Answering patients' questions about the bivalent COVID-19 vaccine

Answering patients’ questions about the bivalent COVID-19 vaccine

An updated COVID-19 booster vaccine designed to match the elusive Omicron BA.4 and BA.5 sub variants has arrived just in time for fall.

“Bivalent” means that it is half-original strain, half-omicron explained BA.4, BA.5 Sandra A. Freehofer, MDchair AMA . Board of Trustees and contact the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP).

Bachelor 5 They make up nearly 90% of all circulating COVID-19 strains. Dr. Freihofer said the FDA “hopes that this new bivalent booster will be a good match against circulating strains.”

The only bivalent enhancers allowed are the mRNA versions manufactured by Pfizer-BioNTech and Moderna. The US government has purchased 171 million bivalent vaccine booster doses – 66 million from Moderna and 105 million from Pfizer.

This is the first time that mRNA vaccines have been updated. However, patients must meet certain requirements for their reception. During episode follower”AMA . UpdateIn the video and podcast, Dr. Freihofer has gone down to basics to help clinicians answer the most common questions they will ask from patients about the new booster.


More than 200 million Americans are eligible for a bivalent COVID-19 booster vaccine. Pfizer’s divalent booster is allowed for those 12 and older, while the Moderna license is for patients 18 and older.

Patients must complete the initial series of COVID-19 vaccines before receiving a booster dose.

“This may follow recommendations for a life-extending booster and other vaccines, but that’s what we have for now. Dr. Freihofer advised that children aged 5 to 11 who received the initial Pfizer series should receive the original monovalent booster.

The recommendation is that people should wait at least two months from the last dose of the COVID-19 vaccine to receive a bivalent booster dose. Dr. Freihofer said most people who are eligible for a booster dose are at least six months after their last dose.

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Patients with previous COVID-19 infection are eligible. But they must wait until they have fully recovered from the acute illness and come out of isolation.

The Centers for Disease Control and Prevention (CDC) advises that it is best to wait at least three months after infection with COVID-19 to get a booster dose. “But again, you must have completed the initial COVID vaccine series to be eligible,” Dr. Freihofer noted.

There are human data for bivalent COVID-19 vaccines with beta and omicron strains. The Omicron booster study found that adding a second COVID virus to the original vaccine broadens the antibody response. Among people previously infected with COVID, the bivalent vaccines produced the highest titers of antibodies.

Dr. Freihofer said these human studies targeted BA.1, a strain that is no longer common. “That’s why the FDA has directed manufacturers to make a booster that targets the BA.4 spike protein, BA.5.”

She added that changing the strains of a vaccine already studied is not new. The FDA allows changes to be made in the influenza vaccine as the influenza virus evolves without the need for a full effective trial. “It’s the same kind of thing,” she said.

The updated booster has only been tested on animals, not humans. “There are no clinical trial data specifically for BA.4 and BA.5 divalent enhancers in humans yet, but there will be,” said Dr. Freihofer.

“Like other COVID vaccines, bivalent vaccines are reactive,” Dr. Freihofer said.

Bivalent studies reported fatigue, headache, muscle and joint pain, chills, nausea, vomiting, and fever as the most common side effects.

“There are some subtle differences in the mutations between the BA.1, BA.4 and BA.5 protein sequences. However, experts do not expect any differences in safety or interaction, based on these limited mutations.

The researchers did not report any cases of pericarditis or myocarditis.

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The Centers for Disease Control and Prevention (CDC) says it’s safe to get a flu shot at the same time as any vaccine against SARS-CoV-2. Since the two viruses will be circulating at the same time, the CDC encourages it.

It’s also okay to have the SARS-CoV-2 vaccine or a booster with other required vaccines.

There is only one exception, monkeypox, as noted by Dr. Freihofer. ACAM2000 and JYNNEOS are the two vaccines available for this disease. ACAM2000 has been linked to myocarditis, a heart condition associated with COVID vaccines in young males. The risk of JYNNEOS myocarditis is unknown.

“If you received a dose of either, the CDC suggests waiting four weeks for your dose of the COVID vaccine. However, if you have already received a dose of the COVID vaccine and are now at risk of developing monkeypox due to exposure, there is no need to wait.”

Dr. Freihofer said these vaccines are free for patients, at least for now. “Both the Moderna and Pfizer agreements include options for more doses, but this will require more funding from Congress.”

The AMA recognizes the critical importance of scientific integrity, transparency, and public confidence in the fight to contain the global spread of COVID-19. Stay informed with AMA on COVID-19 and Vaccine Development.

AMA . UpdateCovers healthcare topics that affect the lives of clinicians and patients. Hear from clinicians and experts on public health, advocacy issues, scope of practice and more – because who’s doing the talking matters. You can watch each episode by subscribing to AMAs youtube channel or the Audio podcast version onlywhich also features educational presentations and in-depth discussions.

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