Why COVID-19 Boosters and Masking Remain Vital

With the potential for a fall and winter surge in COVID-19 infections and variants following Omicron in circulation, now is not the time to let your guard down, said Dr. Carol Epling, executive director of Duke Employee Occupational Health & Wellness (EOHW).

Staying up to date on vaccines, including boosters, is among the most effective ways to prevent serious illness, hospitalization, or death as a result of an unpredictable virus. The Centers for Disease Control and Prevention (CDC) recently recommended a second COVID-19 booster for certain people.

While the CDC rates the community level of COVID-19 as “low” for Durham County, COVID-19 cases in North Carolina have been slowly rising since March with 17,092 new cases in the first week of May. That mirrors the national picture, as case counts have risen across the country with an average of 78,238 new cases per day.

“The pandemic is not yet over,” Epling said. “We are still seeing levels of COVID circulating. We are still seeing hospitalized patients, although fortunately lower in numbers. Things are better, thanks mainly to vaccinations and the immunity that’s built up in some communities. But it’s not over yet.”

Working@Duke talked with Dr. Epling about boosters, masks and how we can stay safe moving forward.

What are boosters and what do they do?

The boosters are simply an additional dose of the COVID-19 vaccine meant to energize the antibodies already in a vaccinated person’s immune system.

“The idea for the booster is to provide additional stimulation of your immune system, to wake it up again,” Epling said. “The reason we’re getting these doses is that they’re showing to be quite effective to prevent severe symptoms, hospitalizations and death.”

Epling explained that so far, the COVID-19 vaccine formulas that became available in late 2020 and early 2021 – and are still used in the first and second rounds of boosters – are still effective in preventing severe illness in people who contract the newest variants of COVID-19.

Who should get the second booster?

The second booster is available to anyone 50-years-or-older, anyone 12-or-older who are moderately or severely immunocompromised, and anyone who got a primary dose and a booster of the Johnson & Johnson vaccine.

Epling encourages anyone who falls into those categories – even those with a healthy immune system – to strongly consider getting the second booster, as long as it’s been four months since they got their first booster. 

She said the second booster is especially important for people who have chronic medical conditions that could increase the risk of facing severe illness from COVID-19, and for people who are planning activities – such as traveling or attending events with large numbers of people – which could increase the risk of contracting COVID-19. 

Epling said that getting the second booster a few weeks ahead of a trip or large event will help ensure your immune system is ready to fight off any potential infection.

“When it comes to the second booster, you need to think about your own personal risk, what’s right for you and the best timing for you given what may be coming up in your life,” Epling said.

With the predictions for a rise in COVID-19 cases this fall and winter, what factors should people keep in mind for when to get the second booster?

Epling said worries about what could happen with variants in the fall shouldn’t prevent  someone’s decision to get a second booster now. 

“There’s probably no need to wait that long,” Epling said. “If you’re eligible now, it’s a long time until the fall. We hope that in the fall, there will be a new version of the vaccine that will give us a boost that’s more specific to the most recent circulating strains. That’s the hope. So I would expect we’re all going to be looking at another round of boosters when there’s a new vaccine product available to us.”

How should someone who has contracted COVID-19 plan a second booster?

Anyone who has tested positive for COVID-19 should still consider getting a second booster. 

Epling said that, even if a bout with COVID was recent – within the past few weeks or months – getting a second booster can still be beneficial. Community members need to be sure they’re out of the CDC-recommended 10-day isolation period before getting the second booster. Ultimately, Epling said, decisions about if and when someone should get the second booster are best made in consultation with a regular health care provider. 

“If you become eligible, but you’ve faced a COVID illness, what I recommend is that a person talk with their health care provider to really think together about their personal health condition, risk factors, and what they’re thinking of doing in terms of activities over the coming months,” Epling said.

Will we need to get more boosters in the future?

Epling said that COVID-19 boosters seem to provide their best antibody boost for around three or four  months, meaning it’s likely that people who may be particularly vulnerable to severe infections will need to get boosters again in the future. 

As new strains emerge, it’s possible that the current vaccines will need to be refined in order to provide effective protection, Epling said.

“As we move into the fall, we may have new versions of boosters which target newer strains of COVID,” she said. “There will be additional doses of the COVID vaccine that we’ll be needing to consider, we just don’t know what they are just yet.” 

Where can Duke community members get boosters?

Duke students, staff and faculty members who are eligible for the second COVID-19 booster can get the Pfizer booster at no cost at several Duke locations. Walk-ins are available Monday through Friday at Duke Clinic 1J and on Fridays at Duke Raleigh Hospital. Boosters are available with an appointment on Wednesdays and Thursdays at the newly-opened Duke vaccination clinic at 1400 Morreene Rd. in Durham.

Find more information on vaccination clinic locations or to make an appointment, visit Duke’s COVID-19 vaccination website.

Why should people keep wearing masks?

While masking regulations have been relaxed in many situations, Epling said there are certain situations when it’s still wise to mask up. 

She singled out air travel, public transportation and any situation where large gatherings of people congregate in crowded and poorly ventilated spaces as instances where wearing a mask is smart.

“When we’re in small places with crowds of individuals, like on buses, trains, airplanes, or in the airport when you’re boarding, there’s poor airflow and you’re right beside everybody,” Epling said. “It’s a good idea to mask at that point.”

She pointed out that it’s important to respect people’s decision to wear a mask. People who are immunocompromised or otherwise vulnerable to severe illness from COVID-19, or people who have close contact with vulnerable loved ones, often choose to wear masks. Likewise, people who are showing symptoms, or who may have been exposed, often choose to wear masks to protect those around them.

“You just don’t ever know why someone is choosing to wear a mask,” Epling said. “It could be for their own protection, or it could be for your protection. So we need to give them the respect, and even gratitude, for what they’re doing.”

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