You may have noticed that more people you know have gotten COVID-19 recently. One reason is the virus that causes COVID-19 continues to evolve into variants that are more contagious.
The latest one is known as XBB.1.5, and since early December it has become the predominant variant in the New York metropolitan area, according to the Centers for Disease Control and Prevention (CDC).
This variant is thought to be highly transmissible due to its ability to partially evade antibodies produced through vaccines or past infections. However, the vaccines still offer excellent protection against severe illness and death.
In this Q&A, Bernard Camins, MD, MSc, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai and the Medical Director for Infection Prevention for the Mount Sinai Health System, explains more about the new variant and how to protect yourself.
- If you feel sick, stay at home.
- If you want to be more vigilant, wear a high-quality mask, avoid being unmasked at large indoor gatherings (such as eating at restaurants), especially when infection rates in your area are very high.
- If you are at high-risk for a serious infection, talk with your medical provider so you are prepared should you get infected.
- Don’t forget to get your flu shot; you can get that at the same time you get your COVID-19 booster shot.
How does this new variant differ from the earlier variants?
The nature of COVID-19 is that the new variants are likely going to be more contagious than the older ones. There is currently no evidence that this latest variant is more dangerous. The symptoms do not appear different.
Does the newest, updated booster shot help protect me from this new variant?
According to the CDC, being up to date with the bivalent booster that became available in September 2022 offers the best protection against COVID-19. (It is the only booster now available.) The updated bivalent booster specifically targets both the BA.5 sub variant of Omicron, of which XBB.1.5 is a descendent, and the original SARS-CoV-2 virus. The original COVID-19 monovalent vaccines, and the monovalent booster that became available in the fall of 2021, only target the original virus, and therefore potentially offer less protection against the Omicron subvariants.
I was recently infected with COVID-19. How long should I wait to get the latest bivalent booster?
You may consider waiting up to 90 days from your last infection before getting the bivalent booster. Reinfection is less likely in the weeks and months after infection. But you may want to talk with your provider if you are at increased risk of severe disease.
I never got any vaccines. Can I skip the first and second monovalent vaccines and just get the bivalent booster?
No. Before you can get the bivalent booster, you still need to get two doses of the monovalent vaccine.
I received my bivalent booster more than two months ago. Has my immunity started to wane?
Your immunity does begin to wane after three to four months, probably more so if you’re older, such as older than 50.
Can I get another dose to bolster my immunity?
No. Currently, there are no more recommended doses after you have already gotten the bivalent booster, regardless of how long it has been.
Will the bivalent booster and antiviral medications prevent me from developing long COVID?
We do not have definitive data yet to know how much protection the bivalent booster and antiviral medications such as Paxlovid™ offer against the development of long COVID. But we do know that being vaccinated certainly reduces your risk of developing it.
I am at high risk for complications from COVID-19. What should I do to protect myself from the latest subvariant?
Because COVID-19 is so widespread now, it’s hard to avoid getting infected or exposed. While it is reasonable to take precautions to avoid a COVID-19 infection, the goal should be to reduce the severity or prevent complications when you do get COVID-19. High-risk individuals should have a plan for how to get antiviral medications, which can prevent severe illness or death. For this to work, you must take the medications within the first five days of symptom onset. If you have not done so already, you should talk with your doctor or your care provider to create a plan for what antivirals you would need and how to get them. Having a plan is also important because you may be on medications that interact with certain antivirals, and you may need to stop taking those medications temporarily to prevent drug interactions. Those at high risk include older adults, those with chronic medical conditions, such as diabetes, and those with reduced ability to fight infections, such as those being treated for some cancers.