Answer Man: Two days after the Food and Drug Administration and the Centers for Disease Control and Prevention authorized the second booster shot, it seems that the state of Missouri has failed to authorize it. It seems a bit suspicious that they are dragging their feet on this. Would you care to rattle their cage a bit and write it up? — Randy Hoops, of Springfield
For review, here's what Randy is talking about.
The U.S. Food and Drug Administration on March 29 authorized a second booster shot of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for individuals 50 and older — as well as for certain immune-compromised people.
This decision makes it possible for someone like me, age 68, to receive vaccine shot No. 4 — aka Booster No. 2.
Maybe it's the fog of living in this time of COVID, but it was difficult for me to recall when I received my previous vaccine shots so, excuse me, as I head home to retrieve my COVID-19 Vaccination Record Card ...
(Imagine Bruce Springsteen music as you wait.)
... OK, I'm back.
My three shots were March 7, April 4 and Nov. 13 of 2021.
To clarify Randy's question, the Centers for Disease Control and Prevention recommended the second booster for those 50 and older and the Food and Drug Administration authorized it.
The main reason cited for a second booster is not necessarily to prevent infection but to greatly reduce the risk of severe illness leading to hospitalization or death for those who become infected.
During the Omicron surge of 2021, according to the CDC, those who were boosted were 21-times less likely to die from COVID-19 compared to those who were unvaccinated, and seven-times less likely to be hospitalized.
According to the New York Times, federal health officials initially considered limiting second boosters to those at least 60 or 65 years old. But they settled on a lower age because many Americans over 50 have chronic medical conditions that put them at risk.
Hmm. Maybe I should get Booster No. 2?
So, back to the question. Did the state of Missouri drag its feet — as Randy suspects — in authorizing this second COVID booster shot for the millions of Americans 50 and older?
Since I don't know how this process works, or even if a state “authorization” was needed, I contacted Lisa Cox, communications director for the Missouri Department of Health and Senior Services.
She responded via email:
“Some, but not all, providers throughout the state rely on a written order authorizing updates in vaccine administration guidance. These are signed by State Epidemiologist, Dr. George Turabelidze.
“We updated our orders on March 30, almost immediately after CDC came out with their updated recommendations. Enrolled COVID-19 vaccine providers were then notified.”
So here's the chronology: The FDA authorized a second booster on March 29; the state of Missouri responded on March 30; and I received Randy's question on March 31.
Cox provided a link to the state's standing order for the Moderna and Pfizer COVID vaccines, as updated for the second booster. The pertinent paragraph states:
“A second booster dose of Moderna (as well as Pfizer) COVID-19 vaccine may be administered to individuals 50 years and older and individuals 18 years and older who are moderately or severely immune compromised at least four months after the first booster dose.”
In addition, for those of you who received the Janssen (also known as Johnson and Johnson) vaccine as a primary and booster dose, you can get a Pfizer or Moderna shot as a second booster, at least four months after the first booster, if you are ages 18-49. You don't have to be immune compromised.
In writing this column, it occurred to me I could have gotten a second booster — if I so desired — as early as March 14.
From what I've read, the scientific evidence supporting a second booster is not as robust as it was for the first booster.
The FDA wrote on March 29: “Emerging evidence suggests that a second booster dose of an mRNA COVID-19 vaccine improves protection against severe COVID-19 and is not associated with new safety concerns.”
As far as I know, there is no personal downside to the vaccine — other than 48 hours of soreness at the injection site.
Of course, not all of you agree with my conclusion the COVID vaccines are safe and effective. I'll stop right there.
Pros and cons of a second booster
I called Dr. Stephen Christiansen, who lives in Springfield and does family medicine in Higginsville. I asked him for a summary of the pros and cons of a second booster for those 50 and older and in good health.
“On the one hand, the chance that it could hurt you is one in 10,000,” he says. “The chances that it will help you will depend on your age, immune status and, in general, how healthy you are.
“The right answer is get the damn shot if you are 80 years old and in a nursing home or if you are 45 and you have multiple sclerosis and taking immuno-suppressing drugs.
“I'm 71 and I've been dragging my feet about getting a second booster,” he says. “I still do OK. I am not coming down with every germ out there and I get exposed a lot.”
Christiansen says he will likely wait three to six months for Moderna to finalize a new version of its vaccine that also works against the Omicron variant.
When that's ready and available, he says, he will likely get Booster No. 2.
So you know, I just signed up online for my second booster of Moderna.
As is so often the case in responding to questions online — without the benefit of talking to another human being — the questions asked by Walmart do not specifically fit my situation. It seemed to me the company has not yet accounted for the recent approval of a second booster.
I was asked if I was previously vaccinated.
Yes.
Then I was given three choices:
Is this my second dose? Or my booster dose? Or an additional dose (immunocompromised individuals only)?
There was no option for the most accurate description of what I sought — “second booster dose for those 50 and older.”
So I selected “additional dose (immunocompromised individuals only)” even though I am not immunocompromised.
In conclusion, thanks to Randy I'm scheduled to get Booster No. 2 Saturday afternoon.
This is Answer Man column No. 7.
