State and local health officials are girding not just for more vaccine hesitancy, but for possible fights over vaccine mandates in schools.
“I think the contention we have seen over the mask issue is likely to pale in comparison to what we’re going to see over the idea of a vaccine mandate” for school children, Dr. Jessica Snowden, chief of the infectious disease division at Arkansas Children’s Hospital, said. At a meeting this week of the F.D.A.’s expert advisory panel on vaccines, several members came out strongly against school vaccine mandates.
What to Know About Covid-19 Booster Shots
The F.D.A. has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
A C.D.C. study suggests that 42 percent of children aged 5 to 11 have coronavirus antibodies from prior infection, prompting some F.D.A. advisers to ask if one dose would be sufficient for children. Use of that study has been questioned by some scientists. F.D.A. panelists also asked whether only those with high-risk medical conditions, such as obesity, should get the vaccine, since it is clear they are most vulnerable to getting very ill with Covid-19.
But C.D.C. officials said it would be hard to narrow eligibility, and the F.D.A.’s advisory panel endorsed offering the pediatric dose to the entire age group by a 17-0 vote, with one abstention.
Dr. Snowden said the Delta variant wiped out any notion that children are impervious to the virus. At the height of the most recent surge, she said, the Arkansas Children’s Hospital was treating as many as 30 children a day for Covid, including some with fully vaccinated parents. While that number has shrunk, “it is still not back to where we were before Delta,” she said.
Much of the burden of the rollout of children’s shots is expected to fall on pediatricians and family physicians, many of whom are strained by staffing shortages and pent-up demand for care at this point in the pandemic but have deep relationships with parents and children. Dr. Sterling Ransone, the president of the American Academy of Family Physicians and a physician in rural Deltaville, Va., said that he would keep his office open later on weekdays and on Saturdays to accommodate demand for pediatric shots.
“We know who to prioritize — asthmatics, those with heart disease, people who are obese,” he said.
Dr. Victor Peralta, a pediatrician in the racially diverse neighborhood of Jackson Heights, Queens, said uptake might be a bit slower at first among his patients, most of whom are poor enough to have Medicaid coverage. But he predicted the pediatric dose would catch on and ultimately help slow transmission of the virus. “I have no doubt that this will make a difference beyond just the worried well,” he said.