Bi-Valent COVID Boosters – Another No Brainer

The bi-valent COVID booster is on its way.  It should be a big deal, but folks out there have omicron-ic fatigue syndrome, it seems.  “COVID vaccine fatigue” is gripping the nation per Google News, and many are predicting low uptake of the newest, baddest booster.

That’s a problem.

The bigger problem?  The messaging (and the media).  Folks are confused, wondering if they even need this, or if there is any point.

The messaging matters most, and I’m going to try to make this bi-valent booster thing crystal clear. I’ll do so by addressing common questions (or statements) I’ve heard in my travels as Captain COVID Buster.

“I’m sick of getting boosters!”

OK. Thanks.  I’m sick of movie reboots.  

Now that we’ve gotten that out of the way, I reflect back: why?

We took a primary series, about 5 months later we received a booster, then 50+ year olds got another booster about 5-6 months later.

By my calculations…

That’s one vaccine every 6 months.  Is that remarkably greater than the one vaccine every 12 months we all should get against seasonal influenza?

COVID isn’t seasonal like flu. It’s everywhere with two big peaks: Late Spring and Late Fall.  

For the foreseeable future, COVID is going to be a twice-a-year shot.

The smartest thing you could do would be to get your vaccine immediately before those bumps so you are protected when the bumps arrive… whether you’ve recently had COVID or not.

This brings me to my next point…

Stop Counting Boosters

“I’m on my 20th flu vaccine booster!” says no one ever.

We really need to start referring to these boosters as your “Spring COVID Booster” or your “Fall COVID Booster.”

The count of your boosters matters less than how recently you received one.

“Isn’t this too many boosters too much?”

Nope.  There were early concerns of immune fatigue from multiple boosters.  That did not become a reality, so… yippie!

Most news headlines over the past 9 or so months said “Boosters only effective for 28 days” and stopped for the clickbait.  It is also where most people stopped reading, but it was exactly what people kept saying over and over again.

It DEFINITELY can be said that the 1st and 2nd booster benefits got shorter and shorter as the virus changed and the vaccine didn’t.  But we have to finish that sentence.

The benefit that changed wasn’t the one that REALLY mattered.  

Vaccines were still unbelievable at preventing severe disease, hospitalizations, and death.  They just got less effective at stopping the spread entirely.  “Sterilizing immunity” is what that’s called.

So, no, protecting yourself against severe disease and death is NOT just a 2020 thing. 

We know that these things work.  The news writes the articles based on preliminary data because that’s all we have.  They often neglect the follow-up when the real-world data comes in (usually later, after, you know, real-world situations) to show just how beneficial the booster was at each phase.

We can’t let the rhetoric make us forget that these vaccines are UBER effective.  The virus is just a PITA.  Beat up on COVID, not the vaccines or boosters.

“I’ve already had 2 boosters, do I need this (or should I get this one)?”

Yes.  Everyone who is eligible should get a COVID booster within 2-3 weeks of eligibility opening up.  

Remember, COVID vaccines will probably be twice a year, timed with the normal major waves, and you want the booster ASAP.  It’s a life raft allowing you to float over the wave instead of getting knocked over by it.

If you’ve gotten two doses, that means you’re vulnerable. You definitely need the shot. I remember the clawing and scratching you vulnerable folks did for that primary series…

Don’t forget how far we’ve come and why we’ve come so far.

Bi-valent Boosters are a Darn Miracle

If I may interrupt the question-and-answer format to point out something: all of the things we’ve addressed so far, all of the questions I get, all of the narratives in the media, all of the discussion within groups of people, all have a single common theme: hesitation.

I get it.  Stuff is weird.  Our hesitation is grounded. We’re worried that the booster won’t be effective and COVID will still be around. Why bother being sick for 3 days, right?

We feel this way because the virus has changed in two major ways but the vaccine hasn’t. 

Well, now the vaccine has changed. Ba.4 and Ba.5 became dominant just a couple of months ago, and now you have an approved, safe, effective booster.

On top of this, COVID mutations seem to be staying in the omicron lineage.  That means that this booster will be better than others at squashing COVID as it exists right now

We all definitely need to take a step back and recognize how awesome these bi-valent boosters are.

