COVID-19 Vaccine Update

Updated September 2021


Olympic Internal Medicine is no longer offering vaccines.

For more information about the vaccines, and the Washington State Vaccination Plan please visit the Washington State Department of Health at

To schedule a vaccine appointment visit

COVID Vaccine Booster Facts

There has been a lot of news about COVID vaccine boosters, and probably some confusion about who should receive extra vaccine doses. Hopefully, the following will help clarify where we are right now (though this may be out of date in a few days!).

First, there is a subtle difference between getting the “booster dose” versus the “third dose”. The third dose is for people who never achieved adequate immunity with the normal 2-dose series, due to their immune systems not working well, and is considered a simple extension of the primary 2-dose series many of us have had. The booster dose, on the other hand, is for people with normal immune systems who were immune after being fully vaccinated, but now their immunity is fading over time. For most people who received the Pfizer or Moderna vaccines, this booster would be dose #3 of the COVID vaccine, so the terminology is confusing.

The booster dose is not yet approved by the government, although again this is confusing since other parts of the government have already announced plans to get boosters out once the FDA and the ACIP (national vaccine committee) approve use of boosters (we all think this will happen shortly). We should await the official recommendations to receive the booster doses, as frankly there is not a lot of scientific data to guide the appropriate use of boosters to this point.

The third dose for people with weakened immune systems is available now, for appropriate patients. Some examples of these immunocompromised people include the following (from the CDC website):

  • Receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids

This does not include people with general medical conditions that mildly impair the immune system or raise the risk of serious COVID-19 infection, such as diabetes or obesity. There is no third dose recommendation for individuals who received the Johnson and Johnson vaccine due to a lack of data.

The most important public health objective remains for as many people as possible to receive the initial vaccine series, whether Moderna, Pfizer, or Johnson and Johnson. Experience to this point has shown that COVID-19 infection is much more dangerous than the COVID vaccines (41 million cases of COVID-19 have resulted in 670,000 deaths in the U.S., while 376 million doses of COVID vaccine have been plausibly implicated in very few deaths), and while there obviously are no long term safety data for COVID vaccines yet, long term consequences of COVID-19 infection are also unknown (it is worrisome that at least one report indicates a majority of people with COVID-19 infection still report at least 1 ongoing symptom even 6 months after infection, and “long COVID” lasting weeks to months is now an accepted medical syndrome).

Michael Steele, M.D.