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Amid COVID-19 booster debate, West Virginia to check immunity of vaccinated nursing home residents

Phil Galewitz, Kaiser Health News on

Published in News & Features

West Virginia raced ahead of the country last winter to get people in nursing homes vaccinated against COVID-19, but with cases and hospitalizations on the rise again, state officials want to know whether immunity levels are falling for residents who had their shots.

Starting in August, West Virginia plans to begin measuring the levels of disease-fighting antibodies in the blood of vaccinated nursing home residents, which could help indicate whether they need a booster shot. The process will be voluntary and the data will be shared with federal health agencies evaluating the need for boosters.

Some experts question the strategy, particularly since the federal government has not yet authorized the extra shots.

COVID-19 cases in West Virginia and nationally have more than tripled in the past month. Much of that surge is blamed on the delta variant, a highly contagious form of the virus sweeping the country. In June, about 10% of hospitalized COVID-19 patients in West Virginia and 12% of COVID-19 deaths were among fully vaccinated people, said Dr. Clay Marsh, executive dean for health sciences at West Virginia University and the state’s coronavirus response coordinator. Nationally, about 3% of hospitalizations and 1% of deaths in July have been among people vaccinated for COVID-19.

Still, deaths attributed to COVID-19 remain very rare in West Virginia, which is averaging two fatalities a day. Hospitalizations have risen from 65 COVID-19 patients on July 1 to 133 as of July 28, according to state data.

“In West Virginia, we were very aggressive in vaccinating our long-term care population, but we now worry and are paying more attention about whether we have sufficient immunity in those fully vaccinated,” said Marsh, often referred to as the state’s coronavirus czar.


The question of the need for a booster has gained much attention lately. On Thursday, Israel announced plans to start providing booster shots this weekend to adults over 60 years old who have received their second shot at least five months earlier. The decision comes a day after the release of a paper by executives at Pfizer, one of the companies producing a vaccine, that shows a slight dip in efficacy against any symptomatic cases of COVID-19 four months after immunization is completed. The paper, which has not been peer-reviewed, predicted that a third shot could boost disease-fighting antibodies many times higher than the level achieved from a two-shot regimen.

Pfizer said it plans to seek Food and Drug Administration authorization for a booster shot by mid-August.

Some health experts cautioned that information on antibody levels may not be helpful.

Dr. Michael Wasserman, a California geriatrician and member of the California vaccine advisory committee, said lower antibody levels don’t automatically mean less immunity. “The fact that antibodies are going down is normal and it doesn’t mean that those people are not immune to the virus,” he said.


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