The first batch of COVID-19 booster shots that target the Omicron subvariants still widely circulating are now available in doctors’ offices and pharmacies in Massachusetts and across the country.
The Centers for Disease Control and Prevention late Thursday recommended the new Pfizer-BioNTech and Moderna boosters this fall as the BA.4 and BA.5 subvariants continue to cause tens of thousands of infections and hundreds of deaths daily across the country.
The Massachusetts Department of Public Health said the first vaccine shipments from Pfizer and Moderna arrived Friday and will continue to be delivered over the coming days. They will be available at many locations, the department said, including those where people received previous vaccines, such as doctors’ offices, hospitals, pharmacies, and community health centers. Appointments at pharmacy chains, including CVS and Walgreens, are also available online.
How eager people are to receive the rejiggered booster, however, remains to be seen — especially when it comes to the youngest now eligible for the shots. Federal regulators have approved the new Pfizer booster for adolescents as young as 12; recipients of the Moderna booster must be 18 or older.
Dr. Lloyd Fisher, a Worcester pediatrician and former president of the Massachusetts chapter of the American Academy of Pediatricians, said he hasn’t yet gotten many calls from people seeking the new booster for their children.
“Some are asking but the phones aren’t overwhelmed,” said Fisher.
He and other doctors said interest may pick up after Labor Day weekend passes, with families back to school and more people returning to work. Another possible catalyst: the cooler weather also makes transmission indoors more likely.
For people who received a booster shot recently, the FDA says they could get the new Omicron shot as soon as two months after, although some scientists say that waiting longer between shots may help bolster the immune response.
For Fisher, the priority continues to be ensuring that children have received the primary series of vaccines, which are very effective at preventing severe illness if they become infected with an Omicron subvariant.
“That is definitely the biggest focus at this point,” Fisher said. “We know the primary series is safe and effective at reducing severe illness, so we want to increase the uptake on the primary series.”
He has succeeded in persuading parents to let their teenagers receive two shots of the Pfizer or Moderna vaccines and, in some cases, the original boosters as well, he said. But it’s been much harder persuading parents of kids under 12.
While Massachusetts claims one of the highest percentage of residents vaccinated against COVID, the number of those still eschewing the shots is considerable. CDC data show roughly 67 percent of Americans are fully vaccinated with their primary COVID shots, but in Massachusetts that figure is 78 percent.
The percentages decline significantly when it comes to boosters. Nationally, just 49 percent have received at least one booster shot; in Massachusetts it’s 59 percent. And it drops sharply among the youngest ranks. Just 38 percent of adolescents, aged 12-15 have received a booster in Massachusetts, state data show.
Dr. Shannon Scott-Vernaglia, a pediatrician at Mass General Hospital for Children, said the vast majority of patients in her practice got the primary series of shots, but there was less interest in getting the boosters.
Recently, she said, many parents appeared to be holding off arranging booster shots for adolescents because they wanted regulators to authorize the updated shots for the Omicron strains.
“In the last few weeks, we’ve been playing a bit of a waiting game,” she said. “Families are trying desperately to figure out what the perfect timing is, and it’s hard to know.”
She plans to enthusiastically recommend the new boosters, which she expects will arrive at her office sometime this week. Although patients who receive the primary series of vaccines are well protected from serious illness caused by the Omicron strains, she said, even a mild infection can force teenagers to isolate themselves for several days and have a significant impact on their education and families.
Dr. Armando Paez chief of the division of infectious diseases at Baystate Health in Springfield, cares for patients with HIV and other chronic health issues, and he said many have been glued to the Internet following every development and eagerly anticipating the new booster shots.
“These patients, who are at high risk [of serious complications from COVID], those are the ones who will be rushing in,” he said.
At Atrius Health, the state’s largest independent physician group with more than 30 locations in Eastern Massachusetts, many patients have recently been calling to ask about the shots, said Dr. Jane Fogg, executive chair of internal medicine.
“We are not hearing the initial concerns about adverse reactions as we did with the vaccines originally,” Fogg said. “It’s no longer much of an issue.”
Much of the information submitted to federal regulators by Pfizer and Moderna for their new boosters relied on mouse data because human trials are still ongoing. This concerned members of a CDC expert advisory panel that reviewed the rejiggered boosters on Thursday. But the committee ultimately voted 13 to 1 in favor of recommending the new boosters, suggesting that waiting for human trial data could lead to more hospitalizations and deaths from the virus.
“Anybody who has been skeptical [of the vaccines] will be more skeptical, but despite this, it’s a routine way of doing the data and the science and that has to be clearly communicated as we are rolling out the shots,” said Dr. Katherine Gergen Barnett, vice chair of primary care innovation and transformation in family medicine at Boston Medical Center.
Barnett and others noted that the annual flu vaccine is often updated relying solely on animal data.
Dr. Daniel Horn, a primary care physician at MGH who treats adults, said he detects a strong interest for the new booster among his patients. But they have generally been eager to be vaccinated; many have received the two primary shots and two boosters.
“Arguably those are the patients that will benefit the least because it will be their fourth or fifth shot,” said Horn, director of population health and quality at MGH.
He’s more concerned about patients who still haven’t gotten the primary shots, and he hopes the rollout of the new boosters doesn’t overshadow the urgency to get those people inoculated.
“Ultimately, it will be a good thing that we have an updated bivalent booster,” he said. “But our greatest health benefit would be to continue working really hard to help those who have chosen not to get vaccinated yet to get their primary series.”
Barnett, from Boston Medical Center, put it this way: “We need to continue to work on a layered approach, reminding patients that a booster is an important part of our tool kit going into the fall, but so are ensuring adequate ventilation and ensuring people have good masks available.” She added, “We also need to have free testing available for communities, even though funding has dried up.”