With the new COVID-19 vaccinations for the 2024–25 season arriving in California and across the nation, an important question arises: When is the best time to get the shot?

The U.S. Centers for Disease Control and Prevention says September and October are generally the best times for most people to get the COVID immunization.

But which month is better for your particular situation? Should you rush to get the shot now, considering the high levels of COVID circulating in California? Or should you wait till closer to Halloween in hopes that doing so will extend more robust protection against infection through Christmas and into the New Year?

And what about people who got infected recently or got the old immunization formula a couple of months ago?

Providers in California began administering COVID-19 immunizations using the latest formulation this week. Appointments are available at CVS, Walgreens, Rite Aid, Ralphs, Vons, Albertsons, Pavilions and Safeway stores. Kaiser Permanente expects to begin making vaccines available by mid-September and possibly earlier in some locations. Sutter Health is also aiming for a mid-September rollout.

The CDC recommends that everyone 6 months old and older get the updated COVID-19 vaccination, which was authorized for distribution by the U.S. Food and Drug Administration last week.

Here are some factors to consider:

The case for October

The head of the CDC suggested that the most important decision is not when to get the vaccination, but just getting it.

“The important part is getting it done,” CDC Director Mandy Cohen said at a briefing. “If September, from a calendar perspective, works better for folks, great. October gets you closer to the winter season. But the important part is getting it done.”

Dr. Peter Chin-Hong, a UC San Francisco infectious disease expert, makes the case for an October dose.

Getting the COVID-19 vaccine now or in October will offer good protection against severe disease for at least a year, he said. But the best protection against infection is roughly six to eight weeks after getting vaccinated — although that window can be wider if the vaccine is a close match to circulating subvariants, Chin-Hong said.

“To me, the sweet spot is always October,” he said, as it’s closer to the peak of the late fall and winter respiratory virus season, as well as major holidays like Thanksgiving, Christmas and New Year’s. Based on wastewater data during the last two winters, COVID peaked in California and nationally either the last week of December or the first week of January.

The case for September

But Dr. Elizabeth Hudson, regional chief of infectious diseases for Kaiser Permanente Southern California, suggested that people get the vaccine as soon as they can.

“The way that COVID is looking now — with just the sheer volume of cases — this is not a year that you want to wait,” Hudson said. “As soon as you are able to get the vaccine, you should get it.”

COVID-19 continues to circulate at a very high level nationally and in California. Depending on the region, health officials are “potentially seeing some indication of a plateauing of the summer increase in COVID-19,” said Dr. Demetre Daskalakis, who heads the CDC’s National Center for Immunization and Respiratory Diseases. Still, “we’re not out of the woods yet,” he added. Trends won’t be clear until there are a few weeks of sustained declines, and that hasn’t happened yet.

Not only is the hyperinfectious KP.3.1.1 subvariant gaining dominance nationwide, doctors also are closely watching a new upstart subvariant, XEC, that has been getting attention in Europe.

Dr. Peter Marks, the FDA’s vaccine chief, said in an Aug. 23 briefing that he has scheduled his vaccine appointment.

“Getting vaccinated now probably gives you the maximum amount of protection that you can get against what’s currently circulating, and that will last for several months, at least,” he said.

What about seniors and immunocompromised people?

Chin-Hong said there are certain people he would urge to get the COVID-19 vaccination as soon as possible. That includes those who are older or immunocompromised and haven’t been vaccinated in more than a year. Those groups are at highest risk for being hospitalized with COVID, Chin-Hong said.

“I would love them to get protected,” he said.

Dr. Eric Topol, director of the Scripps Research Translational Institute in San Diego, offered some questions people should ask themselves to determine whether they should get vaccinated now versus in October.

“How long has it been since you had a booster? If it’s been more than six months, you know your immunity has waned,” Topol said. “How is your risk? Are you older — greater than 65? Are you immunocompromised? Are you somebody with a lot of comorbidities? You might want to just go now [if so], because you’re vulnerable.”

“For people at risk, I don’t think it’s a good idea to delay,” Topol said.

Another question: Are you getting vaccinated to reduce your chance of long COVID? “Because the studies in totality suggest up to a 50% reduction of long COVID” following vaccination, he said. “In fact, that’s people in their 30s and 40s that are at the highest risk for long COVID after a mild infection, and a lot of people tend to forget that issue.”

Another consideration is whether you are about to go on a trip or planning an unmissable event or experience.

“Right now, if they want to prevent infection, it’s a good time to get something because it’s so closely matched to what’s going around,” Chin-Hong said of the new vaccine.

