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Third COVID vaccine: Booster shots outpacing first and second shots

About 2½ years ago, Carroll Township resident Rick Puskar was diagnosed with multiple myeloma, a blood cancer, and amyloidosis.

Though his will and determination are strong, the cancer, amyloidosis, and treatments have weakened his immune system, leaving Puskar among the most at risk for a poor outcome if he becomes infected with COVID-19.

“If I were to get COVID, it could be catastrophic,” said Puskar, 56, a retired senior vice president for Schneider Electric who was a standout basketball player at Laurel Highlands High School and Waynesburg College during the 1980s.

Puskar received his first and second doses of the Moderna COVID-19 vaccine in January and February. And when the Food and Drug Administration in August approved a third dose of Pfizer or Moderna for some immunocompromised people, Puskar’s oncologist contacted him and advised him to “get it immediately.”

“I was very relieved to get the booster shot,” said Puskar, who got the booster at Span & Taylor Drug Co. in Monongahela in early September. “I had a little bit of a headache the next day, but that was it. It was simple and easy.”

A growing body of research shows that antibodies wane six months after COVID-19 vaccination, but that a third dose of the vaccine – given six months after the initial two doses – can provide greater protection for some against the virus, including variants.

Right now, booster doses are recommended for people 65 and older, those ages 50 to 64 with underlying medical conditions and those 18 or older with conditions that put them at high risk of severe COVID-19.

Also eligible are people 18 or older who work a job that puts them at increased risk of COVID-19 exposure, such as health care workers, teachers, grocery store workers and people who work in prisons or homeless shelters.

“We are absolutely recommending the booster,” said Dr. Arpit Mehta, director of pharmacy at Allegheny General Hospital. “If the opportunity arises and doses are available, I highly recommend getting it, for the safety of yourself and the protection of your family.”

At both Allegheny Health Network and Washington Health System, the demand for boosters has outpaced the demand for first and second shots.

“We are definitely seeing demand for the booster, more than the first and second doses. The majority of our administrations are booster,” said Mehta.

AHN had given nearly 8,000 booster doses as of Monday at its clinics, and is offering separate clinics for employees.

Since WHS reopened its vaccine clinics two weeks ago, nearly 2,600 shots have been administered.

More than 95% of those shots were third dose booster, and more than 800 of the shots were given to WHS employees, according to the hospital system.

According to the CDC, 6.7 million vaccines were administered between Sept. 30 and Oct. 6. Of those, nearly 2.7 million were booster shots. About 2 million were first doses and nearly 2 million were second doses.

Mehta said the side effects from booster shots are similar to those from first and second doses.

“We’re not seeing any extreme side effects. It’s safe to take, and people are tolerating it well,” said Mehta.

AHN and WHS experts both noted that it’s still important for those who aren’t vaccinated at all to get the COVID-19 vaccine.

The more people that get vaccinated, the less the virus spreads, the less chance of variants, and the better protected everyone will be, Mehta said.

And Pennsylvania data released late last week illustrate that vaccination still keeps people out of hospitals and reduces risk of death, even amid the delta variant.

Last week, the state Department of Health reported that in the past month, 74% of hospitalizations due to COVID-19 were among unvaccinated Pennsylvanians, and about the same percentage of people who tested positive for COVID were not vaccinated.

Since Jan. 1, 93% of COVID-related deaths were in unvaccinated or not fully vaccinated people.

“What is completely clear to me is that vaccines are working as intended to help keep more people out of the hospital and alive after COVID-19,” DOH Acting Physician General Dr. Denise Johnson said late last week. “Because I know it can save their lives, I have encouraged all of my family, friends and others to get vaccinated and, when they are eligible, to get a booster dose.”

For Puskar, the booster shot provides the best chance of fighting COVID-19 while he fights the other diseases he is dealing with.

Chemotherapy and a stem cell transplant have helped slow progression of his diseases.

But Puskar recently returned home from a nine-day hospital stay following pneumonia, and it’s critical for him to avoid getting sick.

“The booster definitely gives me peace of mind,” said Puskar. “I’m really happy I was able to get it.”

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Mon Valley Hospital joins Penn Highlands Healthcare

Monongahela Valley Hospital has officially joined Penn Highlands Healthcare.

The move became effective Oct. 1 following recent regulatory reviews and proposals. Terms of the deal were not disclosed.

The 200-bed nonprofit community hospital will now be called Penn Highlands Mon Valley. It becomes the seventh hospital in the Penn Highlands Healthcare system and the first in Southwestern Pennsylvania.

The new partnership will preserve local jobs and allow Mon Valley to attract and retain physicians.

“It’s a new era for health care in Washington County and the surrounding region,” said R. Caryln Belczyk, chairman of the Mon Valley Hospital Board of Trustees. “We are extremely pleased that our health system is partnering with Penn Highlands Healthcare to maintain and expand our programs and services. I am confident that this new affiliation will also enable our health system to attract and retain high-quality physicians and staff.”

Penn Highlands Healthcare, which was established Sept. 30, 2011, is based in Dubois. Its other hospitals are: Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois, Penn Highlands Elk, Penn Highlands Huntingdon and Penn Highlands Tyrone.

The health care system also runs a home care agency, two long-term care facilities and a senior residential living facility. Penn Highlands Healthcare employs about 4,700 people at 120 locations in 13 counties in North Central/Western Pennsylvania.

A definitive agreement was signed in June by the boards of directors of the health care organization and the hospital.

“We are excited to expand our services into Southwestern Pennsylvania,” said Steven M. Fontaine, chief executive officer of Penn Highlands Healthcare. “Monongahela Valley Hospital has a reputation for providing high quality health care. This partnership will enable the people in the region to continue receiving the care they depend on and provide them with access to more physicians in additional specialties through Penn Highlands Healthcare.”

