The Omicron XBB variants of the SARS-CoV-2 virus continue to be the predominant COVID-19 viruses in circulation in the United States. The current mRNA monovalent 23/24 vaccines are still providing protection against severe disease, hospitalization, and death from COVID. The CDC recommends the newly formulated vaccine for all individuals aged 6 months and older. If you have recently had a COVID-19 infection, wait about 3 months before getting a dose. While vaccines are no longer free, insurance companies typically cover their cost with zero copayment, and an emergency fund has been set up for uninsured patients.
The virus that causes COVID-19 continues to evolve with all variants currently circulating stemming from the Omicron lineage. The current vaccine was developed to target the Omicron XBB 1.5 lineage. Despite low vaccine uptake to date, the incidence of infections, hospitalization, and death from COVID-19 has remained low probably due to existing immunity in the population and the fact that the fall/winter surge has yet to occur.
Currently circulating viruses are all from the Omicron lineage and can be detected by COVID home tests. Per the CDC, the top variants are:
HV.1 (29% of cases)
Highly contagious (prevalence is expected to increase)
Symptoms usually start with a sore throat and progress to nasal congestion and discharge and a persistent dry cough (chronic bronchitis) . More severe flu-like symptoms can also develop (fever, chills, muscle aches, fatigue, headache).
EG.5 ("Eris") (22% of cases)
FL.1.5.1 ("Fornax")
XBB.1.16 ("Arcturus")
Two variants of concern that have extra mutations and that may be more likely to escape immunity are BA.2.96 ("Pirola") and JN.1. These variants are not common in the US.
We cannot predict how the SARS-CoV-2 virus will continue to evolve and the level and duration of protection that vaccines will provide. However, based on recent experience, it is likely that an updated vaccination will be indicated at least annually prior to the fall/winter respiratory viral season (similar to the flu vaccine). Individuals at higher risk of severe/complicated infection may need to receive additional boosters. A combination COVID-flu vaccine will likely be available in future years to make compliance with vaccination recommendations easier.
Most respiratory viruses produce similar symptoms at the start of the viral illness, but some infections can lead to severe illness and complications. Take advantage of viral testing to differentiate between influenza, COVID-19, and RSV infections since the former two can be treated with anti-viral agents to prevent severe illness, hospitalization, complications, or death in vulnerable individuals.
Talk to your doctor or pharmacist about vaccinations available for you and your loved ones ahead of the fall/winter "viral season". Should you get sick with COVID, therapy is available with Paxlovid (more effective, multiple drug interactions) or Legevrio (less effective, no drug interactions). Check with your doctor if either are right for you.
As of January 19, 2022, you can order free at-home tests online at COVIDTests.gov. Four tests per family will be mailed to you. Expiration dates on home COVID tests have been extended in the past, check the manufacturer website for extended dates.
**Updated: 11/15/2023**