COVID-19 is in a lull in the United States, why are we still talking about getting booster shots?
COVID-19 is in a lull in the United States, why are we still talking about getting booster shots?
COVID-19 surged throughout the country during the months of January and February, bolstered by the new Omicron variant. Yet as spring approaches, we have been seeing a continuous decline of both cases and hospitalizations across the board. So why is it still necessary to get your booster shot? Why are experts discussing the possibility of a fourth shot or even a yearly dose?
With the statement from Pfizer regarding the notion of a yearly COVID-19 booster has come an increase in reluctance to get vaccinated, several people likening the virus to the flu. While they are both contagious respiratory viruses, it is important to communicate that we are still in the midst of the COVID-19 pandemic and that they are far from the same in both symptoms and virulence. Compared to the flu, COVID-19 can cause more serious illness, take longer before people show symptoms, and people may remain contagious for longer periods of time.
With all of that in mind, let’s discuss some of the benefits of being fully up to date on your vaccine.
1. Protection against severe disease
The COVID-19 vaccine is safe and incredibly effective. Results published by the CDC place the two mRNA vaccines (Moderna and Pfizer) at around 90% efficacy at preventing severe disease and hospitalization. Even if you are to get a breakthrough case of COVID, this means the difference between cold or flu-like symptoms and potentially life altering sickness.
It is important to note that with how quickly COVID-19 mutates, previous infection alone provides very little protection against severe disease. Natural immunity in those who are unvaccinated and have had COVID wanes after about 90 days and offers little to no protection from re-infection or from emerging variants.
2. Protection against the next surge
Cases are currently in a lull in the state of Maine, though some wastewater monitoring is beginning to pick up an increase in viral load, particularly as noted this past week in the Bangor area. This is potentially due to a combination of a relaxation of precautionary measures and the new variants, such as Omicron and BA2 or “stealth Omicron”.
The good news is that the vaccines are still holding up very well against all variants that have been discovered to date. While breakthrough COVID-19 cases in vaccinated individuals have become more prevalent with Omicron, very few of those cases are becoming hospitalizations. The vast majority of COVID-19 hospitalizations and deaths remain in the unvaccinated population.
Furthermore, the boosters have been shown to be extremely effective, including against Delta and Omicron. The CDC released a series of studies showing that while the original two shot series of mRNA vaccine (Pfizer and Moderna) provide a 57% efficacy against severe disease after six months, the addition of a third booster provided roughly 90% efficacy against severe COVID-19.
Making sure we’re protected against the next surge not only helps keep us and our communities safe, it gives our healthcare system a chance to recover from the onslaught it has faced over the past few years.
3. Reduction of the risk of “long COVID”
Long COVID is a series of symptoms that persist in the body after the individual has recovered from the initial infection. Researchers still aren’t entirely sure how the mechanics of long COVID work, or how long the symptoms will ultimately persist, but the evidence is clear that it can have life altering effects on the person impacted.
Symptoms of long COVID typically persist for months or longer after the initial infection (some people reporting persisting symptoms even now after their initial infection at the start of the pandemic), and include a wide array of symptoms such as:
Difficulty breathing
Continued loss of taste or smell
Extreme fatigue
Digestive issues
Joint pain
“Brain Fog” or difficulty concentrating
Inflammation
Weight loss
Fever and/or fever pain
Decreased Mobility
Chest pain or heart palpitations
Rashes
Increased anxiety
Increased risks of cardiovascular issues (such as stroke, dysrhythmia, cardiomyopathy, etc.)
Neurological effects (tissue damage in areas of the brain associated with smell, reduced brain size and grey matter thickness, cognitive decline)
Even healthy individuals, young and old alike, who had a mild or asymptomatic case of COVID have reported long COVID symptoms. A review of nine different studies found that between 10%-35% of people who had a mild infection reported persistent symptoms, with fatigue, shortness of breath, cough, lung pain, and headaches being the most common even after 3 months post recovery. As this data becomes clarified, it’s clear that the COVID-19 pandemic is not purely an issue of mortality, but also needs to be discussed as a mass-disabling event, with many of these symptoms being quite impactful on people’s daily lives and overall quality of life.
The data is also becoming increasingly clear that vaccination does significantly reduce the chance of contracting long COVID symptoms. More information is still needed, but it’s evident that vaccines do offer at least some protection from the symptoms.
