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Louisville doctors discuss new COVID-19 boosters

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Marty Osborn
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The U.S. Food and Drug Administration approved new COVID-19 boosters that target the omicron BA.4 and BA.5 strains Wednesday.

The Moderna vaccine received emergency use authorization for people 18 and older. Pfizer was approved for people 12 and older.

The updated shots – which contain part of the original vaccine – are expected to be available after final approval from the Centers for Disease Control and Prevention.

Since March, second boosters of the original vaccine have been available to people 50 and older or who are immunocompromised.

Health officials say there should be at least two months between previous shots to get the new booster. It’s meant to offer better protection against the omicron strains most common in the U.S. and Kentucky. But Dr. Kristina Bryant, a pediatric infectious diseases specialist with Norton Healthcare, said it won’t replace the need for the primary vaccine series.

“People who have never had a COVID shot still need to receive the original COVID vaccine before they are eligible for the new bivalent booster,” she said.

Bryant said people currently eligible for second boosters — those who are 50 and above or immunocompromised — should not ignore the chance for more protection.

“I think COVID-19 continues to circulate,” she said. It continues to cause severe disease in some people, and it’s often difficult to predict who is going to develop severe disease.”

Dr. Chuck Anderson, chief medical officer at Baptist Health Louisville, said “immunocompromised” includes more people than just those who have diabetes, cancer or HIV. It can also mean people who are on treatments for conditions like eczema or psoriatic arthritis.

“If you have risk of getting infection from the therapy, that’s immunosuppressive,” he said. “If you’re on any medicine that increases your risk of getting an infection, then your overall status is immunosuppressed.”

Analysis by the New York Times shows Kentucky among the leading states and territories for COVID spread in recent weeks. As of Wednesday, Kentucky had an average of 51 cases per 100,000 residents over the past seven days, behind American Samoa and Puerto Rico.

The Kentucky Department for Public Health shows around 75% of counties in the highest tier for spread, according to the Centers for Disease Control and Prevention community model.

But the department reports only 58% of Kentucky’s total population has been fully vaccinated, with 27% having received boosters or additional doses beyond the primary series.

Researchers at University of Louisville’s Christina Lee Brown Envirome Institute have been testing wastewater for COVID in Jefferson County since 2020. The most recent results from last week show the omicron BA.5 variant found in 66% to 94% of samples, depending on location. BA.4 was found in up to a third of samples.

Anderson said Tuesday, ahead of the FDA approval on new booster formulas, that people who haven’t had BA.4 or BA.5 are “going to get more protection” with the new vaccine.

He said the virus can affect people differently, so it’s important to be as protected as possible. He said he’s talked with people who report it being like a summer cold, while others have “been incapacitated for two weeks” or still have long COVID symptoms.

Since the start of the pandemic, cases have ebbed and flowed, with surges occurring in both warmer and cooler months.

Dr. Mark Burns, infectious diseases specialist with U of L Health, said behavioral changes in fall and winter can make conditions more favorable for viruses to spread. This includes people being indoors more often, and children starting school.

Viruses also survive better in colder weather, he said.

“It is a true recipe for potential spikes,” he said.

Being fully vaccinated and boosted can help prevent severe disease, but Burns said for people in areas with high spread of infection, like Kentucky, more precautions are needed.

“The best thing to do is continue the public health mitigating measures that have gotten us this far – the hand-washing, social distancing, [making] sure we’re in [well] ventilated rooms,” he said.

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