Earlier this week, the Biden Administration and HHS announced that the U.S. will start administering booster shots in September, pending final FDA assessment and CDC’s Advisory Committee on Immunization Practices (ACIP) recommendation. Now, health care leaders need to assess their vaccination strategy once again as the United States prepares to officially authorize booster shots. Boosters may be rolling out at the same time as flu shots, and we may see a vaccination rollout for children under the age of 12 in the next few months. The scramble to roll out booster vaccinations during the current delta surge is reminiscent of last spring's all-hands-on-deck effort to get shots in arms.
How can health leaders prepare for the upcoming booster shot rollout? Building from our research and lessons learned from last spring's vaccination campaign, we've highlighted six considerations that can fast-track preparation to ensure a smooth rollout.
1. Plan early to overcome the logistical challenges with delivering boosters.
Whether you are part of a provider organization, pharmacy, or government leadership team, expect to face the challenge of finding vaccinators and effectively managing inventory. Given that most mass vaccination sites have closed, vaccinating entities will need to think about the most efficient method to get shots into arms. They may decide to ramp up staffing at existing vaccination clinics, re-open temporary mass vaccination sites, or rely more heavily on provider clinics to administer shots. Regardless of the method chosen, leaders will need to re-think inventory management processes to manage growing vaccine supply.
To make use of limited vaccination staff, organizations may find ways to coordinate Covid-19 and flu vaccine efforts. The CDC found it is safe for Covid-19 vaccines and other vaccines to be administered simultaneously, so it is worth considering this approach. If done properly, this will allow for patients to be seen only once for their vaccinations. It may also encourage higher vaccination rates for both the flu and Covid-19 so that you only have to interact with patients once.
2. Proactively communicate with patients to provide clarity and understanding about boosters.
Providers often serve as a patient's most trusted source of insight, so it’s especially important that they have the support needed to develop consistent and clear messaging about boosters to promote uptake and prevent misinformation. In a recent poll from SymphonyRM, 41% of patients lost trust in their doctors amid the pandemic. And among those individuals, just over half noted it was because their provider rarely or never communicated with them about Covid-19. Health care leaders should take these findings as another sign to proactively communicate with patients, especially those who are on the fence about receiving a vaccine or a booster.
In particular, health leaders from across the ecosystem need to be ready to distill the facts from the flood of information and misinformation. They also need to be able to address confusion due to a lack of guidance around mixing-and-matching vaccines and for recipients of the Johnson & Johnson vaccine.
3. Anticipate and prepare for individuals seeking boosters early (prior to the 8-month mark).
We’ve already seen some individuals seek out third shots, or a second, mRNA-based shot for those who initially received the Johnson & Johnson vaccine. It’s likely that individuals who are not yet at the 8-month mark might start proactively looking to get a booster, even if not officially eligible. Therefore, providers need a cohesive strategy for how to approach these requests and have conversations with patients. This may also mean revisiting their technology strategy for identifying and tracking eligible patients and those who have received boosters.
4. Continue prioritizing access and equity.
It's important to acknowledge how critical it is to continue focusing on global access to vaccines. We now know that a true slowdown of the pandemic will rely on efforts to support the entire world, especially in the countries that have seen low vaccination rates due to limited access.
At the same time, we mustn’t lose sight of the need to support equitable vaccine access in the U.S. as well. Strategies to increase vaccine access and equity during the initial vaccine rollout included deploying mobile clinics, holding mass vaccination sites, having flexible hours for people who didn’t want to take off work, and providing transportation support, among other methods. Health care organizations and governments also created diverse channels for patients to sign up for vaccinations—including internet portals, telephone lines, community registration sites, and home-based signups—to increase accessibility to all. Health care leaders may consider deploying these strategies again. Health care leaders may have the largest opportunity to mitigate the disease’s devastation by lowering access barriers for vulnerable populations in communities that are low-resourced and have historically had low vaccination rates.
5. Track data about boosters and their efficacy.
Real-world data will help us understand the benefits of boosters—and any unintended side effects. This may advance our future understanding cadence of booster shots as well as prioritization and allocation criteria. We saw the importance of data tracking during the initial rollout of Johnson & Johnson vaccines when real-world data taught us about the potential for rare blood clots. Regulators were able to act quickly to assess impact. Providers, regulators, and government agencies must be prepared to do the same for the third doses.
6. Consider the role that boosters play in employee vaccine mandates.
Employers seem to be waiting for full and final authorization of booster shots before acting, but the looming possibility raises many questions for employers that have implemented Covid-19 vaccine mandates. If boosters are authorized, how will we define “fully vaccinated”? Does this title now also include receiving an eligible booster shot? Will individuals who have had a diagnosed Covid-19 infection also be required to receive the booster? How much of a grace period beyond the 8-month mark will employees have to receive their booster and remain in compliance with the policy? Will organizations provide paid leave for employees receiving a booster shot?
These are just some of the many questions that should be expected in the coming weeks and months. And rather than waiting for them to get asked, begin having discussions surrounding these questions within your organization.
It's easy to feel overwhelmed with the constant updates related to Covid-19. With this big update pending on the near horizon, we believe it is important to begin preparing as soon as possible to offset major challenges. While there are more than six considerations in the booster shot rollout, these are some of the most critical to ensuring an effective path forward.
Advisory Board's Andrew Mohama contributed to this article.