Federal authorities have approved another COVID-19 booster for kupuna ages 65 and older, as well as for those who are immunocompromised.

The Centers for Disease Control and Prevention on Wednesday recommended the additional bivalent booster doses by Pfizer and Moderna for adults ages 65 and older. CDC also recommended health care providers administer additional doses to immunocompromised patients as needed.

The original COVID-19 vaccines used for the primary series are no longer recommended for use in the U.S.

CDC’s recommendations follow the Food and Drug Administration’s approval Tuesday of the additional round of bivalent boosters.

The FDA authorized a booster for those ages 65 and older at least four months after the previous dose. Those with compromised immune systems may get more doses at least two months after the previous one

CDC said it has taken these steps to simplify COVID-19 vaccine recommendations and allow more flexibility for people at higher risk.

The state Department of Health recommends people get the bivalent booster if they have not done so yet.

The bivalent booster is the most recent version of the mRNA vaccine, which targets both the original strain and omicron variants of COVID-19. It has been available in Hawaii since September 2022.

In Hawaii, about 27.4% of the eligible population has received the bivalent booster.

The highest uptake for the bivalent booster in Hawaii is among kupuna ages 75 and older, at 59%, followed by kupuna ages 65 to 74, at 51%, according to DOH data. The uptake among adults ages 50 to 64 is at 28%.

Omicron XBB.1.5 is the dominant subvariant circulating in Hawaii, at about 84%, according to the latest DOH variant report released April 11. Other omicron strains detected via genome sequencing in the state include XBB.1.5.1 and XBB.1.9.1/XBB.1.9.2.

The most recent DOH wastewater report shows that XBB.1.16, another omicron subvariant that some have nicknamed “Arcturus,” has been detected in samples collected from Kauai and Hawaii island up to April 5.

Epidemiologists have been watching Arcturus, which edged out other variants and fueled a surge in India. The World Health Organization has classified XBB.1.16 as a “variant under monitoring.”

DOH on Wednesday reported the state’s seven-day average of new COVID-19 cases at 133 a day, about the same as 138 a day reported April 12. The state’s average positivity rate was at 7.9%, down from 9.2% reported April 12.

Actual numbers are estimated to be several times higher since these figures do not include results from home test kits.

On Wednesday there were 73 COVID-19 patients in hospitals, with eight in intensive care, according to the Healthcare Association of Hawaii. The weekly average of COVID-19 patients in hospitals increased to 72 per day, up from 62 per day the previous week.

Ten more deaths also were reported, bringing the state’s COVID-19 death toll to 1,878.