COVID-19 vaccine boosters recommended for all Americans

Federal officials will begin offering COVID-19 booster shots to Americans starting next month, the Biden administration said Wednesday.

The announcement comes as the country grapples with a new surge in COVID-19 cases driven by the highly contagious delta variant — threatening to overwhelm hospitals in some states with low vaccination rates — and as new data emerges that the vaccine’s protection wanes over time.

Federal health officials recommended all Americans receive a COVID-19 booster shot eight months after they got their second dose of the Pfizer-BioNTech or Moderna vaccine.

Q&A WITH UI EXPERT: What we know so far about COVID booster shots

Those who received the one-dose Johnson & Johnson vaccine likely will need an extra shot as well, but federal officials are awaiting more data before offering their recommendation.

Doses could be available the week of Sept. 20, pending evaluation from the U.S. Food and Drug Administration and a review from the U.S. Centers for Disease Control and Prevention.

As the novel coronavirus continues to spread globally, and given the waning nature of these vaccines, an expert from the University of Iowa Hospitals and Clinics says Iowans should anticipate that COVID-19 vaccine boosters become a regular occurrence.

It continues to be vital that individuals who have not received the vaccine obtain the shots as soon as possible, said Dr. Pat Winokur, UI College of Medicine executive dean and principal investigator for the UI portion of the Pfizer-BioNTech COVID-19 vaccine trials.

“I would be happy if people would even get one” dose, Winokur said. “We know that even that first dose is really capable to reduce severe infections.

“It’s not perfect, it’s not as good as two, but if they could even get those two, we’re going to be good for another eight months. That will really help us get the number of cases controlled.”

Booster creates huge improvement in antibody response

Three studies published Wednesday by the CDC showed protection against the novel coronavirus from the vaccines declined over time and is generally less effective against the delta variant. This data is what prompted the Biden administration to issue the third shot recommendation, according to national reports.

The studies show that antibody titers, which measure the level of antibodies capable of fighting off the virus in the blood, dropped by about 75 percent eight months after individuals received the second dose of a two-dose COVID-19 vaccine.

UI researchers still are following the hundreds of individuals who took the Pfizer vaccine during clinical trials, and Winokur said they are seeing a few breakthrough positive tests among that group. She also said there is an uptick in study participants reporting symptoms, including runny nose, sore throat and fatigue.

With a third dose, data shows that antibody titers were sometimes five times higher than after the second dose, Winokur said. Breakthrough cases among vaccinated individuals, even eight months out, are mild, experts say.

The data shows the vaccine’s effectiveness against severe disease, hospitalization and death “remains relatively high,” CDC Director Rochelle Walensky said during a White House news briefing Wednesday.

Winokur also emphasized that waning effectiveness was not unexpected.

“I think we expected it and, honestly, I expected it to be a lot like the flu vaccine,” Winokur said. “We know in the flu vaccine, the antibody titers wane around six months, so it is actually following along that pathway.”

A immune system’s memory typically wanes over time, which is why individuals need booster shots for other immunizations, including the Tdap — tetanus, diphtheria and pertussis — vaccine.

The high rate of community spread, particularly from the highly contagious delta variant, also is a major factor.

“We have a lot of pressure in the community with a lot of circulating virus,” Winokur said. “And so this is where you’re starting to see breakthrough and that’s why these are still really good vaccines. We are still preventing most people from having severe disease.”

UI participated in booster shot study

The UI, which was a Phase 3 site in the Pfizer clinical trials late last year, is participating in a study on the effectiveness of a third Pfizer vaccine dose.

Of 270 UI clinical trail participants, 80 were selected to partake in a study on the booster dose, Winokur said. Forty participants received the actual vaccine and 40 received a placebo about two weeks ago.

Data out of Iowa was not included in the studies sent to federal health officials ahead of the recommendation for booster shots, Winokur said.

Researchers continue to await the FDA’s full approval of the Pfizer vaccine, which Winokur said some anticipate that could come within the first two weeks of September. That vaccine currently is under an emergency use authorization.

Boosters already authorized for at-risk groups

This past week, U.S. health officials authorized a third dose of the Pfizer or Moderna vaccines for people with compromised immune systems, including those who have received an organ transplant, are receiving treatment for cancer or otherwise have a condition that suppresses their immune response.

Sara Willette, of Ames, jumped at the chance to get a booster shot on Monday following the announcement. She received her third shot from a drive-through vaccine site in Polk County.

The 42-year-old has common variable immune deficiency, a disorder that impairs the immune system and increases her risk for severe infection. As a result, she’s been in isolation since March 2020 — more than 500 days, she said.

“It decreases my individual anxiety a lot,” Willette said of receiving the third dose.

Willette also manages the Iowa COVID-19 Tracker, a website where she aggregates coronavirus data from the CDC and the U.S. Centers for Medicare and Medicaid Services.

The booster shot is another reassurance for members of her family who worry about exposing Willette to the virus. It’s also a reassurance that they will have an extra layer of protection as Iowa experiences another surge in new coronavirus cases in recent weeks.

While she’s glad for the opportunity to boost her immunity and the immunity of other Iowans, Willette said the country has to “walk and chew gum at the same time” by continuing the effort to encourage unvaccinated Iowans to get the shot.

“If we vaccinate everyone, that means the virus has fewer people to infect,” she said. “Even if breakthrough positives are common, the vaccine protects against the worst possible outcomes.”

Comments: (319) 398-8469; michaela.ramm@thegazette.com

The Washington Post contributed to this report.