COVID Vaccine and Treatment Information

There are three COVID-19 vaccines currently available in the US:

• Pfizer-BioNTech or Moderna COVID-19 mRNA vaccines are preferred.
• You may get Johnson & Johnson’s Janssen COVID-19 vaccine in some situations – it is significantly less effective than Pfizer and Moderna vaccines and is no longer recommended as first-line vaccine.

The Pfizer vaccine is given in two shots, three weeks apart. A 3rd dose 1 month later is recommended for certain immunocompromised individuals.^*

The Moderna vaccine is given in two shots, four weeks apart. A 3rd dose 1 month later is recommended for certain immunocompromised individuals.^*

The Johnson & Johnson (Janssen) vaccine is given as a single dose shot, with a booster to be administered 2 months later (the booster may be either a second J&J vaccine or one of the mRNA vaccines).

^*Individuals who should get a 3rd dose of mRNA (Pfizer or Moderna) vaccine:

For moderately to severely immunocompromised people, the CDC is now recommending a 3-dose mRNA vaccine schedule (Moderna or Pfizer). The third dose should be given 1 month after completing the initial 2 doses (or as soon as possible, if it has been longer than 1 month since completing the original 2-dose series).

Specifically, this includes people who:

• Are receiving active cancer treatment for cancer
• Received an organ transplant and are taking medicine to suppress the immune system
• Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
• Have moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Have advanced or untreated HIV infection
• Are receiving active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

The CDC has also approved a “booster” dose of COVID vaccine for the following:

• Anyone who received two shots of either Pfizer-BioNTech or Moderna COVID-19 vaccine at least 6 months ago, AND meets any of the following criteria:
  • Age 65 or older
  • Age 18+ and living in long-term care setting
  • Age 18+ with an underlying medical condition (e.g., diabetes, obesity, moderate to severe asthma or COPD or other lung disease, heart disease, chronic liver or kidney disease)
  • Age 18+ and at increased risk for COVID-19 exposure and transmission because of occupational (e.g., medical personnel, first responders, etc.) or institutional setting (e.g., prison)
• Anyone 18+ who got the Johnson & Johnson COVID-19 vaccine at least 2 months ago

Yes. The CDC advises a “booster” dose of COVID vaccine for the following:

• Anyone age 18 and older who received two shots of either Pfizer-BioNTech or Moderna COVID-19 vaccine at least 6 months ago
• Anyone age 18 and older who got the Johnson & Johnson COVID-19 vaccine at least 2 months ago

For more information about these updated recommendations, please see the CDC website.

Protective antibodies that our bodies produce in response to vaccination wane over time. As a result, the CDC is recommending a “booster” dose of COVID vaccine for:

• Anyone age 18 and over who received two shots of either Pfizer-BioNTech or Moderna COVID-19 vaccine at least 6 months ago
• Anyone age 18 and over who got the Johnson & Johnson COVID-19 vaccine at least 2 months ago

Clinical trials continue to monitor vaccine efficacy over time.

Some immunocompromised people may not mount as robust an immune response to the vaccine and should receive a 3rd shot of mRNA (Pfizer or Moderna) vaccine 1 month after completing the 2nd dose, then get a “booster” shot 6 months later.

Yes. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.

Preliminary evidence suggests that mixing two Covid vaccine types produces a stronger immune response than matching the booster to the initial vaccine. Booster doses of an mRNA vaccine (Pfizer-BioNTech or Moderna) seem to raise antibody levels higher than a booster dose of the Johnson & Johnson vaccine.

According to FDA data:

• The Pfizer and the Moderna vaccines are about 95% effective in preventing severe infection and death due to COVID-19 after both doses are received. Over time and as new variants emerge, the efficacy of these vaccines against symptomatic infection declines, though protection against severe disease remains strong (~90% for Pfizer vaccine, 96% for Moderna vaccine). For people at high risk due to age, underlying health conditions, or exposures due to work or living conditions, vaccine boosters are recommended six months after completing the initial vaccine series
• In clinical trials, the Janssen/Johnson & Johnson vaccine was 72% effective at preventing moderate-to-severe COVID-19 in the U.S., and 66% effective at preventing moderate-to-severe COVID-19 overall. Due to declining efficacy over time (and against new COVID variants), ALL people who receive the J&J vaccine are now advised to have a booster (with 2nd J&J vaccine or with one of the mRNA vaccines) two months after receiving their initial J&J shot.

Yes. When you schedule your vaccine appointment, you can find out which vaccine is being offered at that location.

People who are fully vaccinated are much less likely to get infected with COVID, and therefore less likely to transmit infection to others. However:

• Protection from the vaccine doesn’t kick in immediately. Both doses of the vaccine are required, and it may take up to 2 weeks after the second dose to get to maximal immunity.
• Vaccine efficacy declines over time, so if you are eligible for a booster dose, it is important to get one in order to bolster your immunity against infection.
• Breakthrough infections can happen despite vaccination. While COVID infection tends to be much less severe in people who are vaccinated, the virus can be spread to others.

This is why it’s important that even after getting vaccinated, you continue to wear a mask and practice good hand hygiene.

Research is ongoing to find new, safe and effective treatments for COVID-19.

Available treatments include (as of 12/5/21):

• Remdesivir (Veklury): an antiviral medication that can be administered intravenously (IV) to patients whose symptoms are severe enough to require hospitalization
• Monoclonal antibody (mAb) infusions: laboratory-made antibodies given intravenously (IV) to help fight COVID-19 infection and reduce risk of severe disease and hospitalization; examples include Regeneron, Sotrovimab, Bamlanivimab + etesevimab

These infusions are approved for:

• Treatment of patients who have a positive COVID-19 test within the past 10 days and have not yet been admitted to the hospital and are age 12 or older (and at least 40 kg) and are at high risk for developing severe COVID-19 due to one of the following risk factors:
  • age 65 or older
  • Overweight (body mass index over 25)
  • Pregnancy
  • Chronic kidney disease
  • Diabetes (type 1 and type 2)
  • Weakened immune system or are currently receiving immunosuppressive treatment
  • Cardiovascular disease/hypertension
  • Chronic lung disease
  • Sickle cell disease
  • Neurodevelopmental disorders
  • Medical-related technological dependence
• Post-exposure prophylaxis (prevention) with monoclonal antibody infusions for COVID-19 in anyone who:
  • has had close exposure to COVID-19, and
  • is age 12 or older (weighing at least 40 kg), and
  • is at high risk for progression to severe COVID-19 due to one of the above risk factors, and
  • is not fully vaccinated, or is vaccinated but immunocompromised

Other medications and treatment protocols for hospitalized patients depend on the severity of illness, underlying medical conditions and comorbidities at the time of hospitalization.

Multiple new treatments are being developed and evaluated.

While there has been much press coverage of medications such as Plaquenil (hydroxychloroquine) and ivermectin, these are NOT recommended at this time for treatment or prophylaxis against COVID-19.