Now that new Omicron boosters have FDA approval, how soon could they come to Fresno?

A doctor who leads one of the largest coronavirus vaccine and testing programs in Fresno County hopes approval of new booster vaccines by federal regulators will re-energize demand among residents.

The boosters, which have the capability to bolster resistance against the virus mutations believed responsible for almost all of the new coronavirus infections in California and the U.S., won emergency approval Wednesday from the U.S. Food & Drug Administration.

The U.S. Centers for Disease Control and California Department of Public Health also need to sign off on the boosters, and the CDC is expected to issue guidelines this week on who should receive the shots first.

Once those hurdles are cleared, local public health officials will have another weapon in their arsenal to combat the ever-changing virus – even as vaccine rates in Fresno County and neighboring counties in the central San Joaquin Valley have remained stagnant for months and lagged behind California’s statewide rate.

The vaccines could be available within as soon as a week, said Dr. Kenny Bahn, a physician with the UC San Francisco medical education program in Fresno.

“The FDA sent its approval (Wednesday), but there are still a few regulatory steps before we can get it,” Banh said Wednesday. “We don’t have the vaccines yet, and we can’t give the shots until we have them.”

Banh, who leads the UCSF-Fresno COVID-19 Equity Project’s vaccination and testing clinic on Shaw Avenue near the Fresno Fashion Fair shopping center, said his program has already pre-ordered the vaccines.

“But we don’t have a ship date yet; we don’t know when it’s coming.”

“I think people will be excited, including myself, because of the high rates of protection” that the new boosters can provide, he said. “I’m super ready. I’ve got kids over 12 years old in school, where almost nobody’s wearing masks anymore in those settings.”

Dr. John Zweiffler, a public health physician with the Fresno County Department of Public Health, and public health nurse Scotti Blanks issued a statement Wednesday afternoon expressing their pleasure at the FDA’s action to authorize the new boosters.

“This offers the very real opportunity to not only prevent serious complications such as hospitalizations and deaths that the original COVID-19 vaccines offered, but also to prevent new cases of COVID-19,” Zweiffler and Blanks said.

“Even as the original vaccines decreased hospitalizations and reduced deaths, Fresno County has continued to see high levels of COVID-19 transmission that has disrupted lives and businesses.”

To date, Fresno County health officials reported that 13 health provider locations in the county have ordered doses of the new booster from the state, and “these doses are expected to arrive in Fresno County next week,” Zweiffler and Blanks said.

The Associated Press reported Wednesday that the U.S. had already purchased a combined 170 million doses of the new boosters from Pfizer-BioNTech and Moderna.

Pfizer said it could ship up to 15 million of those doses by the end of next week. Moderna didn’t immediately say how many doses are ready to ship but that some will be available “in the coming days.”

The Sacramento Bee reported that retail pharmacy chain CVS plans to administer both the Pfizer-BioNTech and Moderna bivalent COVID-19 booster vaccines once the CDC gives the green light to do so. In a email, CVS West region spokesperson Monica Prinzing said CVS locations across California will receive their vaccine supplies over the next few days. Eligible residents – as determined by CDC guidance – will be able to make an appointment on the CVS Pharmacy website or on the company’s app.

Banh said it doesn’t matter where people get the new booster once they are eligible. “We’re the busiest megasite for vaccines in Fresno County, for sure,” he said of the COVID-19 Equity Project. “But it’s all hands on deck. We’ll be happy if they get it through a pharmacy, through their primary doctor, a clinic or from us. We just want everybody to get protected.”

How it works

Since December 2020, when the first vaccines against COVID-19 received emergency use approval from the FDA, the three vaccines available in the U.S – two-shot products from Pfizer-BioNTech and Moderna, and a one-dose vaccine from Johnson & Johnson – have been aimed at the primary strain of COVID-19. They were also shown to be effective at limiting the severity of cases from subsequent coronavirus variants including the delta strain that dominated new infections from the summer of 2021 into last winter.

The new vaccines are blends, or “bivalent” vaccines, that target the current dominant BA.4, BA.4.6 and BA.5 subvariants of the omicron strain of coronavirus, as well as the original COVID strains that arose in early 2020. The California Department of Public Health reports that as of last week, the three omicron subvariants represent 96% of new COVID-19 cases in the state.

Nationwide, the three mutations make up all but 0.2% of new coronavirus cases, according to the U.S. Centers for Disease Control.

In a statement issued Wednesday, the FDA authorized the vaccines to be given as a single booster dose at least two months after a person has received their primary or previous booster vaccinations. Moderna’s new formulation is for a single dose booster for people ages 18 and up. The Pfizer-BioNTech product is authorized for people age 12 and older as a single-dose booster.

Banh said it’s important for people to realize that the new vaccines are only authorized as boosters, not as a person’s primary vaccination.

The Moderna and Pfizer products both contain two genetic components – one for “the original strain to provide an immune response that is broadly protective against COVID-19,” the FDA said in its statement, and another that has common characteristics with “the omicron variant BA.4 and BA-5 lineages to provide better protection against COVID-19 caused by the omicron variant.”

“Based on the data supporting each of these authorizations, the bivalent COVID-19 vaccines are expected to provide increased protection against the currently circulating omicron variant,” the FDA reported.

Wednesday’s authorization also discontinues the previous FDA action that allowed for the original “monovalent” Moderna and Pfizer vaccines to be used as booster doses for people ages 12 and older. Those vaccines remain authorized as a primary vaccine dose for people as young as 6 months old, as well as for a single booster for children ages 5 through 11 years old.

Local vaccination rates

As of early this week, vaccination rates in Fresno County have been largely flat for months. At the end of February, just under 600,000 county residents – about 58% of the population – had been “fully vaccinated” with two doses of either the original Pfizer or Moderna vaccines or one dose of the single-shot Johnson & Johnson vaccine.

Now, six months later, the rate of fully vaccinated residents has climbed by only a little more than two percentage points, to 60.3% or fewer than 623,000 people..

By contrast, the statewide vaccination rate is almost 71%.

Fresno County has a population of about 611,000 people who have been eligible to receive booster vaccine doses; of that number, just over half – almost 308,000 – have received those follow-up doses. Statewide, almost 60% of the booster-eligible population have gotten those shots.

Banh said some of the lagging vaccine rates have been among people who remained unconvinced that the original vaccines would be effective. “I have some hope that the new vaccine will help people get over that,” he said. “But there is a large population that doesn’t want to be vaccinated and are actively trying to avoid vaccination. … I’m not sure improved vaccine efficacy will make a difference for those people.”

Almost all of the vaccine doses given by the COVID-19 Equity Project over recent months have been for boosters, Banh added. “We’re only minimally doing (first) vaccines.”

While the boosters could help avoid a winter surge similar to what the region experienced in 2020 and 2021 – including a deadly spike in cases, hospitalizations and fatalities last winter – health officials advise that people still need to take common-sense precautions to reduce rates of transmission in the community.

“”Continue to stay home if you are sick and get tested,” Zweiffler and Blanks said, “and consider wearing a well-fitting mask such as a KN-95 when in high-risk settings such as crowded indoor spaces where others are unmasked or unvaccinated.”