Boosters Boosters and more Boosters

Sep 27, 2021

Update on Covid Vaccine Boosters

There has been a fair amount of action by the FDA and CDC on boosters in the past week or so. We’d like to update you and give our thoughts. It has been the case for a few weeks now that certain individuals who were initially vaccinated with the Pfizer-BioNTech vaccine (Pfizer) are eligible for a booster. Now, those who initially received the Janssen/Johnson & Johnson vaccine (J&J) and Moderna are now eligible.

The first question is whether you are eligible. Which vaccine did you get?

1.       J&J: If you received this vaccine, you are eligible for a booster if you are over 18 years of age and it has been over two months since your vaccine.

2.       Pfizer or Moderna: Folks who received this vaccine initially are eligible for a vaccine if it has been more than six months since the second dose and you are:

a.       Over age 65

b.       Age 18+ and live in long term care settings like nursing homes or prisons. This list is here

c.       You have a chronic health problem that increases your risk of severe illness if you were  to get COVID-19. The list is here

d.       Age 18+ and live or work in high-risk settings. The list is here.

The second question is what booster to get. The Pfizer booster is the same exact vaccine as the primary vaccination series. The same is true for J&J. Moderna is different: the approved booster dose of the Moderna vaccine is half the dose of the primary series.

1.       J&J: You can receive any of the three approved vaccines as a booster. We recommend that those who got the J&J vaccine get an mRNA vaccine booster, either Pfizer or Moderna.

2.       Pfizer: You can receive any of the three approved vaccines as a booster. We recommend a third mRNA vaccine dose (Pfizer or Moderna) and not a J&J. If you choose a Pfizer booster, it would be the usual dose. If you choose Moderna as your booster, it would be the half-dose shot.

3.       Moderna: You can receive any of the three approved vaccines as a booster. Similar to the Pfizer booster protocol, If you choose a Pfizer booster, it will be the usual dose. If you choose Moderna as your booster, it would be the half-dose shot.

Reach out to your provider to confirm that you’re eligible and what booster they recommend for you.

One caveat to this is antibody levels. We have been checking antibody levels in patients and have found levels ranging from single digits to >2500 (the upper limit of the assay from LabCorp.) There has been some debate as to the value of antibody testing. Research suggests that antibody levels as measured by the LabCorp assay correlate to “neutralizing antibodies” a.k.a. protective antibody levels. Members who don’t otherwise qualify for a booster (as noted above) are welcome to schedule a time to get their antibody levels checked if it’s been six months since your vaccine. If we measure your antibody levels to be low, no matter your age, work, living situation, your provider will likely recommend the booster. The opposite is also true: if your antibody levels are very high (say, over 1000), your provider may recommend you delay your booster.

The third question is where should you get the vaccine? You can get the vaccine anywhere they’ll let you! We believe that with this new announcement from the CDC and FDA, boosters will become easier to obtain from local pharmacies. Harper Health will also be distributing the COVID-19 vaccine boosters at scheduled times. Unlike other vaccines that we administer, the COVID-19 vaccines are in multiple dose vials, and once you puncture a vial, you must use all of it within hours or it will go to waste. We’re trying to avoid wasting any doses. Because we don’t have the patient volume of a Walgreens or CVS, we can’t assume that on a given day within a few hours we’ll have six (Pfizer) or up to 40 (Moderna) people needing the vaccine. This is why we need to schedule days and blocks of time for administration.

We will be administering boosters to members on select days over the next few weeks. If you would like the vaccine from us, please connect with your provider to confirm you are eligible and which vaccine booster would be best for you. We’ll then get you on the calendar.

One final note, the FDA will soon approve the Pfizer vaccine for children 5-12. If you have a child in this age group we recommend that you talk to your pediatrician if you have questions about the vaccine and whether your child should receive it.

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