COVID cases are on the rise and this week the Centers for Disease Control and Prevention has recommended that anyone who is six months or older get the new COVID-19 vaccines. Health reporter Lynn Arditi talked about the new vaccines with Doctor Ashish Jha, former White House COVID advisor and current dean of Brown University’s School of Public Health.



Lynn Arditi: Dr. Jhah, how is the new COVID vaccine different?

Dr. Ashish Jha: So you know how each year we reformulate the flu vaccine to match the strains that are circulating. That's basically the pattern we've gotten into now with COVID vaccines, where we have a new formulation of the COVID vaccine that matches the strains that are circulating now. And so it's really an updated version that's going to provide much higher protection this fall, as we get into the winter months.

Arditi: For people who are up to date on their COVID vaccinations – which is about 24 percent or one in four Rhode Islanders – how much more protection does the new vaccine provide?

Jha: So if you're up to date because you got your bivalent vaccine a year ago, you don't have much protection against infection. And if you're young and healthy, you still have decent protection against serious illness, but even that can wane over time. And if you're elderly, you've lost some of that protection. So for older people, for high-risk people, this new vaccine is critical to preventing serious illness. And for young people, it'll provide some protection against infection. It also provides some further protection against serious illness. So I think young, healthy people benefit, but elderly people,  high-risk people, they'd benefit enormously.

‘Even if kids don't get super sick, they can have complications from infection,  and they're better off with this vaccine’

Arditi: So what would you tell parents of healthy, young children who are worried about the risk of the COVID vaccine to their child?

Jha: So a couple of things. I mean, for kids under six months, obviously, they can't get vaccinated, and they really benefit from the mom getting vaccinated when she's pregnant. So they get antibodies from their mom, that's actually very critical, and pregnant women should absolutely be getting vaccinated – they're among the highest risk of complications. For younger kids, we know that they tend to have milder disease. If they've not gotten vaccinated at all, I think it's important for them to get vaccinated. So in general, it's one of those things where when the kids are very young, the risks are very tiny, the benefits are modest. To me, it's not as urgent.  It is absolutely much more important as kids get older. I have three children – well, one of them is 18, so she's no longer a kid – but a 16-year-old and an 11-year-old boy, and all three of them are going to get vaccinated. And that's because the risks of these vaccines [are] very, very low. We have very good data now that these are exquisitely safe vaccines. And the truth is that it's much safer to get this vaccine than to get infected. Even if kids don't get super sick, they can have complications from infection. And they're better off with this vaccine. We know this from flu vaccine data that when kids get vaccinated, they're less likely to transmit it to their elderly grandparents. So even if the kid themselves only benefits a little from the vaccine, there's less spread to elderly, high-risk individuals. And this is why when you have communities with high levels of vaccination rates, everybody does better in those communities.

Arditi: How would you respond to people who say: Look, I got the COVID vaccine and the boosters and I still got COVID. Why get another shot?

Jha: These vaccines are not perfect at preventing infection. Undoubtedly, it is true [that] lots of people who have gotten vaccinated still had breakthrough infections. But what they had was much milder versions of the virus. And, by the way, that's also how flu vaccines work. Flu vaccines don't always protect you against infection. But if you get the flu after getting a flu vaccine, you're going to have much, much milder disease. And so what I say to people is: You're going to miss fewer days of work, you're going to miss fewer days of school. The bottom line is that some proportion of people end up having long COVID where they can have substantial symptoms for weeks, months, maybe even years. The risk of that goes down if you've gotten vaccinated. So it's one of those things where the cost here is [that] these are free vaccines, [and] you will get a shot. The upside is you'll have milder disease. If you get an infection, you're less likely to have long COVID. To me, it's really not a close call. It's a no brainer, like you are better off with the vaccine.

Arditi: Besides getting vaccinated, given the latest COVID levels detected in wastewater surveillance in Rhode Island and Massachusetts, should we be masking when we're in crowded stores or buses or other indoor public places?

Jha: What we know is [that] with a virus as contagious as Omicron, first of all you need to wear high-quality masks. So cloth masks, surgical masks largely are not going to cut it. And then you have to wear it very  assiduously, kind of very rigorously, for the entire time that you're there. And if you do, there is no question about it, it will lower your risk of spreading it and lower your risk of getting it. The question then comes up: When do you ask everybody [to do it]? But he did. What are the criteria? Yes, we have elevated levels of COVID right now. We're at about half the level of where we were last summer. At its peak, I think asking everybody to mask up makes sense when you have very, very high levels of infection, doing it for periods of time. So imagine a town has a massive outbreak. And a lot of people are getting infected. In that place, I can imagine a mayor coming out and saying, Hey, for the next month, I want everybody wearing a mask, [a] quality mask, indoors. That makes sense. Asking the whole country to wear masks six months a year, because COVID levels are going to be elevated, and expecting higher levels of compliance, I think that is not sustainable.

Arditi: Since the Biden administration, as you know, declared an end to the public health emergency last May, a lot of hospitals and health clinics dropped their masking requirements, and people stopped masking, pretty much across-the-board. Given the seasonal rise of COVID infections, not to mention RSV and the flu, should masking be required in health facilities?

Jha:  The decision made by the Biden administration was that this is a decision that hospitals should make, local communities should make. And I think that's largely right. I think it makes a lot of sense to be masking around patient encounters, when you're seeing patients. Having the entire healthcare facility always wearing a mask? There are some real challenges to having that and implementing it. And again, the question is: under what context? Are you going to do that forever moving forward? Some people have advocated for that. In periods of time when you have elevated levels of infection, it absolutely makes sense to ask healthcare providers who mask around patients. And when those levels drop down, it really needs to vary by community and by community level practice.

The new COVID vaccines will be available, for free, throughout  Rhode Island and Massachusetts as early as next week. To learn more visit vaccines-dot-gov.

Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter/X @LynnArditi