In addition to significantly reducing the risk of contracting COVID-19 in the first place (the only sure way to eliminate the risk of long COVID), fully vaccinated people are proving to be less likely to develop these symptoms than unvaccinated people. It is difficult to compare studies regarding long COVID, as parameters around what symptoms are counted and how long they need to last to qualify are not standardized, but vaccination so far is proving to reduce the risks of long COVID by as much as 50% across the studies analyzed.
Additionally, in people who contracted long COVID prior to being vaccinated, roughly 30% of patients who then got vaccinated reported an improvement of symptoms. People who were vaccinated soon after a COVID-19 diagnosis were also less likely to report symptoms of long COVID than unvaccinated individuals.
** It is important to note that all of the above data is regarding COVID pre-Omicron, and that data surrounding the recent variant is still being analyzed. In the end, the only sure way to not contract long COVID is to prevent infection.
4. Protecting people who are unvaccinated or incapable of being vaccinated
Not everyone is currently capable of receiving a COVID vaccine. Children under 5 years of age cannot yet get vaccinated as the pediatric vaccine is still pending approval, and roughly 7 million people across the country who are immunocompromised are still at much higher risk of severe illness or death from exposure to COVID-19 regardless of their vaccination status.
As the country looks at a “return to normal” and precautionary measures are being dropped or reduced, along with accommodations that protected the immunocompromised (such as working from home), these more vulnerable populations are often left out of the discussion.
This means that for those who are capable of becoming vaccinated, being up to date on your shots is one of the chief ways to protect others and reduce your risk of spreading it to those who would be more severely impacted.
What kind of booster should you get and when?
What does it mean to be up to date on your vaccinations? To be up to date, you should have the initial two dose course as well as your first booster. For those over the age of 50 or who are at high risk of severe disease, and who are four months out from their first booster, it is a good idea to receive your second booster. Furthermore, if you have the J&J booster, it is recommended that you switch to the mRNA vaccines (Pfizer and Moderna).
To further explain the recent approval of a booster for those age 50 and older for the COVID-19 vaccines and what this means in a practical sense:
· If you are over 50 years of age, and at least four months out from your first booster, it is a good idea to consider getting your second booster at this time. Particularly for those who are immunocompromised or at high risk of severe disease.
· The data has come in, mixing and matching the mRNA vaccines (Pfizer and Moderna) is not only safe and effective, it does provide a slight boost in immunity compared to just getting either Pfizer or Moderna all the way through your booster series.
· Individuals who have gotten the J&J vaccine should instead receive one of the mRNA vaccines for their next shot, and the J&J vaccine does not currently meet satisfactory standards of efficacy against the merging variants.
· You should still get vaccinated even if you have already been infected. Natural immunity from COVID-19 fades completely after 90 days and will not protect you from re-infection.
· If you are under 50 and not high risk, you do not need a second booster at this time as the first round of boosters is still holding up quite well in the younger age groups. Though it is likely that (similar to the first round of booster shots) this will be expanded to the younger age groups as time goes on.
Where Do We Stand on The Pediatric Vaccine?
At present, the FDA is still waiting for the last round of data to come in on both the Pfizer and Moderna pediatric vaccines. There was hope that they would be ready to roll out as of this month, however current predictions place the potential time of authorization in May or a little thereafter.
According to a recent poll, roughly one-third of parents say that they plan/planned to get their child vaccinated immediately as soon as they are eligible, with the remainder taking a more cautionary “wait and see” approach or not planning on getting their children vaccinated at all.
With the decrease in cases, relaxing of safety measures, and reports of waning efficacy in the 5–11-year-old vaccine it’s easy for parents to feel that the pandemic is over or that there is no more cause for immunization. However, with low national vaccination rates in children under 11 years of age and children still representing roughly 20% of weekly reported COVID cases, it is still crucial to take safety measures and get children vaccinated to protect them from disease.
The CDC and the Journal of the American Medical Association, among others, provide very useful information below on hesitancy and how to talk to parents about vaccinating children.
The vaccine is currently approved for all people ages 5 and older.
The booster is available to everyone 12 years and older at least 5 months after completing the primary COVID-19 vaccination series.
Nina Duggan is Healthy Acadia’s COVID-19 Vaccine Equity Project Coordinator. They share weekly updates about COVID-19 in the state of Maine and beyond, along with resources you may find useful on testing, vaccination, and best practices in preventative measures.
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If you or anyone you know have questions or concerns about COVID-19 or the available vaccines please call or text our COVID-19 Peer Support Line at 207-271-6023, Monday through Friday, 10 a.m. to 7 p.m.