Since the peak of the most recent wave of COVID-19 disease in early August, Orange County has seen a steady decline in cases of COVID-19. In the last two weeks, however, there has been a flattening of the curve, with a rate still substantially higher than was seen in the late spring. To date, 86% of those ≥ 65 years and 63% of the entire population of the County are fully vaccinated against COVID-19.
Throughout this wave the rate of disease has consistently been 4-6 times higher among those not fully vaccinated compared to those fully vaccinated. Since July 1st, an estimated 92% of hospitalizations in Orange County have been among unvaccinated individuals. Over this same period 410 COVID-19 related deaths were reported of whom 84% (345/410) were unvaccinated.
While the greatest risk remains among the unvaccinated, several studies have shown evidence of waning of immunity with time most evident in those >65 years of age. In Orange County, the majority of serious breakthrough disease has occurred in persons who are ≥65 years of age and/or have significant underlying medical conditions. The average age of fully-vaccinated individuals in the county who are subsequently hospitalized due to COVID-19 has been over 70 years of age, compared to between 50-60 years among those not fully vaccinated. Of the 65 deaths that have occurred in fully-vaccinated individuals since July 1, 52 (80%) were ≥65 years, and the other 13 all had significant underlying medical conditions.
On October 21, 2021 the CDC’s Advisory Committee on Immunization Practices (ACIP) made recommendations on the use of booster doses for both Moderna’s and Johnson & Johnson/Janssen’s (J&J) COVID-19 vaccines. Included in these recommendations was an endorsement of a “mix-and-match” strategy allowing for the use of a different COVID-19 vaccine than was received for the primary series.
mRNA Primary COVID-19 Vaccine Series (Moderna & Pfizer-BioNTech)
For eligible people who received their primary vaccine series with either Moderna or Pfizer-BioNTech COVID-19 vaccine, a single dose of any FDA approved/authorized COVID-19 vaccine may be administered at least six months after completing a primary series with the Pfizer-BioNTech COVID-19 vaccine. Eligibility criteria for those who received a primary series with Moderna vaccine are the same as was previously approved to receive a Pfizer-BioNTech booster and are listed below:
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people 65 years and older and residents in long-term care facilities (LTCF) should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
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people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
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people aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
The booster dose of Moderna COVID-19 vaccine is authorized at a 0.25 ml (50mcg) dose which is half the dose used for a primary Moderna COVID-19 series.
J&J Primary COVID-19 Series
Everyone who received J&J primary series is eligible for a single booster dose with any FDA approved/authorized COVID-19 vaccine two months after receipt of their primary dose.
