The delta variant of the coronavirus is making its way through Southern California, and in the process fueling a rise in cases and hospitalizations — and new questions from residents, too.
Throughout the region, public health departments are reporting increased case rates, and are facing renewed public health mandates, such as masking up in public. It’s prompted talk of vaccine requirements at local businesses, and already set them for many public workers, including employees of Los Angeles County.
And, as the months wear on, and immunity wears off, the question emerges for the community’s vaccinated: How much and when — and when can I get my booster shot? Here’s a brief Q&A on what experts have told us about boosters:
Q: It’s been months since I got fully vaccinated. Should I get the booster — and when?
A: Not yet, experts say. But you’ll likely need one eventually, because evidence show that immunity wanes with time.
The Pfizer-BioNTech vaccine was found to be 91.3% effective against COVID-19, measured seven days to six months after the second dose. It’s at that point, experts believe immunity begins to wane.
Pfizer’s latest data in July shows that a third dose is also successful against the delta variant. Last month, Pfizer released data from its long-running 44,000-person study showing that while protection against any symptomatic infection declined slightly six months after immunization, protection against severe COVID-19 remained at nearly 97%.
Moderna, too, has found that a booster dose provided a robust antibody response against the disease. It’s vaccine had already been shown to provide at least 93% immunity for up to six months.
Still, companies and federal agencies are studying the extent to which a full dose will protect you. And that’s why local public health departments are waiting on those agencies to sign off on boosters.
“We’re going to defer to the Food and Drug Administration and their scientific panels and the Centers for Disease Control and Prevention and their scientific panels to make decisions on how to most appropriately use the three vaccines that are available,” said Los Angeles County Public Health Director Barbara Ferrer, adding that her department intends to align with such guidance when it comes.
The reason, Ferrer said, is that both federal agencies have the early, front-edge benefit of teams that look at data from clinical trials and from manufacturing companies, plus real-world data from all local health departments in the country to evaluate the efficacy of the vaccines and the need for boosters.
The FDA expects to have a strategy on COVID-19 vaccine boosters by early September, according to reports. It would lay out when — and which vaccinated individuals should get the follow-up shots, based on vaccine efficacy laboratory data, clinical trial data and cohort data — which can include data from specific pharmaceutical companies.
“This is being closely looked at and the guidance may change over time as new variants arise for which the vaccines may not be as effective — or if we notice a significant waning of immunity over time,” said Dr. Robert Kim-Farley, who studies the eradication of communicable diseases at UCLA’s Fielding School of Public Health.
Q: But my immune system is compromised. Can I get a booster now?
A: That’s why the Biden administration wants a booster strategy on the fast track. The urgency appears to be because some populations — namely people older than 65 and people who are immunocompromised, along with those who got jabbed way back in December or January — would need a booster ASAP.
“I also know many of you are wondering if you’ll need a booster shot to add another layer of protection,” Biden said on July 29. “As of now, my medical advisors say the answer is no. No American needs a booster now. But if the science tells us there’s a need for boosters, then that’s something we’ll do. And we have purchased the supply — all the supply we need to be ready if that was called for.”
Look for the CDC and FDA to issue guidance in the coming weeks on when and who should be getting a booster shot, based on evaluation of the clinical data. “Until they complete that full assessment, we need to just wait,” Ferrer said.
That said, people who are immune-compromised “should be looked at on an individual basis together with their physician,” Kim-Farley, said.
Q: What about those people in San Francisco who are getting another shot?
A: According to media reports, people vaccinated with the one-shot Johnson & Johnson COVID-19 vaccine will be able to receive a supplemental mRNA vaccine dose in San Francisco, the city’s health department said this week.
San Francisco Department of Public Health officials said they were making an “accommodation” for those who have consulted with a physician. They stressed that it was not a recommendation or policy change.
And even then, the city’s health department aligns with the CDC, which does not — at the moment — recommend a booster shot for anyone, including J&J vaccine recipients.
Q: But other countries are already doing boosters, aren’t they?
A: Israeli Prime Minister Naftali Bennett announced July 29 that the country would offer a coronavirus booster to people older than 60 who have already been vaccinated. It made the nation the first country to offer a third dose of a Western vaccine to its citizens on a wide scale.
But many researchers have pushed back on that strategy, warning that it will further slow a global recovery because widespread boosters ahead of the rest of the world would take precious doses from parts of the world that have little immunity.
The danger, they warn, is that variants can emerge in those unvaccinated parts of the world, ultimately coming back to hit other countries — a kind of vicious cycle that some experts fear keeps the virus alive.
And that taps into how equity connects with public health imperatives. Leaders from coast to coast have pointed to societal inequities highlighted by this virus, from lack of testing in marginalized communities to cramped housing that makes families more vulnerable to catching COVID-19.
“It would be better for all of us if those in developing countries could get access to vaccines to stop the emergence of variants, such a delta having arisen in India, as compared to persons in more developed countries receiving booster doses at this stage,” said Kim-Farley of UCLA.
Ferrer, whose health department operates in the most populous county in the United States, appeared sympathetic to the booster effort being more coordinated, with the world outside of L.A. County in mind.
“We’ve seen first hand how what happens in different countries affects what happens here in the United States,” she said, “so there is a laudable goal we are working toward across the entire world, and that helps us all prevent particularly the emergency of dangerous variants.”
Q: I’ve already had the disease. So I’m immune now, right?
A: Not exactly. Even if you’ve been infected, experts urge that you get your vaccination. Here’s why:
It’s not news that for months, public health experts have been urging even people who have had the virus to get vaccinated. But according to a new Gallup survey, one of the main reasons Americans cite for not planning to get vaccinated is they think they’re protected after already having the virus — that was nearly 20% of Americans.
And yes … they may sort of be right, at least for the moment.
Natural immunity is said to be a powerful force in the fight against many diseases, from measles to chickenpox to, yes, COVID-19. In fact, epidemiologists believe there’s more collective immunity built in than we officially know, because of cases that went unreported.
Going back to the Israeli situation, there have been reports there that coronavirus patients who recovered from the virus were less likely to become infected during the latest wave of the pandemic than people who were vaccinated against COVID. But no one definitely knows how long such natural immunity might last, or if it’s as strong as the vaccines.
There’s also the emergence of the delta variant, known to be much more contagious than it’s progenitor, sparking an even more furious campaign to get people vaccinated.
A new study shows survivors who ignored that advice were more than twice as likely to get reinfected. The study looked at hundreds of Kentucky residents previously infected through June 2021, finding that those who were unvaccinated had 2.34 times the chances of being reinfected compared with people who are fully vaccinated.
Friday’s report from the Centers for Disease Control and Prevention adds to growing laboratory evidence that people who had one bout of COVID-19 get a dramatic boost in virus-fighting immune cells — and a bonus of broader protection against new mutants — when they’re vaccinated.
“If you have had COVID-19 before, please still get vaccinated,” said CDC Director Dr. Rochelle Walensky in a statement Friday. “Getting the vaccine is the best way to protect yourself and others around you, especially as the more contagious delta variant spreads around the country.”
The Associated Press contributed to this report.
Source: Orange County Register
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