Area counties prepare for booster shots of Pfizer’s COVID-19 vaccine, face unique challenges

With U.S. Food and Drug Administration approval of a third booster dose of Pfizer’s COVID-19 vaccine for recipients six months out from their second dose, area counties are busy planning for what that rollout will mean locally.

“We now can start giving boosters of Pfizer six months after the second dose,” said Mary Rose Corrigan, City of Dubuque public health specialist and member of the Dubuque County COVID-19 Incident Management Team. “Suddenly, we can move plans forward.”

U.S. Centers for Disease Control guidelines for qualification for a third dose have grown looser than expected.

“The CDC broadened the group far beyond just 65 and older and those who are immunocompromised,” Corrigan said.

CDC guidelines now say that people 65 and older, residents of long-term care and people 50 through 64 with underlying medical conditions “should” get the booster dose. They also say people 18 and older with underlying medical conditions or those who are at increased risk for COVID-19 exposure due to occupational or institutional setting can get the booster.

This third dose is recommended because vaccine efficacy is shown to diminish over time. But, Corrigan stressed that people who are fully vaccinated are still greatly protected from COVID-19.

“There isn’t the urgency for people to get the booster,” she said. “But, knowing that protections weaken down the road, this is another tool… It’s not uncommon for people to need to get additional shots of a new vaccine. We’ve learned that from other diseases.”

The tricky point in creating messaging around this is that the guidance is only for those who received the Pfizer vaccine, not the Moderna or Johnson & Johnson.

“It’s important to know what you got the first time,” Corrigan said. “All of this is based on people getting the same type of vaccine they received the first time. We haven’t studied yet what mixing does with a booster.”

Early shipments of vaccines to the area were comprised of what was most available at the time. Many of those were Moderna, which would exclude many area residents from receiving a booster at this time.

Jo Daviess County Public Health Administrator Sandra Schleicher said that her county has only ever received Moderna COVID-19 vaccines.

“We’re just starting to develop our third dose, booster dose messaging,” she said. “But we only have one type of the vaccine (Moderna). As our (positive case) numbers keep going up, I think more people are becoming interested in it.”

The Moderna vaccine has been submitted to the FDA as a booster dose but has yet to receive approval.

Corrigan said that in Dubuque County, too, most early doses were Moderna, not Pfizer.

While that might frustrate residents eager to further protect themselves with a third dose, Corrigan said it actually helps to not overwhelm providers who would be administering the boosters.

“That is one of the factors that’s influencing especially the health care providers,” she said. “They won’t be giving as many booster vaccinations as they would be otherwise. The timing works out with the more gradual number of people. That will help in the spacing.”

That more gradual influx also could help staff-strapped health care providers whose staff will themselves be among the first to qualify for booster doses, as they were among the first to receive the vaccines originally.

“One of the challenges with the health care providers is, they don’t necessarily have the staff to spare to operate their booster vaccine clinics,” Corrigan said. “Some of them are trying to work them into their influenza clinics.”

Grant County also received mostly Moderna in the beginning, so demand has not yet shot up, according to Health Director Jeff Kindrai. But, he does not expect that calm to last long.

“We are monitoring for demand to see if we need to open a separate clinic,” he said. “Moderna will probably be approved in weeks or a month. Then we’re anticipating Pfizer to be approved for children. So, we’ve tried to recruit additional staff and volunteers to make sure we have enough staff for demand if it spikes.”

The Dubuque County COVID-19 Incident Management Team has organized a new point of distribution for booster doses of the vaccine at the Dubuque County Firefighters Association Regional Emergency Responder Training Facility, 14928 Public Safety Way, Peosta. The Visiting Nurse Association will hold its first clinic there from 3 to 7 p.m. today.

Further clinics will be announced as scheduled and be staffed by the VNA as well as private providers.