Considering getting a COVID-19 booster shot? Here's what you need to know.
Oct. 31—More than 17.7 million people in the United States have received an additional dose or booster shot of the COVID-19 vaccine as of Saturday, according to data from the Centers for Disease Control and Prevention.
The Food and Drug Administration on Aug. 12 authorized a third dose of an mRNA vaccine — Pfizer-BioNTech or Moderna — for people with conditions that moderately to severely compromise their immune system. On Sept. 22, the FDA authorized booster shots of the Pfizer vaccine for people in other categories, and on Oct. 20 authorized Moderna and Johnson & Johnson boosters.
"The available data suggest waning immunity in some populations who are fully vaccinated," acting FDA Commissioner Dr. Janet Woodcock said in the most recent FDA announcement. "The availability of these authorized boosters is important for continued protection against COVID-19 disease."
The delta variant has made vaccines less effective in preventing infection, but people who have two doses of an mRNA vaccine or one J&J shot still have much higher protection against death and hospitalization than the unvaccinated.
The Connecticut Department of Public Health reported that as of Wednesday, 70.2% of people hospitalized with laboratory-confirmed COVID-19 aren't fully vaccinated, whereas people who aren't fully vaccinated make up less than 30% of the state's population.
Booster shots have proven controversial among public health officials and scientific researchers.
The CDC's Advisory Committee on Immunization Practices in September voted against recommending boosters for people who work in high-risk settings. But CDC Director Dr. Rochelle Walensky took the unusual step of overruling the panel, instead siding with an FDA panel.
Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told The New York Times that "this whole booster mania" probably won't affect the pandemic much, saying that "if you're hospitalized with this virus, it's not because you haven't gotten a third dose; it's because you haven't gotten any dose."
Others have questioned the ethics of providing third doses when most people in poor countries haven't had the opportunity to get one dose.
On Aug. 5, World Health Organization Director-General Tedros Adhanom Ghebreyesus unsuccessfully called for "a moratorium on boosters until at least the end of September, to enable at least 10% of the population of every country to be vaccinated."
"We cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world's most vulnerable people remain unprotected," he said.
In Connecticut, officials have indicated there is plenty of supply for people who want a booster, and if you're considering getting one, here is some more information.
What is the difference between a booster shot and an additional dose?
The CDC says an additional dose "is administered to people with moderately to severely compromised immune systems" to improve their response to their first vaccine series, whereas a booster shot is administered when protection against the coronavirus has waned over time.
A booster is given at least six months after the second mRNA vaccine or two months after a J&J shot, whereas a third dose can be given to immunocompromised people 28 days after their second vaccine dose.
In tracking data, Connecticut officials don't draw a distinction between boosters and additional doses.
Who is eligible for a booster?
People over age 65 who got their second dose of the Pfizer or Moderna vaccine at least six months ago are eligible for a booster shot. So are people 18 or older who live in long-term care settings, have underlying medical conditions, or work or live in high-risk settings.
According to CDC data, people over age 65 have accounted for 85% of deaths among the fully vaccinated.
Long-term care settings include nursing homes, assisted living facilities and group homes for intellectually and developmentally disabled people.
Underlying medical conditions include cancer, chronic kidney disease, chronic liver disease, chronic lung disease, dementia, Alzheimer's, Down syndrome, heart conditions, HIV, immunocompromised state, mental health conditions, obesity, pregnancy, sickle cell disease, smoking, solid organ transplant, stroke, substance use disorders and tuberculosis.
Eligible occupations include health care workers, firefighters, police officers, teachers, day care workers, and postal workers, in addition to people working in food service and agriculture, manufacturing, corrections, public transit and grocery stores.
The CDC also recommends that anyone who received the J&J vaccine more than two months ago, regardless of age, get a booster shot.
Can I get a different type of vaccine for my booster?
You are allowed to "mix and match" your booster shot. Regardless of which vaccine you originally got, you can now get the Pfizer, Moderna or Johnson & Johnson vaccines for your booster.
