{"id":62574,"date":"2022-02-17T14:29:35","date_gmt":"2022-02-17T21:29:35","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=62574"},"modified":"2024-07-18T14:42:21","modified_gmt":"2024-07-18T20:42:21","slug":"making-sense-of-covid-vaccine-boosters","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/making-sense-of-covid-vaccine-boosters\/","title":{"rendered":"Making sense of coronavirus vaccine boosters"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_62577\" aria-describedby=\"caption-attachment-62577\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-62577 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine.webp\" alt=\"nurse gives man a vaccine, helping him make sense of covid boosters and when he should get one.\" width=\"300\" height=\"200\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine.webp 800w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine-768x513.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine-200x134.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-62577\" class=\"wp-caption-text\">Confused about COVID-19 booster shots? You&#8217;re not alone. Photo: Getty Images.<\/figcaption><\/figure>\n<p>If you\u2019re confused about coronavirus vaccination, you\u2019re not alone. Blame the confusion on the coronavirus itself.<\/p>\n<p>With SARS-CoV-2 mutations \u2013 particularly the mutations that give rise to the <a href=\"https:\/\/www.uchealth.org\/today\/new-omicron-covid-19-booster-shots-fall-2022-what-to-know\/\">wildly contagious omicron variant<\/a> \u2013 have come scientific studies that have fed into changing vaccination guidance. Let\u2019s cut through the noise and make sense of COVID-19 vaccinations and boosters, starting with those who are immunocompromised or have a weakened immune system.<\/p>\n<p>First, to be clear, \u201cimmunocompromised\u201d does not apply to those whose immune systems are undergoing inevitable age-based decline. <a href=\"https:\/\/www.uchealth.org\/provider\/thomas-campbell-md-ms-internal-medicine\/\">Dr. Thomas Campbell<\/a>, a University of Colorado School of Medicine and UCHealth virologist and infectious disease specialist, says there\u2019s a sliding scale to immune-system deficiency.<\/p>\n<figure id=\"attachment_43602\" aria-describedby=\"caption-attachment-43602\" style=\"width: 240px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-43602 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/12\/21073951\/Dr.-Campbell-headshot.webp\" alt=\"dr. Thomas Campbell helps make sense of COVID booster guidelines.\" width=\"240\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/12\/21073951\/Dr.-Campbell-headshot.webp 450w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/12\/21073951\/Dr.-Campbell-headshot-240x300.webp 240w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/12\/21073951\/Dr.-Campbell-headshot-120x150.webp 120w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/12\/21073951\/Dr.-Campbell-headshot-200x250.webp 200w\" sizes=\"auto, (max-width: 240px) 100vw, 240px\" \/><figcaption id=\"caption-attachment-43602\" class=\"wp-caption-text\">Dr. Thomas Campbell.<\/figcaption><\/figure>\n<p>\u201cIt\u2019s a continuum. On one hand, there are people who are severely immunocompromised \u2013 those with recent bone-marrow or heart or lung transplants,\u201d Campbell said. At the other end, there are changes in the immune system associated with age.<\/p>\n<p>The U.S. Centers for Disease Control and Prevention\u2019s <a id=\"\" href=\"https:\/\/www.cdc.gov\/covid\/vaccines\/immunocompromised-people.html\" target=\"_blank\" rel=\"noopener\">definition of \u201cimmunocompromised\u201d<\/a> with respect to the coronavirus is for now strict. It includes those with immune systems pharmaceutically throttled after organ transplants, those in active cancer treatment, stem-cell transplant patients, those with immunodeficiency syndromes or advanced HIV infections, or patients on high-dose corticosteroids or other immune-suppressing drugs. Such patients have been especially vulnerable to severe disease <a id=\"\" href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0257641#:~:text=(version%207.1).-,Results,female%20patients%20(62.2%25%20vs.\" target=\"_blank\" rel=\"noopener\">and death<\/a> since the beginning of the pandemic.<\/p>\n<h2><strong>What does the CDC say about vaccinations and boosters?<\/strong><\/h2>\n<p>For those immunocompromised and older than 12, the <a id=\"\" href=\"https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html#vaccination-people-immunocompromised\" target=\"_blank\" rel=\"noopener\">CDC guidance<\/a> with respect to the Moderna and Pfizer vaccines that more than 90% of the Colorado population has received is as follows:<\/p>\n<ul>\n<li>The primary vaccine series \u2013 that is, what is now considered a basic level of vaccination \u2013 is three shots from Moderna (ages 18+) and Pfizer (ages 5+). The third shot comes <strong>four weeks<\/strong> after the second.<\/li>\n<li>On Feb. 11, the CDC shortened the waiting time between the third shot and the fourth-shot booster to <strong>three months<\/strong>. (Those ages 5 to 11 don\u2019t get the fourth shot.)