ÁñÁ«ÊÓƵ

ST. LOUIS — Area hospital and county officials said on Wednesday that they were preparing to ramp up COVID-19 vaccine clinics and were once again discussing mass vaccination events as federal officials moved toward booster doses for all residents.

Missouri is now allowing third doses for individuals with weakened immune systems. But on Wednesday, U.S. officials also outlined plans to recommend boosters for all Americans, beginning the week of Sept. 20.

The second rollout, announced as only half of Missouri's population has received at least one dose, should look different than the first. Unlike in December and January, when hospitals were responsible for most of the shots, now pharmacies, independent clinics and rural health centers are as well.

St. Louis County health officials are preparing to ramp up vaccine clinic capacity, in case they need to begin administering booster doses to the public at large, deputy health director Spring Schmidt said during a briefing Wednesday morning.

BJC HealthCare will likely scale up its vaccine clinics to some extent in the coming weeks, Dr. Hilary Babcock, a Washington University infectious disease specialist at BJC, said in a statement Wednesday. But, Babcock noted, hospital staffing is tight with the current levels of COVID-19 patients.

Dr. Alfred Kim, a Washington University rheumatologist at Barnes-Jewish Hospital, said those who are eligible for the third doses now, generally, include those who were born with a disease that weakens their immune system, those who have contracted a condition that causes them to be immunodeficient during their life, or who rely on medication that suppresses their immune system.

Some medical situations cause immune responses that are too vigorous, like organ transplants, for example, or certain autoimmune diseases. Those individuals are often prescribed medication that suppresses the body's natural immune response.

"We use immunosuppression to be able to kind of pull back the intensity of the immune response so that the organ transplant can survive or so the autoimmune disease is put in check," Kim said. "Unfortunately, the collateral damage to this is that responses to natural infections or to vaccines are also pulled back."

A  published earlier this month in the New England Journal of Medicine found that organ transplant recipients received better protection after a third dose of vaccine.

Immunocompromised people can get a third dose now at the county health department's , including John C. Murphy Health Center in Berkeley, the North Central Community Health Center in Pine Lawn and the South County Community Health Center in Sunset Hills, the county said.

Walk-ins are accepted, and people should bring their previous vaccination card. The department recommends immunocompromised patients discuss the issue with their health provider, but they do not need a doctor's referral in order to get the third dose.

Like the first and second doses, the third doses are free.

People are three times less likely to catch COVID-19 if they are vaccinated, Schmidt said on Wednesday, and 10 times less likely to have severe disease or death. St. Louis County's seven-day average of new COVID-19 infections, at 283 on Wednesday, has been on a relatively flat trajectory for about six days, she said, but the number is "still significantly high." And the county's positivity rate, denoting the percentage of all tests that return positive, is 11.8%, high enough to suggest that testing is probably not adequately catching all of the cases in the community.

The federal plan to offer booster doses to all Americans depends on an evaluation by the Food and Drug Administration, and the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. 

Under the timeline federal officials outlined Wednesday, Moderna and Pfizer booster doses would be administered eight months after an individuals' second dose, putting health care workers, nursing home residents and other seniors at the front of the line. Health officials said they will release a "timely plan" for Johnson & Johnson boosters, too.

The Biden administration said it will continue to reimburse states for National Guard response, and the Federal Emergency Management Agency is prepared to help with the new rollout.

The CDC on Wednesday released three new articles on the vaccines, suggesting that while they remain relatively effective against severe illness, protection against milder infections begins to decrease over time.

"Given this body of evidence, we are concerned that the current strong protection against severe infection, hospitalization and death could decrease in the months ahead, especially among those who are at higher risk or who were vaccinated earlier," said CDC director Dr. Rochelle Walensky, who received her undergraduate degree from Washington University.

In Missouri 51% of the population have at least one dose of a COVID-19 vaccine, and 43% are fully vaccinated, according to state data. Nationwide, 60% have at least one dose, and 51% are fully vaccinated, according to the CDC.

BJC HealthCare has begun administering third doses to immunocompromised patients. Individuals who qualify can go to a walk-in clinic at the Clayton Avenue building or at Christian Hospital.

The Mercy health system plans to formally start offering third doses to immunocompromised patients by Monday. 

St. Luke's Hospital has not started offering booster doses yet. SSM Health physicians are working to identify and contact patients who qualify now for third doses, and those who are interested should contact their doctor, a spokeswoman said Wednesday.