Question of the Week: Do I need a booster?

When can I get one?

Great question. Let me begin by explaining the difference between the terms third dose and booster.

Third Dose
The Federal Drug Agency (FDA) has authorized a third dose for individuals who qualify as immunocompromised and received either Moderna or Pfizer COVID-19 vaccine for their first two doses. Studies have shown that immunocompromised people have less of an initial antibody response after two doses compared to the general population. The third dose in immunocompromised individuals is considered a part of the primary series to ensure an adequate antibody response and may be given any time 28 days or longer after the second dose. Note that as of this writing, the FDA and the Centers for Disease Control and Prevention (CDC) continue to study whether an additional dose is needed for those who are immunocompromised and received the Johnson & Johnson COVID-19 vaccine.

For the purpose of the third dose, an individual is qualified as an immunocompromised by having one or more of the following conditions:

• Been receiving active cancer treatment for tumors or cancers of the blood
• Received an organ transplant and are taking medicine to suppress the immune system
• Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
• Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Advanced or untreated HIV infection
• Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

Those qualifying do not need permission from a doctor and may schedule their third dose by registering at www.svhealthcare.org and selecting “Get vaccinated”.

Booster
The U.S. Department of Health and Human Services (HHS) announced several weeks ago the intention to make COVID-19 booster shots available on September 20, 2021,  to the general public 8 months after receiving their second dose of Moderna or Pfizer vaccine. A booster is an additional dose given at a time far removed from the primary series when vaccine efficacy may begin to wane. Unfortunately, the situation has been a bit confusing for nearly everyone, as September 20 is less than two weeks away, and boosters have yet to be authorized by the FDA. The FDA and CDC are currently weighing whether boosters would decrease hospitalizations and deaths and thus be of value to the general public. Studies are also ongoing on the need for a booster in individuals who initially received Johnson & Johnson.

I do anticipate the FDA will authorize boosters soon, perhaps as early as next week. It is less certain whether the authorization will cover the entire population or be initially limited to individuals over 65 and healthcare workers. The SVMC COVID Resource Center is prepared to provide the high volume of vaccinations that will be needed when boosters do become available. Our website will be updated regularly to reflect changes as they occur. Please visit www.svhealthcare.org and select “Get vaccinated”.

Trey Dobson, MD, is the chief medical officer for Southwestern Vermont Medical Center in Bennington.