COVID-19 Vaccine Booster Shots & Third Doses: Should You Get Them?

The Ministry of National Health Services has approved the COVID-19 booster shot of certain vaccines for high-risk patients and those traveling to countries where this additional layer of protection is mandated.

This booster shot is not available for every vaccine; only Pfizer, Sinovac, Sinopharm are the vaccine brands that are approved for this additional dose in Pakistan. Read on to know more about the third dose of the COVID-19 vaccine.

Where are the COVID-19 booster shots available in Pakistan?

As mentioned before, the vaccines approved in Pakistan for the booster dose are Sinovac, Sinopharm, and Pfizer for fully vaccinated individuals. These booster shots are available at the 21 designated vaccination centers in 18 major cities of the country.

• In Punjab, the vaccination centers are in: Lahore, Rawalpindi, Sialkot, Faisalabad, and Multan.
• In KPK, the vaccination centers are located in: Peshawar, DI Khan, Mingora, and Abbottabad.
• In Sindh, the vaccination centers are in: Karachi, Sukhar, and Hyderabad.
• In Baluchistan, the vaccination centers are in Quetta alone.
• In Gilgit Baltistan, the vaccination centers are in: Skardu and Gilgit.
• In Azad Jammu and Kashmir, the vaccination centers are in: Mirpur and Muzafarabad.
• The federal vaccination center is in: Islamabad.

Which COVID-19 booster shots are available in Pakistan?

1. Sinopharm

Sinopharm has passed phase 3 trials and has been approved by the World Health Organization (WHO). The efficacy of the vaccine extends beyond six months with a booster dose according to research data. Currently, Pakistan offers this booster dose for travelers.

2. Sinovac

Sinovac recipients saw a decline in the serum antibody levels six months after the second dose of the vaccine, according to the paper published by Chinese researchers. In the participants who received the booster shot, the levels of the neutralizing antibody increased 3 to 5-fold in the subsequent four weeks.

3. Pfizer

Pfizer plans authorization approval for the booster shot, worldwide. Research data shows waning protection six to twelve months post-vaccination for Pfizer with the current two-dose regimen. With the booster dose, reports show increased levels of the delta variant antibody up to eleven times for the 65 to 85-year age group, and five times for the 18 to 55 years age group.  

Are the COVID-19 booster shots free?

The fee of the booster dose is PKR 1,270 across the nation. This payment has to be deposited before going to the vaccination center at the National Bank of Pakistan (NBP).

The National Command and Operation Center (NCOC) is considering free booster shots for the healthcare providers aged 50 and above, as well as the immunocompromised.

Who is eligible to receive the COVID-19 booster shot?

According to the American Centers for Disease Control and Prevention (CDC), the booster shot is applicable for the following:

• Individuals aged 65 years and older
• Individuals between the ages 50 and 64 years or those between 18 to 64 years, with an underlying chronic medical disorder based on the risk assessment by the healthcare provider
• Individuals between the ages of 18 and 64 years with the occupational risk of contracting covid-19

For the mRNA vaccines, the booster may be received after the six-month period, while a two-month period suffices for the single-dose Johnson and Johnson vaccine.

The CDC allows for the mixing and matching of the vaccines for the booster shot. Research data from the National Institutes of Health (NIH) found an acceptable spike in the serum antibody level of individuals receiving the booster shot of a different vaccine.

What are the side effects of the COVID-19 booster shot?

Data review by the American Federal Drug Authority (FDA), shows no safety risks with the booster shots. The side-effect profile of this extra shot doesn’t show any additional side effects than the first two doses, namely:

• Fever
• Chills
• Headache
• Pain at the injection site
• Vomiting and diarrhea
• Fatigue
• Muscle pain.

In fact, some studies found fewer side effects with the booster dose than the second dose.

COVID-19 vaccine third dose for the immunocompromised vs the booster shot

The booster dose is not the same as the third dose. The third dose of the vaccine is, in fact, recommended for individuals with moderate to severe immunocompromise who are particularly vulnerable to the virus despite the two-dose vaccination.

According to research data, the vaccine is not as effective in immunocompromised people as it is in people with a strong immune system. Therefore, a third dose is beneficial in such individuals in ensuring maximal protection against COVID-19.

The third dose is given 28-days after the second dose. The American Centers for Disease Control and Prevention (CDC) recommends the third dose only for people who have completed their dual dose of the mRNA vaccine—Moderna or Pfizer.

The single-dose Johnson and Johnson vaccine is not yet approved for a third dose. It is preferable to get the third dose of the same brand as the previous two doses; however, in case of unavailability, an mRNA vaccine is recommended. Presently, the CDC does not recommend more than three doses of any mRNA vaccine. 

Who is eligible to receive the third dose of the COVID-19 vaccine?

Individuals meeting the following criteria qualify for the third dose of the vaccine:

• Patients with blood cancers
• Patients receiving cancer treatment for any tumor
• Patients on immunosuppressant medication post-transplant
• Patients with untreated HIV or those with AIDS
• Recipients of stem cell transplant in the last two years
• Patients on high dose corticosteroids for immune-suppression
• Patients with immunodeficiency disorders—like DiGeorge syndrome or Wiskott-Aldrich syndrome
• Any of the aforementioned criteria qualifies for the third dose of an mRNA vaccine.

COVID-19 Vaccine and Waning Immunity

There are no fixed criteria for estimating waning immunity, as every person is different. Moreover, immunity is not just measured by the serum antibody levels, as cellular immunity also plays a role in defending against infection.

The biggest challenge as yet for the healthcare providers is tackling the evolving and mutating coronavirus that may adapt to the vaccine, as well. The present data, however, suggests that the vaccines are effective against all the strains of COVID-19, including the delta variant.

For more information about the booster or third dose, reach out to your healthcare provider or a general physician in Karachi, Islamabad, Lahore, or any other city in Pakistan through oladoc.com.