New COVID-19 booster shots have begun rolling out across Maryland and the country this week, and experts and officials are again stepping up their efforts to persuade the public to get another shot.
The boosters have been retooled, and authorized by federal officials for everyone age 12 and older, to protect against the original strain and the currently circulating omicron variants known as BA.4 and BA.5.
Maryland preordered 157,000 doses of the so-called bivalent booster, and the federal government also shipped doses to a network of pharmacies, including Walgreens and CVS, in an effort to get the new vaccines from Pfizer/BioNTech and Moderna out quickly. They will be free and replace all boosters offered to those eligible.
“If you choose to be boosted this fall, you not only reduce your personal risk, but risk to your family and the community,” said Keri Althoff, associate professor in the Johns Hopkins Bloomberg School of Public Health’s department of epidemiology, during a media briefing Thursday.
While experts are not predicting a fall or winter wave like the massive one in January, they say there could be a smaller surge as students return to classes and others do more things indoors. There also is the potential for a new variant to gain steam and cause infections, and the flu remains a big concern.
Other mitigation efforts, such as masking and testing, are now mostly voluntary, and the U.S. Centers for Disease Control and Prevention no longer recommends quarantining for people exposed to the coronavirus. That means there is a bigger chance people will encounter someone who is infected, Althoff said.
She said people need to assess their own level of risk, their risk of infecting vulnerable people and their risk tolerance.
To protect themselves and their families, Althoff said, parents can, for example, ask their children to wear masks in class for the days after a fellow student tests positive. They can wear masks when visiting vulnerable grandparents. They can take rapid tests before gatherings. And they can understand the level of air filtration in public spaces.
The public has many more tools available than at the start of the pandemic and knows how to use them, said Andrew Pekosz, a virologist and professor and vice chair of Bloomberg school’s department of molecular microbiology and immunology.
There are tests for infections, antiviral medications to prevent severe disease, masks and those new boosters, he said during the briefing.
“There may be a little shortage initially because they are just being rolled out across the country,” Pekosz said of sites offering boosters. “Pharmacies, health care clinics and your health care provider will be the best places to … check for availability and make appointments.”
The state continues to maintain a database of places to get vaccines and boosters, though confirming availability and making an appointment takes additional clicks or calls.
Maryland health officials reported 1,339 new COVID-19 cases Friday, and the infections appear to be slowly declining from the last uptick that topped out in May, well below the pandemic peak in January. Experts say that many cases, however, are not being reported because people aren’t reporting the results from at-home rapid tests.
Demand for the new boosters is uncertain, as uptake of the extra shots already available has lagged. In Maryland, state health data shows 58.3% of residents age 12 and older already have received at least one booster. Far fewer have gotten a second booster, until recently directed to those age 50 and older and the immunocompromised.
Ahead of school starting last week, the Maryland Department of Health made a plea to parents to vaccinate children against COVID-19, as well as get their routine vaccinations.
Officials reported that just under 45% of children ages 5 to 11 were fully vaccinated against COVID-19, with about 15.5% boosted. About 78.8% of children ages 12 to 17 were fully vaccinated with 36.4% boosted.
The lowest level of vaccination was in those 6 months to 4 years, with 9.6% with at least one shot and 2.6% fully vaccinated. They are not eligible for boosters.
The state does not plan to report use of the new boosters separately, though they will replace boosters for all those who are eligible. Testing is underway for younger children with the new bivalent booster, Althoff said, and it could be available for them soon. For now, they can receive a booster with the original vaccine.
Pekosz said that although the CDC recommended those age 12 and older can receive the new booster two months after the last shot, ideally people should wait four to six months for the best immune response.
Going forward, an annual booster “is being seriously discussed,” he said.
“We know immunity wanes over time so we may need to be immunized annually, or maybe it’s limited to at-risk population or for the general population,” Pekosz said.
Others have suggested that oral or nasal vaccines would do a better job of not just preventing severe disease, but stopping transmission. China and India have approved such vaccines, but there is no published data yet on their effectiveness, according to Hopkins experts.
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To encourage uptake this fall, the Maryland Department of Health has launched radio ads on the new booster and brought back its “GoBoost!” messages on outdoor digital boards. There are also “COVIDReady” television ads encouraging people to check their vaccination status and seek out shots when eligible. The health department also plans calls and text messages.
“This new bivalent booster shot is another important tool in our toolbox to help Marylanders stay COVIDReady,” said Gov. Larry Hogan in a statement when the boosters were authorized days ago.
“While federal guidance has made it confusing at times for people to know if and when they’re eligible, everyone 12 and older will be able to get to this new shot,” he said. “Maryland continues to be one of the most vaccinated and boosted states, and we have always focused on staying ahead of the virus, which is why getting this new shot is so critical.”
The Moderna vaccine is authorized for those 18 and older and the Pfizer vaccine is authorized for those 12 and up.
The Hopkins experts said that while people are getting their COVID-19 booster, they should consider also getting the flu shot. Australia, a bellwether continent for North America, had one of its worst flu seasons in years. That was likely due to a reduction in use of masks and other measures that had kept many viruses at bay during the pandemic.
The Hopkins experts said they would be watching to see whether the cases come earlier than the usual start to flu season in October or November, and whether cases are severe in younger as well as older people because they’ve been protected from flu during the pandemic and not developed any immunity.
“The small children have not had a lot of exposure to influenza, so we’ll be paying attention,” Althoff said.