Michigan Association of Health Plans

COVID boosters likely coming to Michigan in September. What to know.

COVID booster shots will be widely available starting Sept. 20, the White House announced Wednesday, as the delta variant continues to tighten its hold across the nation and in Michigan.

At least for now, boosters are recommended for anyone who received the two-dose Pfizer and Moderna shots, and will be available eight months after they received their second dose. Those who received their second vaccine Feb. 1, for example, could receive a booster as soon as Oct. 1.

Those who are moderately to severely immunocompromised, are more immediately eligible, under the federal plan.

Experts say boosters likely also will be recommended eventually for those who received the one-dose Johnson & Johnson dose, but it needs more study.

The booster plan must still be reviewed and approved by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention, U.S. Surgeon General Vivek Murthy noted Wednesday, in announcing the plan. The broad recommendations drew criticism from some health experts, who are skeptical boosters are necessary for all Americans who’ve been vaccinated.

So why is a booster needed, and who should get it and how?

Three Michigan health experts helped sort through questions.

Who needs to get a booster?

The recommendations for the time being are limited to those who received the Moderna and Pfizer shots, with one group singled out for more urgent priority — “moderately to severely immunocompromised people.”

Last week, the CDC’s Advisory Committee on Immunization Practices recommended a booster for immunocompromised people as soon as 28 days after they completed their first series of Moderna or Pfizer vaccines. While the booster’s “clinical benefit is not precisely known,” it’s believed that the booster will trigger a more robust response.

On Wednesday, the White House announced boosters would be recommended for anyone else eight months after completing their second dose of the Pfizer or Moderna vaccines.

Who gets the booster first?

For now, there is no detailed distribution plan for boosters in Michigan as there was when the first vaccines became available in December. When vaccines were first approved last year, they were limited, so people most vulnerable to the coronavirus were given priority. That included health care workers and residents and staff of nursing homes and other long-term care. They were later made available in increments to others in the general public, starting with seniors. The limited availability of vaccines meant thousands of shots were dispensed daily, with frequent complaints of long waiting lists and line-cutters.

Much has changed since then.

There is now ample supply of vaccine — so much that the state has been forced to discard expiring doses or send them out of state when possible. And pharmacies, family doctors and specialists have supplies, too, said Linda Vail, health officer in Ingham County.

Vail said the eight-month waiting period before people can get a booster will more naturally spread out demand: “Everyone is going to land on their mark at a different time.”

Meanwhile, those who are immunocompromised may call local providers about scheduling an appointment. That includes, for example, solid organ transplant recipients, those being treated for cancer or with an active or untreated HIV infection.

The Macomb County health department, for example, will make those doses available starting Monday. Residents can book appointments online.

Because of the staggered rollout of the initial doses, priority for booster shots will likely follow a similar pattern — with health care workers and seniors being the first eligible, said Phillip Bergquist, chief operating officer at Michigan Primary Care Association, which represents medical clinics throughout the state that serve, among others, the poor and uninsured.

“It’s not as formal, but we will find ourselves falling into the same cycle,” as the earlier distribution patterns, he said.

But I thought the initial vaccines were supposed to protect me?
For the vast majority of vaccinated people, they do, but medical experts never promised a lifetime of protection. Some early, not-yet-peer-reviewed studies show the Pfizer vaccine in particular is proving less effective against the delta variant, with Pfizer itself acknowledging a slow decline in efficacy.

“We know that even highly effective vaccines become less effective over time,” Murthy said Wednesday, in announcing the boosters. “Our goal has been to determine when that time might come to the COVID-19 vaccines.”

Studying blood samples and the human immune system, researchers say a person’s antibodies against COVID — one of the immune system’s layers of protection from a vaccine or from a prior infection — can wane over time.

In much the same way, immunity wears off against other illnesses such as tetanus — a rare but potentially fatal disease — which is why a tetanus booster is recommended every 10 years. Boosters also are recommended for children and young adults against diseases like measles, pertussis, Hepatitis A and B and pneumonia.

“It’s not as though (your immunity) is gone but we’re looking at providing a more robust immune response” with boosters, said Vail, the Ingham County health officer and former Pfizer biomedical researcher.

Some previously have predicted that a COVID vaccine ultimately might follow the same route as the yearly flu vaccine. But that’s a bit different. Each year’s flu shot is a brand new, reformulated vaccine — rather than a booster shot. The reformulated flu shot is designed to protect against strains of influenza most likely to circulate during flu season.

It’s not clear whether an annual COVID vaccine calibrated to the latest variants will be required, similar to an annual flu shot.

For now, the COVID booster shot is a repeat — the same formula — of the shot you likely received earlier this year, meant to trigger your earlier defense.

This article originally appeared in Bridge. Read more here.

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