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Latest on the Booster Vaccine for COVID-19

If you’re already fully vaccinated against COVID-19, our primary care doctors in Delray Beach want to congratulate you for helping in the war against the coronavirus.

And now that the Pfizer-BioNTech vaccine has been fully authorized by the U.S. Food and Drug Administration (FDA), we hope any of our patients who haven’t received the vaccine will do so as soon as possible.

But do you need a booster shot if you receive the vaccine? Would you achieve even better protection from the highly contagious delta variant?

The answer is, it depends.

Okay for immunocompromised

Last month, the Centers for Disease Control and Prevention (CDC) recommended a third dose of the Pfizer-BioNTech or Moderna vaccines. It was specifically recommended for someone who is immunocompromised. As many as seven million Americans fall into this category.

This includes those who:

  • have received organ transplants and are taking drugs that suppress the immune system
  • are receiving cancer treatments
  • received a stem-cell transplant within the last two years
  • have advanced or untreated HIV
  • have moderate or severe “primary immunodeficiency”
  • are actively taking treatment with high-dose corticosteroids or other drugs that may suppress their immune response

CDC Director Rochelle Walensky said in a statement explaining the agency’s decision that several small studies found that fully vaccinated people who are immunocompromised have accounted for as many as 44 percent of the so-called “breakthrough” cases of COVID-19.

The CDC doesn’t require those requesting a second or third shot to get a prescription. If you want an additional vaccine, you will simply have to testify that you are immunocompromised.

And for early adopters

As of last month, the Department of Health and Human Services (HHS) recommends that a third dose be made available to the general population. This would begin the week of September 20 for those who received their inoculations eight months ago.

This would include older Americans and healthcare workers who were first in line to get the vaccine.

Early data out of Israel appears to show the efficacy of both the Pfizer and Moderna vaccines begins to wane after about eight months. The data found that for those who were vaccinated in January and are 65 and older, the Pfizer-BioNTech vaccine was less than 55 percent effective against severe disease and hospitalization than those who were vaccinated more recently.

HHS officials said that, based on this and other studies, the data “make very clear” that protection against COVID-19 begins to wane over time.

No hurry on booster vaccine

At the same time, experts cautioned against a mass rush to line up for a booster dose.

“We have to look at both sides of the equation—the benefits to be reaped and the safety of giving an additional dose,” Dr. William Shaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, told ABC News. “You’ll get a more robust immune response if you wait a little longer before you get your booster.”

ABC News contributor Jay Bhatt, an internist, and geriatrician, told the network much the same thing.

“We don’t have data that suggests you benefit from having the additional dose of the vaccine before your immunity drops off,” he said.

Experts agree that this doesn’t begin to happen until between six to eight months after being fully vaccinated with both doses of the Pfizer-BioNTech or Moderna vaccines.

Surgeon General Dr. Vivek Murthy agreed. “We are not recommending that you go out and get a booster today,” he said during a recent briefing.

What about a Johnson & Johnson booster vaccine?

While it seems likely that those who have received the single-dose Johnson & Johnson vaccine could need a booster in the future, last month researchers at the company reported that the vaccine appears to provide sufficient protection against the delta variant and that a booster dose wouldn’t be necessary.

Nevertheless, Murthy recently told CNN that he expects the research will eventually support a second dose.

“We believe that J&J recipients will likely need a booster,” he said, “but we are waiting on some data from the company about a second dose of J&J so the FDA can fully evaluate the safety and efficacy of that dose.”

Another question that hasn’t been resolved yet is whether it is safe to mix-and-match vaccine types. Early data, however, seem to suggest that combining the Johnson & Johnson vaccine protection with one of the mRNA vaccines isn’t a problem. Again, this question is still being studied.

Yes, the vaccines work

Some have taken the apparent need for boosters as a sign the vaccines don’t work. Not true.

“The Hepatitis B vaccine, the dose that’s given to people with weakened immune systems like dialysis patients is greater than [for] a normal person,” South Florida infectious disease expert Dr. Larry Bush told WPTV recently.

“The same thing for the influenza vaccine,” he said. “There’s a high-dose vaccine for people over 65 because they have less of an immune response. It doesn’t mean that we were wrong. It just means that we’re learning more.”

We know the evolving information can be difficult to keep track of at times. We will keep you up to date on the emerging science regarding this ever-changing virus.

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