Times Chronicle & Public Spirit
Boosting protection
What you need to know about fourth vaccine dose
Like many people, Mary Kendig has spent the last two years wading through the fear and challenges of the COVID pandemic.
The threat of the highly contagious disease has kept the 70-year-old Wyomissing woman and her husband spending most of their time at home.
Kendig, who has a chronic health issue that makes her more susceptible to COVID, has been ordering her groceries and picking them up in the grocery store parking lot. Weekly dinners out have become weekly take-home meals.
She hasn’t seen her daughter who lives in San Francisco since the pandemic began. Visits with her two children who live locally have been few and far between.
So anything Kendig can do to gain a little bit of extra protection and make her feel safer about returning to her normal life is something she’s eager to do.
That’s what brought her to the Medicine Shoppe in Shillington on Friday morning. She was there to get her second booster dose of the COVID vaccine.
“I decided that whenever they decided it’s time to go get a shot I’m going to go get it,” she said. “Since things are getting better with the pandemic, I feel more comfortable going out in the world. But whatever shots will make me feel even better about it, I will take.”
Last Tuesday the U.S. Centers for Disease Control and Prevention announced it is now recommending a fourth dose of the Pfizer and Moderna vaccines for people over age 50 and those with compromised immune systems.
This is the second booster shot that has been approved by the U.S. Food and Drug Administration to increase the ongoing effectiveness of the original two-dose regimen for the Pfizer and Moderna vaccines.
“Data continue to show the importance of vaccination and booster doses to protect individuals both from infection and severe outcomes of COVID-19,” a statement from the CDC says. “For adults and adolescents eligible for a first booster dose, these shots are safe and provide substantial benefit.”
MediaNews Group spoke with a pair of medical experts to learn a little bit more about the new booster opportunity. Here’s what they had to say.
Why is another booster needed?
While the COVID pandemic has eased in Pennsylvania and the U.S., it has proven in the past to be resilient.
And a new wave may already be on the way.
Dr. Mohammad Ali, an infectious diseases physician at Penn State Health, said a subvariant of the omicron variant — which pushed daily case numbers in the county to record levels in December and January — is causing case spikes in Europe and Asia.
“Some countries have seen a lot of cases, and some have seen a lot of hospitalizations, too,” he said.
Ali said that when is comes to variants and subvariants of COVID the U.S. tends to lag about three or four weeks behind Europe. That means the new omicron subvariant will likely be making an impact here soon.
“Nobody really knows what it’s going to be, but we’re pretty sure there’s going to be a spike in cases,” he said.
Dr. Debra Powell, chief of Tower Health’s division of Infectious Diseases and Medical Director Infection Prevention, said the new omicron has already arrived in the U.S. Data has shown it represents about 48% of new cases in the Pennsylvania-Maryland-Virginia region, and as high as 77% in New England.
There is concern about the new subvariant because it is more infectious than the original omicron variant, Powell said.
Right now, Powell said, COVID case numbers and hospitalizations are low in Berks, and getting the new booster can help maintain that.
“The numbers are really low at this point, and that’s how we want to keep it,” she said. “The booster will provide extra protection and people who do get infected will have a mild infection.”
So far, no spike in cases has been evident in Berks or across the country.
Who should get the new booster?
The new booster has been approved for people over age 50 and those with certain medical conditions that make them prone to severe complication from COVID, like those with compromised immune systems.
“This will give them extra antibodies to give them more protection,” Powell said.
Powell said people should get the new booster if it has been at least four months since their first booster dose. That’s because over time people’s levels of antibodies begin to drop, and the booster helps raise them again.
Getting the new booster dose is particularly important for people over age 65 and those with high risk of severe illness, she said.
“I think those are the people we should really focus on,” she said. “Other people probably wouldn’t have as bad an outcome if they get infected.”
Ali said initial studies have shown the new booster can reduce the risk of death from the new subvariant in people over age 60.
“My recommendation is anyone who is 50 years or older and have risk factors — and who are six months from their first booster — it’s a good idea to get it,” he said. “It’s safe, and it will give some reduction of the severity of the illness.”
Ali said people who have had their first booster shot and then experience a breakthrough illness don’t have to rush to get their second booster shot.
“They can perhaps delay this process,” he said. “The hybrid immunity works very well against these subvariants.”
Ali said that if people don’t get the fourth booster it doesn’t mean that they’re vulnerable to severe illness, only that they’re not as protected as they could be.
“In my opinion the first booster still works fine, so I don’t think we should say that you’re unprotected,” he said. “But if someone wants this extra protection they can get it.”
What is the booster shot?
The new booster is exactly the same as the first booster for Moderna and Pfizer, Powell said.
That means people can get them at any pharmacy or other location that is providing vaccine shots.
For Pfizer, the new booster is also the same as the first two vaccine doses, Powell explained. Moderna slightly altered its dose from the two initial shots and the boosters.
Powell said that it is OK, and data in fact shows perhaps a good idea, to mix what versions of the vaccine people get. She said getting initial doses of Moderna and then turning to Pfizer for the boosters could help improve immunity — or vice versa.
Powell also said it is now being recommended that anyone who got the oneshot Johnson & Johnson vaccine get either a Pfizer or Moderna booster.
Are more boosters on the way?
Ali said the future of vaccine booster shots really depends on the ultimate goal of the fight against COVID.
“It really depends on what the end game is here,” he said. “If we’re aiming for a world that is COVID-19 virus free, I don’t think we’re going to achieve it.”
Ali said rolling out boosters every few months to fight new variants might not be the best approach. That would be the approach if eradicating the virus was the goal.
But getting rid of COVID-19 isn’t realistic, he said.
“There are plenty of people not vaccinated around the world and in the U.S.,” he said. “There’s plenty of room for the virus to move around.
“The virus will mutate and will change its course and we might see situations where we get more infections, but I think the end game is to reach a stage where we’re preventing severe infections and hospitalizations.”
To that end, Ali said he envisions developing annual booster shots.
Powell said the same thing.
“I think it will become endemic, seasonal,” she said. “I think what is going to happen is we’ll get into a seasonal sort of booster, like a flu shot.”
Like Ali, Powell pointed to areas where vaccinations rates remain low, saying new variants will develop there and spread across the globe.
What she sees happening in the future is the annual development of COVID boosters that use data from places like China and Australia, which tend to predict what the virus will look like in the U.S. That’s what’s done to develop the annual flu vaccine.
Of course, much like with the flu shot, the effectiveness of producing annual COVID vaccines that way will vary, Powell added.
“Sometimes they get a close match, sometimes it’s not as close,” she said.
“Data continue to show the importance of vaccination and booster doses to protect individuals both from infection and severe outcomes of COVID-19. For adults and adolescents eligible for a first booster dose, these shots are safe and provide substantial benefit.” — Statement from the CDC