A new generation of COVID-19 boosters appears to be on the horizon as average case counts in Hawaii continue on a downward trend.

The Biden administration plans to offer the next generation of COVID-19 booster shots to Americans ages 12 and older soon after Labor Day, according to The New York Times, ahead of an expected winter surge.

Both Pfizer-BioNTech and Moderna have asked for emergency authorization of boosters that also target omicron subvariants such as BA.5, the Times reported, and federal health officials are eager to offer them as quickly as possible.

The Hawaii Department of Health on Wednesday reported the state’s seven-­day average of new cases fell to 322, down from 404 reported Aug. 17, representing a decline for the fifth week. Actual numbers are estimated to be at least five to six times higher since these do not include home test kit results.

The state’s average positivity rate also continued to trend down to 8.6% compared with 10.7% reported the previous week, representing a decline for the fourth week in a row since July 27.

Hospitalizations of patients with COVID-19 are also trending down. For the past week, the Healthcare Association of Hawaii reported an average of 119 COVID-19 patients hospitalized per day, down from 136 the previous week, and an average of 20 new COVID-19 admissions per day.

Omicron subvariant BA.5 is now the predominant strain in the U.S. and Hawaii, according to the latest variant report, published Aug. 16.

BA.5 made up at least 83% of variants circulating in Hawaii for the two-week period ending July 30, while BA.4 made up 5%, based on genome sequencing of samples collected statewide. Omicron subvariant BA.4.6 is also present in Hawaii.

Wastewater data from Biobot Analytics shows about 100% of samples sequenced on Kauai and Hawaii counties are now BA.5.

Tim Brown, an infectious disease expert from the East-West Center in Manoa, said the availability of the new bivalent vaccines is welcome as COVID-19 trends continue on a downward path.

“The challenge is they’ve got to be careful about overpromising,” he said. “Everyone 12 and up will be eligible for this, but they’re almost certainly going to have limited supply of this vaccine at first, so will have to go through a prioritization process again.”

He is hoping average COVID-19 cases will decline further to 50 to 60 a day, and remain low for a few months as happened during the post-delta phase. But the pandemic is not over yet, he warned, and there are bound to be new variants.

“The good news is that this is now basically a pure BA.5 epidemic and right now there are not major variants in the U.S. that seem to be rising rapidly,” he said in a summary, “so we may actually get a lull in the epidemic for a couple of months until viral evolution of SARS-CoV-2 brings something new along.”

The Centers for Disease Control and Prevention last week moved Honolulu and Maui counties from high-level, orange communities to medium-level, yellow communities, which was still the case Wednesday. At yellow, one should wear a well-fitting mask if one is at high risk or has a household member at high risk.

Kauai and Hawaii counties were ranked as low-level, green communities.

CDC updates the community levels every Thursday based on case rates and COVID-19 hospital admissions per 100,000, and percentage of staffed inpatient beds used by patients with confirmed COVID-19.

CDC also released data on pediatric seroprevalence — or the percentage of people with antibodies against the coronavirus – in kids ages 6 months to 17 across the nation.

In Hawaii, 54.4% of those tested had coronavirus antibodies, or were infected with COVID-19, according to CDC, which was lower than the national estimate of 79.7%. The 185 samples from the state were collected between May 2 and June 25.

“What that tells me is our masking worked,” Brown said. “Let’s remember until March 25 we had a mask mandate in place and most people were following it, and that certainly is going to help protect the kids.”

Hawaii also required masks indoors at public schools through the end of the past school year and summer, but has now made them optional.

DOH on Wednesday reported 2,219 new COVID-19 infections over the past week, lower than reported the previous week, bringing the total number of cases since the start of the pandemic to 337,737.

By island, there were 1,520 new infections reported on Oahu, 282 on Hawaii island, 268 on Maui, 101 on Kauai, four on Molokai and one on Lanai. An additional 43 infections were reported for out-of-state Hawaii residents.

As of Wednesday, DOH reported 77.3% of Hawaii’s population had completed their primary series of COVID-19 vaccinations, with about 45% boosted once and 11.5% boosted twice.

An estimated 323,500 residents in the state remained unvaccinated.

DOH also reported 13 more deaths, bringing the state’s coronavirus-related death toll to 1,632.