Ask an Expert: Do I Really Need the Bivalent Booster? And Will I Need It Again?

Hilary Marston, MD, MPH, is the chief medical officer of the Food and Drug Administration, serving as the primary clinical advisor for the commissioner of the FDA. She also oversees the Office of Clinical Policy and Programs (OCPP). 

Before joining the FDA, Marston was a senior advisor on the COVID-19 Response Team at the White House and served as director for medical biopreparedness and response at the U.S. National Security Council.

If you’ve been dragging your feet on getting the newest version of the COVID-19 booster shot, you’re not alone.

While over 226 million Americans are fully vaccinated, only 19 million of them have received the bivalent booster, which targets two Omicron subvariants in addition to the original type of COVID.

The enthusiasm and sense of urgency surrounding vaccines has certainly waned, and is complicated by the fact new variants always seem to outpace vaccine technology. Do you really need this booster if it wasn't designed to target those so-called “Scrabble variants” like BQ.1 or XBB? Can you just wait for the next one, especially if COVID boosters are going to become an annual reality?

You really need it, and you need it now, says Hilary Marston, MD, MPH, is the chief medical officer of the Food and Drug Administration (FDA).

“This is the right moment,” Marston told Verywell. “Before the holidays—particularly about a month before you’re going to be gathering with your families, multi-generational families in particular—is the moment to get yourself protected.”

Verywell spoke with Marston about the efficacy, timing, and outlook of the COVID-19 bivalent booster, as well as what to expect for this winter.

This interview has been edited and condensed for clarity.

Verywell Health: The latest bivalent COVID booster targets the Omicron BA.4 and BA.5 subvariants, but other variants are already circulating, like B.Q.1 and B.Q.1 1. How well is this booster going to do against those variants and anything else that pops up?

Marston: All of these variants that are coming are of the Omicron lineage. We’re still confident that the booster will provide protection against severe disease. But it’s very important that people get the updated vaccines as soon as they can.

There are a number of variants that we have our eye on, along with the CDC [Centers for Disease Control and Prevention]. We are always looking at the latest science that’s available, particularly in the setting of getting boosted. Folks do seem to maintain their protection from past variants, particularly against severe disease.

Verywell Health: Are people going to need another booster in six months, a year, two years?

Marston: The virus has the say about this. We’ll be keeping track of variants as they emerge, and of the degree of protection that the vaccines provide over time, The pace at which they’re updated still has to be determined.

Verywell Health: Do you see a COVID booster shot becoming annual like a flu shot?

Marston: It’s very, very possible. Influenza has been around for time immemorial. The pace at which it spreads across the country over the course of a year is pretty well set. COVID is not yet a seasonal virus. It has some seasonal properties, and we expect to see increases as we’re indoors more, which is one of the reasons why we’re encouraging these boosters. But it will continue to transmit across the course of the year and that means new variants can continue to evolve.

Verywell Health: As of October, the new booster shot is recommended for everyone over age 5 or 6, depending on the brand of the vaccine. Why is it important for kids that young to get vaccinated and boosted?

Marston: There’s no question that the folks who are suffering the most illness, the most hospitalizations, and the most deaths from COVID-19 are adults with comorbidities and those who are elderly. But that’s not to say that there are no health effects in children.

COVID can have post-infection consequences such as long COVID or blood clotting issues, and I think we’re still trying to understand how much of a public health problem that we have there. But even if they make up just a small percentage of cases [in kids], with so many people getting infected, it is going to have significant public health consequences.

Verywell Health: What’s your biggest recommendation for protection against a winter COVID surge?

Marston: I think the most important thing that everyone can do as we’re approaching the winter months is to go out and get your booster shot if you’ve not already done it. We’re fortunate to have updated vaccines against BA.4 and BA.5. We looked very carefully at the science on the safety and immune response that these vaccines were able to give.

We’re confident that we’re offering the best product that could be available to the American people, and it’s offered free of charge in your neighborhood. So, we really, really encourage people to go out and get it.

I think folks have a lot of things on their mind and we’re competing for attention with other concerns. But we really would encourage people to take advantage of the program that’s being made available.

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.