We have received a supply of frozen Moderna vaccine sufficient to offer booster shots to all of our members. This is great news.
We do need to follow the CDC guidelines (COVID-19 Vaccine Booster Shots | CDC) for giving boosters, which start with urging everyone over 65 and as well as anyone 50-64 with underlying medical conditions (People with Certain Medical Conditions | CDC) to get the booster. Also anyone 18-49 with those underlying conditions may get a booster. And people with unusual risks and occupational exposures and those in close contact with those at high risk. All of these boosters are presumed to be at least 6 months out from their last vaccine dose, except that for Johnson & Johnson recipients the timing is at least 2 months.
We expect the criteria for boosters to be progressively expanded over the next month by the CDC so that if we follow a brisk but orderly pace consistent with CDC priorities we should still be able to get everyone in the practice immunized by mid-December, certainly before Christmas. Please remember this is not a crisis. All the vaccines remain effective against severe disease, and you still must mask and be cautious in any indoor venue with other than family in your circle of safety. But it is also true that the booster will substantially increase your protection (especially that of the older population) and make it more durable.
As to which booster, the CDC clearly says the Moderna vaccine that we have in hand can be used as booster for any of the vaccines used for primary vaccination: Pfizer, Moderna, or Johnson & Johnson.
No blood tests (such as spike antibody levels) are indicated before getting the booster (nor afterward). We cannot currently determine your level of disease protection from the spike antibody level, for example, and in addition there is no crosswalk between the tests from Quest or LabCorp or other labs. The exception is in severely immunocompromised patients, when we have sometimes found no antibody developing after several vaccine doses. This is a serious concern for those patients (and us), but not for the overwhelming majority of our patients with pretty normal immune systems. Fortunately, in the near future (see Oral Drug Therapy and Antibody Prevention for Covid-19 Coming Soon) we will be able to treat those people with antibody injections every six months in lieu of vaccination.
Booster clinic practicalities
- We will administer the booster shots at our offices on Mondays and Fridays starting this coming Monday, November 8, followed by Friday, November 12. We will open up each subsequent week as the initial clinics are fully subscribed.
- Moderna vaccine comes frozen in 7.5 mL vials that each may provide 28-30 booster doses of 0.25 mL. We plan to administer each vial’s 28 shots in a single 2-hour clinic session (six 20-minute time slots each for 5 people).
- Monday clinics will have 2 sessions. The first from 10 a.m. to noon, and the second session from noon till 2 p.m.
- Fridays will have only the noon to 2 p.m. session.
- We will be using the flu clinic suite across the hall from our office where there is ample room for people to stay separate, get their shot, and stay for observation for the required 15 minutes. As you know, there is no charge to you for the boosters.
Scheduling your booster on our website
You schedule your booster appointment on our website as you did for our influenza clinics this year and last. There is a link on the front page (Orchard Health Care) of our website that says Schedule Your Covid Booster and which takes you to the online schedule tool. You select an available day and then choose a time block within either the morning or afternoon session. When the time block is full you will not be able to choose it. You need to enter name and email. You’ll receive a confirming email and we will be notified.
If you are uncomfortable using the online schedule or for some reason it is not functioning properly, please email what session you want to attend to adminOHC@orchardhealthcare.com or just call the office.
Filling up each clinic
We must strive not to waste vaccine. Unused vaccine cannot be carried over to the next day. That means we really need to fill up the 28-30 people for each 2-hour session.
To help achieve this goal, we are therefore only opening up the vaccine clinic schedule one week at a time, starting with Monday, November 8 and Friday, November 12. That accommodates about 90 members. As soon as we see those clinic schedules filled on the website, we will open the following week.
Since we have about 240 members over 65, we don’t expect difficulty filling up the clinics within CDC guidelines when we plan 90 shots weekly. If every OHC member chose to get the booster with us, we’d be done in just six weeks.
If you get your booster elsewhere
We also recognize that some members have already gotten their boosters, and that for some of you going to a local CVS or Walgreens will be more convenient. In that case kindly email to email@example.com and let the staff know which booster you got and when so we can note it in your record.
Standby booster appointments
As a safeguard to cancellations and no-shows that might waste opened vaccine, we want to organize a standby or “backup crew” for each vaccine session. For this purpose, anyone in OHC can offer their name for a specific session by emailing to adminOHC@orchardhealthcare.com. You would then be “on call” to come to that particular session to get the booster dose if a scheduled patient did not show up. We likely will offer first to those older patients who meet the CDC criteria of the moment, but the final priority will be not to waste vaccine. In that way we should be able to fully subscribe each clinic.