How COVID is evolving this fall + what you can do to stay safe

Close up of an ill man with a headache lying on the couch

COVID hospitalizations are once again rising across the U.S. Older adults and children under 5 have been most affected so far.

“COVID is still here and disrupting our everyday lives. New virus variants are making people sick again – or for the first time,” explains Dr. Andrea Willis, chief medical officer for BlueCross BlueShield of Tennessee. “But there are things we can do to help us avoid getting severely sick – and help save the lives of those who are most vulnerable.”

Here are 9 facts about the current state of COVID and how you can best protect yourself and your loved ones.

1.   There continue to be new virus variants causing COVID.

The original SARS-CoV-2 has many lineages that all cause COVID. New variants can potentially bring changes in contagiousness or how well it responds to treatment.

The Omicron variant emerged in November 2021. It now has many lineages and has been the predominant strain in the U.S. for almost 2 years.

Omicron Subvariant Nickname What to keep in mind
XBB.1.5 Kraken The dominant subvariant in the U.S. earlier this year and late 2022
EG.5 Eris It’s now the dominant strain in the U.S. and a Variant of Interest due to a growing number of cases and hospitalizations
FL.1.5.1 Fornax It currently accounts for a large number of cases in the U.S.
BA.2.86 Pirola It’s less widespread but being closely monitored because it has multiple mutations, which may help it evade our immunity

2.   There are updated COVID vaccines and they target newer variants.

The original SARS-CoV-2 virus is no longer circulating widely, which is why the 2 newly approved vaccines now target the most dominant variants.

SARS-CoV-2 hasn’t yet fallen into a seasonal pattern like influenza viruses (which cause the flu). But much like the flu vaccine, COVID vaccines will continue to be updated to protect against the most prevalent strain.

XBB.1.5 was the dominant subvariant in June, when the U.S. Food and Drug Administration (FDA) selected the XBB lineage to target this fall. And almost all circulating subvariants are in the XBB lineage:

Stay up-to-date with COVID vaccines

3.   Most people should receive at least one updated COVID vaccine, but some may need more.

mRNA vaccines

The updated mRNA vaccines are each approved for people ages 12 and older and are authorized for people ages 6 months-11 years. Previous COVID vaccines are no longer recommended.

The timing and number of recommended doses varies with age and prior immunizations, but most Americans should receive at least one shot of the updated COVID mRNA vaccine:

  • People ages 5 and older, regardless of previous vaccination are eligible to receive a single dose of an updated mRNA COVID vaccine at least 2 months since the last dose of any COVID vaccine.
  • People who are moderately or severely immunocompromised may get additional doses and should talk to their healthcare provider about additional updated doses.
  • People ages 6 months-4 years who are previously vaccinate are eligible to receive 1 or 2 doses of an updated mRNA vaccine (timing and number of doses to administer depends on the previous COVID vaccine received).
  • People ages 6 months-4 years who are unvaccinated are eligible to receive:
    • 3 doses of the updated authorized Pfizer-BioNTech mRNA vaccine, or
    • 2 doses of the updated authorized Moderna mRNA vaccine

Traditional protein, non-mRNA vaccine

An updated Novavax vaccine, a non-mRNA vaccine alternative, is also available for people ages 12 and older. The timing and number of recommended doses varies based on prior immunizations:

  • People ages 12 and older, previously vaccinated with any COVID vaccine are eligible to receive:
    • a single dose of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula), at least 2 months since the last dose of an original monovalent or bivalent (original and Omicron BA.4/BA.5) COVID-19 vaccine.
  • People ages 12 and older who are unvaccinated with any COVID vaccine are eligible to receive:
    • 2 doses of Novavax COVID-19 Vaccine, Adjuvanted (2023-2024 Formula) administered 3 weeks apart.
  • People who are moderately or severely immunocompromised may get additional doses and should talk to their healthcare provider about additional updated doses. 

Get the complete COVID vaccination schedule for all updated vaccines

4.   COVID vaccines are safe and prepare your body to fight off illness.

COVID vaccine safety is closely monitored by the Centers for Disease Control and Prevention (CDC). Vaccination is a proven way to lower the chances you’ll get sick or reduce the severity of illness if you do get sick – which could help avoid disruption of your daily life.

Vaccination also reduces your chance of suffering the effects of Long COVID, which can develop during or following acute infection and last for an extended duration.

Remember, you could experience a mild reaction from vaccination. That’s actually a sign your immune system is responding well. Serious reactions after COVID vaccination are rare.

5.   COVID infection is still disruptive for everyone – and dangerous for some people.

People with COVID have reported a wide range of symptoms ranging from mild to severe, including fever or chills, difficulty breathing, fatigue, heart complications, muscle aches, headache, sore throat, heart complications, nausea or vomiting, diarrhea and more. Common symptoms may change with new variants and can vary based on vaccination status.


Each time a person is infected with COVID, they also have a higher risk for Long COVID, which includes a wide range of ongoing health problems, such as myocarditis, lasting for weeks, months or years. Unvaccinated people are also a higher risk of developing Long COVID.

Most people with Long COVID showed symptoms of infection, but in some cases, a person with Long COVID may not have known they were infected or tested positive for the virus.

Severe illness or disruption to daily life

Older adults and people with weakened immune systems are also at greatest risk for hospitalization and death from COVID.

And healthy children and adults can still experience severe disease complications that could keep them out of work or school for several days or longer. Regardless of vaccination status, you should still isolate from others if you have COVID, which can interrupt your daily life.

6.   Most Americans can still get a COVID vaccine for free.

Most health insurance plans will cover COVID vaccination at no cost. People who don’t have health insurance (or with health plans that do not cover the cost) can get a free vaccine from their local health department and pharmacies participating in the CDC’s Bridge Access Program. Children eligible for the Vaccines for Children program also may receive the vaccine from a provider enrolled in that program.

The updated COVID vaccines are being distributed to health departments, pharmacies and healthcare provider offices across the U.S. Contact your preferred facility for vaccinations to schedule an appointment.

7.   You can choose either brand of approved mRNA COVID vaccine, no matter which brand you’ve received in the past.

You don’t have to stick with the same brand of mRNA COVID vaccine you previously received. Both updated vaccines are expected to provide good protection from the currently circulating variants. Keep in mind you may still experience similar side effects as previous vaccines.

8.   You can get a flu and COVID vaccine at the same time, but they are two separate shots that cannot be combined.

The flu shot is a separate vaccine from COVID vaccines. And the COVID vaccine is not present in flu shots. You can get a flu vaccine and a COVID vaccine at the same time, but you should talk to your doctor if you have questions or concerns.

9. Vaccination is recommended, but hygiene, testing and treatment is critical, too.

Vaccination remains the best recommendation to protect yourself against COVID – and those around you. Proper hygiene practices like handwashing, wearing a mask if you’re sick and avoiding touching your face can help reduce the risk for spreading infection.

At-home tests for COVID can also help detect infection if you are symptomatic, so you can protect your family, co-workers, and the general public. If you do get sick, talk to your doctor about proven, effective treatments that can reduce the risk of severe illness, hospitalization, and death.

Use these tips to help protect yourself and others




Ali Whittier, CHES®

Ali joined the BlueCross BlueShield of Tennessee corporate communications team in 2014 and is a Certified Health Education Specialist (CHES®) through the National Commission for Health Education Credentialing (NCHEC). A native of Iowa, she has more than a decade of experience in health promotion and community engagement, as well as health care communications. When she’s not at BlueCross, she and her husband Spencer are racing their bikes, spending time outdoors or cooking healthy food and treats in their kitchen.

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