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Following the announcement Oct. 15 that U.Va. Health will be providing booster doses to supplement COVID-19 vaccines and that children ages 5 to 11 are now able to receive Pfizer vaccinations, the health system has reported less difficulty with distribution.
Boosters and Third Doses
Booster shots are administered at least six months after a patient completes the primary vaccine sequence. The goal is to boost the concentration of COVID-19 antibodies in the body. Receiving a booster shot is especially important in the context of the contagious Delta variant and increasing breakthrough infections.
Booster vaccines allow for people in these at risk groups to feel more relaxed in their work and living environments. History Prof. Caroline Janney, who received her booster, explained that it made her feel safer when seeing her family.
“I think it certainly made me feel more comfortable knowing that I had gotten a booster,” Janney said. “My mother has an autoimmune disease, and ... I want to be around her so I'm trying to take every precaution.”
Eligibility for booster shots does not include the entire population of those who are 18 years old and over.
According to the CDC, populations who should receive a booster currently include people 65 years and older, 50 to 64 years old with underlying medical conditions and those ages 18 years and older who live in long-term care facilities. People 18 years and older who have underlying medical conditions or live or work in high-risk settings are also eligible for the vaccine. Additionally, anyone 18 years or older who received the Johnson & Johnson vaccine should receive a booster shot at least two months after their single-dose vaccine.
Third doses fall under a separate vaccine sequence than boosters. According to Dr. Costi Sifri, director of epidemiology at U.Va Health, third doses are intended to provide a third dose of the messenger RNA vaccine to immunocompromised people. They are therefore part of a patient’s primary vaccine sequence, and are to be given to eligible patients 28 days after their second vaccine dose.
This is necessary because many immunocompromised people do not respond to the initial two dose vaccine series, Sifri said. They therefore need a third dose in order to reach the level of antibodies that non-immunocompromised people receive after two doses.
This immunocompromised population recommended for third doses includes — but is not limited to — people receiving active cancer treatment, those who have received an organ transplant and are taking medications to suppress the immune system, people who have advanced or untreated HIV and individuals who have moderate or severe primary immunodeficiency.
Pfizer boosters and third doses are available by appointment only at the University Education Resource Center located at 1220 Lee St. and three University outpatient pharmacies — Pantops Pharmacy, Medical Park Zion Crossroads and Augusta Pharmacy.
Dr. Reid Adams, chief medical officer for U.Va. Health, explained that the vaccine booster rollout should run more smoothly than the first one. Issues from the first rollout included a lack of sufficient vaccine supply, limited vaccine clinics, equitable distribution and difficulty in collecting and sharing data.
“Now it’s much more widely available,” Adams said. “There are a lot of different resources through Blue Ridge Health District as well as local pharmacies, so I think folks have a lot of options to choose from to be able to get a booster.”
Appointments are readily available through MyChart or by calling (434) 297-4829. Next day appointments can be made at the Education Resource Center and Augusta Pharmacy. Spots are more limited for Pantops Pharmacy and Medical Park Zion Crossroads.
Over the two week period from Oct. 10 to 23, these four clinics administered 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 administered a total of more than 131,000 vaccines — boosters, third doses and primary series — and have 30,690 more doses in stock, according to Eric Swenson, public information officer for U.Va. Health.
U.Va. Health’s recent announcement comes after the CDC approved the Moderna and Johnson & Johnson boosters last week. This came after the FDA’s emergency approval of the boosters Oct. 20. The Pfizer booster was given emergency approval by the FDA Sept. 22 and was authorized 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 encoding the viral spike glycoprotein of SARS-CoV-2. For the Johnson & Johnson vaccine, the main ingredient is a recombinant, a replication-incompetent Ad26 vector, encoding a stabilized variant of the SARS-CoV-2 Spike protein.
Concerns surrounding the safety of these vaccines have been addressed.
“What the clinical trials have shown is that the vaccine side effects 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 pain at the injection site. Effects are generally mild to moderate, though they can be severe in rare cases.
Mixing and matching vaccines has also been found to be safe. Sifri said no concerns have arisen with regards to receiving a different booster vaccine than that of one’s primary sequence.
“It’s not perhaps as 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 is offering 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 at the CVC. Appointments are available through the Virginia Department of Health.
Despite the expansion of booster shots, Sifri said the national focus is still getting as many people vaccinated with their primary series as possible. Following these priorities, Sifri believes that it is unlikely that this eligibility for boosters will expand to the entire population ages 18 and over in the near future.
“If things were to stay the way they are, I don’t think the CDC would be compelled to recommend boosters broadly for everybody,” Sifri said.
Vaccines for children ages 5 to 11
A key group that has just received access to their full primary vaccine series is children ages 5 to 11. The dosage for this age group is one-third of the dose for adolescents and adults.
U.Va. Heath announced Nov. 3 that Pfizer COVID-19 vaccination appointments could be scheduled for children ages 5 to 11 years old. Vaccines are being administered at the U.Va. Health Pediatric Community Vaccination Center.
The BRHD is also offering vaccinations by appointment only. Children ages 5 to 11 can receive their Pfizer dose 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 big relief to many parents such as Janney, who is the mother of an eight-year-old child. She has been limiting some of her engagements due to the concern that she could infect him.
“I have been less willing to do certain travel, in part because he wasn't vaccinated and I've been worried about bringing things home to him,” Janney said. “As soon as we got the announcement from the doctor's office last week, I called but all the appointments were already taken. But we have an appointment for tomorrow.”
U.Va. Health has reported a surge in vaccination appointments for children ages to 5 to 11, which Janney viewed positively.
“It made me feel good that it was hard to get an appointment because it means that a lot of parents are doing it,” Janney said.
In order to make this process as smooth as possible, Sifri reports that vaccine rollout will look slightly different than for adults and older children.
“There's [an] emphasis on trying to make sure that the vaccines that are offered [are] in places that are child-friendly,” Sifri said.
This includes pediatric clinics, pop-up community events and school vaccination centers.
Guidelines and approvals on COVID-19 boosters, third doses and children’s vaccines are changing every day. See the U.Va. Health and BRHD media websites for updates on vaccinations.
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