COVID-19 boosters bring thousands to Pa. and N.J. clinics, but experts say more first doses are needed ‘to get out of this pandemic’

More Pennsylvanians are showing up for coronavirus booster shots than are getting newly vaccinated, following a national trend in the first days that boosters of all three vaccines have been available to millions of Americans.

Last week, more than 100,000 Pennsylvanians and 80,000 New Jerseyans got boosters, according to state data, including some who became eligible after the FDA and CDC endorsed Moderna and Johnson & Johnson boosters midweek.

Vaccine providers and health officials across the Philadelphia region said they have seen modest increases in vaccinations since the approval and expected demand to rise further.

“The demand has gone up, but not through the roof,” said Joe Ralston, owner of Academy Pharmacy and Fairdale Pharmacy in Northeast Philadelphia and Village Shires Pharmacy in Holland, Bucks County. “We’re probably averaging half the shots that we did during the peak” in the spring, when nearly 150,000 doses were being administered per day across Pennsylvania.

» READ MORE: What you need to know about COVID-19 booster shots

While shoring up immunity for scores of high-risk Americans, the booster campaign doesn’t chip away at doctors’ and officials’ most pressing goal: to get more people vaccinated.

“We are not going to get out of this pandemic through boosters,” said Delana Wardlaw, a Temple University Health System physician who runs community vaccine clinics with her sister as Twin Sister Docs. “We have to make sure that we continue to reiterate that vaccinating the unvaccinated is still the number-one priority.”

More than twice as many people got boosters last week as got first doses, and the pace of first-time coronavirus vaccinations has slowed — over the last three months, the average daily number of people receiving their first shot dropped 25%. Yet more than a fifth of Pennsylvanians 12 and older are still unvaccinated.

As of last week, all fully vaccinated seniors, high-risk workers, and immunocompromised people are eligible for boosters — along with everyone who got Johnson & Johnson shots. The FDA also approved “mix-and-match” boosters, meaning people can get a different vaccines from what they received before.

Since August, third doses have been permitted for some moderately and severely immunocompromised people, and Pfizer boosters for seniors and high-risk adults got the FDA and CDC’s green light in late September.

Anyone who got single-dose Johnson & Johnson should get a second vaccine two months after their initial shot, the CDC recommended on Thursday.

For Moderna and Pfizer recipients, those over 65, living in a nursing home, or over 50 with underlying medical conditions should get a booster, the CDC said. Those 18 to 49 with underlying conditions or in high-risk jobs are allowed to get a booster. The additional shots are permitted six months after the second dose.

» READ MORE: To encourage COVID-19 booster shots, Philly officials set up shop at senior centers

Though data indicates the vaccines remain effective in preventing severe illness and death, according to the CDC, some studies have indicated that vaccine efficacy wanes over time, prompting the decisions to recommend boosters.

Even with more than 10,000 people getting boosters daily for the last two weeks, just under 10% of vaccinated Pennsylvania seniors have gotten the extra shots, compared to about 20% in about two dozen other states, according to CDC data. In New Jersey, 18% of vaccinated seniors have received boosters, in line with the national average.

In the last week, half of all doses given in New Jersey have been boosters. Since the FDA approval last week, more than 15,000 people showed up for boosters, said Department of Health spokesperson Donna Leusner.

More than three million people in New Jersey are currently eligible for boosters, and more than four million will be by the end of the year, Leusner said. The Pennsylvania Department of Health did not respond to questions about boosters.

Some doctors who advised the CDC and FDA on the decisions debated the merit of the focus on boosters — particularly when millions of Americans still haven’t gotten a single shot.

It’s a debate that added to confusion for some residents, but with COVID-19 science constantly evolving, questions are inevitable “anytime you have new information,” Wardlaw said. Providers in the region said the public should follow the CDC’s recommendations.

Tony S. Reed, executive vice president and chief medical officer of Temple University Health System, dismissed debate among members of federal advisory panels about whether younger people in high-risk settings should get the additional dose alongside older, more vulnerable people.

“The science doesn’t care whether a person is a teacher or a doctor or an environmental service worker,” Reed, a physician, said in an email. “If the immunity wanes over time, then it wanes for all people and we should consider a booster.”

Delaware County medical adviser Lisa O’Mahony agreed: “Our threshold is low for giving boosters,” she said, adding that the county isn’t advising anyone eligible against getting it.

» READ MORE: FDA advisory panel backs Pfizer’s COVID-19 vaccine for kids 5-11. Here’s what else you need to know.

One clear — and expected — trend has already emerged in the first days of eligibility for Johnson & Johnson recipients: Most of them want a different shot.

A National Institutes of Health study — which has yet to be peer reviewed but was presented last week to an FDA advisory committee — found that a Moderna booster increased antibody levels in J&J recipients 76-fold after 15 days, while another J&J dose only upped antibodies fourfold. A Pfizer booster conferred a 35-fold increase.

Out of more than 15,500 New Jerseyans who sought boosters last week, only 500 of them got Johnson & Johnson, and Montgomery County’s clinics administered just 20 J&J doses out of 500 booster shots on Monday.

And at clinics for teachers run by Eric’s RX Shoppe, few educators are choosing to get another dose of J&J, said Marc Ost, co-owner of the Horsham drugstore, which administered nearly a thousand Moderna boosters between Friday and Monday. In one district, out of hundreds of teachers, only a few dozen got J&J again, Ost said.

At his pharmacy, people — mostly seniors — have been flocking to the store for boosters since Friday, said Ost. Though appointments remain widely available across the region, it has created, at least for a few days, an atmosphere “very similar to January and February.”

“We are nuts,” Ost said. “I wish I had more time in the day.”

Graphics artist Chris A. Williams contributed to this article.