People at High Risk for COVID Can Now Get Another Bivalent Booster

vaccine vials layered on top of each other
Andriy Onufriyenko / Getty Images.

Key Takeaways

  • Older adults and immunocompromised individuals can now get an additional bivalent booster.
  • All COVID vaccine doses in the U.S.—whether a first-time shot or a booster—will now be this updated (bivalent) formulation.
  • A recommendation for the general population is expected later this year.

An additional bivalent booster shot is now authorized for adults 65 and older, as well as immunocompromised people with a higher risk for COVID-19, the Food and Drug Administration (FDA) says.

The move comes nearly a month after WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) recommended older adults and high risk individuals receive another COVID vaccine. Canada and the U.K. have already begun expanded vaccination efforts for these groups.

The FDA says that people 65 and older who have already received one dose of the updated (bivalent) booster shot at least four months ago may receive an additional bivalent booster.

Immunocompromised individuals may be able to receive boosters more frequently. For now, an additional bivalent vaccine is authorized if an immunocompromised person received a dose of the updated booster at least two months ago. Additional doses may be administered at the discretion of their healthcare provider.

The bivalent booster is better suited to current COVID-19 strains than the original vaccine and boosters, but it still doesn’t specifically target the COVID variants that are circulating now. Both Pfizer and Moderna’s bivalent vaccines target the original strain of COVID and the BA.1 subvariant of Omicron. 

The original (monovalent) COVID vaccine is no longer authorized. Anyone receiving a COVID vaccine for the first time will get the bivalent vaccine.

“At this stage of the pandemic, data support simplifying the use of the authorized mRNA bivalent COVID-19 vaccines and the agency believes that this approach will help encourage future vaccination,” Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

During a reporter briefing on Tuesday, Marks referenced data showing that without further vaccination, immunity in older adults wanes over time. Additionally, he said both human and animal data suggest immunocompromised individuals now require more doses.

“I have always thought that COVID booster vaccines should be risk-based, and I think there exists a group of people who might benefit from frequent boosting—the immunocompromised, the elderly, those with multiple medical comorbidities,” Amesh Adalja, MD, senior scholar at the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, told Verywell. “Targeting those at risk for severe disease, as opposed to one-size-fits-all recommendations, has always been the optimal policy, and it is good that the FDA is finally embracing this strategy.”

The CDC’s Advisory Committee on Immunization Practices (ACIP) has since backed the FDA guidance, meaning the shots will be available to eligible people in the coming days.

The FDA added that most people who’ve already received one dose of the bivalent vaccine aren’t yet eligible for another dose. A decision for offering more boosters to the general population this fall will likely be made in June.

Despite the new recommendation, it’s doubtful that everyone who can receive another booster will actually get one. The Kaiser Family Foundation, a national health research group, recently reported that only 23% of U.S. adults received the initially authorized bivalent booster. Only half of U.S. adults surveyed said they would get an annual COVID-19 vaccine if it were recommended.

What This Means For You

If you are 65 and older or immunocompromised, you are now eligible for another bivalent booster if you’ve already received one dose of it. Until May 11, 2023, when the COVID public health emergency ends, the vaccines are free.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

By Fran Kritz
Fran Kritz is a freelance healthcare reporter with a focus on consumer health and health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.