Even With Updated Boosters Complacency a Key Obstacle to Getting Vaccinated By Sunita Sohrabji

As the U.S. faces predicted surges this fall of Covid-19 infections, the Centers for Disease Control and Prevention recently announced its approval of both the Pfizer and Moderna updated boosters.

Designed to combat more infectious and lethal subvariants of the Omicron variant, the updated boosters contain a combination of the original formulation and an additional formulating targeting the BA.5 subvariant, now the dominant version of the virus.

Public health experts predict that the updated boosters will also protect against the emerging BA.4 and BA.2.75 subvariants, which have been detected in other countries and are gaining ground in the US.

Speaking at a Sept. 7 news briefing jointly organized by Ethnic Media Services, California Black Media, and the California Department of Public Health, four doctors who have been on the frontlines of the pandemic hailed the new updated boosters.

Speakers included: Dr. Gil Chávez, Deputy Director in the Center for Infectious Diseases at the California Department of Public Health; Dr. Maggie Park, County Public Health Officer, San Joaquin County Public Health Services; Dr. Oliver Brooks, Chief Medical Officer, Watts Healthcare; and Dr. Eva Smith, Medical Director, K’ima:w Medical Center in rural Hoopa, California.

California has already received 600,000 doses of the new updated booster. Anyone over the age of 12, who has completed the primary two-dose regimen is eligible to receive an updated booster. Those who have received a booster two months prior are also eligible to get the new updated booster. Shots will not be prioritized, as there is adequate supply for all who want them.

“The updated boosters are pulling double duty by increasing immunity against the original coronavirus strains while also protecting against the newer Omicron variants,” said Chavez.

“These vaccines have literally saved millions of lives, helped protect us against the worst outcomes of the virus, and frankly, helped us move on as a community and as a state,” he said.

“I have personally been the beneficiary of the Covid vaccine,” Chavez added, noting that despite being vaccinated and boosted, he nonetheless had an encounter with Covid.

“Thanks to the vaccine, I was able to have a mild illness and recover quickly without any long-lasting effects. My children, my grandchildren, all are vaccinated and boosted. They all have had mild cases of COVID. We are very grateful to this vaccine for really allowing us to continue to be a family and stay healthy,” said Chavez.

The doctor also noted that those who have had Covid should still get an updated booster, as the degree of protection from an infection wanes rapidly over time.

Park countered the myth of the pandemic “being over.”

“This virus is not going away just because we want it to. It is evolving. It is actually becoming more highly transmissible and getting smarter about evading our immunity, whether that’s natural immunity from prior infection or immunity from vaccination. So we have to try to stay a step ahead of it,” she said.

More than 72 percent of California’s population has received the primary series of vaccinations. But less than 59 percent have been boosted. Park noted that in San Joaquin County, less than 49 percent of those who are eligible have received a booster.

Park also countered another myth. “We’re still hearing that shots don’t work. People saying, ‘My friend is fully vaccinated and boosted, but she still got Covid.’”

“And to that I say ‘yes, but is she still alive?’ And yes, of course she is. We never promised that the vaccinations would mean you wouldn’t get Covid. We just said that it would reduce the severity of your disease and your chances for requiring hospitalization,” she said.

Brooks addressed vaccine hesitancy with what he called a “three Cs” approach: vaccine confidence, vaccine complacency, and vaccine convenience. His patients have expressed their hesitancy, saying: “It came out too soon, too fast. Don’t trust the government, don’t trust the pharmaceutical agencies, don’t trust public health care.”

But the doctor noted that the mRNA technology on which the vaccine is based was developed 11 years ago and has been used to treat illnesses prior to Covid.

He addressed convenience, noting that booster shots are available at pharmacies without an appointment, and are free, even for those who lack health insurance. Vaccine complacency, said Brooks, has become the prevailing factor: people see those who are vaccinated and boosted but still getting symptomatic Covid.

The doctor said he was especially concerned about long Covid: people who are unvaccinated are more likely to have symptoms even six months after an initial infection.

“We have a vaccine that is a biotechnological miracle. There’s a miracle in front of you that’s averted 16 million deaths and it’s safe,” said Brooks.

Smith, who runs a clinic on the Hoopa Valley Reservation in Humboldt County, noted that when the vaccine first became available, she was surprised to see elders lining up to get it.

“They wanted it. They didn’t want to die. They were watching on TV what had happened in other native communities with really horrible, horrible death rates,” she said.

Younger and middle-aged people were more resistant to getting vaccinated. So, despite the enthusiasm of elders, the Hoopa community has gone through several Covid spikes.

“We are a small tribal clinic trying to deal with a lot of acute and chronic disease issues. But we’re dealing with complacency. We’re dealing with people being tired, tired of having a shot, tired, honestly, of the inconvenience of ‘I’m going to be sore for a couple of days.’”

“I’m regularly saying I’d rather have mild flu-like symptoms for a day or two then to be sick. I want to live,” said Smith, noting that she has extended family on both coasts and wants to be able to take care of her children and grandchildren.

“And so I’m going to do whatever it takes, whether it’s getting a flu vaccine or getting a couple of different Covid vaccines,” she said.