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Powell’s death sharpens focus on ‘immuno- compromised’ and need for booster shots

The death of Colin Powell from complications of COVID-19 on Monday (Oct. 18) was shocking news, while giving anti-vaxxers an opening to question the efficacy of the COVID vaccines.  

Powell, 84, the first African-American U.S. Secretary of State and a former chairman of the Joint Chiefs Staff, had been fully vaccinated, but had serious pre-existing medical issues.

Powell was scheduled for the booster last week, just before he became ill, according to his longtime chief of staff.

His health issues brought into focus a growing concern doctors have for patients who are “immuno-compromised,” which leaves their immune system in a weakened state and not fully able to fight off infections.

COVID-19 has been of particular concern.

Powell was battling both multiple myelomas, or cancer of the blood, as well as Parkinson’s Disease. 

Those facts are something many vaccine opponents either ignored or did not consider concerning Powell’s breakthrough COVID-19 case and death.

According to the World Health Organization (WHO), a booster could be life-saving for an immuno-compromised person. 

Research shows that people who have serious immuno-compromised conditions need the third shot to achieve the primary response that should have occurred with the original vaccination.

A booster is the third dose of either the Pfizer or Moderna, vaccine, and the second shot of the Johnson & Johnson vaccine. Boosters, generally, are not higher doses than the other shots. Generally speaking, they are the same strength, but add another layer of protection from COVID-19, according to WHO.

“It may be necessary to receive a third dose because those first two aren’t doing what they do in, otherwise, normal, healthy people,” said Dr. Katherine O’Brien, director of the WHO’s Department of Immunization, Vaccines and Biologicals.

O’Brien continued, “We do see evidence that the third dose actually increases the immune response.”

Dr. Stanley Dowell is a primary care physician, who treats, primarily, seniors.  Many of his patients are immuno-compromised. 

Not only should these patients be fully vaccinated, Dowell said, but they should get the booster as quickly as it becomes available to them.

“When a patient is immuno-compromised, their bodies are unable to mount an immune response to infection,” said Dowell. “No antibodies are being produced to fight the virus. When the level of antibodies increases, the patient can wage a more robust resistance to COVID-19,” said Dowell.

Most of Dr. Stanley Dowell’s patients are seniors and many are immuno-compromised. (Courtesy photo)

“A positive outcome is more likely for immuno-compromised patients who receive the booster. It could make all the difference,” Dowell added.

Shelby County Health Department Medical Officer Dr. Bruce Randolph agreed that vaccination and booster shots for seniors are the best protection from the coronavirus, especially those who are immuno-compromised.

“We learned that Colin Powell was already fighting multiple myeloma, which is cancer of the blood, as well as Parkinson’s,” said Randolph. “Immuno-compromised individuals account for many of the breakthrough cases of COVID-19. 

“Because the level of protection is not what is would be in a healthier individual, severe illness and death are the result. That is why the booster makes sense for more vulnerable seniors and others.”

For weeks, boosters have been approved for immuno-compromised persons.

Only Pfizer, to date, has been approved by the Food and Drug Administration (FDA). 

But on Oct. 14, a panel of medical experts convened by the Food and Drug Administration (FDA) recommended that a Moderna booster be approved to open up third shots to more Americans.

Dr. Bruce Randolph

Randolph said booster shots are being recommended in Shelby County for persons 65 and older, those under 65 with immuno-compromising conditions and persons at higher risk for contracting COVID-19 because of their employment (working in close proximity to many people).

“Many of our seniors live in multi-generational households,” said Randolph. “We continue to encourage all those eligible to get vaccinated. Anyone eligible to receive a booster should take it, especially in households with children and seniors. 

“Being a senior does not put a person at greater risk. Anyone can be infected. What matters is the level of protection,” Randolph said.

Taking a booster has raised concerns about whether a person will get ill, or what side effects might be expected. Taking the booster is like taking the vaccination shot, according to Dowell. 

“A healthy person taking the booster may come down with a slight fever because the shot will cause a low-grade infection,” said Dowell. 

“They may feel sick, maybe a slight headache for 24 hours and that’s it. In an immuno-compromised person, it may take a few days, a week or so, to feel better.” 

Boosters should be consistent with the vaccination, Dowell said.

“Generally speaking, the booster should be the same as what was taken for the vaccine initially,” said Dowell. “But, in the event that there is no other choice, then the booster can be a mixed dose. A booster is the best protection after vaccination.”

The Centers for Disease Control and Prevention (CDC) currently “does not recognize mixed vaccines.

But the website states that the mixing of Moderna and Pfizer doses is acceptable in “exceptional situations,” such as when the initial vaccine is no longer available.

In mid-October, however, an advisory panel to the Food and Drug Administration (FDA) recommended emergency use authorization) of Moderna and Johnson & Johnson COVID-19 booster shots. Both are expected to be available in coming days.

According to the covid19.memphistn.gov website, the Pfizer booster shot is available in Memphis and Shelby County to:

■ Persons 65 and older.

■ Residents in long-term care settings.

■ People aged 50-64 with underlying medical conditions.

■ People aged 18-49 years with underlying medical conditions, based on individual benefits and risks.

■ People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of their occupation or institutional setting, based on individual benefits and risks.

Vaccinations and boosters are available at the Midtown Pipkin Building, Southwest Tennessee Community College-Whitehaven, Shelby County Health Department Immunization Center and Germantown Baptist Church.

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