Vaccine Confident mark
An initiative to help pharmacists strengthen vaccine confidence in their patients and communities
How to talk to people about COVID-19 vaccines Addressing concerns that the COVID-19 vaccines were “rushed” Addressing concerns about COVID-19 vaccine side effects Addressing concerns related to pregnancy, breastfeeding, and fertility Addressing the belief that COVID-19 vaccination is “not needed” Addressing concerns about COVID-19 breakthrough infections Addressing concerns related to religious beliefs Understanding the “COVID skeptics” Addressing concerns about staying up to date with COVID-19 vaccines How to restart the vaccine conversation Understanding the “system distrusters” Addressing concerns about SARS-CoV-2 variants Identifying credible information about COVID-19 Vaccines Addressing COVID-19 vaccine myths Understanding the “cost anxious” Addressing concerns about vaccinating children and teens Addressing COVID-19 vaccine misinformation and disinformation Addressing COVID-19 vaccine misunderstandings Addressing concerns about administering COVID-19 vaccines with other vaccines Addressing concerns of people who are immunocompromised Effectiveness of COVID-19 vaccines during pregnancy and after delivery Using numbers to communicate COVID-19 risk to patients Managing pandemic-related exhaustion

Addressing concerns about staying up to date with COVID-19 vaccines

The Issue

COVID-19 vaccine hesitancy extends to getting repeated doses of COVID-19 vaccines. People who completed a vaccination series a year or more ago may doubt the need for additional doses or question their value, especially in light of sometimes confusing or conflicting media coverage. Some people no longer see COVID-19 as a threat or have grown weary of preventive measures (“pandemic fatigue”). Others balk at the prospect of repeated vaccination.

Sound Bites

  • It is normal for the protection provided by a vaccine, including COVID-19 vaccines, to decrease over time. This is not a sign that the vaccines don’t work.
  • Giving updated doses of COVID-19 vaccines can enhance or restore protection against COVID-19 that may have decreased over time.
  • Giving updated doses of COVID-19 vaccines are especially important for protecting against serious COVID-19 disease, including severe illness, hospitalization, and death.
  • People are protected best from COVID-19 severe disease when they stay up to date with their COVID-19 vaccines.
  • Staying up to date with COVID-19 vaccines is important as the virus continues to change into new variants.

Questions for Exploring Patient Concerns

  • What do you know about the updated COVID-19 vaccine?
  • What concerns you most about getting another COVID-19 vaccination?
  • What would have to be true for you to think it was important to get the current COVID-19 vaccine?
  • What if I told you…? (Provide information about the importance of staying up to date, like with software or a cell phone .)

What We Know

In the United States, the first COVID-19 vaccine was authorized in December 2020. The first booster doses were authorized in September 2021 for a limited population. Over time, additional data accumulated, providing the basis for broader recommendations for who would benefit from additional doses. By July 2022, recommendations for booster doses had expanded to include everyone 5 years of age and older; some people were encouraged to receive a second booster shot. Recommendations continued to change as the virus generated new variants and the contents of the vaccine were updated to match it.

Our understanding of COVID-19 vaccine durability and the value of additional doses took time to develop. Given that the initial messaging about the COVID-19 vaccines emphasized their ability to prevent infection—breakthrough infections initially were described as “rare” or even “extremely rare”—it is not surprising that some people question the necessity or effectiveness of boosters. Breakthrough infections became more common as Omicron and its subvariants became dominant, even in people who were up to date with COVID-19 vaccines. A systematic antigenic analysis found that while the BA.2.12.1 subvariant was only modestly (1.8-fold) more resistant to sera from vaccinated and boosted individuals than BA.2, BA.4/5 was substantially (4.2-fold) more resistant and more likely to lead to breakthrough infections.1

Persons who are reluctant to receive another COVID-19 vaccination should be aware of the following information:

Immunity against SARS-CoV-2 infection decreases slowly over time. This is true whether the immunity comes from a previous SARS-CoV-2 infection or vaccination. Immunity may begin to wane as soon as 4 to 6 months after an infection or vaccination.

It is normal for the protection provided by a vaccine to decrease over time. This is not a sign that the vaccine doesn’t work.

Giving updated doses of COVID-19 vaccine can further enhance or restore protection that might have decreased over time.

Giving updated doses of COVID-19 vaccine are especially important for protection against serious COVID-19 disease, including severe illness, hospitalization, and death.

Even as SARS-CoV-2 variants become increasingly adept at evading immunity provided by vaccines (or previous infection)—so that vaccines offer less protection against breakthrough infections and mild symptomatic disease—vaccines continue to offer strong protection against severe COVID-19 disease.

Certain groups have an increased risk of severe COVID-19 disease, including people 65 years of age and older and people who are immunocompromised. People in these groups may need additional doses to increase the immune response and improve protection against severe COVID-19 illness, hospitalization, and death.

People are protected best from severe COVID-19 disease when they stay up to date with their COVID-19 vaccines.

Staying up to date will be crucial as vaccines are formulated to better protect against emerging virus variants.

Take note that COVID-19 vaccine recommendations are updated periodically as the Centers for Disease Control and Prevention (CDC) continues to use the latest data on safety and how well vaccines work, including over time and against new variants. The latest CDC recommendations on COVID-19 vaccination schedules are available in an At-a-Glance format.

Reference

  1. Wang Q, Guo Y, Iketani S, et. Al. Antibody evasion by SARS-CoV-2 Omicron subvariants BA.2.12.1, BA.4 and BA.5. Nature. 2022 Aug;608(7923):603-608. doi: 10.1038/s41586-022-05053-w. Epub 2022 Jul 5. PMID: 35790190; PMCID: PMC9385487

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