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COVID-19 Update 8/12: Boosters, Efficacy, and More

August 12th, 2021 | 4 min. read

By Steve E. Bishop, M.D.

COVID-19 Update 8/12: Boosters, Efficacy, and More

On this week's COVID-19 update, Dr. Bishop discussed the impending booster announcements, vaccination recommendations, and more. Watch the video below and read on for the recap. 

Vaccine Boosters

(Editor's Note: Shortly after the update, the FDA authorized the "use of an additional dose in certain immunocompromised individuals, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise." More information here.)

First of all, let's talk about vaccines. So, a vaccine booster question is coming fast and furious to us here pretty frequently here at PartnerMD and elsewhere. Lots of people are curious about that.

And I think we're probably going to see an announcement about this in the next, hopefully the next few days to a week or so, we'll see an announcement from CDC and the FDA about vaccine boosters, not only who should get a booster, but what boosters to use, and if we can or should mix and match different vaccines.

Say, if you've got Pfizer, can you get a Moderna booster, or vice versa? So we'll see more about that. I think that that's probably going to be, initially going to be restricted to people 65 and up, or people that have immune system problems.

And the reason that these boosters are going to be important, especially for those at higher risk, to consider getting is that we've seen in a number of studies now that the protection of the vaccines from the Delta variant has shown a decline over time.

They just don't work quite as well for the Delta variant that they did for the original Alpha variant that the vaccines were all produced against. There's a little bit of a decline in protection from infection. And that's the key thing. The protection for hospitalization and death from COVID from those vaccines remains very, very high, even against Delta variants.

I guess one takeaway I want to say is, if you are a high-risk person, or if you want to protect yourself against COVID, especially getting hospitalized, getting very sick, possibly dying from COVID, I want to encourage you to go ahead and consider strongly getting vaccinated.

At this point, we're probably going to keep seeing waves of these variants in the coming months. Delta is not going to be the last variant we see, and it's not going to all disappear by September.

Please do strongly consider getting vaccinated. If you're someone who already got vaccinated and you're thinking about a booster, probably when those announcements come out, if you're above 65, if you have an immune system problem, it's going to be a good thing, a good option for you. Hopefully we'll get recommendations on that soon.

Moderna vs. Pfizer vs. No Vaccine Pre-Print

This paper just came out in the media. It's what's called a pre-print, which means it hasn't been completely vetted by peer review just yet, but it is publicly available, showing the decline in efficacy for infection, and by that same token transmission, of the virus for the two vaccines.

It actually compares Moderna and Pfizer, and compares those two to no vaccine at all. And what they did see was a decline in protection from infection from in the 80% range for the Moderna, down to the 70-some percent range.

And then Pfizer dropped from the 80s down actually to the 40s. So there's some data there showing that the Moderna vaccine may in fact have better efficacy against the Delta variant than Pfizer.

Don't worry if you got Pfizer. Again, the Pfizer vaccine still protects very robustly, just as Moderna does, against hospitalization and death, even going out many months, including against the Delta variant. So your vaccine still works fine.

It just may mean that you still may acquire COVID, and be at risk for passing it onto others. But it's still, if you've been vaccinated, whether it's Pfizer or Moderna, you should still be very well-protected and feel good about that. 

Numbers in Virginia

Now, we'll talk about what's going on a little bit with case numbers in Virginia. Some good news is it looks like in Virginia, the case numbers are probably starting to peak and maybe plateauing off, which is good. Hopefully over the next few days, we'll start to see those come down as well. And hopefully that'll also be the case in the rest of the country.

Just looking at the data from what I'm seeing, they've not quite peaked nationally, but it looks like we're about to peak in Virginia, so that's good news.

Still though, in Virginia, we've only got about 70% or so of adults with at least one dose of vaccine. We need to continue to hopefully get those numbers up over time.

The good news in the numbers though, even though the cases have risen with Delta, and hospitalizations have risen some as well, deaths have remained very low, which is good.

But not zero, of course, there has been a slight uptick, but we still are reporting well under 10 deaths a day on average. Nowhere near our peak back in the winter and such, so that's great. Hopefully we will continue to see that stay stable, even if we continue to have new variants pop up.

Boosters at PartnerMD?

"Will the boosters be given in the PartnerMD offices?"

We are actively exploring that and waiting to hear from the local health departments, and from CDC and the FDA, in terms of who we can give boosters to, and once we get information about who we can give booster to, then of course we'll have to get vaccine supply. We're actively looking into that. Nothing definite yet, but hopefully we will be able to do that in the coming weeks and months.

Booster Timing and Availability

"Once they're approved, what do you think the timing will be on their availability?"

Probably fairly quick assuming that what's approved is the same dose regimen. Just the third dose of the same vaccine from before, because they're already available and ready.

It'll really just be a question of ordering them and getting them into the offices. Probably within a few weeks of them being approved, we'll be able to deliver them here at the practices. But as I said, hopefully we're going to get some more data on that shortly.

Booster Formula

"Will the boosters cover for the Delta or will it just be the same formula?"

The boosters will probably be the same formula. It'll just be a boosted up immune response to that same formula. And remember, the Delta variant is still well covered by the vaccines in terms of preventing hospitalizations and fatalities, which are the most important outcomes we want to prevent, right?

Boosting that protection up a little bit, I think makes good sense. And especially for those who didn't respond super well the first time or whose immunity may have waned, and I think that's why you're going to see a recommendation come out for the 65 and up crowd, and those with immune system problems to get a booster, and probably not right away for other people.

Breakthrough Infections = Booster Shot? 

"If you get a breakthrough infection, does it do similar things as what a booster would do, effectively the same impact immunity-wise?"

That's a good question. Probably, it is similar would be my guess. But it's one of those questions where we just have no idea. My guess would be, yes, it would probably have the same impact as getting a booster, depending on what they call host factors. So the health and the immune status of that person. Probably similar, yes. 

Steve E. Bishop, M.D.

As a board-certified internist and concierge doctor in Richmond, VA, Dr. Steven Bishop is passionate about helping his patients improve their lives through better health. He helps healthy adults adjust their lifestyles as they age and helps patients with complex medical diseases manage and improve their health.