Opinion | Real-World Data Support Bivalent COVID-19 Boosters in Older Adults

In this video, Jeremy Faust, MD, editor-in-chief of MedPage Today, discusses a new study from Israel outlining the effectiveness of the bivalent booster in adults ages 65 and up.

The following is a transcript of his remarks:

Hello, I’m Jeremy Faust, medical editor-in-chief of MedPage Today. Thanks for joining us.

Let’s talk about the bivalent COVID-19 boosters, which we’re just starting to get some readouts in terms of their effectiveness in the real world, because we got to this point pretty much on laboratory data, which is how things went forward with the FDA’s authorization.

Let’s start with a clinical study out of Israel, which showed pretty clearly that people who got the bivalent booster had much lower rates of hospitalization than people who didn’t. Now, that’s not surprising because it wasn’t a study of the bivalent booster versus some other kind of booster, like the previous monovalent booster. It was just what we have now, the bivalent booster, which is some Omicron and some Wuhan, against nothing — against people who didn’t get boosted.

And we know for a fact that people who get boosted have a very good short-term response and will mount antibodies and will not get infected, and therefore there will also be fewer other bad outcomes, because if you’re not infected, you can’t get hospitalized; if you’re not infected, you can’t die; if you’re not infected, you can’t get long COVID. So for that short period of time, we know this works — it works real well.

What caught my eye was that, yet again, we’ve got a large study that really showed that even in a high-risk group — this is a group of seniors in Israel — the rate of hospitalization in general was quite low for both groups. So even though the bivalent booster had a great effectiveness in this very short-term period — to the tune of an 81% reduction in hospitalizations — the group that didn’t get boosted didn’t get hospitalized all that often either. It’s really close to one in 2,000 people, which is not a great number overall, but is so much better than we’ve seen in the past.

So, the Israeli data really helps us understand that for 65-years-olds and over, getting a bivalent booster is going to protect against hospitalization. We don’t know how long that’s going to last, and that’s the key. If it turns out that the bivalent booster ends up having a much longer tail of effectiveness than the monovalent did, that’ll be good news, but it’ll depend upon what variants are circulating and other factors, but we are watching that.