<\/li>\n<li>Note that, if the first two vaccine doses were Moderna, the third dose should also be Moderna (same story with Pfizer). The fourth shot \u2013 the booster, can be either Pfizer or Moderna.<\/li>\n<li>In the case of Moderna, the third-shot dosage should be the standard primary-series dosage of 100 micrograms of mRNA \u2013 not the lower 50-microgram dose of the Moderna booster. (The Pfizer vaccine\u2019s 30-microgram doses are uniform anyway.)<\/li>\n<\/ul>\n<figure id=\"attachment_42091\" aria-describedby=\"caption-attachment-42091\" style=\"width: 229px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-42091 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/09\/21142711\/Mindy-Lam.webp\" alt=\"Dr. Mindy Lam, explains COVID booster shots and third doses.\" width=\"229\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/09\/21142711\/Mindy-Lam.webp 676w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/09\/21142711\/Mindy-Lam-229x300.webp 229w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/09\/21142711\/Mindy-Lam-114x150.webp 114w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/09\/21142711\/Mindy-Lam-200x262.webp 200w\" sizes=\"auto, (max-width: 229px) 100vw, 229px\" \/><figcaption id=\"caption-attachment-42091\" class=\"wp-caption-text\">Dr. Mindy Lam<\/figcaption><\/figure>\n<p>This last point is subtle, says <a href=\"https:\/\/www.uchealth.org\/provider\/huong-mindy-lam-md\/\">Dr. Mindy Lam<\/a>, a CU School of Medicine and UCHealth internal medicine physician.<\/p>\n<p>\u201cAmong patients who go to outside pharmacies for vaccination, there\u2019s some confusion about that third dose,\u201d Lam said. \u201cI write it down and ask them to tell their pharmacy that it\u2019s a third full dose and not a booster.\u201d<\/p>\n<p>For those who are immunocompromised but got the single-dose Johnson &amp; Johnson vaccine, the CDC recommends a dose of mRNA vaccine 28 days after the J&amp;J dose and then an mRNA booster dose at least two months after the mRNA\u00a0 dose (learn more detail <a id=\"\" href=\"https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html#appendix-b\" target=\"_blank\" rel=\"noopener\">about J&amp;J guidelines<\/a>).<\/p>\n<p>Dr. Tomer Mark, a CU School of Medicine and UCHealth blood cancer specialist, says vaccination is particularly important for his immunocompromised patients.<\/p>\n<p>\u201cI\u2019m absolutely encouraging my patients to get third and fourth doses,\u201d he said. \u201cI think everybody agrees that immunocompromised patients do not have the same vaccine response as people with intact immune systems do, and even if they\u2019ve had natural COVID-19 infections, they don\u2019t produce antibodies the same way.\u201d<\/p>\n<p>Lam says anecdotal evidence backs emerging data that immunocompromised patients who get a fourth dose fare better should a breakthrough infection occur.<\/p>\n<p>\u201cI think we\u2019re seeing that people who have gotten boosted have less severe illness that\u2019s more short-lived,\u201d she said.<\/p>\n<p>As well, Mark says, immunocompromised patients who take weeks or months to clear COVID-19 can incubate new coronavirus variants. Odds are that\u2019s what happened with the omicron variant, which has 30 mutations on its spike protein alone.<\/p>\n<p>\u201cIf these patients are infected, they can carry live virus for a long time and give it the opportunity to mutate,\u201d Mark said.<\/p>\n<p>Campbell adds that immunocompromised patients can also receive an antibody combination, Evusheld, to provide a protective boost beyond that of the four-shot vaccine regimen. The<a id=\"\" href=\"https:\/\/www.fda.gov\/media\/154701\/download\" target=\"_blank\" rel=\"noopener\"> AstraZeneca infusion received U.S. Food and Drug Administration emergency-use authorization<\/a> as a coronavirus pre-exposure prophylaxis in December 2021, and UCHealth has good supply of the drug.<\/p>\n<h2><strong>Clear your confusion and get a boost<\/strong><\/h2>\n<p>For the majority who enjoy healthy immune systems, the CDC\u2019s guidance is simpler. Assuming an mRNA vaccine, those 12 and older should get the <a id=\"\" href=\"https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html#booster-dose\" target=\"_blank\" rel=\"noopener\">two-dose primary series and then<\/a> a booster. The booster can be different than that of the primary series and should come five months after the second dose.\u00a0Those initially vaccinated with the single-dose J&amp;J vaccine should get a single mRNA booster two months after the J&amp;J dose, for a total of two doses to be up to date.<\/p>\n<figure id=\"attachment_62585\" aria-describedby=\"caption-attachment-62585\" style=\"width: 226px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-62585 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17143918\/Capture1.webp\" alt=\"Dr. Tomer Mark helps make sense of COVID-19 boosters.