A health care worker prepares a COVID-19 shot.

JOHN DAY — Grant County residents 65 and older and those with underlying medical conditions such as diabetes and chronic lung ailments who have received the Pfizer-BioNTech vaccine against COVID-19 now qualify for booster shots to help increase their protection against the worst effects of the disease six months after receiving their second dose.

According to a news release from the Grant Count Health Department, the Western States Scientific Safety Workgroup reviewed the federal process and recommended Oregon, Washington, California and Nevada make the booster shots available to the following groups:

• People over 65.

• Those living in a long-term care facility.

• People 18-64 with underlying medical conditions.

• People 18-64 working in a high-risk setting, such as first responders, educators, food and ag workers, and corrections officers.

• People living in high-risk settings, such as correctional facilities and homeless shelters.

While Grant County Health Administrator Kimberly Lindsay noted that the Pfizer vaccine has been available locally only since June, the Food and Drug Administration plans to hold public meetings with its panel of independent vaccine experts on Thursday and Friday, Oct. 14 and 15, to consider booster shots for adult recipients of the Moderna and Johnson & Johnson vaccines.

The committee will also deliberate over whether people should get a shot from a different vaccine than they originally received.

The FDA plans to hold another public session Oct. 26 in anticipation of a request for emergency authorization of the Pfizer-BioNTech vaccine for children 5 to 11.

Since mid-August, people with compromised immune systems have been eligible to receive third shots of the Pfizer-BioNTech and Moderna vaccines 28 days after their second dose of the vaccine.

Whether and when booster shots are necessary became a hotly debated topic between members of advisory committees at both the FDA and the Centers for Disease Control and Prevention.

While top health officials in the Biden administration pushed for boosters to be made more widely available for the general population, scientists and public health experts argued the U.S. should prioritize getting shots in the arms of the unvaccinated. The vaccines, they said, still provide strong protections against hospitalization and death.

An Israeli study found that immunity from the Pfizer vaccine dropped from 95% in January through early April to nearly 40% in June. However, protection from severe disease and death did not budge and held at 90%.

Booster shot?

Ali Ellebedy, an immunologist at Washington University School of Medicine in St Louis, said referring to an additional COVID-19 shot as a booster is imprecise.

Ellebedy said that people get a tetanus shot, a yearly flu vaccine or a booster against a vaccine from childhood every 10 years because doctors know how much immunity is needed to fight those infections.

“When you say, I’ll give you a booster,” Ellebedy said, “that means I know exactly how much immunity you have or how much immunity you need to be protected, and we suspect your level of immunity will be below that needed amount for protection, and that’s why you need the booster.”

‘Correlate of protection’

With COVID-19, Ellebedy said, no one yet knows what scientists refer to as the “correlate of protection,” the level of antibodies needed to stave off infection.

If researchers had a firmly established correlate, Ellebedy said, then it would be accurate to deem it a booster shot.

The first jabs, he said, could be part of an initial series of immunizations but spaced out at later points in time.

Ellebedy said it would not be the first vaccine requiring three shots to achieve a correlate of protection, citing hepatitis B as an example.

“I think the argument should be that this could be part of the initial immunization that we are establishing,” Ellebedy said. “We are driving in the middle of the pandemic and we are making decisions as things are moving.”

Ellebedy said the hypercontagious delta variant forced public health experts and scientists to move to a three-jab regimen for vulnerable populations.

Ellebedy said in the six months after the last shot, the body generates immune memory cells that are not producing antibodies. Still, he said, memory cells are ready to engage with a pathogen once there is a need for the cells. Ellebedy said the third shot is akin to restarting a smoldering fire.

“Once we’ve restarted it, it is restarted to an even higher level,” Ellebedy said.

Scientists have been uncertain about the virus since the beginning of the pandemic, Ellebedy said.

“This uncertainty is what makes the third immunization especially needed for those who are 65 and older or those who have any immunosuppressive effects,” Ellebedy said.

Ellebedy said the third jab is probably unnecessary for young and healthy people with a robust immune response to their last shot.

Indeed, he said it is not for people who had contracted the virus before and then got vaccinated.

However, Ellebedy said that people from vulnerable populations who have had the virus and got their last shot six months ago should get the third jab.

Myocarditis, inflammation in the heart in young men, is a rare side effect that researchers have found with the Pfizer-BioNtech and Moderna vaccines, Ellebedy said, but to his knowledge the myocarditis has never led to a death.

A study published Oct. 6 in the New England Journal of Medicine reported that 11 out every 100,000 males in that age group developed the inflammation of the heart. However, studies have shown that COVID-19 is much more likely to cause heart problems than the vaccination.

He said it is unclear why a small portion of young men get the side effect.

{span style=”font-size: 1.17em;”}The new normal{/span}Ellebedy, who told the newspaper he is not conducting research on the vaccines that would pose a potential conflict of interest, said the coronavirus is here to stay.

“This virus is not going to be eradicated,” Ellebedy said. “So either you get vaccinated, or you get infected.”

Ellebedy said those taking a chance because they trust their immune system are hoping that the infection will be mild. However, he noted that young people with no significant preexisting conditions are being intubated.

COVID-19 may become a routine illness like a common cold or the flu one day, Ellebedy said.

However, he said scientists are trying to figure out if the virus is evolving more deadly and contagious new variants.

What can be worse, Ellebedy noted, is that if the virus could replicate as efficiently and quickly as the delta variant but also evade immunity better than delta. There are trickier variants of the virus, but so far, he said, none of those variants have been able to compete against the delta variant.

“I think the major thing for us is we really have to think that we are not alone in this,” Ellebedy said. “And there are no walls that can block the virus from coming from outside.”

The Pfizer-BioNTech booster is available to people over 65 and over, adults with weakened immune systems or those living in a long-term care facility who had their second shot at least six months ago.

Eligible recipients can call the Grant County Health Department at 541-575-0429 to schedule an appointment.