The Covid-19 pandemic has been MORE than trying. It’s been disquieting, disheartening, and unfortunately deadly, for well over 750,000 Americans and millions globally. It has not spared even those who followed public health measures as best as possible, and more importantly got vaccinated. While there have been notable breakthrough infections, with the passing of General Colin Powell most recently, vaccination is STILL the best defense against hospitalization and death and remains the quickest way for us to clear this pandemic.
There are new recommendations and emergency use authorizations for vaccine booster shots. This can be confusing for many with the rapidly changing variables of the pandemic including variants (Delta), differing and changing guidelines, politics, and most importantly MISINFORMATION AND DISINFORMATION. In addition, we have three vaccines approved for use in the United States. Two of these are messenger RNA (mRNA) vaccines (Pfizer, Moderna), and one a traditional adenovirus vaccine (JNJ). I will summarize and give references for the new recommendations for vaccine boosters. If you want to go directly to the recommendations at the END, that sums it all up.
· Who should get a booster? Everyone that received either two doses of the mRNA vaccines or the single dose JNJ vaccine. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-
· Are booster shots unusual? No. Most antiviral vaccines require more than one dose, and sometimes more than two. Hepatitis B requires 2-4 doses. Hepatitis A, Chicken Pox, MMR (Measles, Mumps, Rubella), and Shingles all require 2 doses. Tetanus is 3 shots, followed by a booster every 10 years.
· Why are there breakthrough infections? Not unexpected, and you have to understand the initial intent of the vaccines, which was to prevent hospitalization and death. The numbers are already proving that vaccination works. The VAST majority of hospitalizations and deaths now are in the UNVACCINATED or in vaccinated people with significant underlying conditions like cancer, immunodeficiency, and advanced age. General Powell was 84 with Multiple Myeloma, a type of blood cancer that significantly reduces your ability to fight off infection. His booster plans came too late unfortunately.
· Many thousands of deaths could have been prevented by the simple act of vaccination. https://www.healthsystemtracker.org/brief/covid19-and-other-leading-causes-of-death-in-the-us/ Boosters are a big part of that equation due to decreasing immunity or persons that due to underlying conditions don’t mount or maintain immune protection.
· What about the Flu shot? Can you get it at the same time or in close proximity? YES! Studies so far have shown preservation of effectiveness and SAFETY. Anyone with military backgrounds understand this! Now, if you want to space them out you can, but it is not necessary to wait two weeks for example. https://www.medicalnewstoday.com/articles/vaccinating-against-flu-and-covid-19-at-the-same-time-is-safe-study-finds
So which booster should you get? It really depends on your initial vaccination. This is MOST critical for people who got the Johnson & Johnson vaccine. We knew at approval that this vaccine while providing very good protection against severe infection (hospitalization and death), it wasn’t as effective as the Pfizer and Moderna vaccines for preventing symptomatic disease. The Delta variant is AT LEAST as deadly as the original virus and many, many times more infectious!
RECOMMENDATIONS:
1. Boosters are recommended 6 months after your last dose of the initial vaccine for the mRNA vaccines but TWO months for JNJ.
2. If you got JNJ, I believe the BEST option is to get one of the mRNA vaccines, Pfizer or Moderna as your booster. That booster should be a FULL dose of one of those. Pfizer as a booster for JNJ provides over a 30-fold (30 times) increase in neutralizing antibodies, and Moderna over a 70-fold increase. This could significantly impact even mild illness. The JNJ booster is still a viable option for people who received a single JNJ vaccine.
3. If you got Pfizer or Moderna, the current recommendation is to get boosted with the same vaccine that you got before. If you had a severe reaction (allergic reaction for instance like facial swelling, difficulty breathing), speak to your Doctor about the best option. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/specific-groups/allergies.html
4. If you got Pfizer or Moderna and that vaccine is not available, it should still be very effective and safe to get a booster with the another mRNA vaccine.
5. IF YOU ARE SIGNIFICANTLY IMMUNOCOMPROMISED, EVEN A THIRD SHOT MAY NOT BE ENOUGH. For people like General Powell, he should have gotten a FULL dose of the mRNA vaccine and a 4TH shot has just been recommended by CDC. Talk to your physician, particularly if you have cancer, autoimmune disease, organ transplant, or anything that results in significant immunodeficiency. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#considerations-covid19-vax-immunocopromised
6. Can you get the Flu shot at the same time or in close proximity to the Covid booster? Yes! Anyone that has been in the military knows that you can get vaccines at the same time. To be safe, space them out by a few days if you’d like, but you don’t have to wait longer than that.
Knowledge is Power. To that end, the PANDEMIC IS NOT OVER, so continue to be safe!
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