COVID shot now or later? Just getting it at all is great, officials respond.

With the impending arrival of the 2024–2025 COVID-19 vaccines approved yesterday, some Americans are now gaming out when to get their dose—right away while the summer wave is peaking, a bit later in the fall to maximize protection for the coming winter wave, or maybe a few weeks before a big family event at the end of the year? Of course, the group pondering such a question is just a small portion of the US.

Only 22.5 percent of adults and 14 percent of children in the country are estimated to have gotten the 2023–2024 vaccine. In contrast, 48.5 percent of adults and 54 percent of children were estimated to have gotten a flu shot. The stark difference is despite the fact that COVID-19 is deadlier than the flu, and the SARS-CoV-2 virus is evolving faster than seasonal influenza viruses.

In a press briefing Friday, federal health officials were quick to redirect focus when reporters raised questions about the timing of COVID-19 vaccination in the coming months and the possibility of updating the vaccines twice a year, instead of just once, to keep up with an evolving virus that has been producing both summer and winter waves.

"The current problem is not that the virus is evolving so much, at least in terms of my estimation," Peter Marks, the top vaccine regulator at the Food and Drug Administration, told journalists. "It's that we don't have the benefits of the vaccine, which is [to say] that it's not vaccines that prevent disease, it's vaccination. It's getting vaccines in arms." When exactly to get the vaccine is a matter of personal choice, Marks went on, but the most important choice is to get vaccinated.

Estimates for this winter

The press briefing, which featured several federal health officials, was intended to highlight the government's preparations and hopes for the upcoming respiratory virus season. The FDA, the Centers for Disease Control and Prevention, and the Department of Health and Human Services (HHS) are urging all Americans to get their respiratory virus vaccines—flu, COVID-19, and RSV.

CDC Director Mandy Cohen introduced an updated data site that provides snapshots of local respiratory virus activity, national trends, data visualizations, and the latest guidance in one place. HHS, meanwhile, highlighted a new outreach campaign titled "Risk Less. Do More." to raise awareness of COVID-19 and encourage vaccination, particularly among high-risk populations. For those not at high risk, health officials still emphasize the importance of vaccination to lower transmission and prevent serious outcomes, including long COVID. "There is no group without risk," Cohen said, noting that the group with the highest rates of emergency department visits for COVID-19 were children under the age of 5, who are not typically considered high risk.

So far, CDC models are estimating that this year's winter wave of COVID-19 will be similar, if not slightly weaker on some metrics, than last year's winter wave, Cohen said. But she emphasized that many assumptions go into the modeling, including how the virus will evolve in the near future and the amount of vaccine uptake. The modeling assumes the current omicron variants stay on their evolutionary path and that US vaccination coverage is about the same as last year. Of course, beating last year's vaccine coverage could blunt transmission.

Free tests coming

"We need to continue to be vigilant," Cohen said, emphasizing that we should protect ourselves with vaccines, testing, and treatments. "We have the tools to do it. We just need to use them."

To that end, Dawn O’Connell, the assistant secretary for preparedness and response at HHS, made the announcement in today's briefing that in late September, the government will once again provide free COVID-19 tests. Households will be able to order four free tests on the website COVIDTests.gov.

The FDA's Marks, meanwhile, highlighted yesterday's vaccine approvals and explained further why the agency has taken such a firm stance to try to couple the vaccines against flu and COVID-19, which are unquestionably different diseases. It comes down to opportunity, he said.

"The point of this campaign is that, if you have someone in the [doctor's] office and you can get them to get a COVID-19 vaccine while they're getting their flu vaccine, and we get that immunity into them, then that is probably better even than what we have now, which is people who haven't had a COVID-19 vaccine for one or two years," Marks said. "Even though COVID is not the flu, being able to get that shot in the arm is what we really need to have happen."

There's also the fact that winter is still when we see the highest levels of hospitalizations and deaths from COVID-19, Cohen noted.

When to get vaccinated

For those who are already certain they'll get a COVID-19 vaccine this year and are only deciding on when exactly to get it, the officials offered some things to consider. First, the CDC recommends that Americans get their 2024–2025 COVID-19 vaccines sometime in September or October, with the idea of boosting protection against the winter wave (not necessarily the summer wave). Deciding whether to go within that window or later, Marks leaned on the earlier side, though he considered it a personal choice.

"We're talking about a vaccine that is covering a virus that is continuing to evolve. And it is likely that what is going to be there in four or five months from now will further evolve from where it is now," Marks said. "Now, getting vaccinated a little later probably will help protect against it then, too. But getting vaccinated now probably gives you the maximum amount of protection against what is currently circulating, and that will last for several months at least."

"I can tell you," he concluded, "I already have my appointment."