Christina Salazar vaccinates Sebastian Gonzalez at Rosa Parks Elementary on November 13, 2021. Credit: Kelly Sullivan

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Michael Souza was trying to get one of the new Moderna COVID-19 boosters, but the 33-year-old Oakland resident wasn’t having much luck finding an available appointment. He tried going through his insurance provider and checked chain pharmacies all over the area, some telling him they were having issues with the supply chain. 

Souza’s luck changed Thursday when he learned that the Center of Hope Community Church on MacArthur Boulevard in Oakland was hosting a vaccine clinic run by Umoja Health and had doses. Souza was able to get his, just before they closed up for the day around 2:30. 

Souza said he really didn’t need the added incentives—$10 or $25 gift cards to Target and DoorDash, respectively—but staff members at the vaccine site insisted. When The Oaklandside visited the site earlier that day, there were more workers ready to check people in than there were people to give shots to. “Everyone working there thanked me for coming,” Souza told The Oaklandside. “Really friendly people.” 

Souza’s experience echoed the early days of the COVID vaccination effort, when a sudden demand for new vaccines was met with limited supply, and there was no centralized place to book an appointment. 

The Center of Hope clinic, for example, was listed on Alameda County’s vaccination calendar but didn’t show up in a search on the MyTurn, the state’s website for booking COVID vaccines and tests. 

In Berkeley, Mayor Jesse Arreguin sent an email on Sept. 15 saying that booster appointments were now available, and encouraging residents to schedule through Carbon Health at vaccine clinics being coordinated by the city on specific dates in September and October. But on Monday, a search for appointments on the site returned a message saying there were “no available times or licensed providers.”

On social media, people have reported mixed results in getting their latest shots. Some have found appointments at walk-in clinics with ease, while others reported appointments being canceled due to a shortage of boosters. 

Neetu Balram, the spokesperson for the Alameda County Public Health Department, said there hasn’t been a “rush” of people wanting boosters, unlike when the initial vaccines rolled out. Doses of the new boosters, she said, should be widely available through healthcare providers and pharmacies.

“We continue to prioritize partnering with organizations to place clinics and vaccine in communities that have been disproportionally impacted by COVID-19 and have greater barriers to access,” Balram told The Oaklandside. 

In Oakland, one of those organizations continues to be Umoja Health. Dr. Kim Rhoads, Umoja’s founder and associate director of UCSF’s cancer center, said demand for the booster hasn’t picked up yet and will take time, and messaging. 

“I think there’s a lot of skepticism about why you need another booster,” Rhoads said. “And the fact that it’s called a booster makes it seem like, ‘Well, I already have two boosters. So why do I need another one?’ I’m not sure the messaging has been effective in helping people understand it’s a targeted booster” for the more contagious omicron subvariants BA.4 and BA.5.

Why get a new booster?

Dr. Rita Ng, physician-in-chief at Kaiser Permanente Oakland, said that BA.5 is now the predominant omicron variant of the novel coronavirus currently spreading in the United States. 

“It’s causing most of the cases in the U.S. and also predicted to continue to circulate through the fall and winter,” Ng said. “Hence, the importance of this new vaccine.” 

The new boosters are “bivalent” vaccines, which means they are designed to prime a person’s immune system against two variants of the coronavirus. In this case, it’s the BA.4 and the BA.5, as well as the original novel coronavirus that was first discovered in Wuhan, China in 2019. 

The U.S. Centers for Disease Control and Prevention has stated that adults can get either one of the new bivalent Pfizer or Moderna boosters, regardless of which boosters they received previously. In other words, if you received Moderna for your first two or three shots, you can get the Pfizer booster and it should provide the same protection. 

Balram said that as of Friday, the county’s first pre-order of the updated Moderna booster—600 doses—had been delivered, and that vaccine sites around the county had administered 375 of those doses. Because the new Pfizer shot “is readily available,” Alameda County health officials are encouraging healthcare providers to order the Pfizer boosters now instead of waiting on Moderna booster deliveries. 

Since the new Pfizer and Moderna boosters were approved by the U.S. Food and Drug Administration on Aug. 31, Alameda County has recorded 1,175 boosters administered, Balram said Friday. 

Who should get a new booster?

Dr. Nicholas Moss, Alameda County’s head doctor, said that the new Pfizer boosters are recommended for anyone over the age of 12 and the Moderna shots for anyone 18 and older, if they’ve already received their first and second doses of either brand.

“They can be given as early as two months after the last vaccine dose and they are already available, so people can get them at this time,” Moss told the county’s Community Advisory Group on Tuesday. 

The FDA deauthorized all previous COVID boosters for people 12 and older when approving the new boosters, so the bivalent boosters should be the only type available at vaccine sites.

Moss said there’s currently no new booster recommended for children under the age of 12. Many young children are still currently completing their initial three-shot cycles after the FDA approved children as young as six months for the Moderna and Pfizer shots on June 17

“As we head into fall and begin to spend more time indoors, we strongly encourage anyone who is eligible to consider receiving a booster dose with a bivalent COVID-19 vaccine to provide better protection against currently circulating variants,” FDA Commissioner Dr. Robert M. Califf said in a statement.

Alameda County vaccine rates are high, and cases remain low

Alameda County has delivered close to 4 million doses of the vaccine (all versions) to date, with 1.4 million residents, or 86% of the population, considered fully vaccinated. Most doses now being given on a daily basis are booster shots for fully vaccinated adults. 

By the time the newest boosters were approved, the seven-day average for all COVID vaccines administered in Alameda County had dwindled to 975, a whisper from the peak of 21,000 in April 2021, when mass vaccination sites were available all over the county.

According to Alameda County’s COVID-19 dashboard, positive test rates have ticked up slightly to near 6%, but it’s a far cry from the 18% spike in early July. Total COVID-related hospitalizations county-wide continue to hover around 100.

Ng said the new boosters are meant to provide immunity against permutations of the now-dominant variants, much like the annual flu virus attempts to stay ahead of mutating versions of the influenza virus. Early data, she said, show the new vaccines and boosters are working. 

“Even if you get COVID, having been vaccinated and boosted, your chances of having severe disease are much lower, and your chances of getting hospitalized are much lower,” said Ng.

Getting vaccinated, tested, and wearing masks in some environments are still encouraged

Kaiser Permanente will have the new COVID boosters available by appointment and at walk-in clinics alongside the annual flu vaccine, said Ng, as they did at this time last year.

But health messaging remains a crucial part of the continuing vaccine effort, whether getting people their initial doses or the new boosters. The county’s strategy remains “meeting people where they are,” in terms of both physical location and culturally relevant messaging. 

“We try to make sure that we reflect the communities we serve,” Ng said. “And that’s everything from mindset to the programs that we offer, to pamphlets and medical information provided in multiple different languages and making sure that our facilities feel safe [for] people to get care.”  

Umoja is urging people to get their boosters now to protect themselves against the dominant variants that are currently spreading and expected to get worse as people head inside and gather for the holidays.

But Rhoads says the messaging still needs to be about wearing masks, testing if you feel sick, and being vigilant about ventilation if you gather indoors, even if everyone is fully vaccinated and up to date on their boosters.  

“People should not be reassured that because they’re vaccinated that they can now do family gatherings indoors with the windows closed and poor ventilation,” Rhoads said. “It doesn’t work like that. That’s not what this vaccine is meant to do and never was.”