Mon Valley Hospital has a 225-member staff representing more than 40 specialties. The hospital, which resulted from the consolidation of Charleroi-Monessen Hospital and Memorial Hospital of Monongahela, was dedicated in September 1978.

In addition to the hospital, the heath system includes a skilled nursing home, assisted living facility, outpatient rehabilitation and medical imaging services, a durable medical equipment provider, ambulatory surgery centers, a physician hospital organization and physician practice management services.

“Monongahela Valley Hospital’s affiliation with Penn Highlands Healthcare will allow us to enhance services, leverage PHH’s innovation and clinical expertise, advance quality initiatives and continue our long-standing commitment to provide superior compassionate care to patients throughout the region,” said Louis J. Panza Jr., president and CEO of Mon Valley Hospital. “Monongahela Valley Hospital is proud to now be Penn Highlands Mon Valley.”

Next on FDA's agenda: Booster shots of Moderna, J&J vaccines

WASHINGTON – With many Americans who got Pfizer vaccinations already rolling up their sleeves for a booster shot, millions of others who received the Moderna or Johnson & Johnson vaccine wait anxiously to learn when it’s their turn.

Federal regulators begin tackling that question this week.

On Thursday and Friday, the Food and Drug Administration convenes its independent advisers for the first stage in the process of deciding whether extra doses of the two vaccines should be dispensed and, if so, who should get them and when. The final go-ahead is not expected for at least another week.

After the FDA advisers give their recommendation, the agency itself will make a decision on whether to authorize boosters. Then next week, a panel convened by the Centers for Disease Control and Prevention will offer more specifics on who should get them. Its decision is subject to approval by the CDC director.

The process is meant to bolster public confidence in the vaccines. But it has already led to conflicts among experts and agencies – and documents the FDA released Tuesday suggest this week’s decisions will be equally difficult.

In one earlier vaccine dispute, the CDC’s advisory panel last month backed Pfizer boosters at the six-month point for older Americans, nursing home residents and people with underlying health problems. But CDC Director Dr. Rochelle Walensky overruled her advisers and decided boosters should also be offered to those with high-risk jobs such as teachers and health care workers, adding tens of millions more Americans to the list.

Some health experts fear the back-and-forth deliberations are muddling the public effort to persuade the unvaccinated to get their first shots. They worry that the talk of boosters will lead people to wrongly doubt the effectiveness of the vaccines in the first place.

When the FDA’s panel meets to review the Moderna and J&J vaccines, experts will discuss whether a third Moderna shot should contain just half the original dose and what’s the best timing for a second shot of the single-dose J&J vaccine.

The panel will also look into the safety and effectiveness of mixing-and-matching different brands of vaccine, something regulators have not endorsed so far.

An estimated 103 million Americans are fully vaccinated with Pfizer’s formula, 69 million with Moderna’s and 15 million with J&J’s, according to the CDC. Regulators took up the question of Pfizer boosters first because the company submitted its data ahead of the other vaccine makers.

Tim Anderson, a U.S. history teacher at a high school outside Louisville, Kentucky, already had his two Moderna shots months before he came down with COVID-19 in August. While his symptoms hit him “like a sledgehammer,” he is convinced that the inoculation saved him and his girlfriend from the more severe effects of the disease.

The two are now awaiting clearance of a Moderna booster shot.

“Until we can build up enough immunity within our own self and, you know, as a group of humans, I’m willing to do what I need to do,” Anderson, 58, said.

The FDA meetings come as U.S. vaccinations have climbed back above 1 million per day on average, an increase of more than 50% over the past two weeks. The rise has been driven mainly by Pfizer boosters and employer vaccine mandates.

While the FDA and CDC so far have endorsed Pfizer boosters for specific groups only, Biden administration officials, including Dr. Anthony Fauci, have suggested that extra shots will eventually be recommended for most Americans.

In a new review of Moderna’s data, the FDA did not indicate Tuesday if it was leaning toward clearing the company’s booster.

It said vaccines used in the U.S. still provide protection, and it raised questions about some of Moderna’s data.

The two initial Moderna shots contain 100 micrograms of vaccine each. But the drugmaker says 50 micrograms ought to be enough for a booster for healthy people.

A company study of 344 people gave them a 50-microgram shot six months after their second dose, and levels of virus-fighting antibodies jumped. Moderna said the booster even triggered a 42-fold rise in antibodies able to target the extra-contagious delta variant.

Side effects were similar to the fevers and aches that Moderna recipients commonly experience after their second regular shot, the company said.

As for people who got the J&J vaccine, the company submitted data to the FDA for different options: a booster shot at two months or at six months. The company said in its FDA submission that a six-month booster is recommended but that a second dose could be given at two months in some situations.

J&J released data in September showing that a booster given at two months provided 94% protection against moderate-to-severe COVID-19 infection. The company has not disclosed patient data on a six-month booster, but early measures of virus-fighting antibodies suggest it provides even higher protection.

Even without a booster, J&J says, its vaccine remains about 80% effective at preventing COVID-19 hospitalizations in the U.S.

Scientists emphasize that all three vaccines used in the U.S. still offer strong protection against severe disease and death from COVID-19. The issue is how quickly, and how much, protection against milder infection may wane.

In one recent study, researchers compared about 14,000 people who had gotten their first Moderna dose a year ago with 11,000 vaccinated eight months ago. As the delta variant surged in July and August, the more recently vaccinated group had a 36% lower rate of “breakthrough” infections compared with those vaccinated longer ago.