By Damon Raskin, M.D. | Special to the Palisadian-Post
Q: I keep hearing about COVID-19 vaccine booster shots. I was hoping to be done after my two doses. What’s the deal with them? Is it important to get one?
“To boost or not to boost, that is NOT the entire question!”
The questions include who to boost, when to boost and why do we need to boost. The answers can be as complicated as a Shakespearean tragedy.
Due to the spread of the highly infectious Delta variant of the coronavirus, we are in a new phase of the pandemic. Although the two-shot mRNA series is still considered highly protective for serious illness, hospitalization and death, the medical community is starting to see that there is some waning protection, especially among those with low immune systems.
Therefore, a third shot of the Pfizer or Moderna vaccine is now recommended for patients undergoing chemotherapy, on immunosuppressive drugs for organ transplants, those with advanced HIV or other immunodeficiency diseases, and those receiving drugs that suppress immune response, like high-dose steroids or biologic agents for conditions such as rheumatoid arthritis, psoriasis and ulcerative colitis. These patients can get their third shots now as long as it has been 28 days since their second shot.
For the rest of us, a third shot is going to be available after September 20, and patients can get their third shot eight months after they received the second shot. This is still subject to final approval of the CDC. Those who received the one-dose J&J vaccine will most likely need a booster as well, but those guidelines have not yet been established.
The third shot is no different than the first two shots, and the side effects seem to be similar to the first two shots. Since it will go in order of when you had the second shot, those in nursing homes and healthcare workers will be first, followed by those over 65, and so on.
Although there is currently a surge of hospitalizations for COVID-19 right now in Los Angeles County, it is primarily those who are unvaccinated who are being hospitalized. The good news is that the FDA gave formal approval for the Pfizer vaccine this week rather than it being authorized for emergency use only. This may hopefully convince those unvaccinated folks who are on the fence to finally get the shot.
I have seen several breakthrough cases of COVID-19 in my vaccinated patients in my office, and most have had mild to moderate symptoms such as body aches, mild cough and runny nose. The whole point of getting the booster shot is that we are starting to see waning of the efficacy around the eight-month mark, and we want to get ahead of a new round of problems. The booster shots can help maximize protection and prolong the durability of the vaccine. Of course, if you still have friends, coworkers or family members who have not been vaccinated at all, this is still a priority.
With this Delta variant, even if you are vaccinated, please continue to take common sense precautions. If you are not feeling well, get tested and stay isolated until you know the results of the test. Continue to wear masks in crowded places, and continue to practice good hand washing and social distancing in indoor environments.
We do not want this story to end like Hamlet or Macbeth, but rather end with “happily ever after.”
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