Like the 1918 Spanish flu pandemic that killed my grandmother at the age of 36, COVID-19 has come at us in waves. One of the key lessons we’ve learned is that this virus will continue to evolve. The Omicron variant that hit us this past winter was more infectious than the original strain that first emerged in Wuhan, China, but caused milder illness. Now, the Omicron subvariant BA.2 is spreading even faster and helping to drive another surge in East Asia and Europe.
BA.2 was first identified in the United States on December 24, 2021, from a sample collected on December 14, 2021, in New Jersey.1 That variant is now believed to represent about half of the positive cases.
But it’s difficult to predict when and how severe the next surge will be. As Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said during a visit to Princeton University this spring, “We’ve been thrown enough curve balls that it’s hard to predict.”2
“Booster shots are our best protection against BA.2 and likely will be for variants that may emerge in the future.”
What we do know is that the vaccine protects against severe disease and death and that keeping up to date with booster shots protects us even more. Booster shots are our best protection against BA.2 and likely will be for variants that may emerge in the future.
On May 19, 2022, the CDC expanded eligibility of COVID-19 vaccine booster doses to everyone 5 years of age and older. CDC now recommends that children ages 5 through 11 years should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series. In addition, the CDC strengthened its recommendation that those 12 and older who are immunocompromised and those 50 and older should receive a second booster dose at least 4 months after their first. While older Americans have the highest coverage of any age group of first booster doses, most older Americans received their last dose (either their primary series or their first booster dose) many months ago, leaving many who are vulnerable without the protection they may need to prevent severe disease, hospitalization and death.3
The COVID-19 vaccination program has been the largest vaccination effort in our state’s history. And, fortunately, New Jersey has one of the best vaccination programs in the nation—17.7 million doses have been administered in our state: 92 percent of the eligible population five years of age and older have received at least one dose; 79 percent have completed their primary vaccination series; and 55 percent have gotten a booster shot.4
But that also means that 2.7 million residents who are eligible for a booster have yet to receive one—including 65 percent of 16-17-year-olds, 58.5 percent of 18-29-year-olds and 41 percent of 60-64-year-olds.4
During a recent visit to the New Jersey Department of Health, CDC Director Dr. Walensky told the Department’s pandemic response team that we have done “incredible work” ensuring equitable access to vaccination in the state. In the past six months, 2.4 million doses of the COVID-19 vaccine were administered in New Jersey through more than 2,400 point of distribution sites (PODS), covering more than 400 municipalities in all 21 counties.4 At the same time, DocGo and our Rapid Mobile Response Team made further outreach into communities and held more than 600 vaccination events.
Our goal from the beginning was for every person in New Jersey to have equal access to a vaccination site within a 15-minute walk (0.67 miles) or a 10-minute drive (5 miles). But we must do even better—especially in communities of color—to not only ensure access but to encourage vaccination. Of those who have gotten a booster shot, only 7.7 percent are African American, and 11.3 percent are Hispanic.4
We must ensure that everyone has access to vaccines and therapeutic treatments by focusing efforts on reaching people who have been disproportionately affected, so that they can be protected from the effects of the virus, which include severe illness, hospitalization and death.
“One of the biggest challenges we face is pandemic fatigue.”
Everyone—including the medical community and the public—has had enough of this unrelenting virus and its emerging variants. With the easing of COVID restrictions and warmer weather, people understandably want to think about summer travel plans—not about getting a booster shot. And we know that the public can be confused by changing recommendations as to who should receive boosters and how often they may be needed. We would all like stability and a guarantee that recommendations won’t change, but unfortunately this is a novel virus. We need to continue to learn and adapt if we are to stay ahead of it.
Getting Out the Message
The New Jersey Department of Health has worked to address vaccine hesitancy and use science-based facts to dispel myths and concerns. We created a vulnerable-populations plan to focus on special populations such as those in psychiatric hospitals, prisons and tribal nations, as well as individuals who are homeless and those with substance use disorders.
Last summer, we also developed a County Ambassador program to help achieve community protection in high-risk municipalities in 11 counties. Ambassadors were deputized by the Department leadership to oversee and orchestrate vaccination strategy and efforts with community partners across these municipalities.
In addition, pediatric infectious disease expert Dr. Meg Fisher, who serves as a special adviser to the Department, and I have hosted hundreds of calls to stakeholders to share vaccine information with groups including AARP, colleges and universities, community health centers, disability groups, medical professional boards, the New Jersey Business and Industry Association, the New Jersey Employers Association, pharmacies and hospitals.
And, finally, through a statewide public awareness campaign, we have developed more than 100 videos in English and Spanish featuring physicians, nurses, interfaith leaders, coaches, parents and students. The videos can be found on the Department’s YouTube page along with podcasts, virtual town hall meetings and a Facebook Live session to encourage parents with children age five and older to get vaccinated.
What You Can Do
We need the assistance of our medical community in our continuing effort to convince those who are hesitant to get up to date on their vaccinations—including boosters.
As trusted sources of medical information, it would be extremely helpful if you would explain to your patients that COVID-19 vaccination continues to help protect them against severe illness and hospitalization. It’s important for patients to know their risk level for severe COVID-19 disease and hospitalization. That’s especially true for those 65 and older and the 20 percent of the state’s population who have chronic conditions like heart disease, stroke, obesity, chronic pulmonary obstructive disease and diabetes.
Physicians who care for vulnerable populations can be especially helpful in ensuring that patients understand their risk of severe disease and hospitalization as well as the need to boost their immunity by being up to date on vaccinations.
Your patients need to understand that immunity wanes over time and that a booster shot strengthens protection against the Omicron subvariant BA.2. They also need to know that recommendations including how often or how many booster shots may be needed may change—and that this is a sign that we are evolving with the virus and not a sign that vaccines don’t work.
Testing also remains important, and physicians should talk to their patients about getting tested if they develop signs or symptoms suggestive of COVID-19, or if they are planning travel or attending a large indoor event like a family gathering or concert.
Patients who are medically vulnerable or develop severe disease also need to understand the importance of seeking care immediately, and they need to know that there are effective treatments such as antiviral medications and monoclonal antibodies. The federal government has authorized several therapeutics to support the treatment and prevention of severe COVID-19 outcomes. None of these therapies are a substitute for COVID-19 vaccination and layered prevention measures are recommended.
Physicians can remain up to date on information about therapeutics by checking what’s new on the CDC website at https://www.cdc.gov/ and the therapeutics website run by the federal Office of the Assistant Secretary of Preparedness and Response at https://covid-19-therapeutics-locator-dhhs.hub.arcgis.com/federal.
CDC has developed toolkits to assist providers in having conversations about the COVID-19 vaccine. These toolkits can help you have a motivational conversation with patients and help answer common questions patients may ask their healthcare professional.5
You can also help increase our vaccination rate by becoming a COVID-19 vaccine provider. To learn more about becoming a vaccine provider, visit NJIIS.NJ.gov.
This pandemic has been a marathon, not a sprint. And we are not yet done. We need your help to get across the finish line.