\" width=\"226\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17143918\/Capture1.webp 282w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17143918\/Capture1-226x300.webp 226w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17143918\/Capture1-113x150.webp 113w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17143918\/Capture1-200x265.webp 200w\" sizes=\"auto, (max-width: 226px) 100vw, 226px\" \/><figcaption id=\"caption-attachment-62585\" class=\"wp-caption-text\">Dr. Tomer Mark<\/figcaption><\/figure>\n<p>Limited vaccine supplies early in the pandemic led to recommendations that vaccination lag a coronavirus infection by 90 days (natural immunity, the logic went, would be at least partially protective during that time). That has changed, Campbell says, and the CDC recommends, for the safety of others, only that you don\u2019t get boosted while you\u2019re still contagious.<\/p>\n<p>\u201cI\u2019d say wait a minimum of 10 days after the onset of covid symptoms,\u201d he said. \u201cNatural immunity will give you protection from that infection, so there\u2019s no reason to rush out and get the booster.\u201d<\/p>\n<p>As to whether those with age-related immune-system decline will be at some point be getting a fourth shot as is <a id=\"\" href=\"https:\/\/www.usnews.com\/news\/top-news\/articles\/2022-01-23\/fourth-covid-vaccine-shot-sharply-raises-serious-illness-resistance-for-over-60s-israel\" target=\"_blank\" rel=\"noopener\">happening in Israel<\/a>, Campbell says nobody knows yet. As the coronavirus becomes endemic, public health officials and policymakers must weigh the emergence of new coronavirus variants and the severity of the disease they cause, vaccine effectiveness over time, and other factors, he says. Among those factors are that vaccines \u201care not the only tool in our box,\u201d Campbell says: Monoclonal antibodies and new antiviral therapies, if administered early in the course of COVID-19 infection, can sharply reduce disease duration and severity among the immunocompromised and the rest of us.<\/p>\n<p>\u201cSo my advice to people at high risk is, if you\u2019ve contracted COVID, don\u2019t hesitate to contact your doctor and get a treatment that will prevent you from getting hospitalized,\u201d he said.<\/p>\n<p>And, he adds, if you aren\u2019t among the roughly half of eligible Colorado residents who have gotten their third- or fourth-dose booster shot, now is the time.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you\u2019re confused about coronavirus vaccination, you\u2019re not alone. Blame the confusion on the coronavirus itself. With SARS-CoV-2 mutations \u2013 particularly the mutations that give rise to the wildly contagious omicron variant \u2013 have come scientific studies that have fed into changing vaccination guidance. Let\u2019s cut through the noise and make sense of COVID-19 vaccinations [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":62577,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[4859,4860,9069,162],"class_list":["post-62574","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-coronavirus","tag-covid-19","tag-covid-19-vaccine","tag-infectious-diseases"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.7 (Yoast SEO v27.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Making sense of COVID-19 vaccine boosters - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Need help making sense of COVID-19 boosters? Guidance changed with respect to coronavirus boosting, particularly among the immunocompromised.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/making-sense-of-covid-vaccine-boosters\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Making sense of coronavirus vaccine boosters\" \/>\n<meta property=\"og:description\" content=\"Need help making sense of COVID-19 boosters? Guidance changed with respect to coronavirus boosting, particularly among the immunocompromised.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/making-sense-of-covid-vaccine-boosters\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2022-02-17T21:29:35+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-07-18T20:42:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2022\/02\/17135932\/GettyImages-1298595974vaccine.jpg\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Todd Neff, for UCHealth\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Todd Neff, for UCHealth\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/\"},\"author\":{\"name\":\"Todd Neff, for UCHealth\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/da7733ff5562e48e55c027d111ee5911\"},\"headline\":\"Making sense of coronavirus vaccine boosters\",\"datePublished\":\"2022-02-17T21:29:35+00:00\",\"dateModified\":\"2024-07-18T20:42:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/\"},\"wordCount\":1147,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2022\\\/02\\\/17135932\\\/GettyImages-1298595974vaccine.webp\",\"keywords\":[\"Coronavirus\",\"COVID-19\",\"COVID-19 vaccine\",\"Infectious diseases\"],\"articleSection\":[\"Healthy living\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/\",\"name\":\"Making sense of COVID-19 vaccine boosters - UCHealth Today\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/making-sense-of-covid-vaccine-boosters\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2022\\\/02\\\/17135932\\\/GettyImages-1298595974vaccine.webp\",\"datePublished\":\"2022-02-17T21:29:35+00:00\",\"dateModified\":\"2024-07-18T20:42:21+00:00\",\"description\":\"Need help making sense of COVID-19 boosters? 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