Vocational Nurse Cleopatra Oniya administers the Pfizer booster shot at a COVID vaccination and testing site decorated for Cinco de Mayo at Ted Watkins Memorial Park in Los Angeles on May 5, 2022. (Frederic J. Brown/AFP via Getty Images)
That's according to Dr. Peter Chin-Hong, infectious disease expert at UCSF, who says that most healthy people who are up to date on their COVID vaccines can expect to get another booster shot after about a year.
"All roads lead to an annual COVID booster," Chin-Hong told KQED. "We know so far that immunity from the booster in general should last for about a year."
"If you've gotten the primary series, you have protection from serious disease, hospitalization and death for at least a year — probably even longer for most people," he said.
State health officials told KQED that there are no additional booster recommendations at this time, but they will update statewide guidance in the future based on changes or further information from the Food and Drug Administration and CDC.
But, Chin-Hong added, "There are a lot of caveats, meaning that maybe some immunocompromised individuals are older and may need a booster more frequently."
People who are immunocompromised or who have recently had procedures that could disrupt their immune system should ask their doctor about additional bivalent booster shots and whether that’s something they could benefit from, Chin-Hong said.
Chin-Hong said that he’s more concerned about low uptake for the bivalent booster overall, rather than additional doses in people who are up to date with their shots.
Just 38% of San Franciscans have received the bivalent booster, compared with 86% who completed the initial series, according to data from the San Francisco Department of Public Health. Across California, around a quarter of residents have received the bivalent booster and 61% got the initial vaccine.
That’s concerning, Chin-Hong said, because the majority of people who are testing positive for COVID in hospitals today are either not vaccinated or not up to date on their vaccines.
"More than 70% of the people being hospitalized right now haven't gotten a single booster, and the rest are unvaccinated," Chin-Hong said. "The vast majority of vaccinated people haven't even gotten a booster. So that's really the focus."
Immunity provided by a booster typically starts to wear off about five or six months after the jab.
But the immune system doesn’t start from scratch when a vaccine’s immunity begins to wane.
The vaccine provides a blueprint to the body’s cells for how to protect against COVID, Chin-Hong explained — and a booster shot acts as a "reminder" to the immune system. For the majority of people who have been infected with COVID already, that experience provides them with a layer of immunity also.
"The more times your system gets reminded, the longer immunity lasts," said Chin-Hong. "That, to me, is a victory — because as an infectious disease doctor, I'm more concerned that people don’t come into the hospital, are not put in the ICU and do not die."
Under that approach, most people would be advised to get the latest version of the vaccine annually, likely in the fall or winter, similar to the flu vaccine. And also like with the flu vaccine, drug manufacturers would update the annual shot to match the dominant variant that year — like the latest bivalent COVID booster was updated to target both the original coronavirus strain and the dominant omicron variants.
"Having just one bivalent booster is going to take you through the year," Chin-Hong underscored. "If everyone got the bivalent booster that they're supposed to do, that's really the most important point."
What other COVID questions do you have?
This story was in part inspired by audience questions we received about the bivalent booster, and when we might all expect a second dose.
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