8: COVID-19 Booster Shots

ASTHO Chief Medical Officer Dr. Marcus Plescia considers what states and territories need to do to deliver COVID-19 booster shots starting next month; Dr. Anne Zink, ASTHO President-Elect and Alaska’s Chief Medical Officer, shares her approach to...

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ASTHO Chief Medical Officer Dr. Marcus Plescia considers what states and territories need to do to deliver COVID-19 booster shots starting next month; Dr. Anne Zink, ASTHO President-Elect and Alaska’s Chief Medical Officer, shares her approach to school mask and vaccine messaging; and the latest update to the ASTHO COVID-19 Vaccine Comparison.

CDC: Joint statement from HHS public health and medical experts on COVID-19 booster shots

COVID-19 Vaccine Comparison

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This is Public Health Review Morning Edition for Thursday, August 19th, 2021. I'm Robert Johnson with today's news from the Association of State and Territorial Health Officials.



Having reviewed the most current data, it is now our clinical judgment that the time to lay out a plan for COVID-19 boosters is now.


That's U.S. Surgeon General Vivek Murthy with the news that Americans who got a Pfizer or Moderna vaccine will need a COVID-19 booster shot eight months after their last dose.

The first boosters are expected to go into arms starting September 20th.

CDC director, Dr. Rochelle Walensky, on the announcement.


The data we will publish today and next week demonstrate that vaccine effectiveness against SARS CoV-2 infection is waning; and, even though our vaccines are currently working well to prevent hospitalizations, we are seeing concerning evidence of waning vaccine effectiveness over time and against the Delta variant.


The decision means states and territories, again, will need to prepare for mass vaccinations.

ASTHO chief medical officer, Dr. Marcus Plescia, says there's some work to be done in the coming weeks.


States and territories, together with the federal government, need to begin to see if we can get a sense of what kind of response we're going to get, what kind of demand there's going to be starting on September 20th.

States and territories should also look at how we're going to, if there is a big demand, how are we going to prioritize it? Who's going to go first, who will come later? We can probably use the same system we used for the initial launch of the vaccine, but we need to think through that and have those systems in place.



Also keeping states and territories busy—helping schools open safely.

Dr. Anne Zink is ASTHO's president-elect and Alaska's chief medical officer. She talks about back-to-school vaccine and mask messaging in today's morning conversation.

Students and teachers are heading back into the classrooms.

How are you addressing them as the school year gets underway?


I think the first thing that we're really trying to do is partner with schools, parents, and kids over the excitement of returning back to in-person learning. A lot of kids missed out on a lot last year in Alaska—we had some kids in-person, some kids were not in-person, and it was a hard year. And we know that kids do best in-person, so we're really trying to unite with parents, teachers, and students for the excitement of getting back to school.

But then, also making sure that we're doing it safely. And not only are we getting schools open, but we're keeping them open. And so, giving parents, teachers, students tools to be able to stay open once they do open.


Delta is really putting a damper on a lot of that excitement because it is making kids ill.

How do you get that point across to parents who've yet to vaccinate their own children?


Parents have great questions—they want to make sure that their kids are safe, they want to make sure these vaccines are safe and efficacious—and really trying to listen to their questions as well as provide information and data from trustworthy sources.

We're partnering a lot with pediatricians, so every one of our school boards we've encouraged either have a local family practice doc or a pediatrician who's local in their community on their board to be able to answer their questions.

Making sure it's easy and accessible—a lot of parents are working, and I think that parents are seeing that Delta is different and that Delta is spreading quickly, and that we're seeing a lot of people getting sick, particularly those who are unvaccinated. And making sure that they know that this is our most effective tool at slowing the spread of this and protecting their kiddos not only from COVID, but also keeping them in school.

I just got a text from, you know, 130 runners with two positives on the school bus, but all those kids that were close contacts were fully vaccinated. And so, they're able to, you know, mask and test at day three to five, but keep on running, which makes a difference to keep kids in school and sports and moving forward.


Let's talk about mask wearing.

Your peers are listening, so tell them how you make the case for mask wearing in schools.


That's a great question. Each one of our school boards in Alaska is independent and gets to make that decision themselves, so we spent a lot of time having a lot of conversations about tools that they can use to be able to keep kids in-person in school and safe, and masking is an important tool in that. It's become highly politicized, so I always try to put it into a larger context of tools that they have.

So, for example, you know, I wrote an op-ed this weekend and I talked about having space and grace and letting each other realize we've all had a hard experience; focusing on physical and mental health so that we're not just focusing on masks, but we're focusing on physical, mental health; three, getting vaccinated as an important tool for testing and making sure that we have a plan for testing; and then the fourth one I put in there with layered mitigation including masking and how little COVID we saw spreading last year when kids were properly masked and that they don't need to quarantine if the kids are properly masked and distance.

And so, I think putting it into a larger context and not making it the number one focus and putting it into the context of safe schools that are healthy and in-person helps to de-politicize it, and helps us support schools and parents and districts to be able to choose to be able to mask.

I think it's also important that we move away from words like mandates and really speak in terms of choices and protocols and put it in context for when we have a lot of cases spreading.

I have communities in Alaska that have no cases of COVID, haven't, and they have, you know, anywhere from 90–100% of those eligible to be vaccinated. That's not an area where I'm going to put a lot of effort and time into masking, it's not going to provide that much additional benefit. But when I've got, you know, 12% of my 12- to 18-year-olds vaccinated in 500 person schools, that's going to be a place that's going to take a lot of effort.

So, I think we have to be careful to not think that one tool is the end all be all, and to put it into a larger context. And I think that helps to de-politicize it and really helps to put our focus where it needs to be, which is the overall physical and mental wellbeing of our children—which includes COVID, but also includes other things.



Finally this morning, ASTHO's COVID-19 vaccine comparison has been updated. It includes information about the Delta variant and guidance for pregnant people.

Find a link to this document as well as links to the CDC guidance on boosters in the show notes.

Also, remember to follow us on Apple Podcasts and Spotify, or you can listen on Alexa. And, if you have a minute, please take time to share our show with a colleague.

Join us tomorrow for more ASTHO news and information, including ongoing coverage of the decision to give COVID-19 booster shots.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Anne Zink MD FACEP

Chief Medical Officer for the State of Alaska

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO