The FDA has approved newly formulated boosters for the mRNA COVID-19 vaccines from Pfizer and Moderna. These new shots give vaccine recipients — including those who are immunocompromised — extra protection against variants of SARS-CoV-2, the virus that causes COVID-19. These variants spread more quickly from person to person and can be resistant to the original vaccines. The spread of the omicron variants has led to a spike in breakthrough cases — people become infected with the coronavirus despite being fully vaccinated.
Following the FDA’s approval, the Centers for Disease Control and Prevention (CDC) recommended the updated boosters. “The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant,” said Dr. Rochelle Walensky, director of the CDC, in a statement. “They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants.”
The Spondylitis Association of America notes that people with spondylitis who are taking biologics or methotrexate are typically considered immunocompromised and refers to vaccination against COVID-19 as “the first line of defense” in people with spondylitis.
The updated COVID-19 boosters are available now throughout the U.S. Vaccines.gov offers a tool to find nearby locations to receive the booster.
People who’ve followed the recommended COVID-19 vaccine schedule are no strangers to booster shots. Their purpose is to keep your immune system primed with the necessary antibodies to fight the coronavirus. These antibodies naturally lessen over time.
The first set of FDA-authorized mRNA vaccines contained a blueprint of the spike protein found on the original strain of the coronavirus. Using the blueprint in the vaccine, a person’s immune system learns what the coronavirus looks like and how to fight it. The original mRNA vaccines are called monovalent vaccines because they contained blueprints for just one virus component (part).
The new versions are called bivalent vaccines because they contain blueprints for two different spike protein components: one from the original version of the coronavirus and a new one found on the BA.4 and BA.5 omicron subvariants. These are the subvariants that have proved resistant to the original vaccines. An updated bivalent booster allows your immune system to recognize and fight both the older and newer, more prevalent subvariants.
Bivalent booster guidance from the FDA and CDC varies depending on a person’s age, vaccination status, and whether or not they’re moderately or severely immunocompromised — that is, whether they have a weakened immune system.
Per the CDC and FDA, people 6 and up who are fully vaccinated and who aren’t immunocompromised are eligible for a single booster dose of the bivalent Moderna COVID-19 vaccine. People 5 and up who are fully vaccinated and who aren’t immunocompromised are eligible for a single booster dose of the bivalent Pfizer COVID-19 vaccine.
Before getting an updated booster, people should wait at least two months after completing their initial vaccine series or receiving a booster dose of a monovalent COVID-19 vaccine.
The booster you receive doesn’t need to be from the same manufacturer as your primary series or previous boosters.
Public health experts advise people who’ve recently contracted COVID-19 to wait until they fully recover from the acute illness before getting an updated booster. The CDC has said that getting a booster between the time you first recover from your infection up to three months later may boost your immune response.
“If you’ve had a recent infection or were recently vaccinated, it’s reasonable to wait a few months,” said White House COVID-19 Response Coordinator Dr. Ashish Jha during a Sept. 6 press conference.
The agency offers a COVID-19 booster tool to help people determine if and when they can get a booster.
People who are moderately or severely immunocompromised due to other health conditions face a higher risk of severe illness or death from COVID-19, according to the CDC. Although spondylitis isn’t on the CDC’s list of underlying conditions that put people at higher risk for severe illness, certain medications (including biologics and methotrexate) can cause you to be immunocompromised.
Some members of MySpondylitisTeam have shared their experiences with vaccination against COVID-19. “I got my fourth COVID vaccine yesterday,” one member wrote. Another said, “I’ve had three boosters and haven’t had a problem — I haven’t been sick, so I’m good.”
According to the FDA, bivalent COVID-19 vaccines — that is, vaccines containing the old and new spike proteins — are safe and effective, based on results from human trials. Notably, those tests used a bivalent vaccine containing an earlier omicron subvariant called omicron BA.1. Currently, the newly approved vaccines containing the omicron BA.4 and BA.5 subvariants have been tested only on animals.
Nevertheless, the FDA and CDC believe the positive test results of the older bivalent vaccine are relevant to the newly approved vaccines, as they were all developed using the same manufacturing process.
It’s not unusual for the FDA to approve an updated vaccine that hasn’t undergone tests on humans. The most common example is the flu vaccine, which is updated annually based on what scientists predict will be the most common version of the flu virus that year. Those flu shots are generally updated using the same manufacturing process that’s consistently yielded safe, effective vaccines.
When it comes to people with spondylitis, the effects of getting a COVID-19 vaccine or booster shot don’t appear to be any different from the shot’s impact on the general population.
One recent study shared the outcomes of 47 people with spondyloarthritis (SpA) who received the COVID-19 vaccine and 97 people who did not have SpA (who were referred to as the “control group”). The study participants with SpA experienced fewer adverse events after full vaccination compared to the control group, and no one experienced worse SpA symptoms following full vaccination.
U.S. health officials predict people who receive an updated COVID-19 booster won’t need another booster for a year. According to Dr. Jha, people may be able to receive a single booster each year that’s been updated to combat the most prevalent coronavirus variants. “Barring any new variant curveballs, for a large majority of Americans, we are moving to a point where a single, annual COVID shot should provide a high degree of protection against serious illness all year,” he said during a press briefing.
Potential side effects, both common and rare but serious, are similar to those of previous versions of the vaccine. Among individuals with spondylitis, the common side effects included weakness, fever, and muscle aches. It may be helpful to schedule your vaccination for a day when you’ll be able to rest afterward.
Side effects generally fade within a few days. Applying a cool, clean washcloth to the injection site can reduce discomfort. It may also help to move your arm around to relax your muscles and lessen soreness. Try to drink plenty of fluids after the vaccination.
Contact your health care provider if these side effects last longer than a few days, if they seem especially intense or worrisome, or if your injection site is still red and irritated 24 hours after your shot.
Health experts generally agree that severe side effects from a COVID-19 vaccine are extremely rare. “The benefits of COVID-19 vaccination outweigh the known and potential risks,” notes the CDC.
People who aren’t fully vaccinated face a higher risk of developing a severe COVID-19 infection, requiring hospitalization, or dying from the disease.
If you’re living with spondylitis and have questions or concerns about getting the updated booster, speak with your rheumatologist or another health care provider.
On MySpondylitisTeam, the online social network for people with spondylitis and their loved ones, more than 87,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.
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