Healthwise Maui

Q: Do I need to get a vaccine even if I’m young and healthy? Doesn’t the coronavirus mainly affect the elderly?

Dr. Michael Shea, Intensivist and Chief Medical Director, Maui Health: In the first phase of the pandemic, older people seemed to be hit harder by COVID. That’s not the case anymore. The patients we are seeing at the hospital now are much younger than we’ve seen in previous surges, and they’re very sick. Normally, a younger person can fight off serious viral illness without any residual effects, but with COVID we’re seeing otherwise healthy individuals decline quickly.

Currently, around 60 percent of COVID patients being treated at Maui Memorial Medical Center are under the age of 60. This is partly because the Delta variant is so much more aggressive, and partly because younger people are less likely to be vaccinated. Also, younger individuals (compared to those older than 60) are more likely to be out and about, whether it is because their jobs require them to be in contact with people, or they are attending more social gatherings.

The bottom line is the vaccine is very effective at preventing hospitalization, severe illness, and death from COVID-19. The majority of patients we’re seeing in the hospital now are unvaccinated. Sadly, most patients I’ve treated have told me they wish they could turn back time and get the vaccine. Many beg their family members to get vaccinated, so they don’t end up in the hospital.

COVID-19 is not like the flu. With the flu, most people get better after a few days. Rarely does a young, healthy person end up on a ventilator or die because of the flu. Compared with the flu, the severity of COVID illness in young people is staggering, especially with the Delta variant.

The COVID-19 vaccine is safe and highly effective. Protect yourself and your community by getting vaccinated today. If you have medical, religious, or other personal reasons why you can’t or won’t get vaccinated, please take extra steps to stay safe. While it is true that both vaccinated and unvaccinated individuals can contract and spread COVID, current research still shows that vaccinated individuals carry far more protection against serious illness from COVID than those that are not vaccinated.

Q: What is the difference between the third dose and a booster shot? I’m fully vaccinated against COVID-19. Should I get the booster shot?

Dr. Michael Shea, Intensivist and Chief Medical Director, Maui Health: There has been some confusion and misinformation on the COVID-19 vaccine “third dose” also sometimes referred to as the “booster” shot. Many are asking “what’s the difference?” and that is a great question.

The “third dose” of the vaccine, which is available now, is for the immunocompromised individuals who may not have benefited from the full efficacy of the two-shot vaccine series because of their compromised immune system. This can include people who are in cancer treatment, dialysis patients, and people with medical conditions that weaken the immune system, like HIV and sickle cell disease (a full list can be found on the Maui Health website at www.mauihealth.org/covidvaccine). The third, additional dose, is needed to increase vaccine efficacy and essentially “catch-up” to the full protection the vaccine can provide. You can get a third dose if you meet health qualifications, had the Pfizer or Moderna vaccine, and if it has been more than four weeks since you received the second dose. If you received the Johnson & Johnson vaccine, you should not receive an additional dose at this time.

A “booster dose” will soon be offered to individuals who were fully vaccinated and are not immunocompromised, to provide a “boost” to increase vaccine efficacy, as the vaccine has been shown to decline in efficacy after a period of time. To receive the booster dose, you must be at least eight months past your second dose of either the Pfizer or Moderna vaccine. At this time, the Johnson and Johnson vaccine has not been approved for any additional doses. Per the CDC, once the booster dose is available to the general public, we will follow a similar phased rollout as the COVID vaccine, with healthcare workers qualifying first.

Both the third dose and the booster dose are administered in the same way and in the same dosage as the first and second dose.

Also, as a reminder, we are only administering the Pfizer COVID-19 vaccine in our clinic for first, second and third doses. For more details, please visit www.mauihealth.org/covidvaccine.

Finally, we want you to know that the approval of the third dose and booster shots does not mean that the first two doses of vaccine were not effective. Studies continue to show that the vaccine provides lasting protection against COVID-19, and significantly reduces the chance of hospitalization and death. So, if you haven’t been vaccinated yet, it is still the best thing you can do to protect yourself and your loved ones.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on the first and third Thursdays of the month. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.


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