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Confused about COVID-19 booster shots? Here are answers

Federal panel recommends extra dose for Moderna vaccine recipients

Nurse Jon Hight draws a Pfizer-BioNTech COVID-19 vaccine into a syringe at the Salt Lake Public Health Center on Thursday, Sept. 30, 2021.
Nurse Jon Hight draws a Pfizer-BioNTech COVID-19 vaccine into a syringe at the Salt Lake Public Health Center on Thursday, Sept. 30, 2021. Even though COVID-19 booster shots are available to older and more vulnerable Utahns who received the Pfizer vaccine earlier this year, many are still waiting to hear when they can get an additional dose as federal authorities continue to sort through proposals from other manufacturers.
Shafkat Anowar, Deseret News

COVID-19 booster shots are currently only available for older and more vulnerable Utahns who received the Pfizer vaccine at least six months ago, but more in that group may soon be eligible after an advisory committee to the U.S. Food and Drug Administration recommended the shots for those who got the Moderna vaccine.

The unanimous vote Thursday backed a half-dose of the Moderna vaccine as a booster under the same restrictions as set last month for a third dose of the Pfizer vaccine. The advisory committee is expected to vote Friday on whether to also endorse booster shots of the single-dose Johnson & Johnson vaccine.

Federal regulators will have the final say, although they typically follow the panel’s recommendations.

“I’m sure there’s some confusion,” Rich Lakin, Utah Department of Health immunization director, said of the question of who’s able to get a booster shot in the state. “People need to take the responsibility to kind of educate themselves, also. There’s just too many people to make sure everybody understands.”

Most of the more than 1.7 million Utahns who are fully vaccinated against the deadly virus got the two-dose Pfizer vaccine, just over 979,000 total. That’s compared to nearly 592,000 Utahns who received the Moderna vaccine, which also requires two doses, and almost 147,000 who got the single-dose Johnson & Johnson vaccine.

Lakin said there have been 84,240 third doses administered in Utah since the FDA approved the Pfizer booster shots in late September. He said that number includes previously authorized third doses of the vaccine for the immunocompromised, who don’t have to wait six months for a boost in antibodies.

At least for now, only the Pfizer booster shots are available and they’re limited to people who:

  • Got their second dose of the Pfizer vaccine at least six months ago
  • Are at least 65 years old OR are 18 or older AND
  • Live in a long-term care facility OR
  • Have a specified medical condition seen as making someone more likely to become severely ill from COVID-19, such as cancer, heart failure, stroke, diabetes, chronic kidney, liver or lung disease, obesity, pregnancy, HIV, organ transplant, smoking or substance abuse OR
  • Work in a setting deemed high risk, such as health care, first responders, schools, correctional facilities, grocery stores, manufacturing plants, the U.S. Postal Service, homeless shelters, public transit, food and agriculture.

The guidelines are the same for the Moderna booster shots, which would be available only to those who initially received that vaccine. The same is likely to be true of the Johnson & Johnson vaccine, if a booster is recommended, although there are discussions about mixing vaccines when it comes to a booster shot.

Mixing and matching

Han Kim, a professor of public health at Westminster College in Salt Lake City, said Utahns may want to wait to get a COVID-19 booster shot until they have the option of choosing which vaccine they want, given the findings of a just-released National Institutes of Health study on mixing and matching booster shots.

According to the study, keeping with the same vaccine does increase immune response. But people who got the single-dose Johnson & Johnson vaccine produced much stronger antibody levels after a booster shot of the Moderna or Pfizer vaccine than they did with a second dose of Johnson & Johnson.

And Pfizer vaccine recipients saw the best benefit from a Moderna booster, while either a Pfizer or Moderna booster performed well for those who initially received the Moderna vaccine. The study, however, used a full Moderna dose as a booster, not the half-dose recommended Thursday.

Other countries have already mixed vaccines and some places in the United States, including San Francisco, have offered Pfizer boosters to those who’d gotten other vaccines. Utah is following the guidelines set by the Centers for Disease Control and Prevention for the shots, intended to boost waning immunity to COVID-19.

The study is “more evidence to what a lot of us suspected, that mixing and matching vaccines may actually be more effective,” Kim said, adding that might be a good reason to wait for the CDC to provide guidelines for using different vaccines for booster shots.

While some people may feel more comfortable getting a booster shot as soon as it’s available, especially if they have medical issues or something else that puts them at risk, the professor said for many Utahns, getting another dose of vaccine is not critical.

“For the rest of us, I think it would be OK to wait a few more months until some of the data comes in, especially if the mixing and matching works as we hope it does,” Kim said. “That will also reduce the confusion and hopefully, it will allow people to get whatever vaccine they want.”

But I want a booster now

Some Utahns who aren’t yet eligible for a booster shot are still trying to get one anyway.

“Most of the phone calls are people who were either on the Moderna or the Johnson & Johnson, that want a booster. Well, that’s not approved for those two yet,” pharmacist Tad Jolley, of Jolley’s Pharmacy in West Jordan said recently.

When they’re told booster shots are not available yet for anyone who didn’t get the Pfizer vaccine initially, there are callers who press him to bend the rules.

“I get those calls everyday,” the pharmacist said, adding he tells them, “Pfizer’s the only one approved and you have to stick with the same vaccine. If you got Pfizer, then you get the booster with Pfizer. If you got Moderna, you need to wait until the Modern booster is approved,” and the same goes for Johnson and Johnson.

A few just won’t take no for an answer, Jolley said.

“They’ll even call back and try to talk to somebody else to try to get a different answer,” he said, likely because they’ve been confused by hearing at one point both Pfizer and Moderna booster shots would be widely available as of Sept. 20, the initial plan announced by President Joe Biden in August.

That plan would have provided booster shots eight months after the second dose, targeting the frontline healthcare workers, first responders, long-term care facility residents and staff and others who were the first to receive the vaccine.