Delaware medical experts explain difference between vaccines’ third dose and booster

By Tim Mastro
Posted 10/5/21

DOVER — COVID-19 booster shots and third doses are being administered throughout Delaware, but there are some key differences between the two.

Third doses are for those who have certain …

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Delaware medical experts explain difference between vaccines’ third dose and booster

Posted

DOVER — COVID-19 booster shots and third doses are being administered throughout Delaware, but there are some key differences between the two.

Third doses are for those who have certain immunocompromising conditions. These include individuals who have received organ or stem cell transplants, are undergoing treatment for HIV or cancer or are taking medication that suppresses the immune system, based on recommendations from the Centers for Disease Control and Prevention.

“This identified a group of individuals within our communities and population at whole that would benefit from having a third dose of a Pfizer or Moderna vaccine,” said Dr. Bill Chasanov, Beebe Healthcare’s chief population health officer. “The people that are considered to be in this third-dose category are those who have certain medical conditions or are on certain medications that cause their immune system to be weaker.”

The third dose is only available for those who have received either the Pfizer or Moderna vaccines. It must be administered at least 28 days after a second dose, per CDC guidance.

Dr. Karyl Rattay, director of the Delaware Division of Public Health, said providers should use their clinical judgment and consider additional factors for their patients when determining if a person meets the qualifications for immunocompromised status and is therefore eligible for a third dose.

These factors may include assessing patients who reside in a long-term care facility or patients of advanced age, especially those over age 85, Dr. Rattay said.

Vaccine boosters, on the other hand, refer to a shot administered six months after a second dose of Pfizer. Currently, Pfizer is the only vaccine approved for booster shots, although boosters of Moderna, as well as Johnson & Johnson, are being studied.

According to CDC, while data shows that vaccines remain effective in preventing hospitalization and severe disease, a booster shot will help provide continued protection against serious symptoms in certain populations who are especially at risk for acute COVID-19, including those over 65, residents of long-term care facilities and persons 50-64 with underlying health conditions.

“The data shows that vaccinations remain effective in preventing hospitalization and severe disease, but the recent evidence shows that they are less effective at preventing infection due to waning over time,” Dr. Rattay said. “The delta variant has made this even more complicated. So these are the reasons why the boosters are especially important for our seniors.”

Individuals 65 and older, nursing home residents and those ages 50-plus who have underlying medical conditions are the populations who should be offered a booster once they’re six months past their second Pfizer dose, based on CDC recommendations.

Other individuals can choose to receive a booster if they so wish — including people aged 18–49 with underlying medical conditions and those aged 18-64 who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional settings.

Underlying medical conditions, according to DPH, include but are not limited to cancer; chronic heart, lung and kidney diseases; dementia; diabetes; Down syndrome; HIV; obesity; pregnancy; organ transplantation; and stroke. Those 18-64 with one or more of those conditions should decide if they want the booster based on their individual benefits and risk, per DPH.

Dr. Rattay said the “high-risk professions” who should consider a Pfizer booster after six months are “first responders, health care workers, teachers and day care staff, grocery workers, manufacturing workers, U.S. Postal Service workers, public transit workers, those working with congregate settings, including (in) long-term care facilities, homeless shelters or correctional facilities.”