Heres what you need to know about fall booster shots for COVID-19, other respiratory illnesses – The Boston Globe

How does the current COVID surge compare to previous waves?

Though the latest numbers suggest that COVID infections are continuing to rise nationwide, infections peaked locally in mid to late July and are now slowly falling. At their apex, waste water numbers in the Boston area were roughly one-third what they were in the last winter wave, which peaked around Jan. 1, said Dr. Shira Doron, chief infection control officer for the Tufts Medicine health system and hospital epidemiologist at Tufts Medical Center.

The good news is that COVID deaths are about a quarter of what they were in January, a decoupling of severe disease, compared to case numbers that Doron attributes to increasing levels of immunity over time.

People have had multiple vaccinations, multiple infections, and the disease is going to just get less and less severe over time, she said.

With autumn quickly approaching, the falling infection rate could easily reverse, Doron noted, which highlights the importance of keeping up to date with boosters.

Local infectious disease experts anticipate updated shots to arrive sometime in September. There will be two different varieties: a traditional vaccine and two vaccines created using the newer mRNA technologies. Both will confer added protection against the latest variants of the disease, but there are some differences.

Both Moderna and Pfizer have updated the formulations of their mRNA vaccines to combat the mutations that have allowed members of the FLiRT family, a subfamily of the Omicron variant, to better evade immune detection, said Dr. Sabrina A. Assoumou, associate professor of medicine at Boston University and infectious disease physician at Boston Medical Center.

But the Novavax booster relies on an older vaccine technology that takes longer to produce, and the process started before the latest surge. It was, however, updated to protect against the JN.1 strain of the virus, an immediate predecessor to the FLiRT variants, which contains many (though not all) of the mutations that have helped FLiRT to evade existing immunity.

Though slightly less effective, Novavax vaccines may appeal to individuals who are reluctant to embrace the relatively new mRNA technology, said Assoumou.

There are probably some people out there who, for whatever reason, did not want to get mRNA vaccines and its important to also let them know that the more traditional version of vaccines is also available, Assoumou said, adding that the safety of the mRNA shots is now well established. The most important message is get something, increase your immunity so that you have some protection, because we do know that immunity wanes. The goal of these vaccines is to prevent severe disease, hospitalization, and death. And all of these vaccines should do that.

The CDCs Advisory Committee on Immunization Practices recommends updated COVID-19 and flu vaccines for everyone age 6 months and up.

Last year, some experts recommended waiting until the approach of an anticipated peak of respiratory infections in the winter, and getting the COVID shot in tandem with an influenza booster, Doron said. But recommendations may differ this year if COVID rates are still high when the new boosters arrive in the clinic.

Assoumou recommends any individual who has not received a booster in four months get the shot as soon as it becomes available.

Cases are high right now, she said. I feel like we all know somebody who had COVID or is recovering from COVID. So I think that given that theres a lot of virus circulating in the community, I would say as soon as it is available to get vaccinated.

The CDC recommends that everyone 6 months and older in the US, with rare exceptions, get a seasonal influenza vaccine. The shot is particularly important for people at high risk of developing flu-related complications, including adults 65 and older, children younger than 2 years of age, and individuals with certain chronic conditions.

But this year, older adults, pregnant women, and the parents of small children also have a new vaccination to consider.

After decades of research, vaccines protecting against respiratory syncytial virus, or RSV, made their debut last year. The highly contagious virus usually causes mild symptoms. But in some cases, it can lead to life-threatening pneumonia and dangerous lung swelling, causing between 60,000 and 120,000 hospitalizations and 6,000 to 10,000 deaths every year among adults 65 and older.

Federal officials have gone back and forth over who should get the one-time shot. Though approved for use by all adults 60 and older, evidence has emerged in recent months suggesting the vaccine may be linked to a heightened risk of a rare nervous system condition called Guillain-Barr syndrome . In its June meeting, a CDC advisory committee said more research and safety analysis is needed.

On Aug. 6, the CDC issued revised guidance, recommending individuals age 75 and older receive the new one-time vaccination. But it stopped short of recommending the shot for all seniors below the age of 75, instead highlighting 11 risk factors that place people age 60 to 74 at increased risk for severe disease due to RSV, including those with chronic heart, lung, or liver disease; severe obesity; certain types of diabetes; and who reside in a nursing home.

In the absence of those risk factors, a provider may still determine that a person in that age range is at high risk and should get the shot, the CDC said.

The CDC also suggests pregnant women and the parents of newborn babies protect themselves from the virus. It recommends either maternal RSV vaccination during weeks 32 through 36 of pregnancy, or infant immunization with RSV monoclonal antibodies. That advice applies to all infants age 8 months and younger, born during or entering their first RSV season, and to infants and children ages 8 to19 months who are at increased risk for severe RSV disease and entering their second RSV season.

Late summer and early fall are the best time to get vaccinated, the CDC says.

Adam Piore can be reached at adam.piore@globe.com.

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Heres what you need to know about fall booster shots for COVID-19, other respiratory illnesses - The Boston Globe