But if you’re doing lower-risk activities and would rather save your time of enhanced protection against infection for the fall and winter holidays, some doctors say it’s reasonable to wait until October to get vaccinated

Already, it appears that XEC, the new subvariant detected in Europe, may be a contender for a late autumn and winter COVID wave, Topol said.

“Waiting a couple extra months so you’re closer to whatever the next wave/wavelet is like, that’s a reasonable plan,” Topol said. But protecting against infection is less important than protecting against severe illness, which the vaccine is very good at doing.

Topol said he’s getting his COVID-19 vaccination Friday, in part because he’s going on a cross-country trip and he’ll be indoors with crowds and unable to avoid exposure to the virus, he said.

Masking remains important to avoid infection, but there are some situations where people may not be able to wear a mask all the time.

Overall, though, there isn’t any one simple answer as to whether September or October is better for timing your COVID vaccination. “It’s really up to the person,” Topol said.

What about people who had COVID-19 recently?

After infection, people may consider waiting three months to get the latest COVID vaccination, according to the CDC. In terms of when to start counting the three-month period, Hudson said a good rule of thumb would be from when your symptoms began or, if asymptomatic, when you were diagnosed.

Part of that reason, the CDC says, is that “the risk of getting COVID-19 is less likely in the weeks to months following a SARS-CoV-2 infection,” using the formal name of the virus that causes COVID.

Besides potentially being able to benefit from some natural immunity, “there are also some studies that show that waiting for a few months after you’ve had COVID to get your COVID vaccine may increase your overall level of protection,” Hudson said.

But this advice applies only to people who are at lower risk for COVID and its complications, Hudson added.

For those at higher risk — such as seniors 65 and older and those who are immunocompromised — or anyone in frequent contact with people at higher risk, “they should get their vaccine as soon as they’re feeling better,” she said.

What about people who got the old vaccine this summer?

A number of people who weren’t up to date on their vaccinations may have gotten the old vaccine formula — originally released in September 2023 — over the summer. Those people should wait two months before getting the newer shot, Hudson said.

As more species are pushed to the brink of extinction, conservationists are responding to our biodiversity crisis in new and sometimes controversial ways. One such novel approach could be described as the mammoth in the room: “de-extinction” technology that has the potential to protect and restore species on the brink of extinction and, more provocatively, those that disappeared from the planet long ago.

We can avoid such innovation and the controversy that comes with it. But the reality is that many milestone moments in conservation have been contentious.

Take the California condor, whose population was down to 22 known individuals in 1982. At the time, taking all the animals out of the wild for a captive breeding program sparked outrage among conservation professionals and in local communities. Today, however, thanks to those efforts and subsequent reintroductions of the birds into the wild, their population exceeds 500. Now captive breeding programs are regularly used to maintain and restore a variety of threatened species.

Or consider conservationists’ difficult decision in 1995 to relocate eight female mountain lions from Texas to infuse new genes into the population of Florida panthers, a subspecies of the puma. Only about 30 Florida panthers were left at the time, and inbreeding had rendered them susceptible to disease and other health problems. Although this genetic rescue effort was highly controversial at the time, it was also very successful, decreasing the effects of inbreeding and allowing the population to steadily grow. Today about 200 adult panthers live in southwest Florida, and the intervention is regarded as a model.

The use of assisted reproductive technology such as artificial insemination and in vitro fertilization to bolster dwindling species has been a more recent subject of debate within the conservation community. But since these tools were introduced, they have become standard among zoos’ “insurance” populations of threatened species and in captive breeding programs aimed at reintroducing species into the wild.

Our organizations, the biotechnology company Colossal Biosciences and the conservation group Re:wild, recently announced a partnership to use de-extinction technology to protect and restore species on the brink of extinction. It is a powerful collaboration between an organization with extensive experience in wildlife and ecosystem conservation and a company that is using gene editing and genetic engineering technology to make extinction a thing of the past.

Both Re:wild and Colossal want to save species that are going extinct now. But at the heart of Colossal’s mission is a belief that the science to restore and recover species on the brink can be accelerated by moonshot projects such as reviving the mammoth or the dodo. This focus on de-extinction, or bringing back extinct species, is understandably a subject of vigorous debate.

So it’s no wonder that our partnership caught some in the conservation community by surprise. Even internally, it took lots of thoughtful and nuanced discussion — involving often passionate and sometimes seemingly insurmountable differences — to align around shared goals.

