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Virginia health leaders plan for COVID-19 vaccine booster shot rollout

While vaccines continue to prove highly effective against hospitalizations and death, Virginia officials said efficacy is starting to drop against the Delta variant.

NORFOLK, Va. — Virginia public health leaders are planning for a rollout of COVID-19 vaccine booster doses of the Pfizer and Moderna mRNA vaccines, if approved next month. 

The Centers for Disease Control says immunocompromised people should get a third dose to reach full immunity now, while federal health leaders could approve booster doses for everyone else by September 20.

Dr. Danny Avula, Virginia's vaccine coordinator, said the COVID-19 vaccine is still highly effective against hospitalizations and death, but overall protection is starting to slowly decrease when fighting the Delta variant.

"The sense of urgency or emergency is very different; your protection against vaccination doesn’t drop off overnight, it is a slowly waning decrease in effectiveness and so there does not need to be an urgent need to go out on the day you hit eight months and get your vaccine."

Currently, federal health leaders are recommending a booster dose about eight months after an individual received their second dose, if approved.

On Thursday, Marjorie Allen waited in a line at the Military Circle Mall vaccination clinic in Norfolk, hoping to protect her weakened immune system with a third dose to combat the delta variant of COVID-19.

"I do have a compromising condition, so I’m here to see, yes or no can I get it," Allen said.

A Norfolk Public Health Department official confirmed the clinic provided third doses to immuno-suppressed people today. Soon, millions of other Virginians could be in line.

“The federal government has very much assured us that supply is not an issue. There is enough vaccine for a third dose for every American," Dr. Avula said. "That means this will be a very different scenario of what we were working with from December to March [when supply was limited]."

Dr. Avula said Virginia now has thousands of approved pharmacies and medical providers to help with a booster shot rollout, and the Virginia Department of Health is working on its plans for booster shot rollouts at the local level, filling any gaps.

"At the state level that’s really reassuring, that the peak of eligibility is far below our overall capacity to deliver vaccine," Avula said.

Avula said no vaccine is 100% effective or "lasts forever," and booster shots are a natural byproduct of vaccine science. He said people don't need to rush to get a booster shot of the Pfizer or Moderna vaccine on their first day of eligibility -- eight months after their second dose.

"I want Virginians to know they still have a high degree of protection, a very high degree of protection against severe consequences, and when their turn comes up they can approach that in a more relaxed way and identify providers in their community where they can go get that booster dose," he said.

A booster shot of a Pfizer or Moderna vaccine uses the same vaccine formulation as a first or second dose, according to Virginia health leaders.

While manufacturers are testing different versions to see how they react against different variants of the virus, those vaccines likely wouldn't be approved until next year, Avula said.

He added that while the current focus is on third doses for people with weakened immune systems and booster shots for all, getting more people to receive a first dose is still "more important in the long run" to progressing beyond the pandemic.

Avula said fear of the Delta variant is helping vaccination rates increase, and he expects that full FDA approval of the vaccines -- likely coming in September -- will help vaccination rates climb as well.

Virginia health leaders said testing is still in progress on a potential booster shot for the Johnson & Johnson vaccine. Dr. Avula said he expects a recommendation for people who received a single dose of the J&J shot before September 20. He also said the Virginia Department of Health and private medical providers will likely remind people when they’re close to eight months out from their second dose, but it's good to check your records as well.

To get a third dose now, VDH is relying on people to "self-attest" as immunosuppressed, which includes people who are undergoing cancer treatments, received organ transplants, have chronic immune system conditions, or other factors.

Dr. Avula said VDH is following CDC and not requiring proof of a weakened immune system for a third shot in order to not discourage people from getting an additional dose. 

He said it's possible people could be deterred from getting a first vaccine dose when hearing about the new recommendation for a booster dose, but he stressed the statistics and health benefits of vaccinations.

"I am sure there will be a segment of the population who says the inclusion now of a booster dose starts to lessen confidence in [vaccine] effectiveness," Avula said. "We just have to keep going back to what is happening in real life... we're seeing cases and hospitalizations skyrocket, the vast majority of that is happening in unvaccinated people."

About 80 to 90 percent of COVID-19 cases in Virginia are attributed to the Delta variant, according to VDH. 

More than 97% of people who have been hospitalized due to COVID-19 symptoms have been unvaccinated. More than 98% of people who have died from COVID-19 have been unvaccinated.

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