With new COVID-19 vaccinations for the 2024-25 season coming to California and across the country, an important question arises: When is the best time to get shots?
The U.S. Centers for Disease Control and Prevention says September and October are generally the best times for most people to get their COVID immunizations.
But which month is better for your situation? Should you rush to get your shot now, considering the high rate of COVID in California? Or should you wait until closer to Halloween in the hopes of adding stronger protection against infection through Christmas and New Years?
And what about people who got infected or got old immunization formula months ago?
Providers in California began administering the COVID-19 immunization using the latest formulation this week. Appointments available at CVS, Walgreens, Rite Aid, Ralphs, Vons, Albertsons, Pavilions and Safeway stores. Kaiser Permanente expects to begin making the vaccine in mid-September and possibly earlier in some locations. Sutter Health is also aiming for a mid-September launch.
The CDC recommends that everyone 6 months and older get the updated COVID-19 vaccination, which was approved for distribution by the US Food and Drug Administration last week.
Here are some factors to consider:
The case for October
The head of the CDC suggests that the most important decision is not when to vaccinate, but simply to get it.
“The important part is getting it done,” CDC Director Mandy Cohen said in her briefing. “If September, from a calendar perspective, is better for people, good. October brings you closer to winter. But the most important thing is to finish.”
Dr. Peter Chin-Hong, a UC San Francisco infectious disease expert, made the case for the October dose.
Getting the COVID-19 vaccine now or in October will provide good protection against severe disease for at least a year, he said. But the best protection against infection comes about six to eight weeks after being vaccinated — although that window could be longer if the vaccine matches a circulating subvariant, Chin-Hong said.
“For me, the sweet spot is definitely October,” he said, because it’s near the peak of fall and winter respiratory virus season, as well as major holidays like Thanksgiving, Christmas and New Year’s. Based on wastewater data from the last two winters, COVID peaks in California and nationally in the last week of December or the first week of January.
Case for September
But Dr. Elizabeth Hudson, regional chief of infectious diseases for Kaiser Permanente Southern California, recommends that people get vaccinated as soon as possible.
“The way COVID looks right now — with the high number of cases — this is not the year you want to wait,” Hudson said. “As soon as you can get the vaccine, you should get it.”
COVID-19 continues to spread at a very high rate across the country and in California. Depending on the region, health officials “potentially see some indication of a summer spike in COVID-19,” said Dr. Demetre Daskalakis, who heads the CDC’s Center for Immunization and Respiratory Diseases. Still, “we’re not out of the woods yet,” he added. The trend will not be clear until there are several weeks of continuous decline, and this has not happened yet.
Not only is the hyperinfectious KP.3.1.1 subvariant gaining dominance nationwide, doctors are also keeping a close eye on the new onset subvariant, XEC, which has gained attention in Europe.
Dr. Peter Marks, the FDA’s vaccine chief, said in a briefing on August 23 that he had made the vaccine appointment.
“Getting vaccinated now probably gives you the maximum protection you can get against what’s currently circulating, and at least for several months,” he said.
What about the elderly and the immunocompromised?
Chin-Hong said there are certain people who will get a COVID-19 vaccination as soon as possible. That includes people who are older or immunocompromised and have not been vaccinated for more than a year. That group is at the highest risk of being hospitalized with COVID, Chin-Hong said.
“I’m glad he’s protected,” she said.
Dr. Eric Topol, director of the Scripps Research Translational Institute in San Diego, offers some questions people should ask to determine whether they should get vaccinated now rather than in October.
“You haven’t had a booster in a while? If it’s been more than six months, you know your immunity is decreasing,” said Topol. “How do you risk it? Are you older – over 65? Are you immunocompromised? Are you someone with a lot of comorbidities? You might want to leave now (if you do), because you’re vulnerable.
“For people who are at risk, I don’t think it’s a delay,” Topol said.
Another question: Are you vaccinated to reduce the chance of prolonged COVID? “Because studies in total suggest a 50% reduction in long-term COVID” after vaccination, he said. “In fact, it’s people in their 30s and 40s who are at the highest risk for prolonged COVID after a mild infection, and many people forget the problem.”
Another consideration is whether you plan to travel or plan an event or experience that you cannot do.
“Now, if we want to prevent infection, it’s a good time to get something because it’s very relevant to what’s going on,” Chin-Hong said of the new vaccine.
But if you’re doing lower-risk activities now and prefer to save time to protect against infections in the late fall and winter holidays, some doctors say it’s enough to wait until October to get vaccinated.
Already, it appears that XEC, a new subvariant detected in Europe, may be a contender for the fall and winter COVID waves, Topol said.
“Waiting a few extra months so you’re closer to whatever the next wave/wavelet is, that’s a reasonable plan,” Topol said.
Topol said he got his COVID-19 vaccination on Friday, in part because he will be traveling cross-country and he will be indoors with many people and cannot avoid the virus, he said.
Masking remains important to avoid infection, but there are some situations when people cannot wear a full face mask.
Overall, however, there is no simple answer as to whether September or October is better for timing the COVID vaccination. “It really depends on the person,” said Topol.
How are people with COVID-19 recently?
After infection, people may consider waiting three months to get the latest COVID vaccination, according to the CDC. As for when to start counting the three-month period, Hudson says a good rule of thumb is when your symptoms started or, if asymptomatic, when you were diagnosed.
Part of the reason, the CDC says, is that “the risk of contracting COVID-19 is less likely in the weeks to months after infection with SARS-CoV-2,” using the official name of the virus that causes COVID.
Besides the potential benefit of natural immunity, “there are also some studies that show that waiting a few months after you have had COVID to get your COVID vaccine can increase your level of protection,” Hudson said.
But this advice only applies to people who are at lower risk for COVID and its complications, Hudson added.
For those at higher risk — such as the elderly 65 and older and those who are immunocompromised — or anyone in frequent contact with people at higher risk, “they should get the vaccine as soon as they feel better,” he said.
What about people who got old vaccines this summer?
Some people who are not yet aware of vaccinations may have received the old vaccine formula – which was originally released in September 2023 – during the summer. Those people had to wait two months before taking more recent pictures, Hudson said.
What about the flu shot?
This season’s flu shot is widely available, and the CDC recommends that everyone 6 months and older get it in September or October. Because the flu, like COVID, is a respiratory illness that tends to be active in the winter, officials say the same considerations apply when considering when it’s best to roll up your sleeves.
You can get the flu vaccine at the same time as the COVID-19 vaccine.
What about RSV?
A vaccine is also now available for respiratory syncytial virus – the third leg of the “tripledemic” that has caused hospitalizations in recent years.
The CDC has simplified its recommendations on who should be vaccinated for RSV. The agency now recommends the shot for all adults ages 75 and older, as well as ages 60 to 74 who are at risk of severe RSV disease.
These 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 RSV vaccine is not annual, meaning people who got it last year should not get another this time, the CDC says. RSV, flu and COVID shots can all be administered during the same doctor visit.
The RSV vaccine is also available to expectant mothers at 32 to 36 weeks of pregnancy to provide protection to the fetus. RSV antibodies are available for infants and some young children.
