We are glad of the news that the updated bivalent COVID-19 booster is now approved and available. We see the arrival of the new booster as another hopeful milestone with the data the FDA considered in its approval strongly suggesting improved protection against currently circulating variants. We appreciate the continued engagement of many partners involved in assuring equitable reach of the vaccine.

New Bivalent Boosters

The significant news on the vaccination front is that the FDA has authorized and CDC recommended the updated COVID-19 booster for Moderna for adults 18 years and older and for Pfizer for those 12 years and older. This updated booster is now recommended for everyone age 12+ who has completed the primary series. We recommend that populations at greatest risk of severe COVID infection, including the elderly and those with underlying medical conditions, get the booster as soon as they are eligible. In addition, those in group settings, such as schools and congregate living facilities, are encouraged to get the updated booster as soon as possible. 

The updated COVID-19 boosters add Omicron BA.4 and BA.5 spike protein components to the current vaccine composition, helping to restore protection that has waned since previous vaccination by targeting variants that are more transmissible and immune-evading. This bivalent vaccine protects against two strains – the original virus strain and the Omicron variant. The COVID-19 booster dose can be co-administered with other vaccines, including flu vaccines. 

To be eligible, those age 12+ must have completed their primary vaccination series or gotten their last booster shot at least two months prior to getting the updated booster. For those age 18+, either vaccine can be used, regardless of one’s prior doses.

For those who have been infected recently, the CDC states that you may consider waiting three months after infection to get boosted. This ensures maximum benefit as the body’s natural immune response, prompted by the virus, starts to wane. 

The updated boosters are available through many pathways. Pharmacies began offering appointments last week, and Kaiser, Palo Alto Medical Foundation, and other primary care providers are making appointments available now. 

We are offering the updated booster through the County-run community clinics in East Palo Alto, North Fair Oaks, San Mateo, Half Moon Bay, South San Francisco, and Daly City on a walk-up basis this week and will be offering appointments through MyTurn around September 21st. Our website will continue to have updated information about our offerings.

We believe Dr. Rochelle Walensky, CDC Director, said it well: “If you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”

Our local San Mateo County COVID-19 epidemiology reinforces the rationale for vaccination, including boosters, as our data show that the COVID-19 virus continues to circulate quite widely even though there has been a decline from peak levels. The concentration of COVID-19 in wastewater in and around San Mateo County is 2- 5 times higher than the lows in March.

The number of patients hospitalized in San Mateo County with COVID-19 was 21 as of yesterday and has fluctuated between 20 and 30 for the last couple of weeks, compared to levels of between 30 and 60 for most of the summer. This decrease is encouraging though these numbers still exceed the low of 4 to 8 hospitalizations in early April. 

There is significantly less risk of severe illness, hospitalization and death compared to earlier periods of the pandemic due to the many tools available to reduce COVID-19 severity. In this context of increased community immunity against severe disease, our number of reported cases and hospitalizations categorize us in CDC’s Low community level.

The key messages for prevention and protection remain relevant as we head into the fall and winter seasons. In addition to vaccination, including boosters, we continue to strongly recommend wearing a high-quality mask in indoor public settings and increasing ventilation – such as by opening windows and doors where possible – to help prevent infection. We urge residents to test if symptomatic and to be in contact with their physician. If you test positive, a physician can assess if COVID treatments are right for you. 

Monkeypox (MPX)

This outbreak is an additional significant current public health priority. The risk of transmission to the public remains low. We continue to support residents who contract MPX, as well as those who are most affected and at greatest risk for infection. We currently have a total of 68 cases. In addition to case investigation and contact tracing to slow transmission of infections, we are supporting improved pathways for treatment for those who need it and vaccination for those at highest risk of exposure.

With the change in vaccination method to extend the limited supply, we are now able to expand the eligibility criteria to include more people and offer second doses so people can complete the series. As we monitor supply and demand, we are coordinating with our state and regional partners to make vaccine available to as many people as possible based on risk informed by the epidemiology of the outbreak. As this situation is evolving quickly, we encourage people to check our website for the most current information.

All together better, 

Louise F. Rogers