Following the announcement on October 15 that U.Va. Health will provide booster doses in addition to COVID-19 vaccines and that children ages 5 to 11 can now receive Pfizer vaccinations, the health system has reported fewer problems with distribution.
Boosters and third doses
Booster shots are administered at least six months after a patient has completed the primary vaccine sequence. The goal is to increase the concentration of COVID-19 antibodies in the body. Getting a booster shot is especially important in the context of the contagious Delta variant and increasing breakthrough infections.
Booster vaccines ensure that people in these risk groups feel more relaxed in their working and living environment. History Prof. dr. Caroline Janney, who got her booster, explained that it made her feel safer seeing her family.
“I think I definitely felt more comfortable knowing I’d been boosted,” Janney said. “My mom has an autoimmune disease and… I want to be with her, so I try to take every precaution.”
Eligibility for booster shots does not include the entire population aged 18 and over.
According to the CDC, populations that should be boosted currently include people age 65 and older, age 50 to 64 with underlying medical conditions, and people age 18 and older living in long-term care facilities. People 18 and older who have underlying medical conditions or live or work in high-risk environments are also eligible for the vaccine. In addition, anyone 18 years of age or older who has received the Johnson & Johnson vaccine should receive a booster shot at least two months after the single-dose vaccine.
Third doses fall under a different vaccine sequence than boosters. According to Dr. Costi Sifri, director of epidemiology at U.Va Health, the third doses are intended to give immunocompromised people a third dose of the messenger RNA vaccine. They are therefore part of a patient’s primary vaccine sequence and should be given to eligible patients 28 days after their second vaccine dose.
This is necessary because many immunocompromised people do not respond to the first set of two-dose vaccines, Sifri said. They therefore need a third dose to reach the level of antibodies that non-immune compromised people get after two doses.
This immunocompromised population recommended for third doses includes – but is not limited to – people on active cancer treatment, people who have had organ transplants and are taking drugs to suppress the immune system, people with advanced or untreated HIV, and people with moderate or severe primary immunodeficiency.
Pfizer boosters and third doses are available by appointment only at the University Education Resource Center at 1220 Lee St. and at three university outpatient pharmacies: Pantops Pharmacy, Medical Park Zion Crossroads, and Augusta Pharmacy.
dr. Reid Adams, medical director of U.Va. Health, explained that the vaccine booster rollout should be smoother than the first. Problems with the initial rollout included a lack of adequate vaccine supply, limited vaccine clinics, equitable distribution, and difficulties in data collection and sharing.
“Now it’s much more widely available,” Adams said. “There are a lot of different sources through Blue Ridge Health District and local pharmacies, so I think people have a lot of options to choose from to get a booster.”
Appointments are readily available through MyChart or by calling (434) 297-4829. Appointments for the next day can be made at the Education Resource Center and Augusta Pharmacy. Seats are more limited for Pantops Pharmacy and Medical Park Zion Crossroads.
Over the two-week period from October 10 to 23, these four clinics delivered a total of 402 COVID-19 vaccine doses, including boosters, third doses, and primary series. Since vaccines first became available in December 2020, U.Va. Health facilities have delivered a total of more than 131,000 vaccines — boosters, third doses and primary series — and still have 30,690 doses in stock, according to Eric Swenson, public information officer for U.Va. Health.
UVA Health’s recent announcement comes after the CDC approved Moderna and Johnson & Johnson boosters last week. This came after the FDA’s emergency approval of the boosters on October 20. The Pfizer booster received emergency approval from the FDA on Sept. 22 and was approved by the CDC on Sept. 24.
The formulation for these booster shots is the same as the current vaccine. However, the Moderna booster is only half the dose of the primary vaccine series.
The main ingredient in the Moderna and Pfizer vaccines is a nucleoside-modified mRNA that encodes the viral spike glycoprotein of SARS-CoV-2. For the Johnson & Johnson vaccine, the main component is a recombinant, replication-incompetent Ad26 vector, which encodes a stabilized variant of the SARS-CoV-2 Spike protein.
Concerns about the safety of these vaccines have been addressed.
“What the clinical trials have shown is that the side effects of the vaccine are largely, if not almost exactly, similar to what people saw after their primary series,” Sifri said.
The CDC lists the most common side effects of the booster as fever, headache, fatigue, and injection site pain. The effects are generally mild to moderate, although in rare cases they can be severe.
Mixing and matching vaccines has also been shown to be safe. Sifri said no concerns were raised regarding receiving a booster vaccine other than one’s primary sequence.
“It may not be that important which booster you get, but just to get a booster,” Sifri said.
In addition to U.Va. Health Resources, the Blue Ridge Health District offers booster doses of the Moderna, Pfizer, and Johnson & Johnson vaccines.
Pfizer booster doses are available at local health departments, the J.Crew Vaccination Site, the Seminole Square Community Vaccination Center, and Mobi on the Mall. Moderna and Johnson & Johnson booster doses are available from the CVC. Appointments are available through the Virginia Department of Health.
Despite the expansion of booster shots, Sifri said the national focus is still on getting as many people as possible vaccinated with their primary series. Given these priorities, Sifri believes it is unlikely that this booster suitability will expand to the entire population aged 18 and over in the near future.
“If things stayed the way they are, I don’t think the CDC would be forced to recommend boosters broadly for everyone,” Sifri said.
Vaccines for children aged 5 to 11
A key group that has just gained access to their full primary vaccine line are children ages 5 to 11. The dose for this age group is one third of the dose for adolescents and adults.
UVA Heath announced on Nov. 3 that Pfizer COVID-19 vaccination appointments can be scheduled for children ages 5 to 11. Vaccines are administered at the U.Va. Pediatric Community Vaccination Health Center.
The BRHD also offers vaccinations by appointment only. Children ages 5 to 11 can get their dose of Pfizer at the CVC in Seminole Square. School-based vaccine clinics hosted by the BRHD, pediatric offices and pharmacies will also host vaccination clinics.
This is a great relief to many parents, such as Janney, who is the mother of an eight-year-old child. She has limited some of her assignments due to concerns that she could infect him.
“I was less willing to go on certain trips, partly because he wasn’t vaccinated and I was worried about bringing things home,” Janney said. “As soon as we got the announcement from the doctor’s office last week, I called, but all the appointments had already been made. But we have an appointment for tomorrow.”
UVA Health has reported an increase in vaccination appointments for children ages 5 to 11, which Janney viewed positively.
“It made me feel good that it was hard to get an appointment because it means a lot of parents do it,” Janney said.
To make this process as smooth as possible, Sifri reports that the roll-out of vaccines will look slightly different than for adults and older children.
“There is [an] emphasis on trying to ensure that the vaccines being offered [are] in places that are kid-friendly,” said Sifri.
This includes pediatric clinics, pop-up community events and vaccination centers in schools.
Guidelines and approvals for COVID-19 boosters, third doses and pediatric vaccines change every day. See the UVA Health and BRHD media websites for updates on vaccinations.