Third shots and now available booster shots, what’s the difference? | News

OSWEGO — With a multitude of information and misinformation circulating around COVID-19 booster shots, it’s important to know what’s being stated as fact and fiction.

Last week, the U.S. Food and Drug administration (FDA) approved booster shots for the Pfizer-BioNTech vaccine for people over the age of 65, and those who have underlying conditions that might make them more susceptible to the virus. Other available COVID-19 vaccines from Moderna and Johnson & Johnson are still awaiting FDA approval, but experts say those approvals should arrive in the coming weeks.

Booster shots and third shots are not one in the same, according to medical experts, who note third doses are for individuals with a weakened immune system due to a variety of medical conditions. Booster shots are for individuals 65 and older, nursing home residents and certain people ages 50 to 64 with health problems that include cancer, diabetes, obesity and asthma, among others.

Oswego County Medical Director Dr. Christina Liepke recently spoke with The Palladium-Times to clear up any confusion. Liepke said third shots are different from booster shots, and noted a third dose of mRNA vaccines, such as Pfizer and Moderna, has been recommended for certain people who may have a weaker immune response than the general population after two doses.

“These types of patients include patients with advanced or untreated HIV, those who received a stem cell transplant in the last two years, those who have had a solid organ transplant and are on medication to suppress their immune system, patients who are on high dose steroids or other specific immunosuppressive medications,” Liepke said.

Timing is also a factor, Liepke said, with a third dose of Pfizer or Moderna recommended for moderately to severely immunosuppressed individuals roughly 28 days from the second dose.

Booster shots are recommended for individuals 65 and older, in addition to some younger people with health problems. The recommended timing of booster shots is a key difference, with the Centers for Disease Control and Prevention (CDC) recommending a six-month timeframe between a second dose and a booster shot.

Another concern is whether people will be safe if they mix and match vaccines. Liepke says current guidance is to stick with the same vaccine.

“It is important to note the Pfizer booster is only recommended for people who have already had the Pfizer vaccine,” she said. “It is not recommended as a booster for those who received Moderna or (Johnson & Johnson).”

People who would benefit the most from a booster shot if they had their last Pfizer dose 6 months ago are those who:

• Are 65 years and older, nursing home residents and assisted living residents

• Other individuals ages 50 to 64 with a long list of underlying medical conditions, including cancer, chronic kidney disease, chronic obstructive pulmonary disease, moderate to severe asthma, dementia, diabetes, heart disease, HIV, chronic liver disease, obesity and sickle cell disease.

Additionally, Liepke said others are eligible who meet specific criteria, but the CDC stopped short of a full recommendation. Liepke said the CDC stated individuals ages 18 to 49 with the same underlying medical conditions, along with people ages 18 to 64 who are at increased risk of COVID-19 exposure due to certain occupations, such as grocery store workers, public transit workers, postal workers, first responders, education staff, corrections workers and manufacturers.

Though serious side effects from the COVID-19 vaccines are rare, the mild to moderate symptoms many experienced with the first two doses is likely to occur with a third dose or booster shot.

“Unfortunately, mild to moderate sickness with booster shots seems to be inevitable,” Liepke said, noting that while similar adverse reactions after the third dose or the booster dose are expected, they shouldn’t be worse than the previous reactions. 

Gov. Kathy Hochul this week announced the state is endorsing the CDC’s recommendations and making booster shots available to atrisk New Yorkers. Hochul in a Monday statement said the state would ensure an “efficient, equitable, and effective distribution of booster doses to eligible New Yorkers statewide.”

“Our top priority remains staying ahead of this constantly changing virus and protecting New Yorkers with effective, long-lasting vaccines,” Hochul said.” A booster dose of the COVID-19 vaccine will help particularly at-risk New Yorkers stay protected from the virus for longer.”

Liepke said the Oswego County Health Department would offer booster vaccines at clinics now that the FDA, as well as the CDC and its Advisory Committee on Immunization Practices (ACIP) have approved the authorization. Regular vaccine shots are available too.

“Oswego County Health Department will be offering booster doses at our COVID-19 clinics on Wednesdays by registration only, “ Liepke said. “We continue to offer walk-in appointments for people who are unvaccinated on Wednesday afternoons because it is critically important that we help anyone who is unvaccinated and willing to be vaccinated get their shot. They will benefit the most from the vaccine.”

Liepke said patients who need a booster need to preregister because the registration system requires the dates of previous Pfizer vaccines to be recorded before administering booster shots.

The most important thing right now is to get as many eligible Americans vaccinated as possible, Liepke said, as cases of COVID-19 have increased dramatically in Oswego County over the past month-plus.

“Across New York, and in our own county, we are seeing an increase in the number of COVID-19 cases and an increase in the number of patients hospitalized with COVID-19,” Liepke said. “The vast majority of those who are hospitalized with COVID-19 are unvaccinated. As our hospitals are stretched to capacity they are simultaneously facing unprecedented levels of staffing shortages.”

Helping eligible unvaccinated people feel reassured about the safety of the currently available COVID vaccines is among the most important tasks of health care workers right now, Liepke said, adding more unvaccinated people becoming vaccinated would help lower the number of COVID-related hospitalizations and deaths more than any booster shots.

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