaccines will need to be updated annually.

Just like the flu vaccine is tweaked every year to better match the strains expected to circulate that season, the COVID-19 vaccine will likely be reformulated to better match the new, mutated variants circulating, the experts note.

While it's unclear how soon the vaccine will need to be reformulated, experts say COVID vaccines — and COVID — are here to stay.

“I know folks are over COVID, and they want to leave it in the rearview mirror, but it’s here with us," Cohen said.

This article was originally published on TODAY.com