In the end, even though Re:wild has reservations about whether the woolly mammoth and other extinct species should be returned to Earth, the organization will advise on the feasibility of such reintroductions because of the projects’ potential to generate technology that could save hundreds of critically endangered species. We will work together to study the advantages, disadvantages and feasibility of each reintroduction, working with local interests and a cross-section of the conservation community. With the world’s sixth great extinction event upon us, we need every available tool to prevent extinctions and accelerate species restoration.

The conservation community has recovered species from the brink of extinction — some of which were down to a few individuals — but every one of those recoveries has been hard-fought. We will be able to restore critically endangered species much more quickly by combining Colossal’s technology with proven approaches such as conservation breeding programs, translocations of endangered species populations, assisted reproductive technology, biobanking of threatened species’ tissues and cells, and genetic rescue.

We are already seeing the benefits of Colossal’s technology for threatened species. The tools and techniques developed for every effort to bring a species back from extinction will also benefit closely related species that still live.

The woolly mammoth project, for instance, has sequenced the genomes of both the Asian elephant and the African elephant; has developed induced pluripotent stem cells with the ability to differentiate into other types of elephant cells; and is accelerating a cure for the deadly elephant herpes virus. Many extant marsupials will likewise benefit from the technology Colossal is developing to bring back the thylacine, an extinct carnivorous marsupial also known as the Tasmanian tiger or Tasmanian wolf. That includes the development of artificial pouches and synthetic milk, which will enable expanded conservation breeding programs and reintroduction efforts.

We’re also using or planning to use this technology to protect and restore northern white rhinos, Sumatran rhinos, pink pigeons, Tasmanian devils, northern quolls (a small carnivorous marsupial) and many other species.

Not everyone agrees that a headline-grabbing de-extinction of the woolly mammoth would be beneficial to our planet. But it’s hard to dismiss the project’s capacity to create tools and technologies that can prevent countless species from going extinct in the first place.

Our partnership is also allowing us to tap into new sources of conservation funding that would not be available without the interest that de-extinction generates. Even though it will always be cheaper and easier to save a species from extinction than to bring it back, we still need more resources to combat the biodiversity crisis.

Conservation is not easy, and the extinction crisis has no single solution. With an estimated 12% of bird species, 26% of mammals, 31% of sharks and rays, 36% of reef-building corals and 41% of amphibians at risk, we need to consider every tool we have to secure the future of our planet and all the life on it. We look forward to the day de-extinction technology is commonly used to restore endangered species and we’re considering the next conservation moonshot.

Matt James is Colossal’s chief animal officer. Barney Long is Re:wild’s senior director of conservation strategies.

In April, a group of Orange County parents flew to Sacramento to attend a conference hosted by Disability Voices United, an advocacy group for people with disabilities and their families.

They wanted to emphasize three issues to state officials at the event: the paucity of mental health care for children with developmental disabilities, the confusing mess of government systems meant to help them, and the gaps in availability of day-to-day caregiving.

Among them was Christine LyBurtus, a single mom living in Fullerton. Last fall, after repeated rounds of 911 calls and emergency hospitalizations, she had made the agonizing decision to move her son, Noah, who is autistic, into a state-operated facility for at least a year.

LyBurtus had struggled to find the support she needed to keep him at home. “Families are being forced to give up their children to group homes and treatment centers over 12 hours from their homes … or out of the state of California entirely,” she told the crowd at the conference.

“I beg you to hear us,” she said to state officials before turning from the microphone.

Despite the growing diagnosis of autism, which has been estimated to affect more than 2 million children and teens across the country, experts and advocates have bemoaned glaring gaps in services to meet the mental health needs of autistic youth.

Some researchers have estimated that upward of 90% of autistic youth have overlapping conditions like anxiety, depression or ADHD. Many have suffered alarming levels of trauma.

Yet “there are very few specialized facilities in the country that meet the unique needs of individuals with autism and co-occurring mental health conditions,” especially in crisis situations, said Cynthia Martin, senior clinical psychologist at the Child Mind Institute, which is based in New York.

Between 2020 and 2021, the number of California children and teens served by the state developmental disability system who were deemed to have “complex needs” — a state term for those who needed a range of crisis services or landed in a locked psychiatric ward — rose from 536 to 677, according to a report released last year by the California Department of Developmental Services.

California has been working to build more facilities to house and support such youth, including STAR homes that provide “crisis stabilization” for roughly a year, like the one into which Noah moved. But the state has seen an uptick in the number of people in need of such programs, as well as more former residents boomeranging back for “further stabilization,” the state report said.

