Kids 5-11 can now get the bivalent, BA.5-targeting COVID booster

The US on Wednesday expanded access to the “updated” bivalent COVID-19 boosters targeting the omicron subvariant BA.5, now allowing children ages 5 to 11 to get a fall booster shot. Previously only adults and kids no younger than 12 were eligible.

In quick succession, the Food and Drug Administration this morning announced the expanded authorization of both the Pfizer/BioNTech and Moderna bivalent COVID-19 boosters, with the director of the Centers for Disease Control and Prevention, Rochelle Walensky, endorsing that authorization—officially making the vaccines available to little arms—just a few hours later.

“This is a critical step in our fight against COVID-19,” Walensky wrote in a tweet announcing her recommendation. “An updated vaccine can help bolster protection for our children this winter.”

The Pfizer/BioNTech bivalent booster will now be available to everyone ages 5 and up, while the Moderna bivalent booster will be available to everyone ages 6 and up. Both vaccines are authorized as just single doses, which can be administered at least two months after any previous vaccine. The authorization of the bivalent booster vaccines simultaneously revokes authorization of the monovalent COVID-19 boosters used previously. Only the bivalent boosters will be available for the authorized age groups.

The updated boosters are bivalent, meaning they carry immune-training genetic code of the spike proteins from both an ancestral SARS-CoV-2 strain as well as the latest omicron subvariant to gain dominance, BA.5. The BA.5-targeting portion of the booster may be critical heading into the winter.

Fall campaign

For now, BA.5 remains dominant in the US and worldwide, but public health experts are closely tracking more than 300 evolving variants, some of which have the potential to mushroom and overtake BA.5. Many of those concerning variants are sublineages of BA.5. If a BA.5 sublineage ends up driving a future wave, those boosted with the bivalent shots may be in the best position to fend off an infection. But, of course, it’s too early to say what the next wave will be, only that another wave is inevitable. Even if a BA.5-sublineage isn’t what emerges, experts say that the updated boosters still strengthen and broaden immune protection and should still prevent severe disease and death.

In the FDA’s announcement this morning, top FDA vaccine regulator Peter Marks made the case for parents to get their children boosted.

“Vaccination remains the most effective measure to prevent the severe consequences of COVID-19, including hospitalization and death,” Marks said. “While it has largely been the case that COVID-19 tends to be less severe in children than adults, as the various waves of COVID-19 have occurred, more children have gotten sick with the disease and have been hospitalized. Children may also experience long-term effects, even following initially mild disease. We encourage parents to consider primary vaccination for children and follow-up with an updated booster dose when eligible.”

In a press briefing Tuesday, White House Coronavirus Response Coordinator Ashish Jha continued to plug for the fall booster campaign generally, urging Americans to try to get their boost before Halloween.

“Why Halloween?  Because it takes a couple of weeks for your immune system to, you know, kind of, generate the benefit from that vaccine,” Jha said. “And that means you will be ready by Thanksgiving and certainly by the holidays,” which often involve family gatherings and socializing that can easily spread the virus. Jha followed up by saying that if you miss the Halloween deadline, you should, of course, still get boosted.

So far, only 11.5 million Americans—about 3.5 percent of the population—have received an updated bivalent booster this fall.