If COVID stays in omicron land, this could be a big victory for us.  I’m thinking that with the proper percentage of uptake, this bi-valent booster may feel a lot like the primary series did against the original strains. 

Has it been too long?  Let me remind you:  the primary series had high sterilizing immunity; it almost entirely reduced spread and symptomatic illness among vaccinated folks.  

With bi-valent boosters, there’s a chance we can regain sterilizing immunity and have greater protection against future omicron strains.

We have a quickly made and approved, fully paid for COVID booster using the new technology that could potentially expedite the off-ramp of COVID as it exists right now. 

Frustration, fatigue, complacency, and hesitation should be put back on the shelf for another day. Right now, we need to get pumped.

“I want to wait to get the booster until_____”

I have heard this the most over the past 7 months.  People want to try to perfectly time their immunization with some party, vacation, concert, or other life events.

That’s like trying to time the stock market.  What’s that famous Warren Buffet quote about timing the market? Oh yeah:

Get the COVID booster when you are eligible, not at some later date, especially if you are vulnerable.  Perfecting the timing for you personally now will screw up the important timing later.

Remember, COVID boosters will probably be twice a year, and vulnerable folks need to stick to that timing.  If you delay vaccination, you could also potentially delay your eligibility for the next dose.

IMPORTANT NOTE: the next dose most likely won’t be more of the same.  We’re going to get better at adapting our twice-a-year boosters to the newest strains.  It’s our only way out.

If you delay, you aren’t protected with the new tech against new strains. That means you’ll have less protection during the upcoming peak.

Ba.4/5 is only a couple of months old, and we already have vaccines for it.  That’s awesome. Take full advantage. Help us reduce omicron transmission NOW.

Therefore, though we think it’s in our best interest to wait until some magical time, delaying vaccination doesn’t help you personally, and it doesn’t help us as a group.

“What about flu shots? Should I wait?”

While it would be uber-convenient to get all your vaccines on the same day.  I’m telling you right now: don’t delay COVID vaccines for flu shots.

In a past article, we highlighted the best time to get a flu shot.

Here, we’re trying to make the point that the best time to get a COVID shot is within 2-3 weeks of them being available, which will probably be about March/April and September.

COVID is the bigger problem, so we prioritize to that. By all means, get vaccinated against influenza, but get your COVID booster as soon as it’s available.

You’re Getting New Cards

You’re entitled to one free ice coffee once you hit 10 boosters!

Seriously, our cards have become less and less relevant (thankfully).  What will matter most is how recently you were vaccinated.  Therefore you don’t need a booster card that looks like this guy:

You just need a card with your most recent bi-valent booster dose.  Put that in your wallet with your completely-full vaccine card, yes, but I’m hoping we drop the original cards and just look at the newest vaccine dates.

My Closing Thoughts

Get this booster.  Be as excited about it as you were for your primary series.

Get it if you’re over 50 and have gotten 2 boosters already.  You are vulnerable, this is especially important for you.

Get it if you’re under 50 and were left out in the cold last booster run due to weird eligibility restrictions that hopefully won’t exist again.  It’s been a while since your last booster. The time is now.

Get this it if you’re completely unboosted and want to join the club.

Move forward with a new perspective: these are amazing marvels that we need to take advantage of. No more counting boosters, just stay current with your probably-going-to-be-twice-a-year booster.

Omicron-ic fatigue syndrome is causing asynchronous uptake of vaccines, and it’s causing many folks to opt out entirely.  We must shut down the rhetoric and return to that shared state of mind we had in January 2021: vaccines are safe, they work, they are THE way out of this, and we all have to do our part.

Don’t forget how far we’ve come and why we’ve come so far.

Just trying to keep it real…

Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth

Dr. Neal Smoller, Holistic Pharmacist

About Neal Smoller

Dr. Neal Smoller, PharmD, is a licensed pharmacist: and owner of Village Apothecary, an independent pharmacy in the most famous small town in America—Woodstock, NY. He’s also the host of the popular wellness podcast, The Big Mouth Pharmacist.”


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