Denby Fawcett: The New Covid Booster Shot May Be A Hard Sell, But It’s Worth It

As we slog through the third year of fighting Covid-19, many people are fed up. They are tired of worrying about the coronavirus; focused instead on returning to life as it was before the pandemic sent everybody running for cover.

But experts say now is precisely the time that people need to be receptive to the new bivalent booster shot that was approved by the Centers for Disease Control and Prevention on Thursday.

I plan to get the new booster as soon as I can. I buy into the logic of physicians and epidemiologists who say the bivalent booster comes at an opportune moment when the formerly successful public health measures such as masking and social distancing are increasingly ignored. And when immunity provided by previous vaccinations and boosters — received by most people more than six months ago — has weakened.

A Covid surge is forecast for the fall and winter. I haven’t caught Covid yet and I don’t intend to get it, especially now when preparing to take off on a hiking and road trip in the remote hinterlands of Newfoundland. I want the longer duration of protection the new shot is said to offer.

Epidimiologist Dr. Tim Brown said, “I am hoping people will see this as something new and be motivated to get it not just for themselves but to prevent the virus from spreading to vulnerable people around them.” Brown is an infectious disease expert and a senior fellow at the East-West Center.

The bivalent booster is the first vaccine approved that specifically targets the super infectious omicron subvariants currently responsible for 90% of Covid infections in the United States. The bivalent vaccine is a combination of two antigens: one to boost protection against the original strain of Covid and the other to generate antibodies to fight the newer omicron subvariants BA.4 and BA.5.

According to some epidemiologists, the bivalent booster may offer yet another benefit: protection against some future omicron subvariants. Emerging strains are lurking out there. The World Health Organization is tracking a new one called BA.2.75 that is infecting people in India and 12 other countries.

Of course, scientists say the new booster’s level of protection against future variants will hinge on how similar the mutations in emerging variants are to the the mutations in today’s dominant strains.

A key challenge for health experts is generating enthusiasm for the new booster arriving just when interest in Covid 19 vaccines appears to be at an all-time low. The rollout of each new booster has had fewer and fewer takers. The Department of Health says an estimated 77.3% of Hawaii’s eligible population completed the primary series of two vaccines but only 45% got the first booster. A second booster was offered to those 50 or older, but only about a third of that population signed up for that shot.

A recent national study by the Kaiser Family Foundation found the same reluctance to get boosters with 6 out of 10 vaccinated adults saying they declined the booster injection because they felt they already had enough protection from the two primary shots.

“We are optimistic the new bivalent vaccines will increase vaccine uptake. We know there are people 50 and older who have put off getting their second booster while waiting for the bivalent boosters to be approved. We also know that a lot of people under 50 years of age who are not yet eligible for a second booster are eager to get enhanced protection from the bivalent boosters,” DOH spokesman Brooks Baehr wrote in an email.

In a phone interview, Dr. Douglas Kwock said the development of the bivalent vaccine has shown that the innovative mRNA technology employed to make it can be successfully generated again and again to quickly come up with new vaccines as they are needed to protect against emerging variants. He says that by no means will this be the last Covid vaccination.

“It is a great development. It allows us to be more nimble and flexible in getting ahead of the virus,” said Kwock, vice president for Medical Affairs for Hawaii Pacific Health.

Anyone at least 12 years old is eligible for the new Pfizer bivalent booster provided they have already had the two-dose series of the primary vaccine. The bivalent boosters formulated by Moderna are for people 18 or older.

“We know there are people 50 and older who have put off getting their second booster while waiting for the bivalent boosters to be approved.” — DOH spokesman Brooks Baehr

To qualify, people should wait at least two months after their recovery from Covid or after their most recent dose of any Covid vaccine, according to the CDC. The reason for the wait is that the higher level of antibodies generated by a recent covid infection or a recent vaccination may reduce the production of new antibodies specifically targeted to fight omicron subvariants. By waiting a person will get more boost from the booster.

DOH said it has ordered 37,800 doses of the new booster and it expects to order more as needed. Clinics and health centers on the islands have been ordering their own supplies. The DOH said it will not organize any mass vaccination events for the new booster. Individual health care providers, clinics and pharmacies will be responsible for administering shots to the public.

Kaiser Permanente Hawaii in an email said it has pre-ordered more than 12,000 doses of the bivalent booster with the first shipment of 5,100 doses expected to be ready for patient injections on Friday. Kaiser said it will encourage patients to get the flu shot at the same time as the bivalent booster. It expects ample additional doses to arrive in waves in the weeks ahead.

Kaiser will generate interest by promoting the new booster on its website and social media as well as deploying front-line medical staff to reach out to their patients, according to Dr. Ross Takara, executive director of Kaiser Permanente Hawaii’s pharmacy operations.

The Queen’s Medical Center said it initially expects about 2,500 doses of the Pfizer and Moderna vaccines with additional shipments to follow.

“When ready, we will offer the vaccine to our employees and the community at various Queen’s clinics and pharmacies on Oahu, Molokai, and the Big Island,” the medical center said in an email. It did not say when it will start administering the new booster.

The number of people who elect to get the new booster is what will determine its success. I am hoping Hawaii’s medical professionals will do the best job they can to urge the “done with Covid” crowd to overcome its indifference. Registration to get the shots is already being offered. You can find out where to register for the booster at the state’s Covid-19 portal.