Residents lined up outside the Novi Fire Station Oct. 7 for a drive-thru vaccine clinic, hosted by Oakland County Health Division.

Residents lined up outside the Novi Fire Station Oct. 7 for a drive-thru vaccine clinic, hosted by Oakland County Health Division.

Photo by Deb Jacques


Third shot’s the charm

Oakland County’s health director explains who should get another dose of the COVID-19 vaccine, and when

By: Tiffany Esshaki | C&G Newspapers | Published October 8, 2021

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OAKLAND COUNTY — This is new to everyone.

First, we were introduced to the nightmare that is COVID-19. Then, the prevention measures: wash your hands, wear a mask, keep your distance.

Then we got the vaccine, and we all had to learn who was eligible to receive a jab and when.

If you think you’ve got the hang of this pandemic, think again. Now, you’ve got to learn the ins and outs of the booster shot and the third shot — yes, they’re different — and decide whether you should book an appointment now for another round of the vaccine or if you’re better off waiting.

Only Pfizer has recommended third or booster shots for adults, so far. Keep that in mind when you’re looking to decide if you’re eligible for another dose. Medical experts believe Moderna is just a half-step behind and will probably make a similar recommendation soon.

So, what exactly makes the COVID-19 vaccination “booster” shot different from a third COVID-19 dose? Honestly, not much, according to Dr. Russell Faust, the medical director of the Oakland County Health Division.

“It’s unfortunate there’s this semantic or vernacular confusion. Logistically, they’re really very similar, the third dose and the booster dose,” Faust said. “The booster is for people already fully vaccinated with presumably a normal immune system. There’s some suggestion that the immune response to the COVID virus wanes over time, even in a fully vaccinated immune system.

“The third dose is a little bit different. It’s intended for those who are immunocompromised for some reason. The (U.S. Centers for Disease Control and Prevention) say those people haven’t mounted a reasonable response to the virus with just one or two doses.”

Think of it this way: If you have a disease or a medication to control a disease that lowers your immune response, then you need a total of three shots. That’s your complete, standard regimen if your immune system is lowered because of diseases like cancer or HIV, or if you take immunosuppressant medications to treat autoimmune disorders like rheumatoid arthritis or some chemotherapies.

The ideal time to get that third shot is about 28 days after your second dose, so essentially at the same interval as the first two administrations. If you wait longer, though, that’s OK, too.

The booster is different. Think of it as a little bit extra, above and beyond your standard vaccine regimen. There is some evidence from pharmaceutical researchers that the COVID-19 vaccine starts to lose some oomph about six months after your second dose. A booster dose can curb that inoculation slump. It’s not necessary, per se, but it’s sure useful for people with a higher risk of developing serious symptoms from the virus, or those who have more probability of exposure. That includes people over the age of 65 of any health status, or those between the ages of 18 and 64 with a “comorbidity,” which is a medical condition that could make a COVID-19 infection more serious.

“The list of comorbidities is just such a long list, I won’t even try to run down that list,” Faust said. The CDC includes a range of illnesses to be COVID-19 comorbidities, from chronic diseases of the kidney and lungs to hypertension (high blood pressure), diabetes 1 or 2, dementia, pregnancy, and even obesity.

Those with an elevated risk of exposure, like first responders, hospitality workers, teachers and public transportation workers, should get a booster, too.

A booster shot comes about six months after the second dose, but that’s not a hard and fast deadline. Faust said there’s some evidence in other countries that have had to ration their vaccine distribution that more time between doses can actually elicit a more robust immune reaction.

Basically, the third shot is a big deal. The booster, not as much. Yet.

“I don’t want people to think that there’s an urgency, because there really isn’t,” Faust explained. “People shouldn’t panic and go out and stand in line for hours. Waiting a week or two or even a month for a booster is OK, and you’ll get a nice strong response. … It’s embarrassing that, in the U.S., we have an overabundance of vaccines right now. There are large groups of people just not coming in to be vaccinated. So those willing to be vaccinated, we’d like to see them be optimally vaccinated.”

For the past several weeks, the Oakland County Health Division has been providing third doses at its COVID-19 vaccination clinics, and now they’ll offer boosters, too, where applicable. Any county-run vaccine clinic can dole out any dose of the shot, so don’t be concerned if you see keywords like “booster” or “third.” Come on in, and you’ll get what you need, according to Bill Mullan, the media and communications officer for the Oakland County Executive’s Office.

“The turnout for third-dose and booster-dose clinics has been a pleasant surprise. We ask people to make an appointment, but we take walk-ins. Every day (there is a clinic), we give out double the number of vaccine doses we were scheduled to because of walk-ins,” Mullan said. “But in terms of how we’re prioritizing, we’re still working to get the unvaccinated vaccinated. It’s not going to be additional doses that end this pandemic. It’s going to be common-sense prevention measures like getting vaccinated, good hand hygiene, social distancing and masking that ends this.”

Asked whether there’s much of an interest anymore for first-time vaccine recipients, Mullan said yes. County nurses have reported lots of people coming in for their very first dose, even after all this time, because they were waiting for something to ease their mind, like full approval from the U.S. Food and Drug Administration or just a solid chunk of the population getting vaccinated without any major side effects.

And so, the clinics continue. Along with private medical professionals and pharmacies offering COVID-19 vaccines, the Oakland County Health Division has a full schedule of dates for vaccine events spread out around the county. Some are in a drive-thru format for some extra convenience — and safety, of course.

At those clinics, residents can also get a flu vaccine at the same time if they’re in need. And if you haven’t gotten a flu shot this year, then Faust said you should definitely count yourself in need — no matter your age or occupation.

“If you happen to have the flu and have COVID at the same time, that doubles your mortality risk,” Faust said, noting that getting both vaccines — that’s the flu shot and any brand of COVID-19 vaccine — simultaneously is considered safe and effective, as the two don’t counteract each other. “So we’ve been administering them at the same time to make it easy for people.”

A drive-thru vaccination clinic will be held 9 a.m.-2 p.m. Wednesday, Oct. 20, at the West Bloomfield Fire Station, located at 4601 Orchard Lake Road. A drive-thru clinic will also be available 1-4 p.m. Thursday, Oct. 21, at the Oakland County Service Center, located behind the Medical Examiner’s building on the county campus at 1200 N. Telegraph Road in Pontiac. While appointments are preferred for both events and can be made online at oaklandcountyvaccine.com, walk-ins are welcome.

In Southfield, a vaccine clinic will be held 2-6 p.m. Thursday, Oct. 21, at the Southfield Pavilion, located at 26000 Evergreen Road.

In Novi, a drive-thru vaccine clinic will be held 9 a.m.-1 p.m. Friday, Oct. 15 at the Novi Fire Station, located at 49375 W. 10 Mile Road. Another clinic will take place 9 a.m.-2 p.m. Saturday, Oct. 23, at Suburban Collection Showplace, located at 46100 Grand River Ave.

At those clinics, residents can also get a flu vaccine at the same time, if they’re in need. And if you haven’t gotten a flu shot this year, then Faust said you should definitely count yourself in need — no matter your age or occupation.

“If you happen to have the flu and have COVID at the same time, that doubles your mortality risk,” Faust said, noting that getting both vaccines — that’s the flu shot and any brand of COVID-19 vaccine — simultaneously is considered safe and effective, as the two don’t counteract each other. “So we’ve been administering them at the same time to make it easy for people.”

For more information or to find a vaccine provider near you, visit oaklandcountyvaccine.com.

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