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Bioscience-Medicine

Everything You Wanted To Know About COVID-19 Booster Shots In North Texas

In this March 29, 2021 file photo, a worker readies syringes with the Moderna COVID-19 vaccine in Metairie, La. Even people who have recovered from COVID-19 are urged to get vaccinated to avoid reinfection, especially amid the threat of the extra-contagious delta variant — and there's growing evidence the shots offer those survivors bonus protection against mutants.
In this March 29, 2021 file photo, a worker readies syringes with the Moderna COVID-19 vaccine in Metairie, La. Even people who have recovered from COVID-19 are urged to get vaccinated to avoid reinfection, especially amid the threat of the extra-contagious delta variant — and there's growing evidence the shots offer those survivors bonus protection against mutants.

Back in August, federal health officials announced that COVID-19 booster shots would be available to people across the country on Sept. 20. Since then, both the Food and Drug Administration and the Center for Disease Control’s Advisory Committee on Immunization Practices (ACIP) have been in discussion on the science and benefit of booster shots.

The ACIP is set to meet next week, after the Sept. 20 deadline, to consider booster shots over two days. A committee from the FDA is meeting today to discuss Pfizer’s petition to be approved for a third dose for people 16 and older.

In the meantime, it’s unclear what a COVID-19 booster shot rollout could look like for providers across North Texas. Chief Medical Officer at Parkland Health and Hospital System, Dr. Joseph Chang, said a lot of people are confused about what’s next.

Yes, if they’re immunocompromised, which include cancer patients, people who received an organ transplant, severe HIV infections, or anyone taking medicine that might suppress their immune systems. Public health departments and vaccine sites across Dallas-Fort Worth have been offering Pfizer and Moderna third vaccine doses since the CDC and FDA authorized them back in August.

“Anyone who is immune-compromised for whatever reason, the antibody response and the overall immune response that they mount toward a vaccine is much, much lower than the rest of us,” Dr. Chang said. “They would benefit from getting another vaccine dose, just to help them boost it up a little bit more.”

Dr. Chang said the words “third vaccine dose” and “booster shot” mean the same thing, it’s simply an additional dose after the initial series of vaccinations, but the effect on someone’s immune system if they’re immunocompromised is the difference.

Another booster might not really make sense, Dr. Chang said, because most people are still protected from their original vaccination cycle.

For most vaccines, people’s antibody levels do drop over time because the body isn’t seeing the infection as an active threat. Antibodies are only one part of the body’s immune response, and a drop in antibodies doesn’t mean there’s less immunity to any specific virus.

Dr. Chang also adds that, for the most part, the fact that most serious hospitalizations in both North Texas and the rest of the country are among unvaccinated people proves that the vaccine is still effective.

“We know that even though a lot of us got vaccinated nine months ago now, we're still protected at a very high level,” Dr. Chang said. “This is exactly the reason why the FDA and CDC have not come out with a recommendation to give boosters to people who have a good immune system.”

He said the other complicating factor is COVID is just so new in comparison to other viruses.

“Unfortunately, we only have about a year and a half experience with COVID,” Dr. Chang. “It’s not like chickenpox, [which] we have hundreds of years of data on, and we know exactly what's going to happen.”

The newness, and the questions of whether a booster shot will be significantly helpful to the majority of the population, are why the FDA and the CDC are still in discussion.

“When we say something is endemic, that's like when we're talking about the flu,” Dr. Chang said. “Flu never really goes away. There's a season for it in the wintertime, [and then] next year it’s back.”

It’s hard to tell if the virus will become endemic, but it’s not outside the realm of possibility.

“The way things become endemic is when they mutate so much that we cannot eradicate it,” Dr. Chang said. “It’s in so many various different forms that we just can’t put our arms around the whole thing.”

But COVID-19 sticking around isn’t necessarily concerning to Dr. Chang. With controllable situations like the flu, people are prepared to deal with it every year, because there are tests, vaccines and other ways to treat it. It does underline for him the continued importance of vaccinations.

“If we get enough people vaccinated, we stop the transmission of disease at any significant level,” Dr. Chang said. “Viruses need infection to mutate. Mutation leads to variants. If we would just stop the chain of infection, we would no longer have variants. And if we don't have too many variants, then this disease does not have the power to be endemic. But the longer this goes, the higher the likelihood that COVID-19 is with us forever.”

Also, he adds, there’s not a magical threshold where a health pandemic moves to an endemic situation.

“To those of us who live in the real world, it doesn't matter what we call it,” Dr. Chang said. “All that matters is if it gets you.”

In limbo. The ACIP hasn’t released an agenda for their meetings on Sept. 22 and 23, so it’s not clear whether it will make firm recommendations on COVID booster shot rollouts or whether the conversations will need to continue. A committee from the FDA is meeting all day Fridayto discuss Pfizer’s petition to be approved for a third booster dose.

“What I really hope is that we will continue to follow research and will do good medicine,” Dr. Chang said. “It's always been very important to me that we do things that scientifically make sense. I do hope that we continue to stick with that.”

Otherwise, he said, the best thing people can do now is get vaccinated if they haven’t yet.

“What really matters is we come together and protect each other in this community,” Dr. Chang said. “I think if we could do that, we’re gonna be out of this in no time.”

Got a tip? Email Elena Rivera at erivera@kera.org. You can follow Elena on Twitter @elenaiswriting.

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