Today, Public Health Director Rachael Banks and Senior Health Advisor Dr. Ann Thomas of the Oregon Health Authority (OHA) answered questions about COVID-19 booster doses and third doses.

While the surge in COVID-19 infections and hospitalizations has leveled off, Director Banks noted that “the Delta variant is still a threat, especially for too-often overlooked communities. These decreases are not experienced the same across all communities, which means there are still unfair and troubling COVID-19 inequities.”

According to OHA’s latest weekly breakthrough case report, the rate of COVID-19 in unvaccinated people is approximately four times higher than in vaccinated people. But the proportion of vaccine breakthrough cases who died with COVID-19 has increased over time, due to:

• More disease in the community caused by the Delta variant and
• The small decrease in vaccine effectiveness found among the elderly, especially among older residents in long-term care facilities, who were vaccinated early in the vaccination roll-out.

Both the booster dose and third dose will help protect those at greater risk of developing severe COVID-19. But all COVID-19 vaccines still provide very high protection against severe illness, including hospitalization and death.

Who needs a third dose?

A third dose is for people who are immunocompromised and may not have built up adequate protective immunity with their first series of mRNA (Pfizer or Moderna) vaccines.

• Immunocompromised people can receive their third dose at least 28 days after receiving their second dose of the Pfizer or Moderna vaccine.
• Currently, there is no additional dose authorized for the Johnson & Johnson vaccine.

“If you are immunocompromised and received the Johnson & Johnson vaccine, please be patient,” urged Dr. Thomas. The CDC does not have enough data to recommend an additional dose of Johnson & Johnson for immunocompromised individuals who received the Johnson & Johnson vaccine.

Dr. Thomas continued, “If you are in a high-risk group, immunocompromised and completed an mRNA vaccination series, you only need one additional shot.” This means if you were fully vaccinated with either Pfizer or Moderna, you should get the third dose of the same vaccine at least 28 days after your second dose.

Who needs a booster dose?

A booster dose is strongly recommended for people whose immunity may be fading six months after completing their second Pfizer vaccination and are in one of these groups:

• People 65 years and older.
• People ages 50-64 with underlying medical conditions.

People ages 18-64, who either have underlying conditions or who are at risk of increased exposure or transmission because of where they work or live, also have the option of receiving a booster dose if they want one. As Director Banks explained, this recommendation “includes people who have been working throughout the pandemic to care for vulnerable populations, and keep society functioning.”

Recognizing that systemic inequities increase risk of severe illness, the Western States Scientific Safety Review Workgroup also recommends social determinants of health be included in assessment of medical conditions.

If you are in a high-risk group, but not immunocompromised, and it hasn’t been at least six months since completing your Pfizer vaccine, “You are still very well protected,” said Dr. Thomas. “Please wait the six months to get the Pfizer dose, so that the first people to complete their Pfizer vaccination series back in December 2020 and January of this year — our residents in long-term care facilities and other adults over age 65 — can get their booster doses now.”

Dr. Thomas explained that more data is needed before the federal government can make recommendations about booster doses for the Moderna and Johnson & Johnson vaccines, or third doses for the Johnson & Johnson vaccine.

Make a plan to get vaccinated

Director Banks and Dr. Thomas encouraged everyone who can get vaccinated against COVID-19, to do so today. There is enough vaccine in Oregon to get vaccinated for:

• Your first COVID-19 vaccination series for any of the COVID-19 vaccines,
• The Pfizer booster dose for high-risk groups, or
• The Pfizer or Moderna third dose for immunocompromised individuals.

Vaccines are safe and the most effective way to protect us against serious illness and hospitalizations due to COVID-19. Find more information and a vaccine site near you today by visiting our Find a COVID-19 Vaccine in Oregon web page.

Watch the video of today’s Facebook Live to get answers to your questions about booster doses and third doses.