Northwell Health is planning to make COVID-19 booster shots and flu shots widely available at retail, medical, and school vaccination sites across the New York City metropolitan area this fall, said Dr. John D’Angelo, senior vice president and executive director of emergency medicine services at Northwell Health.
D’Angelo advises that all individuals get both a flu shot and the COVID-19 booster shot as soon as possible.
The Food and Drug Administration recommended only people 65 and older and those with a high risk of getting COVID-19 to receive a booster shot of Pfizer six months after their second dose.
“Later, it will become critical to be able to separate individuals with COVID-19 from individuals with the flu. There is a potential for confusion. The illnesses have many symptoms in common. If we reduce confusion at the beginning, there will be fewer operational challenges for hospitals later,” said D’Angelo.
D’Angelo said it is safe to get both shots at the same time. There is no single “combination” shot.
“It is safe to get both shots on the same day. It’s likely healthcare staff will give you the shots in different arms. If you are concerned about adverse effects from either shot and opt to get them on separate days, consider getting the COVID-19 booster first. You can wait a week to get the flu shot,” said D’Angelo.
D’Angelo said some individuals might experience adverse effects like fatigue, flu-like symptoms, and headaches for one to two days after either shot.
“If you’re feeling sick beyond that two-day window after getting either or both shots, you may want to get tested for COVID-19. (This is) to make sure you haven’t contracted the virus and were asymptomatic on the day you received the vaccine,” said D’Angelo.
D’Angelo said the primary COVID-19 symptoms to watch for are fever, flu-like symptoms and loss of taste or smell. It is possible for an individual to have a breakthrough infection of COVID-19 even after getting the booster shot. The booster shot, like the initial vaccine series, doesn’t completely eliminate the possibility of contracting COVID-19.
“If you are exposed and become infected, the vaccine will have trained your immune system to recognize and attack the virus. (This will reduce) the severity of infection and chances of ending up in the hospital,” said D’Angelo.
D’Angelo said the booster shot contains the same material as the previous vaccine shots.
“The pharmaceutical companies are currently working on a vaccine that might contain additional coverage for the recent variants. Potentially these will be ready for release around January or February 2022,” said D’Angelo.
It is not possible for an individual to contract COVID-19 from getting a booster or flu shot.
“You might not feel well for a day or two after getting a booster or flu shot or both. Yet no shot will give you COVID-19. The booster shot contains a mRNA vaccine that does not contain the live virus. The flu shot contains an inactivated vaccine, the dead version of the germ that causes the flu,” said D’Angelo.
Getting a booster shot will not affect the result of a COVID-19 test.
“The COVID-19 test looks for live virus in the nasal passages. Since the booster shot does not contain the live virus, getting the shot doesn’t change the result,” said D’Angelo.
D’Angelo said an individual who gets a booster shot and later tests positive for COVID-19 was exposed to the virus. They will not have contracted the virus from the vaccine.
“That’s why people should continue wearing face masks and social distancing. These measures are proven to work,” said D’Angelo.
The logistics behind the rollout
Getting a COVID-19 booster and a flu shot should be easier this time around than the initial vaccination phases in the winter and fall of 2020. Vaccine supply is no longer limited.
Over the past nine months, Northwell has worked hard to create a portfolio of mass vaccination sites. The healthcare provider collaborated with counties and the state to ensure access to meet the high demand of the initial rollout.
“Northwell has the infrastructure in place to administer 100,000 doses of the COVID-19 booster shot a week if we are fully staffed and operational. Right now, we’re operating at low capacity, given the current demand. We have the ability to increase capacity when the demand increases,” said D’Angelo.
It is a concern that the September 20 date for starting to administer COVID-19 booster shots to the general population collides with the required deadline for vaccination for healthcare workers.
New York Governor Kathy Hochul mandated that all healthcare workers in New York State be vaccinated against COVID-19 by September 27, 2021.
“The staffing component is the big unknown. Fortunately, as of early September, 84 percent of all Northwell staff are vaccinated,” said D’Angelo.
D’Angelo said Northwell is operating at an advantage because there is plenty of the vaccine supply for booster shots. There are no supply chain disruptions as there were during the initial rollout in spring 2020.
D’Angelo clarified that there is not a mandate to get the flu shot.
“Flu seasons typically run sometime between October and March, with peaks usually sometime between December and March. In 2020, there were very few incidences of the flu. (This was) largely due to the shutdowns experienced early in the pandemic, coupled with social distancing and mask-wearing practices. Still, individuals should not wait to get a flu shot,” said D’Angelo.
More details on the booster shot
It is not yet known how long the booster shot will last.
“We know for some individuals we may see a slow, steady decline in antibodies after six to eight months following vaccination. Yet antibody levels are only part of the equation,” said D’Angelo.
Currently, it has not been determined whether the decay of serum antibody levels or the decline of antibodies in the blood is a good indicator for the timing of a booster shot. The decay of serum antibody levels may indicate a weakened immune response. The degree of protection may depend more on the initial immune response than on the decay of antibody levels. This is because T memory cells, the cells in the immune system that remember a toxin, are expected to respond to future exposures.
“Our immune system’s memory cells recognize and respond to COVID-19. (They) act as another guard against COVID-19 infection,” said D’Angelo.
D’Angelo said an individual who believes they may have a breakthrough infection should not ignore their symptoms. Instead, they should seek medical attention and will likely require a COVID-19 test.
“There are now options to get further treatment for COVID-19. These include monoclonal antibody infusion,” said D’Angelo.
The term “monoclonal” refers to a clone derived asexually from a single cell. For example, a monoclonal antibody infusion is an infusion of asexually cloned antibodies. This infusion provides a patient with more antibodies to fight a COVID-19 infection.
For more information on COVID-19 booster shots from Northwell Health, visit Northwell Health’s Coronavirus Digital Resource Center: https://www.northwell.edu/coronavirus-covid-19/vaccine/frequently-asked-questions/.