Taking the Pulse: Bivalent COVID-19 Boosters

Last month, the new bivalent COVID-19 booster shot became available to the majority of Americans. However, only a small percentage of eligible people have received a bivalent booster. That’s due to a lot of different factors.

First of all, COVID-19 vaccination has been a hot-button topic from the very beginning. In a recent article, ProPublica pointed out situations in which public health officials did not clearly communicate to the American people what to expect from the vaccines. As a result, when the expected “breakthrough” infections occurred, many people started to believe that the vaccines weren’t working at all. But they were: COVID-19 vaccines have reduced severe illness, hospitalization, and death rates.

This misunderstanding, combined with preexisting anti-vax sentiment, impacted vaccine usage. While 80% of Americans have received at least one dose in their primary vaccine series, only 68% of Americans completed that initial series of shots. Only one-third of eligible Americans have received a booster shot of any kind.

The reason: people simply aren’t as concerned about the virus as they were a year ago. President Biden said the pandemic was over. There are no widespread mask mandates. The CDC has scaled back their recommendations for quarantining after exposure to COVID or a positive test result. That lessening of public cautionary measures has made Americans less likely to care about COVID-19 at all.

So should you get the new booster? Should you be concerned about COVID-19 at all? Let’s tackle those questions and more.

What is the bivalent booster?

This summer, the FDA determined that the COVID-19 vaccines needed to include an Omicron component in order to protect Americans against the dominant variant. This makes the vaccines bivalent, which means they contain two strains of a given virus. This isn’t unusual. Flu shots are typically quadrivalent and protect against two influenza A strains and two influenza B strains.

The CDC strongly recommends getting the updated booster sooner than later.

But isn’t the pandemic over? Why should I get the booster?

The pandemic is not over. Although rates of new cases, hospitalizations, and deaths have declined in recent months, thousands of patients are still hospitalized every day. Hundreds die every day. Over a million Americans have died of COVID-19 since the pandemic began.

The COVID-19 vaccine and boosters can significantly reduce your risk of severe illness and death.

  • Without a primary series of vaccines, people 6 months old and older are 5x more likely to die than those with a primary series.
  • People over 50 without a primary series are 12x more likely to die than people over 50 with the primary series and two or more booster shots.
  • People over 50 with a primary series and one booster are 2x more likely to die than people over 50 with a primary series and two boosters.

Even allowing for some flaws in the data, it is absolutely clear that vaccines are protective. Older people should receive boosters whenever recommended, as risk seems to increase with age. At the very least, everyone over 6 months should receive a primary series of COVID-19 vaccines.

After all, even if you are not a high-risk patient, you could pass a COVID-19 infection to someone who is. Even one mild infection could lead to long COVID. Long COVID has already disabled millions of Americans, keeping up to 4 million people from being able to work. That’s not a risk anyone should take.

Am I eligible to get the bivalent booster?

According to CDC guidance to providers, “Currently, anyone aged 12 years or older who has completed at least a primary series is eligible for a bivalent booster, regardless of number or type of prior booster doses received so long as at least two months have passed since their last COVID-19 vaccine dose.”

On September 26, Pfizer and BioNTech announced they had requested Emergency Use Authorization of a bivalent booster for children 5-11 years old and is studying safety and effectiveness in children as young as 6 months. But as of this writing, no bivalent boosters have been approved for children under 12.

What if I have COVID-19 now or recently recovered from an infection?

It’s recommended that people wait three months after a COVID-19 infection before getting the bivalent booster.

Where can I get the bivalent booster?

It should be available anywhere that offers the primary COVID-19 vaccines. You will probably need to make an appointment, but some locations may allow walk-ins. If you’re struggling to find a bivalent booster in your area, talk to your doctor or try the government vaccine website to identify locations where you can get an appointment.

Is it okay to get the booster and the flu shot at the same time?

Yes, it’s absolutely okay! But weigh the pros and cons before you make your vaccine appointment.

While experts recommend getting the COVID-19 booster as soon as possible, most recommend getting your flu shot in late October. Flu shots offer about four months of protection from influenza. If you get your flu shot too early and the flu season peaks in late February or early March, you might catch the virus after all.

So take a moment to reflect. Will you be exposed to the flu at work or school? Do you care for young children or adults over 65 years old? Do you have a chronic condition or are part of a high-risk group? If so, consider waiting until later in the month to get your flu shot.

If you do choose to spread out your shots, get the booster ASAP. Schedule your flu shot for late October, so you’ll be protected during the winter months. And we do mean schedule that flu shot! Don’t let yourself forget.

If I get both vaccines at the same time, should I get them in different arms?

That’s a matter of personal preference. If you usually experience soreness at the injection site, you may wish to get them both in your non-dominant arm. The vaccines will still work the same way, regardless.


Get the bivalent booster now (though if you haven’t finished your primary COVID-19 vaccine series, do that first). Get a flu shot by the end of October. If you have questions about the booster, the flu shot, or anything else COVID-19 related, talk to your doctor. In short, give your immune system the fuel it needs to protect you as we head into the colder months and spend more time inside.

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