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A UVMMC doctor on second COVID boosters, and whether you should get one

A man holds a syringe in front of several documents.
Kevin Trevellyan
A volunteer prepares to vaccinate someone against COVID-19 at a Vermont Department of Health vaccination clinic at the Berlin Mall on Jan. 14, 2022.

Last week, the Centers for Disease Control and Prevention authorized a second COVID booster for people who were initially boosted at least four months ago. But the agency is only recommending the shot for certain demographics at this time.

VPR's Grace Benninghoff spoke with Dr. Tim Lahey, an infectious disease specialist with UVM Medical Center, about who should consider getting the second booster, and what information we’re still waiting for. Their conversation below has been edited and condensed for clarity.

Grace Benninghoff: Can you break down who the CDC wants to get a second booster, and why the second booster is more beneficial for these particular groups?

Dr. Tim Lahey: The best data we have so far suggests that a second booster is really beneficial for people over 60 and people who are immunocompromised.

A man is pictured.
Ryan Mercer
University of Vermont Health Network
Dr. Tim Lahey

So far, we don't have the same level of evidence suggesting that younger people or people with healthy immune systems get as much benefit. And so the CDC has encouraged people over 60 and people who are immunocompromised to get it. And they've made it available to people who are over 50, who can talk with their physicians to decide if they need it.

What kind of protection against COVID does the second booster provide?

Data from Israel suggest that getting a second booster shot lowered hospitalization rates and death rates. Importantly, protection from infection was really quite modest. And so probably not, in isolation, enough for people to go get a booster a second time.

I've read some things about mixing boosters and how that can be beneficial — like if you've had a Pfizer shot in the past, getting Moderna might offer extra protection. Is that true?

There are some really interesting immunology studies suggesting that mixing and matching vaccines can lead to bigger and cooler immune responses. But really the data linking that to improving protection from severe disease is really not there yet. And so for me, I think it's an interesting idea that I want to see followed up in clinical trials. But I'm not recommending it yet to patients.

What would you tell people who are on the fence about getting a second booster?

I think the question of whether to get a second booster really boils down to how strong your immune system is. If you're either over 60, or some immune-suppressing medicine or condition is taking the edge off of the immune response to the first three shots, then it makes sense to talk with your doctor about whether there's a good reason to get a second booster.

If you're otherwise healthy, and under 60, I think it's reasonable to wait. But you can imagine that the individual preference can get in there. Some people maybe have an unusual medical condition that makes them and their physician worry that they might have a weakened immune system. Orperhaps they just sort of want to take a chance and feel that the risk of COVID is bigger than the risk of a fourth vaccine. And so there's a little room for personal preference in there as well.

You touched on this earlier, but what information are we still waiting for regarding how useful the second booster is for people who aren't older and who aren't immunocompromised?

The studies I'm eagerly awaiting are studies of people who are under 60 with a wide variety of medical conditions, or none, to see if a second booster ends up being important, really, only for that thin slice of the population over 60 and immunocompromised, or if perhaps a wider list of people should get it.

Lastly, the state of Vermont has stopped taking vaccine appointments at this point. How can Vermonters get a second booster if they'd like to?

Increasingly, vaccination in Vermont is happening in walk-in clinics, as well as in larger clinical practices. And this just reflects the reality that most of Vermont has been vaccinated and that those who haven't don't need a big expo center drive to get them vaccinated.

And so I strongly encourage all Vermonters to get vaccinated against COVID-19 if they're old enough to get one and to make sure that it's up to date. And if you're not sure whether you can, go on the Vermont Department of Health vaccine webpage and there are really good directions about where to get a shot.

Have questions, comments or tips? Send us a message or get in touch with Grace Benninghoff @gbenninghoff1.

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