COTTAGE GROVE SENTINEL | AUGUST 19, 2021 | 3A
Additional dose of mRNA COVID-19 vaccine recommended for
immunocompromised
The U.S. Food and Drug
Administration
(FDA),
Centers for Disease Control
and Prevention (CDC) and
Western States Scientific
Safety Review Workgroup
have all recommended an
additional dose of mRNA
COVID-19 vaccine be ad-
ministered to people with
moderately to severely com-
promised immune systems.
On Aug. 12, the U.S. Food
and Drug Administration
(FDA) adjusted the existing
Emergency Use Authoriza-
tions (EUA) for the Pfizer
and Moderna COVID-19
vaccines to allow certain im-
munocompromised people
to receive a third, additional
dose of vaccine.
“The country has entered
yet another wave of the
COVID-19 pandemic, and
the FDA is especially cogni-
zant that immunocompro-
mised people are particular-
ly at risk for severe disease,”
said Acting FDA Commis-
sioner Janet Woodcock,
M.D. “After a thorough re-
view of the available data,
the FDA determined that
this small, vulnerable group
may benefit from a third
dose of the Pfizer-BioNTech
or Moderna Vaccines.”
For the purposes of this
announcement, the FDA
decision refers to “additional
doses” of vaccine in individ-
uals thought not to have an
adequate immune response
following a primary vaccine
series.
“Boosters,” or doses ad-
ministered to individuals
who had adequate immune
responses but thought to
have a waning response with
time, were not the topic of
this FDA decision for autho-
rization.
Under the adjusted EUA
guidelines, “immunocom-
promised individuals” are
defined as solid organ trans-
plant recipients or others
who have similar reductions
in their immune response.
The CDC’s Advisory
Committee on Immuni-
zation Practices (ACIP)
— made up of medical and
public health experts who
develop recommendations
on the use of vaccines in the
US — met Aug. 13 to pro-
vide further recommenda-
tions on the FDA’s decision.
During its meeting, the
ACIP unanimously voted
to adopt the FDA’s adjust-
ed EUA that would allow
immunocompromised in-
dividuals who complete a
two-dose mRNA vaccine
series (Pfizer or Moderna)
to receive an additional dose
of an mRNA vaccine.
The ACIP also expand-
ed the FDA’s definition of
“immunocompromised in-
dividuals” to include people
who:
Are undergoing active
treatment for solid tumor
and hematologic malignan-
cies
Have received solid-organ
transplant and are taking
immunosuppressive therapy
Have received CAR
(chimeric antigen recep-
tor)-T-cell or hematopoietic
stem cell transplant (within
two years of transplantation
or are taking immunosup-
pression therapy)
Have moderate or severe
primary immunodeficiency
(e.g., DiGeorge, Wiskott-Al-
drich syndromes)
Have advanced or un-
treated HIV infection
Are undergoing active
treatment with high-dose
corticosteroids (i.e., ≥20mg
prednisone or equivalent per
day), alkylating agents, anti-
metabolites, transplant-re-
lated immunosuppressive
drugs, cancer chemothera-
peutic agents classified as se-
verely immunosuppressive,
TNF blockers, and other
Dentistry is our profession, people are our focus.
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Dentistry is our profession, people are our focus.
Birch Avenue Dental
biologic agents that are im-
munosuppressive or immu-
nomodulatory
The full list of con-
ditions can be found at
www.cdc.gov/coronavi-
rus/2019-ncov/vaccines/
recommendations/immuno.
html.
Following its meeting,
ACIP sent its recommen-
dations to CDC Director
Rochelle P. Walensky, MD,
MPH who signed and en-
dorsed the recommenda-
tions later that day.
“This official CDC recom-
mendation — which follows
FDA’s decision to amend
the emergency use authori-
zations of the vaccines — is
an important step in en-
suring everyone, including
those most vulnerable to
COVID-19, can get as much
protection as possible from
COVID-19
vaccination,”
said Director Walensky in
an Aug. 13 media statement.
Following Director Wal-
ensky and the CDC’s de-
cision, the Western States
Scientific Safety Review
Workgroup convened to
discuss implications of the
adjusted EUA in Oregon.
The Western States Sci-
entific Safety Review Work-
group — the group of
nationally acclaimed immu-
nizations and public health
scientists
independently
reviewing the safety and ef-
ficacy of all FDA authorized
COVID-19 vaccines for Cal-
ifornia, Nevada, Oregon and
Washington — endorsed the
FDA and CDC recommen-
dations as well.
