Local doctors discuss when the boosters may be distributed, and answer questions.

When it comes to COVID-19, its variants, and the potential need for inoculation beyond the initial single- or two-dose vaccines, one fact is key.

There's a big difference between a so-called "third shot" and a booster, according to experts Wednesday during the Newsday Live webinar, "Delta's Rising: When Can I Get a Booster?"

While few are in medical need of a third shot, the experts said, most will ultimately be able to get a booster should they choose.

The third shot is basically identical to those in the two-dose Pfizer and Moderna sequences and is for a small percentage of the population with severely compromised immune systems due to underlying medical issues, according to Dr. Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine, and Dr. Philip Solomon, director of Geriatric Education and Clinical Integration for Northwell Health.

Candidates for a third shot who did not develop significant antibodies after initial doses would be organ transplant recipients or patients with certain either types of cancer or HIV.

For them, the experts said, a third shot has been recommended about 28 days after the second vaccine dose.

A booster shot, Fries and Solomon said, will likely involve a supplemental dose, intended to "boost" the immune response already generated. For Pfizer and Moderna recipients, this would begin about eight months after their first two vaccination rounds.

Guidance on boosters from the Food and Drug Administration, and likely approval, is expected around Sept. 20, Fries said.

For Johnson & Johnson recipients, the experts said, health care professionals are still awaiting the result of studies by the FDA, which could come in November.

"All of these decisions are based on data," Fries said, adding that immunocompromised patients "tend to have lower antibody response" to COVID vaccinations, while most other recipients actually generate fairly significant antibody development and immune system responses — necessitating only the need for a booster.

Solomon noted that the difference between a third shot and booster has been "a point of confusion" for many.

For those receiving booster doses, the experts said, there should be no interference with their ability to get vaccinated for the flu, shingles or many other diseases.

But consult a physician prior to any medical treatment, the experts stressed.

The delta variant is "more infectious. It replicates faster and it infects more people . . . It's so fast, so efficient," Fries said.

Fries and Solomon agreed that the variant's rise makes it even more important that people wear masks, follow social distancing guidelines when possible, and practice good personal hygiene, in addition to getting vaccinated.

Even though booster shots are still unavailable for most, for those already vaccinated, chances are that if they become infected it won't be anywhere near as bad as if they hadn't been inoculated, the experts said.

"People who are vaccinated or who have had both shots still have great protection," Solomon said.

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