How to determine if you need to get a Covid-19 booster

In August, the FDA and CDC have already announced that people with moderate or severe immunodeficiency who have been vaccinated with either the Pfizer or Moderna vaccine twice will need to be vaccinated with the same vaccine three times. bottom. People in this category who have had an organ transplant, are receiving chemotherapy for cancer, or are in other immunosuppressive states are advised to receive boost immunization now. (The FDA and CDC did not provide guidance to immunocompromised individuals who received a single Johnson & Johnson vaccination.)

Last week it was decided that Pfizer vaccines had already been given twice, at least 6 months after the second vaccination, and with serious consequences from Covid-19 at ages 65 and over, or 50 and over. The underlying medical condition that is more likely. Those people are advised to take Pfizer for a third time.

Another, much wider group could get a Pfizer booster. This is a group of adults over the age of 18 who have an underlying illness or are at high risk of exposure to Covid-19. These individuals are not necessarily advised to get a booster, but you can get a booster by consulting with your doctor and weighing your risks and benefits.

CNN: Why do you distinguish between “should” and “may” in this way?

Wen: We believe that there is the group with the highest risk. It can be someone over the age of 65, living in a nursing home, or over the age of 50 with an underlying illness. They should receive a third dose and the data are most clear that they will benefit. The advisory board basically said that the benefit and risk calculations are a bit unclear for those who belong to the second broader group. Therefore, they can be vaccinated and choose it, but vaccination is not yet recommended.

I think this is an important point. It is clear that people in the highest-risk group need to go out and take a third dose if more than six months have passed since the second injection. Then there are others who have to make their own choices. We are in a pandemic stage where people are making very different decisions about their risks. At this point, I think it makes sense to let people decide what level of risk they have and whether they need boosters.

CNN: What is the difference between a third dose of vaccine and booster immunization? People use those words interchangeably.

Wen: For the time being, it’s a compatible term. Currently, if someone in the United States receives either the Pfizer vaccine or the Moderna vaccine twice, or the Johnson & Johnson vaccine once, it is considered “fully vaccinated.” “Booster” is a term used for another vaccination of a fully vaccinated person. For those who have been vaccinated with the Pfizer or Moderna vaccine, which is the majority of Americans, this is the third vaccination.

Some experts have stated that this additional dose to immunocompromised individuals should not be considered a “booster” in itself, as the first two doses did not provide complete immunoprotection. But that is a very technical response. In fact, for those who have been vaccinated with Pfizer or Moderna, “booster” and “third dose” are synonymous.

CNN: What should people consider when deciding whether to get a booster?

Wen: Again, there is actually a group that should receive a third dose-the group that the CDC advised to do so. If you are in this group, boosters have a very clear advantage in reducing the chances of getting infected with Covid-19 or serious illness.

In a wide range of groups who are allowed to get boosters but have not yet been advised, there is clear evidence that their immunity to mild Covid-19 declines over time. Protection against severe infections still appears to be strong. The third dose seems to enhance protection against symptomatic illness.

Some people may look at the data and say that they don’t need a booster now, as long as they are protected from a serious illness that is enough for me to be hospitalized. Others will say the opposite-they don’t want to get the Covid-19 at all. Something that is considered calm can still be very uncomfortable to pass through. The person may need to miss a job or worry about childcare.

Even mild breakthrough infections can have long-term consequences. For many, avoiding hospitalization is not the only goal they care about. If you really want to avoid the Covid-19, you might be in favor of getting a booster once you reach your 6-month goal.

Similarly, if you work primarily from home, you may not be at much risk, but for children who are not vaccinated in cramped classrooms and are often unmasked. If you are a teacher around you, the risk is high.

CNN: Are there any disadvantages to getting a booster?

Wen: Data from Israel, which has a large booster program, show that the side effects of the third dose are comparable to the side effects of the second dose. The most common side effects are local reactions such as arm pain and short-term symptoms such as pain, malaise, and chills that resolve within a few days.

Very rarely, the side effect is myocarditis. This is myocardial inflammation and appears to be the most common among adolescent and young adult men. It is important to note that myocarditis associated with the mRNA vaccine is generally mild and can be resolved without long-term harm, and that Covid-19 itself can cause myocarditis.

Still, it’s always a good idea to discuss the risks and benefits of a vaccine with your doctor, especially if you’re a young man, but if you’re in the “may” vs. “should” category.

CNN: What if I don’t technically meet the booster criteria? For example, what if your job does not meet the CDC’s high-risk occupational criteria, but you work daily around unvaccinated, unmasked people?

Wen: All you need to get a booster dose is self-certification. That means you can make a decision. No doctor’s notes or other profession or medical proof is required. I think you should be able to decide for yourself what is at high risk in consultation with your doctor. Entering a workplace surrounded by potentially unvaccinated people in a cramped indoor environment ensures that common sense tests for high-risk items are met.

CNN: Where should I go to get a booster?

Wen: The US government has launched an excellent “Vaccine Finder” website. You can find out which local pharmacy or clinic is vaccinated with Pfizer vaccine and book that way. Also check with your doctor-they may also have vaccines available.

CNN: What about those who got the Moderna or Johnson & Johnson vaccines? Can I get a Pfizer booster or a Moderna or J & J booster?

Wen: Currently, only people with weakened immunity have been vaccinated with the Moderna vaccine, which can be given a third dose. Both Moderna and J & J have submitted booster doses for FDA approval, and it should take weeks to get more information. It is not yet recommended to “mix and match” doses, so if you receive a Moderna, you should wait for the Moderna booster instead of getting a Pfizer booster.

I know there’s a lot of booster talk, but one thing to make clear is that from a public health perspective, the most important thing is to ensure that people get their first dose of the vaccine. ..

Unvaccinated people make up the majority of people hospitalized and killed in Covid-19. They also make up the majority of transmissions. Getting a booster for a vaccinated person is an additional plus to enhance personal protection, and people certainly have to do that if they choose to do so, but still vaccinated. We cannot lose sight of the importance of giving the first dose to those who have not received it.