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Boost now or boost later: What eligible Minnesotans should consider in timing COVID-19 booster shots

COVID-19 cases are again on the rise in Minnesota. The state has reported more than 2,000 new cases per day in recent days, up from about 1,300 per day last week.

Health Commissioner Jan Malcolm and Gov. Tim Walz shown waiting to receive their second COVID-19 booster shots at Corner Drug in St. Paul on Wednesday.
Health Commissioner Jan Malcolm and Gov. Tim Walz shown waiting to receive their second COVID-19 booster shots at Corner Drug in St. Paul on Wednesday.
MinnPost photo by Greta Kaul

This week, Gov. Tim Walz and Health Commissioner Jan Malcolm visited St. Paul Corner Drug to get their second COVID-19 booster shots.

On March 29, the Food and Drug Administration authorized second boosters to be given at least four months after the first booster, for people age 50 and up and some younger, immunocompromised people.

Guidance from the Centers for Disease Control says people in these groups may get a second booster. But it says less on when they should do it.

Because heightened immunity from a booster takes about two weeks to fully kick in, and wanes after several months, some eligible Minnesotans are getting second boosters now to have maximum protection as cases again rise in the state. Others wonder if it’s best to wait on the booster in order to have more protection for late-summer travel or event plans.

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Experts say that depends on your health and risk factors, but for some eligible for a second booster, taking plans into consideration isn’t necessarily a bad idea.

The COVID-19 trajectory

COVID-19 cases are again on the rise in Minnesota. The state has reported more than 2,000 new cases per day in recent days, up from about 1,300 per day last week.

While it’s not clear how long this coronavirus wave will continue — or even how big it will be — it’s not looking nearly as severe as some of the waves we’ve seen in the past. So far, the subsequent wave of hospitalizations has been minor, and deaths have been decreasing. 

“If this thing tracks itself, we should see a lull here over the summer,” Walz said Wednesday. “We’re probably going to see spikes in the southern states coming up very shortly in the summer months when they move inside (due to heat), and then our preparations for October (when Minnesotans move indoors as colder temperatures arrive).”

While most people who are up-to-date on COVID-19 vaccinations have a baseline level of immunity that should prevent them from getting very sick from COVID-19, boosters can add a layer of protection against infection and severe disease. That can be especially beneficial for older people and the immunocompromised, whose immune systems don’t always respond as strongly to vaccines.

Malcolm emphasized that new data show vaccine protection is more effective against the newer COVID-19 variants emerging than immunity from prior infection.

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Timing the booster

Just when people need that extra layer of protection is an open question, given the ever-changing nature of COVID  — and it might be different for different people.

“Risks are quite individualized at this point, depending on your age, underlying medical conditions; who you have close contact with that might be at high risk. So you have to factor in all those things,” said Dr. Susan Kline, an infectious disease physician at the University of Minnesota Medical School and M Health Fairview.

While both Walz and Malcolm are eligible for boosters because they are 50-plus, Malcolm said neither of them have been in particularly high-risk situations. They decided to get boosted this week to get the message out to the public.

“(We) wanted to just do this at a time, in a way that would be helpful for getting the message out to the public that the data are clear, the benefits are clear and we are eager for people to take advantage of this,” she said.

Dr. Leslie Surbeck, a doctor at Evergreen Primary Care in St. Paul, said she’s been fielding questions from patients trying to figure out their booster timing. She said people who are immunocompromised or at high risk of COVID-19 complications should think about getting the booster soon so they are protected as cases are rising.

Even for people who aren’t at particularly high risk, the rise in cases means it’s not a bad time to get boosted if you’re eligible, she said. Malcolm said the benefits of a booster seem to hold up for at least four months. 

One reason to hold off might be if you’re lower risk and have travel coming up – particularly an international trip,  because getting sick abroad can pose logistical challenges.

“Not that other countries don’t have good health care systems — they do — but it might be hard for people to navigate,” she said. “I have counseled people, if they know they’re going to be taking a big trip, maybe wait and time it where they get it two to four weeks before they go.” 

Both Kline and Surbeck urged people to talk to medical professionals if they have questions about timing their boosters based on their plans and health situation.

For now, it’s hard to predict what will happen beyond the summer, when the immunity of people who are getting second boosters is waning. But it’s possible — and some say likely — additional boosters could be authorized in the fall, at least for high-risk people.

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“The consensus is that there is added protection to do the booster now, and that wouldn’t preclude additional protection from other vaccines in the fall,” Malcolm said.