TO BOOST OR NOT TO BOOST: WHAT IS THE ANSWER?

TO BOOST OR NOT TO BOOST: WHAT IS THE ANSWER?
By SUNITA SOHRABJI/EMS Contributing Editor

As of Oct. 22, both the Centers for Disease Control and Prevention and
the Western States Scientific Safety Review Workgroup recommended
expanding the use of a booster dose of the Pfizer, Moderna and
Johnson & Johnson vaccines for eligible populations. The CDC and
Western States Workgroup had previously approved the administration
of a third dose to boost immunity for vulnerable and
immunocompromised groups.
The emergency use authorizations were amended to allow a booster
dose of the Moderna COVID-19 vaccine for certain vulnerable
populations, six months after completion of their initial vaccination
series. Approval also was given for the use of a single booster dose of
the Johnson & Johnson COVID-19 vaccine for individuals 18 and over,
two months after their single dose. Further, the two organizations
cleared the way for the use of a “mix and match” of COVID-19 vaccines
which would not require individuals to use the same dose as their initial
series.
These approvals follow the FDA’s previous authorization of third dose
booster doses for individuals who received the Pfizer-BioNTech
COVID-19 vaccine six months after completing their initial series.
In this FAQ, Dr. Dali Fan, a UC Davis Health Science Clinical Professor
who also serves as a volunteer vaccinator at California Northstate
University in Elk Grove, California, answers some of the most commonly
asked questions about boosters.
1) What are the benefits of getting a booster?
DR. FAN: COVID-19 boosters are meant to boost immunity that may
have waned overtime and are the same dose of vaccine that were given
as part of the primary series. Booster doses of vaccines are very
common. They are part of most childhood and adult vaccine series to
ensure a person maintains optimal immunity against infection from a
disease.
2) What is the difference between an additional dose and a booster
dose?
DR. FAN: An additional dose is administered to people with moderately
to severely compromised immune systems. This additional dose of an
mRNA COVID-19 vaccine is intended to improve immunocompromised
people’s response to their initial vaccine series
At this time, CDC does not have a recommendation for
immunocompromised people to receive both a booster dose and an
additional dose. The current recommendation is for
immunocompromised people to receive an additional dose 28-days
after completing an mRNA COVID-19 vaccine series.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendatio
ns/immuno.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.ht
ml
As you can see, an additional dose is specifically meant for those who
are “immunocompromised.” Others do NOT need an additional dose
(28 days after the initial series), but they may be eligible for a booster
two-to-six months after the initial series depending on the type of
vaccine.
3) Are the boosters different than the original vaccination series?
DR. FAN: The boosters are the exact vaccine as the original series for
these vaccines.
4) Does the fact that boosters are recommended mean that the
vaccines are not effective?
DR. FAN: No. COVID-19 vaccines are working well to prevent severe
illness, hospitalization, and death, even against the widely circulating
Delta variant. However, public health experts are starting to see
reduced protection, especially among certain at-risk populations,
against mild and moderate cases of COVID-19.
Vaccine boosters are common, as most of us have had them throughout
childhood and adulthood. Whether it is measles, Hepatitis A/B or
COVID-19 – boosters are great tools in our arsenals to fight disease.
5) Who is eligible to get a booster dose now?
DR. FAN: A Pfizer or Moderna booster dose is recommended if you:
Received your second dose at least six months ago, and
Are 65 or older, or
Age 18+ who live in long-term care settings, or
Age 18+ who have underlying medical conditions, or
Age 18+ who are at increased risk due to social inequity, or
Age 18+ who work or live in high-risk settings
A Johnson & Johnson booster dose is recommended if you:
Received your first dose of the Johnson & Johnson vaccine at least 2
months ago, and
Are 18 or older
If you fall within the categories above, you can get your booster by
going to your healthcare provider, clinics and neighborhood
pharmacies. You can visit MyTurn.ca.gov or call 833-422-4255 to make
an appointment or find a nearby vaccine clinic.
5) The CDC has recommended additional does for those over 65,
people living in group homes, and the immunocompromised. How do
we define who is immunocompromised and needs an additional
dose?
DR. FAN: Currently, the CDC is recommending that moderately to
severely immunocompromised people receive an additional dose. This
includes people who have:
Been receiving active cancer treatment for tumors or cancers of the
blood
Received an organ transplant and are taking medicine to suppress the
immune system
Received a stem cell transplant within the last 2 years or are taking
medicine to suppress the immune system
Moderate or severe primary immunodeficiency (such as DiGeorge
syndrome, Wiskott-Aldrich syndrome)
Advanced or untreated HIV infection
Active treatment with high-dose corticosteroids or other drugs that may
suppress your immune response
People should talk to their healthcare provider about their medical
condition, and whether getting an additional dose is appropriate for
them.
7) The CDC has also recommended that essential workers might
consider getting boosters. Is that your recommendation as well? What
types of workers are particularly high-risk?
DR. FAN: Yes, it is my recommendation as well.
Examples of workers who may get Pfizer-BioNTech or Moderna
boosters:
First responders (e.g., healthcare workers, firefighters, police,
congregate care staff)
Education staff (e.g., teachers, support staff, daycare workers)
Food and agriculture workers
Manufacturing workers
Corrections workers
U.S. Postal Service workers
Public transit workers
Grocery store workers
This list could be updated in the future.
https://www.cdc.gov/vaccines/covid-19/clinical-considerations/essentia
l-workers-boosters.html)
8) Where can we get boosters? And are boosters free?
DR. FAN: Visit the state’s websites at VaccinateAll58.com or
Myturn.ca.gov to learn more about where boosters are being offered
near you. Your healthcare provider or local pharmacists can also help
connect you to resources. The booster is free of charge to all; no
insurance or documentation is required.