memorial hospital from right

Memorial Hospital in North Conway is seen Thursday. Memorial officials said Wednesday the hospital is giving third shots of the Pfizer and Moderna COVID-19 vaccines to people who have compromised immune systems but not to the general population. (RACHEL SHARPLES PHOTO)

CONWAY — While many people have yet to receive their first shot of the COVID-19 vaccine, some who have gotten the vaccine are anticipating getting a third shot this fall following President Joe Biden's announcement last month that booster shots were coming.

“We are getting some calls and walk-ins asking for the booster shot, but we are not scheduling booster shots at this time,” hospital spokesperson Tim Kershner said Wednesday.

“We are waiting for approval from the FDA, the ACIP (the Centers for Disease Control's Advisory Committee on Immunization Practices), and we are waiting for guidance from the New Hampshire Department of Health and Human Services," he said.

President Biden and the CDC have said booster shots for healthy people could start as soon as Sept. 20, but the plan has not received approval, and the FDA is meeting today to discuss boosters of the Pfizer vaccine (tinyurl.com/bb3h68c6).

Scientists are reportedly still debating evidence that may suggest the vaccines' effectiveness is waning, as well as the need to give people boosters when others around the world have yet to receive a single shot.

According to Our World in Data, a website run by Oxford University, 46 percent of the world’s population has received one dose of the vaccine but the doses are not evenly distributed and even countries with high vaccination rates are experiencing surges in COVID-19. About 54 percent of the population of New Hampshire, as well as of U.S., is fully vaccinated.

Some studies indicate an increase in illnesses in people who were vaccinated last winter and spring, but most scientists and health officials say that the vaccines are still very effective in reducing severe disease, hospitalization and death.

Cases of COVID-19 have been rising in New Hampshire and around the U.S. since the end of July. New Hampshire is currently averaging about 430 new cases a day over the past week.

Matt Dunn, chief medical officer at Memorial Hospital, said at an Aug. 30 meeting,"The reason the booster is being offered is to increase our protection.”

Among questions scientists have yet to clearly answer is how much of the reported reduced effectiveness of vaccines is due to loss of antibodies and how much is due to new variants.

Dunn said: “It has to do both with the challenge around the Delta variant, which we know is more virulent, as well as the decrease in neutralizing antibodies that we see, really starting at about six months, but eight months is where it becomes more more prevalent.

“And the idea of the third dose was to kind of boost those neutralizing antibodies back up to very high levels," he said.

Memorial Hospital officials in recent Zoom meetings talked about confusion over the two categories of shots and who can and should get a third dose of the vaccine right now.

A third dose is approved for those who are moderately to severely immuno-compromised. In general, these are people who have an illness or treatment that weakens their immune system, such as some cancer treatments, organ and stem-cell transplant patients, advanced or untreated HIV infections, or who are on high-dose corticosteroids or other drugs that suppress the immune system.

While the CDC recommends that people talk to their health-care provider about their medical condition, and whether getting an additional dose is appropriate, Memorial officials say a referral is not necessary.

Memorial Emergency Preparedness Coordinator Will Owen said the state and CDC are asking clinics to do everything they can to reduce barriers for people to get vaccinated.

The hospital continues to operate its COVID-19 vaccination clinic at the former Mt. Washington Observatory Weather Discovery Center in North Conway Village on Wednesdays from 8 a.m.-4 p.m.

To get a booster, "You simply need to walk in and self-attest that you have an immuno-compromise,” Owen said. “We will dig into that a little bit more, because we have a specific list. And then we'll make the decision right then and there. But, no, you do not need a doctor's note or anything like that — just a conversation with our vaccinators.”

If there is a question as to whether a third shot is appropriate, the clinic might send the person to their primary-care provider for a referral.

The third shot should come at least 28 days after the second shot of the vaccine.

The hospital is currently giving about 50 vaccination shots a week, according to Kershner, with about 45 percent being first shots.

“The numbers have been going up, but they’ve been kind of crawling up, not jumping up," Kershner said. "Any increase is a good sign, but we still have a long way to go to get our community fully vaccinated."

Dunn clarified that whether it's the first, second or third shot, the doses themselves are identical.

Calling it a semantic difference, Dunn said, “I know there's some confusion around the term 'booster.' In fact, ACIP said we should actually not use that term because we think of boosters, like the seasonal flu immunization, as a different immunization every year. What we're calling a booster currently really is a third dose that is to boost back up our current antibodies.”

Some people have questioned the point of getting the COVID-19 vaccine or another shot since people who have been vaccinated can still get COVID and are still asked to wear masks.

Dunn said it is not uncommon for antibodies to wane over time and the possibility of a booster does not mean the vaccine is not effective.

Dunn said, “We know from the data nationally, those that are vaccinated have a much lower risk of severe disease with COVID."

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