The ability to mix and match provides more options, as some locations may only offer one type of vaccine. But there are other factors to consider.
In rare cases, blood clotting has been reported after the J&J vaccine, particularly among women ages 18 to 49. The FDA noted that ongoing analyses from FDA and CDC surveillance have identified increased risks of myocarditis following the second dose of the Moderna vaccine, particularly among men ages 18 to 24.
Early results from a National Institutes of Health-funded study show that people who received Moderna as their booster had the highest antibody levels. People who originally got the J&J shot saw a 76-fold increase in neutralizing antibodies — the kind responsible for fighting off bacteria, viruses or other microorganisms — after a Moderna booster, a 35-fold increase after a Pfizer booster and fourfold increase after a J&J booster.
But the authors noted the study "was not designed to directly compare responses between different booster regimens," as the sample size is insufficient for comparisons. Another limitation is that participants received a full dose of the Moderna vaccine rather than the half-dose that's been approved, and the article is also a preliminary report that hasn't been peer-reviewed.
Moreover, epidemiologists have cautioned that there isn't enough research yet to know the real-world implications of increased antibodies.
Where can I get a booster shot?
Hartford HealthCare has appointments available at Backus Hospital in Norwich for the Pfizer and Moderna vaccines. To schedule an appointment, visit hartfordhealthcare.org or log onto MyChartPLUS.
People are welcome to get their third dose or booster with Hartford HealthCare even if they didn't get their first vaccine series there, the health care network said.
In southeastern Connecticut, Yale New Haven Health is scheduling Moderna boosters at its Northeast Medical Group sites at 2 Sandy Desert Road in Uncasville and 194 Howard St. in New London, though only on certain days at each site. Those interested in scheduling can visit covidvaccine.ynhh.org or call 1 (833) 275-9644.
According to CVS's scheduling portal online, appointments are available for Moderna boosters at 25 Broadway in Mystic, 1657 Route 12 in Gales Ferry, 900 Hartford Turnpike in Waterford, 58 Pennsylvania Ave. and 15 Chesterfield Road in East Lyme, 2005 Norwich-New London Turnpike in Uncasville, and 372 West Main St. in Norwich.
Pfizer appointments are available at 915 Poquonnock Road in Groton, 817 Bank St. in New London and 106 Boston Post Road in Waterford.
Community Health Center, which has locations at 1 Shaws Cove in New London and 481 Gold Star Highway in Groton, is only giving booster shots and third doses at its sites to established patients and to people who received their first or second dose at a CHC site. People can call (860) 863-4600 to schedule an appointment.
Ledge Light Health District is working on the logistics to hold its own booster clinics. Director Steve Mansfield said they will have the Moderna vaccine, and J&J to a lesser extent.
Matt Barrett, president and CEO of the Connecticut Association of Health Care Facilities/Connecticut Center for Assisted Living, said long-term care pharmacies are in the process of scheduling booster clinics at nursing homes.
What are the side effects?
In applying to the FDA in August for approval of a booster dose, Pfizer said in a clinical trial of 306 people ages 18 to 55 who received a third dose between 4.8 and eight months after their second dose, the most common reactions were injection site pain, fatigue, headache, muscle and joint pain, and chills.
"The frequency of reactogenicity was similar to or better than after dose two of the primary series," the drug manufacturer said in a news release.
The CDC also analyzed voluntary reports to v-safe, a smartphone-based surveillance system, between Aug. 12 and Sept. 19. It found that "no unexpected patterns of adverse reactions were observed among 22,191 v-safe registrants who received an additional dose of COVID-19 vaccine" and "the patterns of adverse reactions observed after dose 3 of Moderna vaccine or Pfizer-BioNTech were consistent with previously described reactions after receipt of dose 2."
One limitation is that during this study period, additional doses were supposed to be limited to people with immunocompromising conditions.
