COVID-19: Symptoms, Variants, Vaccines, and Treatment Options Today

It’s January 2026, and COVID-19 isn’t gone - it’s just different. You won’t hear about lockdowns or empty grocery shelves anymore. But if you’ve had a bad cold this winter that just wouldn’t quit, or if your neighbor’s kid missed two weeks of school with a throat so sore they couldn’t swallow, you’re likely dealing with the latest version of SARS-CoV-2. The virus has evolved. So have the vaccines. And so should your understanding of what’s going on.

What Symptoms Are You Actually Facing?

The old list of COVID-19 symptoms - fever, cough, loss of taste - doesn’t tell the whole story anymore. Today’s dominant variant, XFG (also called Stratus), hits differently. People report congestion, a scratchy or stabbing sore throat, headache, muscle aches, and fatigue. It doesn’t always start with a fever. Sometimes, it starts with a cough that won’t go away or a headache that feels like pressure behind the eyes.

Another variant, Nimbus, has been linked to that sharp, sudden throat pain - the kind that makes you wince when you swallow. It’s not unique to one strain, but it’s common enough that doctors now ask patients: “Did your sore throat come on fast and feel like a knife?” If yes, it’s worth testing.

And then there’s the long tail. About 1 in 5 people who’ve had COVID-19 still deal with symptoms three years later. Fatigue. Brain fog. Trouble sleeping. Shortness of breath after walking up stairs. These aren’t “just in your head.” They’re real, documented, and increasingly recognized by doctors as part of long COVID. Hospitalized patients are at higher risk, but even mild cases can lead to lingering issues.

What Variants Are Actually Circulating?

Forget the names you heard in 2021 - Alpha, Delta, even the original Omicron. They’re gone. As of October 2025, XFG (Stratus) makes up 85% of all cases in the U.S. The rest? NB.1.8.1 at 7%, and NW.1 at 3%. These aren’t random mutations. They’re the result of the virus adapting to our immune defenses - especially after billions of infections and vaccines.

What makes XFG so widespread? It spreads faster than earlier versions. It doesn’t necessarily make you sicker, but it’s better at slipping past immunity. That’s why so many vaccinated people still get infected - not because the vaccines failed, but because the virus changed. Dr. Mark Rupp from Nebraska Medicine puts it plainly: “We have a lot of disease out there. People should continue to be careful.”

And while XFG dominates now, surveillance is ongoing. The CDC and global health agencies track every new mutation. The next big one could emerge anytime - which is why vaccine updates happen every year.

Which Vaccines Work Right Now?

The 2024-2025 vaccines were updated to target KP.2, a strain that was common in early 2024. Pfizer and Moderna’s shots are built for KP.2. Novavax’s vaccine targets JN.1, but lab studies show it also works well against KP.2 and KP.3. That’s important - because even if your shot doesn’t match the exact variant, it still gives you protection.

And here’s the key point: the goal isn’t to stop every infection. It’s to stop you from ending up in the hospital. Studies from Ohio State University Health show the vaccines are strongest in the first three months after getting them. After that, protection against infection drops - but protection against severe illness stays high.

For the 2025-2026 season, the FDA approved a new formula in May 2025 based on variants circulating in spring and summer 2025. The CDC recommends everyone 6 months and older get an updated shot every year. If you had COVID recently, wait at least three months after your symptoms started - or after your positive test if you were asymptomatic - before getting the new vaccine.

Side effects? Most people report nothing. Of the 1,245 people surveyed in June 2025, 87% had mild or no side effects. The most common? Fatigue (32%), sore arm (28%), and headache (19%). No one’s dying from the vaccine. But thousands are still being hospitalized because they didn’t get it.

What Treatments Are Available?

If you test positive, you’re not stuck waiting it out. Antiviral pills like Paxlovid (nirmatrelvir/ritonavir) are still the gold standard for high-risk patients - people over 65, those with diabetes, heart disease, or weakened immune systems. You need to start it within five days of symptoms for it to work.

For others, it’s about managing symptoms. Rest. Hydration. Over-the-counter pain relievers. No need for antibiotics - they don’t work on viruses. If you’re struggling to breathe, or your fever won’t break after three days, call your doctor. Don’t wait until you’re gasping for air.

Monoclonal antibodies, once a go-to treatment, have mostly been phased out because they don’t work against newer variants. But one new drug, clesrovimab, got FDA approval in June 2025 - not for COVID, but for RSV in babies. It shows how much the medical world has shifted: we’re now treating multiple respiratory viruses with targeted tools, not one-size-fits-all approaches.

Why Do People Still Skip the Vaccine?

Despite all the data, 41% of unvaccinated adults in the U.S. still say they’re worried the vaccines were rushed. That’s misinformation. The science behind mRNA vaccines has been around for decades. The speed came from global funding and parallel testing - not skipped steps.

Others say, “I already had it. I’m immune.” But immunity from infection fades. And the virus keeps changing. A 2025 study in the Journal of Medical Virology found people who got infected before 2023 had little protection against XFG. The vaccine gives you a broader shield.

And then there’s the confusion. Health departments update guidelines every few months. Websites change. People don’t know what to believe. That’s why trusted sources like the CDC, Mayo Clinic, and your primary care doctor matter more than ever.

What Should You Do Now?

Here’s the simple plan for 2026:

1. Get your updated 2025-2026 COVID-19 vaccine if you haven’t already. Don’t wait for symptoms.
2. If you feel sick, test early. A rapid antigen test works fine at home.
3. If you’re high-risk and test positive, call your doctor within 24 hours. Ask about Paxlovid.
4. Wear a mask in crowded indoor spaces - especially if you’re around older people or those with chronic illness.
5. Don’t panic. But don’t ignore it either. This isn’t 2020. But it’s not over.

Most people who get COVID now recover in 5 to 10 days. But for some, it lingers. The vaccine doesn’t guarantee you won’t get sick. But it gives you the best shot at not getting crushed by it.

Think of it like the flu shot. You don’t get it because you’re scared of getting the flu. You get it because you don’t want to spend a week in bed, or end up in the hospital, or pass it to your grandparent. Same logic. Same outcome.