What About the Booster?

Although this story is accurate as of Monday, October 4, this is a very fast-moving story. For up to the minute developments, readers should also check here, and check their state health departments (list is here).  

Confused about whether it’s time to head out for your COVID booster vaccine? You’re not alone.

Over the past few weeks, the debate has raged, and the decisions and recommendations have come fast and furious—and they didn’t always agree. As of October 4, here is what we know, followed by the back-and-forth that got us to here. And, to help you keep up, we’re listing legit links.

In mid-August, the FDA OK’d a booster of Pfizer-BioNtech or Moderna for certain people who are immunocompromised (such as cancer patients or transplant recipients). Now, many more people are eligible for a booster dose.

Who is eligible for a booster now?

Adults 65 and older, along with residents of long-term care facilities, whose initial vaccine doses were from Pfizer-BioNTech, should get a booster of the Pfizer-BioNTech’s COVID-19 vaccine six months or more after their first two immunizations, according to the recommendation issued by the CDC Sept. 24. People ages 50 to 64 with underlying medical conditions should, too. Adults 18 to 49 with underlying medical conditions may receive a booster 6 months after completing the primary series, based on their personal risks and benefits. Those 18-49 who are at increased risk for exposure to the virus and transmission of it due to occupational or institutional settings, such as teachers and front-line workers, may receive a booster 6 months after the first two, based on individual risks and benefits.

The recommendation applies only to those who got the Pfizer vaccine for their first two rounds.

What else to know

The recommendation applies only to those who got the Pfizer vaccine for their first two rounds. The Pfizer vaccine got its emergency use authorization (EUA) amended by the FDA for use in these populations on Sept. 22

Next up, the FDA will evaluate J&J and Moderna boosters at meetings October 14 and 15. The FDA is also evaluating whether a half dose of the Moderna booster will suffice, say those close to the process.

While people may be tempted to line up for the Pfizer vaccine now, even if they got the Moderna or J&J vaccine initially – don’t

While people may be tempted to line up for the Pfizer vaccine now, even if they got the Moderna or J&J vaccine initially – don’t, advises William Schaffner, MD, an infectious disease specialist at Vanderbilt University Medical Center, Nashville. At least not yet. The FDA will look at the concept of mix-and-match Oct. 15.

“There are studies looking at mixing and matching different types of vaccines,” says Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, Baltimore, ”but for now the recommendation will be to stick with the same type of vaccine for the booster.”

“No rush here,” agrees Robert Murphy, MD, executive director of the Global Health Institute at Northwestern University in Chicago. “They can wait for the Moderna and J&J revised [amended] EUA, probably within the next month,” he says.

The recommendation for boosters for those 65 and up is based on solid data, Adalja says. “If you look at the very rare breakthrough infections that land people in the hospital or kill them, those above the age of 65 are overrepresented.” But, he adds, ”it’s important to remember that the vaccines are meant to stop serious disease, hospitalization and death. For the vast majority of the general population they are doing that tremendously well.”

The Back Story…

Confusion came after the CDC’s Advisory Committee on Immunization Practices, which met after the FDA EUA approval, originally left out front-line workers in its recommendations, who were included in the FDA recommendations. But CDC director Rochelle P. Walensky, MD, MPH, added them back in soon after the panel decision.

Murphy of Northwestern calls the booster approval process ”a mess,” citing the confusion the back-and-forth caused.

Getting to the Jab

Check with your health plan or your local public health authorities for details in your area. For instance, in Los Angeles County, those eligible can make an appointment using the MyTurn system or call clinics or pharmacies that offer the Pfizer vaccine. Proof of the previous Pfizer jabs, such as their vaccination card or digital record, is required. They may also need to sign a form verifying they are eligible.

Keeping Up

The situation, as they say, is fluid. Keep tabs here. Your local public health department webpage is another good source.

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately.