New COVID-19 vaccines are expected to become available as soon as this week, a promising development amid California’s powerful and enduring summer wave of the disease.
The U.S. Food and Drug Administration on Thursday authorized the distribution of updated Moderna and Pfizer COVID-19 vaccines for the 2024-25 season. And in preparation for winter, when COVID typically surges again, federal officials said Americans will soon be able to register to receive up to four free tests in the mail.
Major retailers — including CVS, Walgreens, Rite Aid, Ralphs, Vons, Pavilions, Albertsons and Safeway — are already accepting appointments for the new COVID-19 vaccines, or will start soon. Kaiser Permanente expects to begin administering vaccines by mid-September, and possibly even earlier in some locations.
The new vaccines have been re-formulated in the hopes of providing optimal protection against the most prevalent coronavirus variants, a process that can be compared to the development of the annual flu shot.
The arrival of the latest vaccines comes amid a surprisingly powerful summer Covid wave — the strongest in terms of infections since 2022. The increasing spread of new hyperinfectious subvariants has sickened many Americans, ruined holidays and weddings and forced people to miss work.
Coronavirus levels in wastewater are considered “high” or “very high” in 45 states, including California, and the District of Columbia. Coronavirus sewage levels were considered “moderate” in Michigan, New Jersey, Vermont and West Virginia; no data was available for North Dakota.
Earlier this year, some coronavirus subvariants that emerged after last winter's dominant strain were collectively named FLiRT — based on some technical terms for their mutations. That group included a strain officially known as KP.2.
A successor sub-variant, KP.3, had a different mutation and was therefore named FLuQE – pronounced “fluke”. An even more contagious sub-variant, KP.3.1.1, had a mutation that was removed, giving it the informal name deFLuQE, or “de-fluke”.
For most people, September and October are the best months to get vaccinated against both COVID-19 and the flu, according to the U.S. Centers for Disease Control and Prevention. The CDC said everyone 6 months and older should get both COVID-19 and flu vaccines, and they can get both shots at the same time.
“The important part is to get it done,” CDC Director Mandy Cohen said in a briefing. “If September is better for people from a calendar perspective, great. October gets you closer to the winter season. But the important part is to get it done.”
Dr. Cohen said Friday that the increase in winter hospitalizations for COVID-19, flu and respiratory syncytial virus, or RSV, is expected to be similar to last year, or even improve slightly. But he added that this forecast could prove overly optimistic if certain assumptions prove wrong — for example, if fewer people than expected are vaccinated.
The spread of COVID-19 continues to be at very high levels nationally and in California.
The rate of positive coronavirus tests continues to rise. In the week ending Aug. 14, 14.4% of coronavirus tests reported in California were positive. That's higher than the peaks seen last summer and winter, and up from about 11% a month ago.
But depending on the region, “I think we’re potentially seeing some signs of a summer surge in COVID-19,” said Dr. Demetre Daskalakis, who heads the CDC’s National Center for Immunization and Respiratory Diseases. Still, “we’re not out of the woods yet,” he added.
There are now 26 states, including California, where COVID-19 cases are “increasing” or “likely to increase.” About six weeks ago, there were 44 states in these categories, according to the CDC, but that number has dropped.
There are early signs that the summer surge is starting to peak in some areas, including Los Angeles County, though trends won’t be clear until a few weeks of consistent decline.
During the week ending Aug. 18, L.A. County averaged 421 coronavirus cases per day. The number was 484 the week before.
In the week ending Aug. 18, 3.9% of all emergency department visits countywide were related to the coronavirus, down from 4.3% the previous week. The peak last summer was 5.1%.
Covid hospitalizations have held roughly steady. For the week ending Aug. 17, L.A. County hospitals averaged 478 coronavirus-infected people per day. The week before that, the number was 481. Last summer, the number was 620.
“Since this is just one week of data, it is too early to know if this decline will continue or if this indicates that infections have stabilized or peaked,” the L.A. County Department of Public Health said in a statement to the Times.
Coronavirus levels have increased in the county's wastewater, but this metric has a longer lag time than other indicators. For the 10-day period ending Aug. 10, coronavirus levels in L.A. County sewage measured at 87% of last winter's peak. That's up from the 10-day period ending Aug. 3, when coronavirus levels were at 76% of the winter peak.
Overall, coronavirus levels in California's wastewater have remained largely stable in recent weeks.
In general this summer, the number of emergency room visits, hospitalizations, and deaths from COVID are increasing, but fortunately the increase is not as severe as in previous waves of the pandemic.
