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‘Critically Important’ COVID-19 Boosters Available as BA.2 Becomes Dominant Strain

Close up of a woman's arm with a bright green bandaid on her upper arm
Only one-third of vaccinated Mississippians have received a booster dose, even as the Centers for Disease Control and Prevention now recommend a second booster for qualifying individuals. State health leadership urged residents to get their booster shots in the face of waning efficacy and a new dominant strain in the state. Photo courtesy Centers for Disease Control and Prevention.

The past two years have consisted of a race—one between the still-evolving COVID-19 virus now infecting more than 1 million people every day on average across the globe and authorities trying to vaccinate their populace against the disease.

At least 6 million people worldwide have lost their lives to the virus, and health authorities have reported more than 500 million infections. Up to one-third of those even mild infections leave their host with what is now known as long COVID—a syndrome presenting with a multitude of symptoms like chronic fatigue or depression, due to lingering cellular damage from the virus.

Getting vaccinated helps prevent long COVID.

In Mississippi, just over half the population have received their initial two-dose vaccinations from Pfizer or Moderna, or one shot from Johnson & Johnson. Fatalities among the fully vaccinated comprise just 1.5% of the 12,414 COVID-19 deaths across the state, the Mississippi State Department of Health reported.

The majority of Mississippi’s COVID-19 deaths are among the unvaccinated, with the second-largest category consisting of those who received their initial doses and qualified for yet did not receive a booster.

Efficacy against COVID-19 wanes over time, however. Over one-and-a-half million Mississippians received their initial vaccine doses, but fewer than 600,000 have received a third shot, called a booster.

‘Critically Important’

In October 2021, the Centers for Disease Control and Prevention recommended a booster shot for those over age 65, as well as immunocompromised individuals 18 or older. Six months later, even those who received their initial booster shot may now be in need of an additional booster.

On March 29, 2022, the CDC introduced a new guidance recommending a second booster, for a total of four shots, available for those 50 or older and at least four months out from their last vaccine dose.

“This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time,” CDC Director Dr. Rochelle P. Walensky said in a statement.

Qualification varies based on vaccine, however.

Pfizer’s second booster is available for those 12 and up with compromised immune systems. Moderna’s vaccine is available for immunocompromised people 18 and older. Adults who received a Johnson & Johnson booster dose may also receive a second booster of either mRNA vaccine, as long as they wait four months after their last dose.

Mississippi’s State Health Officer Dr. Thomas Dobbs urged qualifying residents to consider a second booster, but also noted the importance of boosters overall.

“If you’re four months out from your first booster, be thinking about a second booster,” State Health Officer Thomas Dobbs said in an April 8 press briefing with the Mississippi State Medical Association. “Two-thirds of people haven’t had their first booster, yet, so it’s critically important.”

For older Mississippians, vaccination provides a seven- to nine-fold increased reduction in risk of death. Only 40% of Mississippians between the ages of 50 and 64 have received booster doses.

Vaccines are freely available throughout the state through MSDH, as well as pharmacies and other health providers.

Omicron BA.2 Becomes Dominant Strain

As the world’s strategy against COVID-19 evolves, so does the virus itself. The omicron variant dubbed BA.2 now comprises more than 90% of new cases in some areas of the United States, with some states also seeing increases in cases.

The new variant spreads faster than omicron BA.1 and resists the monoclonal antibody treatment sotrovimab, though other treatments are still effective.

About 60% of new cases in Mississippi consist of the new BA.2 variant, with MSDH surveillance data suggesting that percentage will increase over time.

“We’re trending up,” State Epidemiologist Dr. Paul Byers said. “We’re definitely seeing that now it’s the predominant sub-areas in Mississippi.

Byers noted that vaccine efficacy remains consistent against both the old and new omicron strains.

“The real protective effect of the vaccines is preventing hospitalizations and deaths, and the mRNA vaccines are still very good at that,” Byers said.

Byers noted that those infected with BA.1 may still later get infected with BA.2.

“Certainly reinfections do occur over time, and certainly the longer you get from that vaccine or that infection, your immunity will wane,” Byers said. “It’s dependent upon the person and what their original response was, and even the severity of their illness and how up-to-date they are with their vaccines, if they’ve kept up-to-date with their booster and now the second booster.”

Cases and deaths in Mississippi remain low, with MSDH reporting just 199 cases and one death from April 8 to April 11. Across the nation, however, states are seeing increases in cases.

“We’re trying to read all the tea leaves and watch all the signs for potential increases,” Byers said. “We do need to be prepared though that whether it’s sooner or later, we will see more cases at some point.

“We’re in probably a better position right now than we’ve been really at any time during the pandemic previously,” he added.

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