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Maryland to start testing antibody levels in nursing home residents to determine if fourth shot of COVID vaccine is needed

Baltimore Sun - 1/21/2022

Maryland Gov. Larry Hogan said the state would begin testing nursing home residents’ antibody levels over the next two weeks to determine if they needed fourth doses of COVID-19 vaccines.

While fourth shots of vaccine have been administered in other parts of the world, they have not yet been authorized by the U.S. Food and Drug Administration for use. But Hogan said Maryland would move ahead of the federal government if the antibody levels indicated waning immunity among many of the state’s most vulnerable residents.

“We hope [fourth doses] won’t be necessary, but we will be prepared to take action if it is deemed necessary,” Hogan said at a news conference Thursday in Annapolis.

The virus tore through the state’s nursing home population in the initial months of the coronavirus pandemic, with many lacking sufficient infection control protocols. Residents were prioritized for COVID-19 vaccinations right after the FDA authorized them for use in December 2020, and they were among the first in the state to receive booster doses.

Boosters have become critical to the fight against the coronavirus and have been proven to help reduce the risk of serious infection and virus transmission, especially during the latest surge fueled by the more contagious omicron variant. Third doses are now considered part of Pfizer/BioNTech and Moderna’s full vaccination regimen, and should be given six months after the second dose.

People who are unvaccinated or not fully vaccinated account for the vast majority of hospitalizations and deaths caused by COVID-19, according to state and hospital officials. Hogan, who received his third shot in August and contracted the virus in December, encouraged people who were not yet boosted to reconsider.

“No one should think of the booster as a bonus or an extra dose,” Hogan said, adding that his wife, Yumi, tested positive for COVID-19 this week and is only experiencing mild symptoms, likely due to her being fully vaccinated. “Getting your booster shot as soon as you are eligible is absolutely critical to protecting you from severe illness from this virus and its variants.”

The state, in partnership with the University of Maryland, Baltimore, and Johns Hopkins, will start the new round of antibody testing this week, Hogan said. The last round of antibody testing in August among older adults in congregate care settings found more than 60% of those tested had some degree of waning immunity, Hogan said.

Maryland was the first state to move ahead of the federal government in administering booster doses to this population, Hogan said. He said that decision proved to be one of the most critical choices the state made during the pandemic.

Members of the Maryland National Guard, mobilized about two weeks ago by Hogan to help hospitals and health care workers handle a crush of patients seeking care, have begun delivering remdesivir, a lifesaving antiviral medication, to institutional pharmacies that serve nursing homes. The state health department has instructed providers to conserve their supply of antiviral drugs based on need after the federal government determined that only remdesivir proved effective against omicron.

And starting Friday, staff, volunteers and vendors at nursing home facilities in counties with high transmission rates of COVID-19 will be required to get tested twice a week to prevent virus spread there, according to an updated Maryland Department of Health order. People who have tested positive for the virus in the past 90 days are exempt.

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