“While the COVID virus continues to mutate and change faster than the flu virus, our underlying immunity from previous vaccines and previous infections provides some protection,” Cohen said. “But we know that protection wanes over time, and certain groups remain at higher risk from COVID and other viruses, and we need to continue to protect ourselves and our loved ones.”
Covid remains a bigger threat than the flu.
“COVID-19 is a much more dangerous virus than the flu because it's causing more people to be hospitalized and because it's causing more people to die,” Cohen said.
Nationally, at least 50,000 COVID-19 deaths have been recorded since October, while there have been at least 25,000 deaths from the flu. The CDC's estimates on flu deaths will be updated later this year.
Doctors say this is why it is so important for people to get a fresh vaccination before the fall. Those most at risk include the elderly and people with weakened immune systems who have not been vaccinated against COVID-19 for more than a year.
By the end of last winter, only 29% of seniors nationally had received a previous COVID-19 vaccine, according to data from a subset of Medicare beneficiaries. As of July 31, 37% of California seniors had received at least one dose of a vaccine that first became available last September.
It's not just the elderly who are at risk. “Remember … 80% of adults in the country have some kind of disease that puts them at some kind of risk,” Cohen said.
And very young children can be unsafe, too.
“When we look at who went to the emergency room for COVID, we actually saw that it was highest for people under the age of 5,” Cohen said of this summer wave. “We can’t forget that every age group is at risk, including our young children.”
Each new infection also carries with it the risk of long Covid – where symptoms, sometimes so severe as to be debilitating, can emerge, persist, resolve and reappear over a period of weeks, months or years.
“I have a lot of sympathy, because I’ve seen people in their 30s and 40s struggling with long Covid who you would think were otherwise at low risk,” Dr. Peter Marks, the FDA’s vaccine chief, said Friday. Marks said it’s estimated that getting vaccinated could reduce the risk of developing long Covid by as much as 50%.
People who may want to consider getting an updated COVID-19 vaccine as soon as possible include those who are older or have weakened immune systems and those who haven't been vaccinated in more than a year. Dr. Peter Chin-Hong, an infectious disease specialist at UC San Francisco, said these groups are now at the highest risk of being hospitalized due to COVID-19.
“I would want them to be safe if they want to go and get vaccinated now,” Chin-Hong said.
Another thing to consider is if you are about to go on a trip, or are planning an unforgettable event or experience.
“At this point in time, if they want to prevent infection, it's the right time to get vaccinated because it very closely matches the current situation,” Chin-Hong said of the new vaccine.
He said that getting the Covid-19 vaccine now will provide good protection against serious illness in the winter.
Chin-Hong said the best protection against infection occurs within about six to eight weeks of vaccination — though this period could be longer if the vaccine closely matches prevalent subtypes.
Marks said timing is a matter of personal choice, but she has already scheduled her vaccination appointment.
“Getting vaccinated now will probably give you maximum protection against the currently circulating disease, and that protection will last for at least several months,” he said.
According to the CDC, many people who recently had COVID-19 may need to wait up to three months to get vaccinated, since in many cases the infection provides strong, if transient, protection against the virus — at least for a few weeks or months. But there are some reasons to get vaccinated soon after illness, such as if you, a family member or household member is at higher risk for severe COVID illness, or transmission is high where you live.
And people who got vaccinated against COVID over the summer with the older formula can wait two months before getting the updated vaccine, Chin-Hong said, “so October will be fine for them.”
“The best time for me is always October,” he said, because it’s close to the peak of the late fall and winter respiratory virus season, as well as major holidays like Thanksgiving, Christmas and New Year’s.
Another measure health officials recommend, especially as infections rise, is to get tested if you feel sick or before events — especially if medically vulnerable people will be attending.
SStarting in late September, free COVID tests from the federal government will be available for order at covidtests.gov.
The CDC has also made simpler recommendations about getting vaccinated for respiratory syncytial virus, or RSV. The agency now recommends vaccination for all adults age 75 and older, as well as those ages 60 to 74 who are at increased risk for severe RSV illness. Those risk factors include chronic heart or lung disease, a weakened immune system, certain medical conditions such as severe obesity and severe diabetes, and living in a nursing home.
The CDC said the RSV vaccine is not annual, meaning people who got one last year do not need to get another one now. Those who haven't gotten the vaccine can get it at the same time as the flu and COVID vaccines.
An RSV vaccine is also available for pregnant mothers between 32 and 36 weeks of pregnancy to protect their fetus. RSV antibodies are also available for infants and some young children.
“All of these vaccines provide the most protection against these infections,” Cohen said. “That means fewer visits to the doctor, fewer hospitalizations and more time to enjoy the fall and winter with family and loved ones.”