Updated Information Shared on Vaccines, Boosters, and Monoclonal Antibodies

There have been several recent developments at the federal level regarding the COVID-19 vaccine that may bring up questions for the public. Of particular note, the U.S. Food and Drug Administration has authorized boosters of the Moderna and Johnson & Johnson vaccines, as well as mixing and matching of boosters. Along with vaccines, monoclonal antibodies are being administered to help patients fight COVID-19. To help answer questions in the community, here is a rundown of vaccine and booster announcements and what they mean, as well as who is eligible for vaccinations and monoclonal antibodies. We will also list resources at Glendive Medical Center, the Dawson County Health Department, and in the community.

• Johnson & Johnson booster – The U.S. Food and Drug Administration (FDA) authorized boosters of single-shot Johnson & Johnson COVID-19 vaccine for anyone age 18 and older at least two months after their initial dose. However, the CDC must first formally recommend the booster before it can be administered, which is expected within the next week.
• Moderna half-dose – The FDA authorized a half-dosage booster shot of the Moderna COVID-19 vaccine for seniors, younger adults with certain health problems and people in jobs or living situations that put them at increased risk from COVID-19, including health care personnel, six months or more after their initial series. While authorized, the CDC must first formally recommend the booster before it can be administered, which is expected within the next week.
• Mix and match booster – This week, the FDA authorized the administration of COVID-19 vaccine booster shots that are a different brand from a person’s initial doses.
• Pediatric vaccination – Currently, the Pfizer vaccine is approved or authorized for children ages 12 and older. Federal agencies are reviewing the use of the Pfizer vaccine for children ages 5 to 11, but no final approval has been granted at this time.

• Who is eligible:
  • Pfizer – All adults age 18+, children ages 12 and older.
    • Booster eligibility includes older adults (65+), adults age 50-64 with underlying medical conditions, residents of long term care facilities and people who work in jobs with a higher risk of COVID-19 exposure, including health care personnel.

• • Moderna – All adults age 18+.
    • Boosters have been authorized for seniors, younger adults with certain health problems and people in jobs or living situations that put them at increased risk from COVID-19, including health care personnel. They are expected to be available soon, pending formal CDC recommendation.

• • Johnson & Johnson – Adults age 18+ can receive the single-dose vaccine. Boosters have been approved for anyone age 18 or older and are expected to be available for administration soon, pending formal CDC recommendation.
  • Third dose for immunocompromised people - The U.S. Centers for Disease Control recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose.

• Where can you receive the vaccine and/or boosters?- A community vaccine clinic is going to be held at Glendive Medical Center in the Carney Conference Room on November 12^th from 8am-4:30pm for anyone wishing to receive their first dose or boosters. Patients must call 406-345-8901 to schedule an appointment time. Please be sure to specify if you are receiving a first dose along with your preferred vaccine, or a booster. A follow-up clinic for second doses and boosters will be offered on December 10^th, same time and place.

If an individual is unable to make the community vaccine clinic, Dawson County Health Department offers the Johnson & Johnson as well as the Pfizer vaccine by appointment. Please call 406-377-5213 to schedule these vaccines. The Moderna vaccine is available at Albertson’s in Glendive by calling 406-365-3324 to schedule.

What are monoclonal antibodies and who is eligible?- Glendive Medical Center offers high-risk COVID-19 patients with mild to moderate symptoms monoclonal antibody treatments in the outpatient setting. In ongoing clinical trials, these monoclonal antibodies (lab engineered antibodies against the spike protein of SARS-CoV-2) have been shown to possibly reduce viral load and reduce likelihood of advancement to severe disease/hospitalization when given early in the illness of high-risk patients. The following criteria must be met to receive these treatments:

• Are an adult or pediatric (≥ 12 years of age and weighing at least ≥ 40 kg) patient
• Have tested positive for COVID-19
• Are experiencing mild or moderate symptoms of COVID-19
• Experienced your first symptoms of COVID-19 in the last 10 days
• Are at high risk for having more serious symptoms of COVID-19 and/or going into the hospital

People can be at high risk because of many reasons including their age, having an underlying medical condition, and other things. Some of the most common reasons are listed below:

• Age ≥ 65 years
• Obesity or being overweight based on Centers for Disease Control and Prevention clinical growth charts
• Pregnancy
• Chronic kidney disease
• Diabetes
• Immunosuppressive disease or immunosuppressive treatment
• Heart or circulatory conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension)
• Chronic lung diseases including COPD (chronic obstructive pulmonary disease), asthma (moderate to severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
• Sickle cell disease
• Neurodevelopmental disorders such as cerebral palsy
• Having a medical device (for example, tracheostomy, gastrostomy, or positive pressure ventilation [not related to COVID-19])

Glendive Medical Center has received a limited number of doses of Bamlanivimab and Casirivimab + Imdervimab from the State of Montana. There is uncertainty as to what future allotments from the state might look like. Due to uncertain supply, eligibility criteria will continue to evolve through input from a state taskforce and local clinical leaders.