For some kupuna, getting the updated bivalent booster for COVID-19 was top priority once it became available over Labor Day weekend in Hawaii. For others there seems to be no particular rush.

Health officials are urging all eligible ohana, especially seniors, to get the newly updated boosters — even if they already have had one or more boosters — to gain broader protection against new omicron subvariants circulating in the state.

Seniors who had their last booster shot at least two months ago are eligible for the new booster.

“Those who are 65 and older are at the highest risk, and we certainly encourage them to go out and get their bivalent booster as soon as they possibly can,” said Department of Health spokesman Brooks Baehr.

Nationally, seniors over the age of 65 have been the earliest adopters of the primary series of vaccines and initial boosters, but the most recent survey by Kaiser Family Foundation found enthusiasm waning this time around.

According to the September survey, only 8% of seniors of the age group had gotten the new bivalent booster, while 37% said they intended to get it as soon as possible. Twenty-two percent said they would wait and see, 11% said they would definitely not get it and 6% said they would get it only if required.

Nearly 40% were not even sure whether the new booster was recommended for them by the Centers for Disease Control and Prevention.

Risks increase with age, according to CDC, and unvaccinated older adults are more likely to be hospitalized or die from COVID-19.

Tim Brown, an infectious disease expert at the East-West Center in Manoa, also urged kupuna to get their boosters, especially with a “variant stew” of more immune-evasive variants poised to drive another wave in the U.S.

There already have been more than 600 COVID-related deaths in Hawaii this year, he noted Monday during the Honolulu Star-Advertiser’s “Spotlight Hawaii” livestream program, primarily among seniors.

The most concerning variants include BQ.1 and BQ.1.1, both offshoots of BA.5, which drove up cases in Europe and now make up a growing percentage of cases in the U.S. These variants have mutations that not only get around immunity from vaccination or previous infection, but evade monoclonal antibody treatments such as Evusheld and bebtelovimab.

DOH has recently confirmed that both BQ.1 and BQ.1.1 are now present in Hawaii.

“These variants are increasingly spreading in Europe,” said Brown, “and I think that’s what we have to be concerned about, because Europe in the past has been kind of a bellwether for what’s going to happen in the United States two or three months later.”

Cases are already rising in the U.S. Northeast, and will “almost certainly play out in the rest of the country as it is has in the past,” Brown said. But based on what happened in Europe, this wave will hope­- fully be smaller than previous ones, and there is no evidence so far the new variants result in more severe illness.

The bivalent booster is important because the new subvariants are descendants of BA.5, which is targeted in the new formula, he said. While they won’t offer perfect protection, they should offer better protection against these new variants because they are in the same family.

Those at risk of serious illness also should step up other precautions, such as masking with N95s and testing before gathering.

“Remember, we’re exposed to people from all over the world, so what happens anywhere in the world can come home to us here,” he said. “So I think we’ve got to be really cautious there.”

More than 125,000 bivalent boosters have been administered in Hawaii, according to the latest data from DOH. To date, 25% of those ages 65 to 74 and 38% of those ages 75 and older in the state have received the bivalent booster.

Hawaii nursing homes have the top vaccination and booster rate in the country, according to AARP, with 78.4% of residents up to date on their COVID-19 shots. However, AARP is still concerned about protecting Hawaii’s most vulnerable residents.

“When there is large-scale community spread, the virus will get in to nursing homes,” said AARP Hawaii in a statement. “We saw that over the summer. If there is an increase in COVID-19 spread this winter, we want to minimize serious illness, hospitalizations and deaths.”

BIVALENT BOOSTER ELIGIBILITY

>> Pfizer bivalent booster: Ages 5 and up, if it has been at least two months since the final primary series dose or booster dose

>> Moderna bivalent booster: Ages 6 and up, if it has been at least two months since the final primary series dose or booster dose

>> Novavax first booster: Available to those ages 18 and up at least six months after their primary COVID-19 series (Novavax, Pfizer, Moderna or Johnson & Johnson)

>> To schedule a specific COVID-19 booster or vaccine, visit vaccines.gov or search DOH’s vaccine finder map at hawaiicovid19.com/vaccine.

Source: DOH