Omicron’s toughest foe is a booster shot, yet many in the Philly region are skipping theirs

Hundreds of thousands of Philadelphians vaccinated against COVID-19 have not gotten booster shots, leaving them more vulnerable to the omicron variant and, potentially, other strains of the virus.

Millions of Americans have never had any COVID vaccine, but the low uptake of boosters indicates even people who had been willing to take first and second doses are less eager to queue up for a third shot. The majority of the boosters have gone to white and Asian recipients, according to city data. Just 17% of Hispanics and 19% of Black Philadelphians have received the shots.

During a news conference Wednesday, Philadelphia Health Commissioner Cheryl Bettigole said even grassroots outreach efforts haven’t helped enough with boosters.

“I think it’s been a little bit challenging,” she said. “One of the challenges people have mentioned is worrying about side effects.” Though overwhelmingly mild and short-lasting, for some people side effects have caused them to miss work or school.

Some people feel that two shots should offer enough protection, said Stephanie Reid, who runs the city’s outreach team, Philly Counts. Some say they don’t want to face needles. People also worry about an indefinite string of booster shots looming in their future.

“We’re in the dark days of winter,” Reid said. “I think there is just the compounding effect of the fatigue from COVID.”

Vaccination data from the city Department of Public Health showed 364,404 Philadelphians have received booster shots, just over a third of those who are fully vaccinated. That rate is similar to surrounding counties, and the national rate of 40%. Nationally, booster shots have been declining since December, with almost 55% fewer shots given daily this week than during the week of Dec. 7.

» READ MORE: More than 200,000 long-awaited state vaccination records could change the picture of who’s had COVID-19 doses in Philadelphia

Locally, health officials are most troubled by the fact that about a third of the city’s fully vaccinated seniors have not yet received a booster shot, despite being most at risk for serious illness or death due to COVID-19. About 33% of booster shots have gone to people 65 and older. Pennsylvania doesn’t report booster administrations by age, but in New Jersey, 25% of boosters have gone to those 65 to 79 and almost 8% to those 80 and older.

“Regardless of how healthy you are, you are at greater risk” if you are a senior, said physician Ala Stanford, founder of the Black Doctors COVID-19 Consortium. “You’re blessed with six to seven decades of life, and with that comes a lower immune response.”

The term “fully vaccinated” still refers to two shots of Pfizer or Moderna or a single shot of the Johnson & Johnson vaccine, but that definition is increasingly misleading, health experts said. The vaccines’ effectiveness wears off after five to six months, leaving people more vulnerable to any type of COVID-19. Omicron — by far the dominant strain — has proven adept at evading the vaccines’ protection without a recent booster shot.

“It’s about omicron because that’s what’s predominating, but it’s just about COVID in general,” Stanford said. “You’re better protected against anything if you get a booster.”

Booster shots are available to anyone:

Booster shots have played a significant role in keeping Americans out of the hospital, a CDC study released this month showed, notching a 90% effectiveness rate against omicron, and 94% against the delta variant.

Booster shot data released Wednesday for the first time included Philadelphians who got their shots outside the city, important because it makes the data more accurate — and more positive, Bettigole said. About 44% of the city’s 5- to 11-year-olds have received at least a single dose, the data showed, almost 10 percentage points higher than the city had previously reported.

Almost 73% of the city’s 12-and-older population is fully vaccinated — but again, most are not boosted.

Meanwhile, case counts, hospitalization rates, and positivity rates continue to show the omicron surge is declining, though still a danger, Bettigole said.

Case counts are down 75% compared to the peak of the wave on Jan. 12, she said. The rate of positive tests is 12%, compared to almost 40% on Jan. 4. And there were 912 people with COVID-19 in city hospitals this week, she said, down 30% from a week ago.

Aroonsiri Howell, a geriatrician and associate professor of medicine at the Lewis Katz School of Medicine at Temple University, said she’s not surprised many seniors aren’t getting boosted.

“If you’re in North Philly and you have impairment in your function or your cognition, it’s really hard to get a vaccine,” she said. “I think there’s a section of people who are too sick or too poor and they say, ‘Life got away from me.’”

Lack of internet access, confusion over how to make an appointment, or transportation problems all may keep seniors from their shots, Howell said. About 81% of those 65 and older got the first two doses, suggesting that the Health Department was able even to reach the homebound, she said. But that effort has to be continually renewed.

“If we’re going to need boosters every six months going forward,” Howell said, “we need to do better for homebound patients or patients with disabilities.”

Philly Counts’ door-to-door outreach has been limited to apartment buildings due to the cold weather, Reid said. Last week her team met with the Health Department about identifying senior apartment buildings canvassers could focus their efforts on

» READ MORE: How many Philadelphians need boosters? Vaccine-tracking challenges make it ‘impossible to say.’

Of the 3,500 people ages 65 and older in some of the city’s least vaccinated neighborhoods her staff has talked to, about 78% say they have had their booster shots. Reid said it’s possible people don’t want to admit they haven’t had a shot — either out of embarrassment or because they just don’t want one. Some people could be confusing their second dose with a booster shot, she said.

In late December, the Health Department identified 24 nursing homes where fewer than 70% residents had received booster shots, spokesperson Matt Rankin said. Three responded, saying their booster rates have improved, and the department is working with the others to improve their rates. Almost 78% of the city’s nursing home residents are boosted, he said.