Dylan Morrongiello, 27, has a list of health issues, including type 1 diabetes and pulmonary hypertension, that make him more vulnerable to contracting COVID-19, but he is not officially considered immunosuppressed.
Still, Morrongiello, who lives in Indialantic, Florida, was able to secure a third Moderna mRNA,
COVID-19 vaccine shot at a local supermarket pharmacy two weeks ago. He received his first dose at the end of December and his second a month later.
He’s one of a group of people who have been looking for a third shot, even though he wasn’t technically eligible for one. But those considering this route may want to weigh a few different factors before continuing, experts say.
The current position of the FDA
Around mid-August, the Food and Drug Administration declared that some people with weakened immune systems were eligible for a third injection of the Moderna vaccine or the Pfizer PFE,
/ BioNTech BNTX,
vaccine. Some organ transplant recipients and people with compromised immune systems were eligible, the FDA said, but the agency stressed the announcement did not apply to everyone.
Despite data from Israel’s Pfizer which suggests that third injections may restore vaccine efficacy six months after a second dose, a group of independent FDA advisers voted against recommending a third injection of Pfizer for patients. people over 16 on Friday.
The committee, however, recommended that the FDA allow third injections for people with health conditions that put them at a higher risk of serious illness, and for people 65 years of age and older. Morrongiello would probably fall into the first category.
“The scientific debate continues constantly, and this is a very reasonable resolution,” said Dr. William Schaffner, professor in the division of infectious diseases at Vanderbilt University Medical Center, after the votes of the FDA committee.
Type 1 diabetes would count as “high risk,” according to Schaffner, along with conditions such as heart disease and lung disease.
Pfizer says third shot is “essential tool”
Pfizer data on the third injections showed “a favorable safety profile and strong immune responses,” said Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer, after the decision to Friday.
The results, “and the greater body of scientific evidence presented at the meeting, underscore our belief that the third shots will be an essential tool in the ongoing effort to control the spread of this virus,” Jansen said.
“We thank the committee for their thorough review of the data and will work with the FDA after today’s meeting to answer the committee’s questions, as we continue to believe in the benefits of a third dose for a wider population.” , she added.
“We shouldn’t be horsemen”
Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was “not surprised” by the decision, he said Friday in an interview with CNBC.
But given initial data from Israel where third injections are offered to anyone over the age of 12 who received a second dose at least five months ago, Fauci said he was “in favor of the boosters.” but declined to comment on the age groups he would recommend. that for.
““I don’t think a booster dose is going to contribute significantly to controlling the pandemic”“
Fauci also acknowledged that some people receive third injections that are not immunocompromised, but said “it is not advisable to do this until you have obtained approval from our regulatory authorities.”
Schaffner falls into Camp Fauci. For anyone in good health and receiving a third injection, “they would work outside of current recommendations. It should make them think, ”he said.
It’s likely that at some point in the future everyone will need a third shot, Schaffner said. But what happens at this future stage, when someone who has already had a third injection is now advised to get a third?
The side effects of a fourth shot are not known. “We shouldn’t be horsemen,” he said.
Morrongiello did not want to wait
“Considering my conditions, as well as the fact that I will be traveling for work for almost a year in a few weeks, I decided to jump the gun a bit just to make sure I was as protected as possible,” Morrongiello, a professional opera singer, told MarketWatch.
The pharmacy he visited did not ask about eligibility, which did not surprise him given that he saw “two other people on Facebook FB,
mention that they were also able to get third shots without being asked questions.
“It definitely gave me a little bit of power,” he added.
““We reserve the right to cancel appointments if it is determined that the information provided to establish eligibility is not true”“
The United States Centers for Disease Control and Prevention urges vaccinators not to deny “a person a COVID-19 vaccination due to lack of documentation,” the agency said in an online statement. Publish answer frequently asked questions about third shots.
“This will help to avoid barriers to access for this vulnerable population receiving a necessary additional dose,” the agency added.
Some 2.16 million Americans have received a third injection since mid-August, CDC says The data.
How pharmacies verify eligibility
But getting a third injection isn’t always as easy as walking into a pharmacy and asking for one.
CVS CVS pharmacy chain,
said he was asking people “to attest that all information provided, including medical status, is true and correct when scheduling a vaccination appointment,” said Matthew Blanchette, porte – speech of the company.
“We reserve the right to cancel appointments if it is determined that the information provided to establish eligibility is not true,” he added.
stated that patients seeking a third dose will be asked to “complete, sign and date an attestation form confirming that they meet all eligibility requirements for the additional vaccine upon arrival at our stores”, a spokesperson told MarketWatch.
Likewise, independent pharmacies “are not obligated” to administer third injections to everyone who requests them, said Kurt Proctor, senior vice president of strategic initiatives at the National Community Pharmacists Association, a business group that represents more. of 21,000 independent pharmacies.
Will the insurance cover the cost of a third injection if you are not eligible?
“At this time, a member who received a third blow would not see this claim denied,” said Michelle Vanstory, vice president of external communications at Anthem ANTM,
“But it would be misleading to state this as a policy because it could change pending guidance,” she added. “It’s an evolving situation. “
A spokesperson for Aetna stressed, however, that “the additional dose is available free of charge to any eligible patient, whether through insurance or a federal uninsured program,” Ethan Slavin said. , spokesperson for the company.
Slavin did not say whether Aetna members who are not eligible for a third dose would be charged.
declined to comment and Cigna CI,
did not respond to a request for comment.
Jeff Zients, the White House COVID-19 response coordinator, said last month that “recalls will be free, regardless of immigration or health insurance status. No ID or insurance required.
But Zients wasn’t talking directly about what happens when an ineligible person gets an extra dose. Rather, he seemed to be referring to what Americans might expect if the FDA gave the green light to boosters for the general population.
Health and Ethics Considerations
Although Pfizer has said that everyone from the age of 16 should have a third chance, not everyone is convinced yet.
While there is agreement that a third shot is a good idea for people with weakened immune systems, some scientists say the data is still not there to support it for the general population.
“Even though a gain may ultimately be achieved through stimulation, it will not outweigh the benefits of providing initial protection to the unvaccinated,” according to a group of scientists who signed a opinion piece published Monday in The Lancet, a leading medical journal.
““While a gain may ultimately be achieved through stimulation, it will not outweigh the benefits of providing initial protection to the unvaccinated.”“
It can be difficult to disentangle the increase in the number of cases due to the decrease in vaccine effectiveness and the increase in cases due to a change in behavior as more and more people are vaccinated. , they noted.
During Friday’s meeting, Dr Cody Meissner, director of pediatric infectious diseases at Tufts Medical Center and a committee member, seemed cautious to expect too much of a third shot.
“I don’t think a booster dose is going to contribute significantly to controlling the pandemic,” he said.
The World Health Organization has called on wealthy countries to halt their third efforts as people in many parts of the world still await their first vaccine – a point highlighted by the Lancet opinion piece.
Although many countries are struggling to get the first doses of vaccines, Morrongiello said given his condition, he had “no regrets.”
But he acknowledged that “it could be a potential problem if too many people get booster shots too early.”