San Francisco Chronicle

How the booster shots will roll out in the Bay Area

- Catherine Ho is a San Francisco Chronicle staff writer. Email: cho@sfchronicl­ Twitter: @Cat_Ho

“You remain very well protected, so that gives us some flexibilit­y on the timing of the next dose.” Dr. Jennifer Tong, Santa Clara Valley Medical Center

er recipients who are 65 and over or at high risk of severe COVID. Local health officials and providers say they are ready to offer these booster shots if and when federal officials finalize this recommenda­tion. The U.S. Food and Drug Administra­tion’s influentia­l vaccine advisory committee on Friday voted to recommend Pfizer booster shots for these groups, and the full FDA is expected to adopt this recommenda­tion soon. But in order for the policy to be adopted, the U.S. Centers for Disease Control and Prevention would need to approve boosters as well.

The FDA committee also said health care workers should be included in this first group eligible for boosters, but it did not include health care workers in its formal vote.

This time around, the infrastruc­ture to administer shots is much more establishe­d, organized and prepared, local officials and providers say.

“It’s not our first rodeo,” Santa Clara County Supervisor Mike Wasserman said during a discussion of booster shots at a Board of Supervisor­s meeting last week.

The start of the first vaccine rollout in December and January was marked by unpredicta­ble vaccine supply, long lines, confusion over constantly changing rules on who should get shots first, line cutters and general chaos.

The booster rollout, officials say, should go much more smoothly. Vaccine supply is now plentiful. Virtually every pharmacy is offering shots, and walk-ins and appointmen­ts are easy to come by. There are hundreds of vaccine clinics spread throughout the region from private providers, public sites and pharmacies. All in all, “there’s more muscle memory in the system,” said San Francisco Health Director Dr. Grant Colfax.

Local health officials and health care providers envision that this next phase of vaccinatio­ns will be more integrated into people’s individual health care routines. People will probably be able to get a booster the same way they get flu shots, by going to their regular provider instead of a temporary mass vaccinatio­n site. Some counties say they won’t need to set up mass vaccinatio­n sites like those they erected the first time around at fairground­s, stadiums and event centers. Many of those sites, anyway, are no longer available since they have reopened for visitors and regular games.

It’s harder, for example, to use school or college campuses because classes have resumed, said infectious disease specialist Dr. Stephen Parodi, executive vice president of external affairs at the Permanente Medical Group at Kaiser, which is looking into additional sites for vaccinatio­ns in case it needs them. “It may look a little different than last time, but we’re doing space planning because we anticipate there’s going to be a lot of interest and uptake.”

Unlike the first go-around when people had to get their second dose three or four weeks after their first, people will probably have more leeway when to get boosters — as long as they get it within the general time frame of whatever the FDA and CDC decide is appropriat­e. It appears the recommenda­tion will be for Pfizer recipients who are 65 and older, or who are at high risk for severe COVID, to get a third Pfizer shot at least six months after their second dose.

“As I’ve told my parents, it’s not worth getting your blood pressure up to make sure you get it on a specific date. It’s not worth standing in sun all day to see if maybe you can get it on that date,” said Tong, of Valley Medical Center. “You remain very well protected, so that gives us some flexibilit­y on the timing of the next dose once we know what’s approved.”

There should be a natural order for people seeking boosters that mirrors the order of the first shots. If federal officials, for example, finalize the recommenda­tion that people 65 and older should get their third Pfizer shot at least six months after their second, that booster wave would hit in September and October, since many people 65 and older got their second shots in February, March and April.

“We anticipate it will be a stream of people eligible, but not a massive bolus,” Colfax said.

Staffing shortages could be the “Achilles heel,” of this next phase of vaccinatio­ns, Jo Coffaro, regional vice president of the South Bay region of the Hospital Council, said during the Santa Clara County Board of Supervisor­s COVID update last week. The council represents hospitals in 50 of the state’s 58 counties.

A disproport­ionate number of health care workers retired or left the field during COVID because of burnout, Coffaro said. Many of the mass vaccinatio­n sites during the first vaccine rollout were staffed by traveling nurses, and many of them have now been sent to Southern states to help staff overwhelme­d hospitals there.

Because all three vaccines work very well at preventing severe illness, hospitaliz­ation and death, booster administra­tion feels less like an all-out emergency compared to the first vaccine rollout, when the most vulnerable residents like those in nursing homes were in a life-or-death race to get their first shots. Now, getting the unvaccinat­ed their first doses is more pressing than “topping off ” those who have already gotten their first shots, health officials say.

“Getting a booster, depending on the recommenda­tion, is most likely a fortificat­ion of already-existing immunity,” Colfax said. “The level of emergency, or urgency, is not the same.”

 ?? Gabrielle Lurie / The Chronicle ?? Nurse Anna Briggs (center right) chats with a patient before administer­ing the Johnson & Johnson COVID-19 vaccine at the Center for Empowering Refugees in Oakland in March.
Gabrielle Lurie / The Chronicle Nurse Anna Briggs (center right) chats with a patient before administer­ing the Johnson & Johnson COVID-19 vaccine at the Center for Empowering Refugees in Oakland in March.

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