By Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP
UPDATE: “I would like too offer my readers a point of clarification on booster eligibility. Jennifer Barro, MD, shared that my phrasing in one paragraph may not have made an important point sufficiently clear. If there is one thing public health strives for, it is clarity, so thank you Dr. Barro. Here is a re-statement of that point:
On March 29, 2022, the FDA approved everyone over 50 years of age who had received their last COVID-19 booster at least 4 months ago to be eligible now for a 2nd booster shot (https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-second-booster-dose-two-covid-19-vaccines-older-and).
On that same day Dr. Rochelle Walenskey, CDC Director, updated the CDC recommendations to allow certain immunocompromised individuals AND all people over the age of 50 who had received their initial booster dose at least 4 months ago to now also be eligible for another mRNA booster in order to increase their protection against severe disease from COVID-19.
She further added that adults who had been vaccinated/boosted with Johnson & Johnson’s COVID-19 vaccine at least 4 months ago could also receive a 2nd booster dose with one of the mRNA vaccines (Pfizer and Moderna) (https://www.cdc.gov/media/releases/2022/s0328-covid-19-boosters.html).
I hope this clarification helps you make the best decisions for you and your loved ones.
Original article: As Covid-19 has continued, and as hospitalizations, ICU admissions, and deaths from Covid-19 infections have continued, many families, businesses and communities have wondered whether friends and neighbors would get vaccinated, and then whether they would get boosted if it were to be recommended.
Many have, others have declined vaccines for themselves or their children, and yet others have declined to get recommended booster shots. Now the question looms: Will people get a second booster?
The recommendation to get a second booster is very personal-risk-focused. It is important that we each know our risk levels as well as the risk levels of the people with whom we will be in contact.
As more contagious variants emerged and spread, and as scientific studies began to show the diminishing effectiveness of vaccines and boosters over time, the question of additional booster shots entered discussions. We wondered who might benefit from an additional booster, and also who would be eligible to get one. Feelings and perceptions ran the gamut as they have run high since the pandemic began. Some declined to take a Covid-19 vaccine, others raced to become vaccinated, while still others got vaccinated but declined to get boosted. Evidence-based scientific studies explored, debated and discussed the values and merits of vaccines.
This week, over two years into the deadly pandemic, both the Food & Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) came out in support of certain people getting a second COVID-19 booster vaccine (CDC, 2022 & FDA, 2022). Both declared the vaccines to be safe. Scientific evidence has now demonstrated two very important things; a second booster dose of an mRNA vaccine (Pfizer and Moderna) will improve protection against a severe Covid-19 infection; and a second booster shot has been found through scientific studies to be safe, and to not be associated with any new safety concerns (Coronavirus (Covid-19) Update: FDA Authorizes Second Booster Dose of Two COVID-19 Vaccines for Older and Immunocompromised Individuals | FDA).
The Food & Drug Administration (FDA) is responsible for protecting public health, which it does through science-based testing in order to assure that drugs, vaccines and other biological products that we use are safe for human use and consumption. The Covid-19 vaccines and boosters have met this standard.
In her statement of support for a second Covid-19 booster vaccine, Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention, touted the benefits of an additional (second ) booster vaccine for those who are at high risk for contracting a Covid-19 infection, which can and has repeatedly been lethal for far too many people.
She noted a second booster vaccine to be important for people over 65 and especially important for people over 50 who have multiple underlying health conditions (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html)
Current Guidance on Who Should be Getting a second COVID-19 Booster Shot: Who should get a Second Booster?
The Food & Drug Administration (FDA) and the Centers for Disease Control & Prevention (CDC) have authorized the administration of a second COVID-19 booster vaccine of either Pfizer or Moderna (the two mRNA vaccines) for those over 65, and for those 50 + with certain immunocompromising illnesses. This is regardless of which first booster vaccine they took (Pfizer, Moderna, or Johnson & Johnson)
When is one eligible to get a second COVID Booster Vaccine?
• People who received their initial mRNA booster (Pfizer or Moderna) at least 4 months ago are eligible to get their second COVID-19 booster vaccine at this time.
• Those who are 12 years of age and older who are immunocompromised can receive a second booster of the Pfizer vaccine if they are at least 4 months beyond having received their first booster shot of any approved Covid-19 vaccine. This would include people who have had solid organ transplants or who have a condition that would result in a similar level of compromise to their immune system.
• Those who are 18 years of age and older and who are immunocompromised may receive a second booster dose of the Moderna vaccine if they are at least 4 months beyond the receipt of their first booster shot of any approved Covid-19 vaccine
Why Should an Eligible Person Get a Second Booster Shot?
We’ve heard discussions about the diminishing effectiveness of the vaccines over time. We learned that the Omicron B-2 variant is 75% more transmissible than the B-1 variant; it is now our predominant Covid strain. This means many more people will, and have been becoming infected with Omicron B-2 just based on the numbers (prevalence) of the circulating Omicron B-2 in our communities.
Even though both Omicron mutations make us less ill than the Delta variant had done, many more people are becoming ill, and many still require hospitalization; most notably the unvaccinated and those with underlying health conditions. The unvaccinated unfortunately include many children under 5 years old who have not been vaccinated, leaving all of them at higher risk.
The CDC substantiated the importance of people getting vaccinated and boosted against Covid-19 by noting that during the recent Omicron surge, people who had been boosted against Covid-19 were 21-times less likely to die from their Covid infection compared to those who were unvaccinated, and that a vaccinated person was seven times less likely to require hospitalization when infected with COVID-19 (https://www.cdc.gov/media/releases/2022/s0328-covid-19-boosters.html).
To date, 10,744 people have died of Covid in Connecticut (120 of them from Greenwich). This should be shocking. If we consider that the average number of people on a plane is 850, this would be the equivalent of Connecticut having lost all the passengers and crew on 12.5 airplanes since the pandemic began.
We are continuing to acquire more knowledge about the after-effects of Covid even in people who were mildly ill, as well as in those who never even knew they were ill. Six-months has been touted as a point when a second booster shot might be needed. Well, the studies have been done, considered, and evaluated, and the answers are now in.
As a public health professional I urge you to learn and understand your risk factors and well as those of your family members and children. This will help you to make the right choice for your family about vaccines, boosters, and second boosters.
Resource Links for Registering for Vaccines and Boosters
VAMS Login page: Vaccine Administration Management System (VAMS) (cdc.gov)
CDC VAMS information page: VAMS Vaccine Recipient (Guest) Registration | CDC
CT DPH VAMS Appointment Instructions: Guest Registration for scheduling a COVID-19 Vaccine (cdc.gov)
CT DPH Yellow Van Clinic Schedule: DPH Van Clinics (ct.gov)
Vaccine.gov Vaccine Finder: Vaccines.gov – Search for COVID-19 vaccine locations