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Here’s What You Can Expect for COVID-19 Vaccine Booster Shots This Fall

Dr. Bruce Meyer, president of Jefferson Health, provides the latest on booster shot recommendations and updates on vaccines for children under 12.

The U.S. federal government recently announced plans to make COVID-19 vaccine booster shots widely available starting this September. It is no surprise considering the impact of the Delta variant across the country. At Thomas Jefferson University Hospital, Dr. Bruce Meyer, president of Jefferson Health, shares that the Delta variant is 100% of recent hospitalization cases. “This variant produces a thousand-fold number of viral particles in the nasal and oral airways than the original variant of COVID-19 and it produces them much earlier in the course of the disease so you have a longer asymptomatic period where you are spreading viral particles without knowing you are doing so,” he explains.

Due to how much more infectious the Delta variant is, local governments, including the City of Philadelphia and New Jersey Department of Health, have reinstated masking mandates for indoor premises. There is no strong evidence to suggest that this variant is more deadly or increases the requirement for ICU care and ventilation, however, it does appear that the Delta variant increases the risk of severe COVID in children. “We’re seeing a significant uptick in pediatric cases related to the Delta variant that require hospitalization or other medical interventions,” says Dr. Meyer. “However, the risk that a child develops severe COVID is still very small and far less than adults.”

Timing of COVID-19 Vaccines for Children Under 12

According to Dr. Meyer, Moderna and Pfizer have submitted promising data to the FDA for children between the ages of five to 12 years old for vaccination, which suggests significant immune response protection against COVID-19 with minimal side effects. Dr. Meyer suggests approval may come as early as late September-early October. “As a parent of an almost five year old and an 11 year old, I’m eager for that approval,” he adds. “Particularly as we’re seeing this uptick in Delta variant in children, getting a safe vaccine for children cannot come soon enough.”

There is another ongoing trial for Pfizer and Moderna vaccines for children two to five years old. Those results could be available as early as this November with possible approval in December or January. At this point, there are no trials for kids under the age of two for vaccination. However, Dr. Meyer emphasizes that maternal antibodies cross the placenta and are protective for at least six months and that it appears that breastfeeding extends that protection for kids. [Editor’s Note: For more information about the COVID-19 vaccine and breastfeeding safety, click here; and for ways to keep children in the classroom safe this fall, click here.]

On COVID-19 Boosters

For the Immunocompromised

Dr. Meyer emphasizes strongly that the COVID-19 vaccines remain incredibly effective in terms of severe disease that requires ventilation and strongly protective against mortality. “I don’t want people to lose faith in the vaccines because we’re recommending a booster,” he states. “But like many vaccines, the effectiveness seems to wane over time to a point where it’s valuable to provide a booster.”

Booster shots have already been and continue to be administered to immunocompromised patients at Jefferson Health. The CDC and FDA advise that certain immunocompromised individuals should receive at least one booster dosage at least four weeks after the second dose of Pfizer or Moderna vaccination.

This booster is recommended for moderately to severely immunocompromised people who have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

These recommendations only apply to individuals who have received one of the mRNA vaccines (Pfizer or Moderna).  There are currently no guidelines for additional doses for individuals who have received the J&J (Janssen) vaccine.

Immunocompromised individuals who qualify for the booster vaccines should:

  1. Schedule at JeffersonHealth.org/VaccineInfo
  2. Be prepared to sign an attestation that they have an immunocompromised state and consent for vaccination.
  3. Bring their Vaccine Cards to be updated with the booster dose

For the General Public

The U.S. federal government announced their recommendation that booster shots be administered eight months after the second dose of the mRNA vaccines Pfizer or Moderna. If you wondering why there aren’t any recommendations for those who received the J&J vaccine, the answer is in the data coming out of Israel. Israel has been administering only Pfizer vaccines since November 2020, in groups by age, starting with people over the age of 70.

“What they’re seeing is a significant uptick in hospitalizations in people over the age of 60 years old who have been vaccinated,” explains Dr. Meyer. “It is that waning in antibody response in those individuals, about eight months after vaccination that appears significant enough to create vulnerability to severe disease that requires hospitalization.”

Locally, the vaccines became available to most of the public in April/May last year, so December to January will be when most people are eligible for the booster shot. “Logistical issues will need to be worked through nationally to ensure the over 200 million Americans who have been vaccinated will be able to get boosters,” adds Dr. Meyer. “We’re working on plans to make sure boosters will be available”

Booster Dosage

While Pfizer, Moderna and J&J are all developing a booster vaccine targeted at the Delta and Lambda variants, the booster shots recommended are the same dosage as the shot you previously received, says Dr. Meyer. The variant vaccine could take up to four to six months of testing to have substantive data before release.

Dr. Meyer says that people should get the same kind of booster as their vaccination and be ready to bring their vaccination card so you have a singular card with all your information in one place.

Side effects from this third vaccination are similar to those experienced during the initial two-dose series including injection site pain or redness, fatigue, low-grade fevers, and muscle aches which are generally mild to moderate.

Timing Your Flu Shot and COVID Booster Shots

Last year, thanks to masking and social distancing, we experienced a mild flu season. “Generally, we recommend getting your flu shot six weeks before peak flu season, which is usually in January,” says Dr. Meyer. “The CDC recommendations state that it’s safe to get a flu vaccine and booster at the same time. You might want to get one in each arm rather than in one arm though and there’s also no danger in spacing them out if that is your preference.”

[Editor’s Note: Click here for Dr. Meyer’s reaction to the FDA’s full approval of the Pfizer COVID-19 vaccine.]

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