Considerations for COVID-19 Vaccine Booster Dose among certain high-risk groups

Published 12:19 pm Wednesday, August 4, 2021

According to the Mississippi State Department of Health, the number of cases, hospitalizations, and deaths due to COVID-19 are surging in Mississippi with rapid increases since the end of June 2021.

MSDH is estimating that >80% of all COVID-19 viruses circulating and causing illness in Mississippi are now due to the Delta Variant through sequencing of representative samples, making this the predominant strain in the state.

The overwhelming majority of cases, hospitalizations and deaths in Mississippi are among unvaccinated individuals.

As transmission has increased in the state, deaths in fully vaccinated individuals have been increasingly identified. Since April 1, 2021, more than 35 vaccine breakthrough deaths have been confirmed.

The median age of vaccine breakthrough deaths is 79 years with a range of 49-99 years

84% of all the vaccine breakthrough deaths are in individuals 65 years or older

For the vaccine breakthrough deaths in which underlying medical history is known, 58% had either a known immunocompromising condition (e.g., history of transplant, cancer, or RA) or a history of renal disease or underlying DM.

The Mississippi State Department of Health is advising that Mississippi Physicians and Clinicians consider a booster or third dose of COVID-19 vaccine for certain high-risk groups with immunocompromising conditions:

  • Conditions and treatments associated with moderate to severe immune compromise
  • Active or recent treatment for solid tumor or hematologic malignancies
  • Receipt of solid-organ or recent hematopoietic stem cell transplant
  • Severe primary immunodeficiency
  • Advanced or untreated HIV
  • Treatment with immunosuppressive medications such as cancer chemotherapeutic agents, TNF blockers, certain biologic agents (e.g., rituximab), and high-dose corticosteroids
  • Chronic conditions associated with varying degrees of immune deficit, such as asplenia or chronic renal disease.
  • Other underlying medical conditions and treatments that may lead to immunosuppression based on the physician or clinical team assessment.

The MSDH suggests waiting at least four weeks after the final dose in the original vaccine series prior to administering a booster dose. If feasible and available, providers may elect to perform qualitative spike protein antibody testing to determine the presence or absence of detectable antibodies prior to booster dosing. If utilizing antibody testing in the decision process for booster vaccine, consider antibody testing 4-6 weeks after final dose in the original series.

If original series is with mRNA vaccines (Pfizer or Moderna), the recommendation is to consider utilizing the same manufacturer for the booster or third dose.If the original vaccine was Johnson and Johnson, the recommendation is to consider utilizing Pfizer mRNA vaccine as the booster vaccine.

Due to elevated Covid cases in Jefferson Davis County, the Jefferson Davis County Extended Care Facility is restricting visitation in the facility. There have been a total of nine cases and one death reported in the ECF with zero outbreaks.