North Dakota will begin delivering COVID-19 booster shots to recommended groups within the next week or two, state health officials said during a media briefing Friday on the recent Centers for Disease Control announcement that authorizes booster shots for vulnerable populations and essential workers.

“Health care providers are also just receiving this information, and they have to educate their staff and update their protocols in order to provide booster doses,” North Dakota Department of Health Disease Control Immunization Program Manager Molly Howell said during the virtual conference.

At this time, the booster shot recommendation is only for those who have had the Pfizer dose. Boosters for those who took either Moderna or Johnson and Johnson’s one-shot are still being evaluated.

Howell outlined the priority groups as follows:

• Those who are 65 and older and residents of long-term care facilities

• Those who are 50 to 64 with underlying medical conditions that put them at higher risk for severe COVID

• Those age 18 to 49 with either an underlying medical condition or who are at increased risk for COVID-19 exposure and transmission, based on their occupation or institutional setting.

Booster shots should be administered at least six months after completing the Pfizer vaccine series.

Howell does expect further guidance from the CDC on the occupational setting recommendation, but she said it is likely to include all essential workers.

“It definitely does include healthcare workers, but it could include, you know, people who work in correctional settings,” she said. “Or people who work in group homes, or even potentially teachers as well. So it’s really based on how at risk you are for getting COVID-19 at your workplace or spreading COVID-19 to vulnerable individuals in your workplace.”

The state doesn’t expect to implement a schedule for prioritizing booster shots. Supply for the shots is ample. But they have put out a challenge to long-term care facilities and their vaccinators to try and get all long-term care residents who received a Pfizer dose a booster shot within two weeks of the CDC’s guidance.

The state will rely on self-reporting for the booster shots.

“You don’t have to provide any sort of proof of an underlying health condition or proof of employment in order to receive a booster dose of COVID-19,” Howell said.

Vaccines remain top priority

Howell also reiterated a common refrain, that the COVID-19 vaccines in the United States are very effective and continue to be the best way to avoid hospitalization or death from COVID-19.

Immunity against COVID0-19 symptoms may have waned in certain risk groups, such as those 65 and older, Howell acknowledged. But, she added, “You are five times less likely to have COVID-19 if you are vaccinated. And you are 10 to 22 times less likely to be hospitalized for COVID-19 if you have been vaccinated.”

Dr. Paul Carson, Director of Fellow of the American College of Physicians for NDSU, said the data he has looked at continue to show that the COVID-19 vaccines with emergency authorization for use in the United States are safe and effective at preventing hospitalizations and death.

“That hasn’t really declined with time, or with the Delta variant substantially,” he said. “So I think people can be pretty reassured still.”

Moderna, right now, seems to be performing slightly better than Pfizer, and both Pfizer and Moderna seem to be performing a little better than Johnson and Johnson’s shot, he added.

“I do think we’re going to see recommendations coming out in the near future about boosters following those vaccines,” Carson said. “But for the most part, people who have received two vaccines still, by and large, have very good protection against hospitalization and death.”

Monoclonal antibodies in short supply

State officials also talked about the shortage of monoclonal antibodies, which, if administered within 10 days of infection to COVID-19 have been shown to prevent hospitalizations for high-risk patients.

With COVID-19 cases spiking across the country, and most particularly in highly populated, vaccine-hesitant locations, supplies of this life-saving treatment are not keeping pace with demand. The distributions that the state of North Dakota has received amidst this shortage are not likely to meet its total demand, health department officials have said.

North Dakota listed 3,604 active cases of COVID-19 on Friday, Sept. 24, which is the highest that figure has been since Dec. 12. It listed 645 new positives on Friday, and 121 hospitalizations.

“There’s no question that monoclonal antibodies is an effective treatment regarding COVID,” North Dakota Health Resources & Response Section Chief Dr. Tim Wiedrich said. “But we now have increasing demand and inadequate supply across the country for providing monoclonal antibodies.”

Right now, seven states have used almost all of the available monoclonal antibodies supply. They are Alabama, Florida, Texas, Mississippi, Tennessee, Georgia and Louisiana. The Biden administration is implementing a new distribution plan, to try and ensure that all states get at least some of the dwindling supply.

“We had a substantial reduction in the amount of monoclonal antibodies available to us,” Wiedrich said. “And that supply is not meeting the demand that we have within North Dakota. And so we completely anticipate the fact that we’re going to run out of monoclonal antibody.”

Wiedrich said that fact makes it important for people not to rely on that treatment as their mechanisms for avoiding hospitalization due to COVID-19.

“Vaccination is a way to prevent having the illness to begin with,” he said. “I can’t emphasize that enough.”

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