COVID fall guide: The new variant in town, when to get vaccinated and what to do if you get sick

Although rates of new COVID infections have fallen since the summer’s surge, there’s a new variant in town, gearing up to fuel winter illnesses. There’s a new vaccine as well, though uptake has been slow so far. Whether you had COVID during the summer wave, are trying to avoid it this fall or want to know the latest with the virus, we’ve got some answers.

Here’s what experts want you to know to prepare for COVID this autumn.

Is the summer 'FLiRT' variant surge over?

COVID’s high-activity summer season appears to have passed its peak. During the week of Aug. 18, nearly 20% of COVID tests were positive, according to data from the U.S. Centers for Disease Control and Prevention (CDC). After four weeks of steady declines, that figure had fallen to just shy of 15% by the week of Sept. 7.

Although COVID is still too new to accurately predict its patterns, “I expect it to quiet down in the fall, and pick back up in early winter,” Dr. Mark Sawyer, a professor of pediatric infectious diseases at the University of California, San Diego, tells Yahoo Life. He notes that whether the virus’s activity will follow the same trajectory it has in recent years — with cases rising in the summer amid travel and during the winter holidays — depends, in part, on the circulating variants.

Which variants will drive COVID this fall?

The dominant KP variants that fueled the summer’s high case numbers were highly infectious, but led to fewer hospitalizations than past prevailing versions of the virus. They remain dominant in the U.S., but, speaking to Yahoo Life in early September, University of California, San Diego virologist Dr. Davey Smith said: “My best guess is that we will get another variant that will be a close cousin to this one, because that’s what’s happened the past couple of years.”

Now, some experts believe that variant has emerged. It’s called “XEC,” and the number of COVID cases it’s responsible for in Germany and Denmark has quickly accelerated since the variant was first identified in June. As of the first weekend of September, 23 U.S. cases of XEC had been logged by Scripps Research Translational Institute’s variant tracker, Outbreak.info. While it accounts for a very small proportion of infections in America, Scripps’s director, Dr. Eric Topol, said in a September 13 X post that XEC “appears to be the most likely one to get legs next.”

Smith agrees, telling Yahoo Life, “I think this one is the latest to take over and likely the one that will cause our winter wave” of COVID.

Topol told Well and Good that XEC is, essentially, a blend of two variants — KP.3.3 and KS.1.1 — one of which is a cousin of the KP.3 variant that drove August COVID cases so high. There is no evidence as of yet that XEC causes any different or more severe symptoms than its predecessors. Though XEC does not appear to be another FLiRT variant, it, too, is a descendant of the Omicron variants.

Will the new COVID vaccine work against XEC?

Experts say it will almost certainly stand up to XEC better than the previous vaccine. But Topol noted that XEC has considerable differences from the variants the vaccine was based on. Ultimately, it’s just too soon to tell and hardly a surprise to scientists. “The virus is always one step ahead of us,” Smith says.

Who should get vaccinated and when?

When it comes to relatively young, healthy people, there’s some debate among experts about when to get vaccinated. But for anyone who is high risk, the sooner the better, experts say. High-risk individuals include those who have underlying conditions such as heart disease or diabetes, people who are 60 or older and those who have weakened immune systems due to an illness or treatments for problems that include cancer or rheumatoid arthritis — all of which raise the risks of severe infection. “The very high-risk population probably shouldn’t delay vaccination, almost no matter what,” says Sawyer.

However, Smith says that if you had COVID this summer, you may want to wait until three months have passed since your infection to get vaccinated. By getting COVID, “basically you just got boosted,” he says. “Instead of getting your immune system trained by the vaccine, it got trained by the real thing.”

Both Smith and Sawyer say that getting a shot of the new vaccine is a good idea for anyone ages 6 months and up (according to the CDC’s recommendation) to protect yourself and others, especially before the winter surge. But the exact timing depends on a number of variables. Sawyer, who had COVID in June, plans to wait a bit longer, but advises those with travel plans or big events such as weddings coming up to go ahead and get their shots beforehand.

Are free shots available?

Shots aren't as easily available as they once were. The U.S. federal government sunset the “Bridge Program,” which provided free shots to people without insurance, at the end of August. Now, people without coverage could pay up to $200 for the vaccine, the Washington Post reported. However, kids can still get free shots through the Vaccines for Children program. Free or low-cost vaccines may also be available through local health departments and community health centers of fairs. Medicaid, Medicare and many private health insurance plans will cover COVID shots.

What should I do if I get COVID this fall?

The CDC relaxed its isolation guidelines and now recommends that people stay home and away from others for at least 24 hours starting after their symptoms begin improving and after their fever goes away. “The guidance is good, but my take is that it’s still a good idea to isolate if you have COVID,” Smith says. “You don’t want to give it to people — especially people you love or like — so if you don’t feel well, maybe don’t go to that birthday party or events, which is even more important to keep in mind when people at that party might be older or have conditions like cancer or diabetes.”

And, though the same rule of thumb applies whether you have COVID, flu or another respiratory infection, you should still take a test (which the U.S. government is offering for free again). That’s particularly important for people at greater risk of severe COVID because a positive test allows them to talk to their health care provider about whether they should take Paxlovid to help prevent the illness from becoming more dangerous, say Sawyer and Smith.