As of this summer, the STAR homes could accommodate only 15 teens across the state; the one that accepted Noah budgets for more than $1 million per resident annually.

There are other community facilities where developmentally disabled youth in crisis can be placed, but “there remains a critical need for a ‘can’t say no’ option for individuals whom private sector vendors cannot or will not serve,” the state report concluded.

Autistic people and their families have also lamented that they cannot find adequate help in their communities before they reach a crisis point. Researchers have found that mental health workers are often unprepared to work with people with intellectual or developmental disabilities or may chalk up symptoms to their disabilities, rather than overlapping needs.

Christine LyBurtus looks at a drawing of her son, Noah, in their Fullerton home.

(Mel Melcon / Los Angeles Times)

“It’s pretty common for a mental health practitioner to turn away someone with a developmental disability or say, ‘I don’t serve that population,’” said Zoe Gross, director of advocacy for the Autistic Self Advocacy Network.

Alison D. Morantz, director of the Stanford Intellectual and Developmental Disabilities Law and Policy Project, called it a “scandal” that amid a scarcity of psychiatric beds for youth, “if a family member discloses that their child is on the autistic spectrum, they can say, ‘No thank you.’”

“It puts parents in impossible situations,” she said.

The biggest challenges for many families of autistic youth often surround aggression, which isn’t a core feature of autism, but the symptom of other issues that need to be uncovered, child and adolescent psychiatrist Dr. Matthew Siegel told a federal committee last year.

“You have to look underneath or in front of that … for what could be contributing or what is driving this aggression,” said Siegel, founder of the Autism and Developmental Disorders Inpatient Research Collaborative. He and other researchers have seen promising results from specialized units at hospitals, but few exist — “not even one per state.”

“Even specialized clinics that can work on these challenges are quite rare,” he said.

The Supreme Court has ruled that institutionalizing people with disabilities who could live in the community is discriminatory if a community placement “can be reasonably accommodated.” Federal investigations have, at times, faulted states for failing to provide needed services for people to stay in their homes or communities.

The law “requires that services are provided in the most integrated setting appropriate to the needs of a person with a disability,” according to the U.S. Department of Health and Human Services.

But the struggle to find needed services can end up pushing autistic people with mental health needs out of their communities. Bonnie Ivers, director of clinical services for the Regional Center of Orange County, said last year that “more and more families are having to review options that are outside of our county.”

Some Californians even go outside the state: As of June 2022, there were 49 youth with “complex needs” getting services outside of California, and an additional 33 “at risk of being referred to out-of-state resources,” according to the developmental services department.

In the following year, that number grew to 57 youth out of state — and an additional 64 who might be at risk of joining them. The numbers may actually be higher: The state agency says it learns about out-of-state placements only when families inform the regional centers that coordinate developmental disability services.

Nancy Bargmann, director of the California Department of Developmental Services, said their goal is to provide “a continuum of supports” so that families “don’t need to make that really hard decision of having their child not live at home.”

California has launched more than a dozen teams focused on crisis prevention, called START teams, which it says have helped keep people in their homes. Their services include connecting different systems that assist families, such as mental health providers and disability services.

But they do not yet exist everywhere in the state. California also has mobile “Crisis Assessment Stabilization Teams” — or CAST — that are meant for people who have exhausted other kinds of help or are at risk of having to move into more restrictive settings. There were three of them as of this spring, according to the developmental services department.

Judy Mark, president of the advocacy group Disability Voices United, argued it is counterproductive to try to stabilize a child away from his or her family. If at all possible, she said, California should be ensuring constant support in the home, which she argued would also be less costly than caring for a child in a STAR facility.

But disability services providers say that getting such caregivers has continued to be a challenge, with state rates for such workers outstripped by what they can earn elsewhere. Increases in those provider rates have been slowly phased in over time, with the next bump slated for January.

In many cases, “what you’d want to see is somebody, 24 hours a day, in the home helping the parent,” said Larry Landauer, executive director of the Regional Center of Orange County. But “that’s where we have been just drastically short on staffing.”

All the gaps in the system can come to a head when young people with developmental disabilities hit puberty, especially if they face “the inability to communicate in such a complex and confusing time,” said California Commission on Disability Access member Hector Ramírez, who is autistic and lives in the San Fernando Valley.

If autistic teens and their families cannot get the support they need, Ramírez said, it “has compounding consequences that result in people just getting worse — when they shouldn’t be getting worse.”