“To provide maximal pro-
tection to this vulnerable
population, the Workgroup
reiterates its recommenda-
tion that all persons 12 years
and older, especially those
with moderate to severe im-
munosuppression and those
who are in close contact
with them, receive an initial
complete series of an autho-
rized COVID-19 vaccine,”
said the members of the
workgroup in an official me-
dia statement. “Moreover,
persons with moderate to
severe immunosuppression
who have received a com-
plete series should receive an
additional dose of an mRNA
COVID-19 vaccine, based
on current limited data on
the safety and immunoge-
nicity of an additional dose.”
According to the FDA’s
updated EUA:
A third dose of the Pfizer
vaccine may be adminis-
tered at least 28 days fol-
lowing the second dose of a
two-dose regimen to immu-
nocompromised individuals
ages 12 and older.
A third dose of the Mod-
erna vaccine may be admin-
istered at least 28 days fol-
lowing the second dose of a
two-dose regimen to immu-
nocompromised individuals
ages 18 and older.
The additional shot rec-
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ommendation only applies
to individuals who are con-
sidered immunocompro-
mised per the adjusted EUA
language.
Under current condi-
tions, the CDC and ACIP
do not recommend admin-
istering additional doses of
the COVID-19 vaccines to
individuals who are not in-
cluded in the immunocom-
promised definition.
Additional doses rec-
ommended by a doctor to
people who do not meet the
immunocompromised cri-
teria for this EUA should be
discussed directly with the
manufacturer and FDA.
Vaccines given accord-
ing to the currently recom-
mended schedule continue
to be highly effective in re-
ducing the risk of serious
illness from COVID-19.
Observational data confirm
that currently available vac-
cines are effective against
new variants, including the
Delta variant.
People who believe they
are eligible for an additional
dose of an mRNA vaccine
based on the conditions out-
lined in the adjusted EUA
should talk with their health
care provider to learn more.
To monitor the safe-
ty of additional doses, the
Workgroup continues to
encourage all recipients of
COVID-19 vaccine with
access to a smartphone to
participate in the v-safe pro-
gram.
While an additional dose
of mRNA vaccine is like-
ly to increase protection in
moderately to severely im-
munocompromised indi-
viduals, people who receive
a third dose should continue
to wear a mask, stay six feet
apart from others, and avoid
crowds and poorly ventilat-
ed indoor spaces.
Further
recommenda-
tions regarding additional
doses for immunocompro-
mised individuals can be
found on the interim clinical
recommendations released
by the CDC.
No need to fear root canals
Procrastinating in regard to maintaining teeth
and gums can prove harmful. Regular dental
checkups and cleanings can reduce discomfort
and expose conditions before they become
especially problematic.
Root canal is one treatment men and women
fear when going to the dentist. But root canals
are often less painful than the symptoms that
require they be performed.
A root canal is an endodontic therapy that can
treat and save teeth. The American Association
of Endodontists says root canal treats infl am-
mation or infection in the roots of a tooth. This
procedure enables dentists to save a tooth rather
than extract it.
WebMD explains that, during a root canal, the
nerve and pulp of the tooth are removed from
the inside. If the tooth’s nerve or pulp cham-
ber is damaged, it can eventually break down
and bacteria can begin to form within. The
most common causes of pulp infl ammation or
infection are a cracked or chipped tooth, a deep
cavity or fi lling, or another serious injury to the
tooth. All of these can allow bacteria to enter
the pulp. Debris and bacteria can lead to infec-
tion or an abscessed tooth. Abscesses can form
at the ends of the tooth roots. Swelling, pain,
bone loss, and drainage into the gums may oc-
cur if a root canal is not performed.
The AAE says that people may avoid root canal
treatment because they fear it is too painful.
However, with modern technology and anes-
thetic medications, the pain that results from
root canal is on par with having a cavity fi lled.
Damaged tissues in the tooth and the severe
toothache that ensues if root canal is not per-
formed is generally much more
severe than anything that occurs
during the procedure.
Patients who are worried about
discomfort can speak with their
dentists about pain management.
In addition to anesthetic injections,
some dentists specialize in medi-
cal sedation that can further calm
patients’ nerves during procedures.
The American Dental Association
says this is what people can expect
during a root canal.
• The tooth is numbed for comfort.
• A thin sheet of latex rubber is
placed over the tooth to keep it dry, and an
opening is made through the crown of the tooth.
• The nerve or pulp is removed. The excavated
canal is then cleaned and shaped.
• Medicine may be placed in the pulp chamber
to deter bacterial growth.
• The root canal is then fi lled with a rubber-like
material to seal it. A metal or plastic rod or post
may be placed in the canal to help retain the
fi lling material so it can properly support the
tooth.
• A temporary fi lling is placed in the tooth.
During a subsequent treatment, the temporary
fi lling will be replaced with a permanent crown
or fi lling.
Root canals are nothing to fear. Such proce-
dures are routine and generally produce little to
no pain. TF185991
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