By Karen Kier, Pharmacist on behalf of the ONU HealthWise team

The idiom “to go overboard” is used to describe a person who does something that is excessive or extreme. An example would be a person going overboard to prepare food for a party or spending an excessive amount of money on an item. Some may remember the 1987 romantic comedy Overboard that starred Goldie Hawn and Kurt Russell. The movie was a box office success and can still be seen on television. A 2018 remake of Overboard starred Anna Faris and Eugenio Derbez that reversed the roles of the original movie. Others may remember Adam Sandler’s movie in 1989 titled Going Overboard about a struggling comedian who works on a cruise ship.

So, why am I discussing going overboard as it relates to COVID-19? The FDA cleared the way for a third, fourth, and fifth booster dose for the mRNA COVID-19 vaccines.

There is confusion on this topic especially within social media. It can be difficult to find good scientific answers to the questions about the boosters. There is significant debate in the media related to the risk versus the benefit of the booster COVID-19 vaccines.

With the FDA announcement on booster doses, those individuals who received Janssen (J&J) are eligible for a third dose of vaccine following a first initial dose, then a second booster shot. The third dose for those who received J&J should be a mRNA vaccine (Moderna or Pfizer).  For an individual who received the first and second doses of the mRNA vaccines, as well as the first booster dose (3rd dose), they could be eligible for a 4th dose of mRNA vaccine.  An individual that received four doses of mRNA vaccine due to a suppressed immune system such as cancer or an autoimmune disease may be eligible for a 5th mRNA vaccine. The FDA approved another mRNA booster for those 50 years and older or those 12 years and older who have a suppressed immune system. At this time, those under 50 years of age with a sufficient immune system are not eligible for the next round of boosters. The data shows that younger individuals have a more sustained or longer lasting antibody response to COVID-19 vaccines than older individuals.

The benefit of the additional booster doses of mRNA vaccines comes from studies with the Omicron variant.  The studies from Israel show a benefit of protection from severe disease and death from COVID-19 with an additional booster (4th dose). The goal with the Omicron variant and vaccines is to reduce severe disease rather than preventing infection. The additional mRNA vaccine doses did show a benefit albeit a marginal improvement.  As one article stated, a marginal benefit is still a positive move forward in reducing severe outcomes and death.  The booster provides a good reason to protect the most vulnerable groups from severe illness. 

The most critical information about the additional booster is the time frame for administering the vaccine.  The data supports a minimum of four months since the last vaccine administration.  This is important because the body may have an inadequate response if given too soon.  Some data suggests that five-six months may be a more valuable time span between boosters.  This interval has more to do with maximizing the immune system’s ability to mount the best defense against the virus. The Israeli study with Pfizer indicated that the second booster increased antibodies by 5-fold, but the antibodies are not the only story in providing protection. Ultimately, it is about training the immune system to recognize and defend the body against severe infections with COVID-19. A CDC study evaluating the Omicron surge in the United States did prove the mRNA vaccines were still 79% effective against death and mechanical ventilation (respiratory support) with just two of the original doses but showed a 94% effectiveness in those with a two-dose series plus one booster.

Some of the concern circulating, even among experts, is if too many COVID-19 vaccine doses can be bad for the immune system. This is where social media has confused the issue. The science supports if the time interval is at least four months between vaccine doses, then the immune system will not be overloaded and can respond adequately. Hence, the time frame is critical!  Some other cons to getting additional booster doses include the repeated side effect profile (very similar to the first few doses) and the cost and coverage for the vaccine since the government has announced they can’t afford to pay for the additional doses.  A more global concern is the United States giving more vaccine while other parts of the world have not had access to first vaccine doses.

This is a great opportunity to talk to your healthcare professional about when is the right time to get a booster COVID-19 vaccine.

Feel free to call the ONU HealthWise Pharmacy for the science on COVID-19. ONU HealthWise is offering COVID-19 and flu vaccines Monday through Friday from 4 pm to 6 pm. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna, Pfizer and flu shots and high-dose flu vaccines. Call the pharmacy to get more information.

ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com