By Joyce Reingold
There’s a follow-up question to last season’s conversation starter — Pfizer, Moderna or J&J? — on the tip of many tongues: Are you boosted?
Dr. Daniel Goldman is.
“Last Monday, because I’m 68, I got my flu shot in one arm and I got my Moderna booster in the other,” the chief medical officer at Bethesda Hospital, part of Baptist Health, said in early November.
He is among the legions of U.S. residents who’ve already rolled up their sleeves for a third time for a dose of Pfizer or Moderna, the mRNA coronavirus vaccines.
Later in November, the Centers for Disease Control and Prevention expanded the pool of people eligible to receive a Pfizer or Moderna booster shot to include everyone 18 and older who received a second dose at least six months before.
The CDC also signed off on a second dose of the Johnson & Johnson vaccine for adults at least two months after the first dose and said using different vaccines from the original doses is OK.
Read much more about eligibility at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html and consult your doctor if you have concerns.
“I can tell you that boosters are very important,” Goldman said. “One of the early findings of that was from the Israeli experience. They were very aggressive about vaccinating with the Pfizer vaccine. And after about six to eight months, they had an increase in cases. It turned out antibodies were low, and they needed to do the booster. So, they jumped on board actually before most of everybody else.”
Goldman says the delta variant surge in the U.S. telegraphed the need for a booster: “Most of the patients we saw were unvaccinated. But there were patients that were vaccinated who got it, particularly older patients and some immunocompromised. So, that was the trigger that maybe we needed to do something, too.”
Dr. Rosa Marin, who practices internal medicine in Boynton Beach, says her older patients are “very willing” to be vaccinated and many have headed straight to their pharmacies for boosters as the CDC now recommends for people 50 and older. But with some patients who haven’t received boosters, Marin has taken a different approach. For those who originally received the Moderna or Pfizer vaccines, she offers a blood test introduced by Quest Diagnostics in February to measure antibodies to the spike protein of SARS-CoV-2, the virus that causes COVID-19.
She uses the results to help gauge patients’ potential post-vaccination immunity status.
“When I found out that you could do the IgG (Immuno-globulin G) titer for the spike protein, I said, well, let me try it with some patients and see what happens after they get vaccinated. And I can tell you, as the months progress since the last dose, they do drop immunity.
“And so, depending on how much it has dropped, I will tell the patients to go and get a booster,” she said.
Marin explained that test results fall on a numerical scale: “From 0 to 1, there is no immunity but from 1 to 20, a person is partially immune.” She said she might advise a patient with a reading at the higher end of the scale to wait a month or two before getting the booster.
Though she and other health care providers are offering this test, Marin points out that the CDC does not sanction its use for this purpose.
In a May 19 statement, the U.S. Food and Drug Administration said, “While a positive antibody test result can be used to help identify people who may have had a prior SARS-CoV-2 infection, more research is needed in people who have received a COVID-19 vaccination.”
But what they do know for sure is that the vaccines are working, the doctors said.
“Let me tell you, I really recommend the vaccinations because I’ve had patients with breakthrough COVID and they have done very well,” Marin said. “Some of them have not even required monoclonal antibody treatment. I’ve only had one patient who required it.”
In early November, there were five COVID patients at Bethesda, a dramatic and hopeful drop after delta’s surge. But Goldman said that “we shouldn’t relax.”
“I think we have a lot going on. We have flu season coming and they’re predicting a hard flu season. I would encourage everybody to get their flu shot as well as their booster.
“We all pay attention to the science, and the University of Miami team that has predicted all these surges is actually predicting another surge in early December. And we’ve seen surges after the holidays,” Goldman said. “But even if you get vaccinated, even if you get boostered, you still need to mask and do social distancing and be responsible.”
Joyce Reingold writes about health and healthy living. Send column ideas to joyce.reingold@yahoo.com.
Comments