HOWARD GAMBLE

WHEELING — Jim Justice’s plea to the federal government for West Virginia to begin offering fourth doses of the COVID-19 vaccine was a means for the state to signal interest, according to Wheeling-Ohio County Health Administrator Howard Gamble.

Justice on Thursday pushed for state officials to request permission from the Centers for Disease Control to offer a fourth dose of vaccine against the coronavirus, citing a breakdown in trust at the federal level and looking to have states lead the pack in administering vaccine.

Gamble said Friday that Justice’s comments amounted to little more than a request, but that requests were what got the ball rolling on future action.

“It’s only a request, and it’s a request of one state,” Gamble said. “… If this request is seen as anything, it probably needs to be seen as one state telling the federal government, or a federal program such as the CDC, ‘It’s time we consider moving to a fourth vaccine.'”

Gamble said the chief concerns that must be addressed first would be considerations such as what timeframe should be followed since a third dose, how it’s administered, and eligibility.

“For a state just to get this approval, I think it’ll be difficult. But for purposes of telling the CDC that it may be something we need to begin to look at, I think it’s a good step to let them know that there’s concerns, and maybe this needs to be done to protect people appropriately.”

Gamble added that as far as the necessity of a fourth dose, many vaccines and treatments require multiple doses to be fully effective, such as rabies.

“There’s times where we’ve had vaccines that had lots of stages in them, and now are down to a few,” he said.

“There used to be a lot of injections with a rabies vaccine, and now it’s down to a three-shot series. … Things change. Vaccines will change.

“… With this, the vaccine may change because the virus changes. For the state of West Virginia, governor’s office, state health department, those who are looking at this pandemic on a statewide level, there’s a need. We have a population at risk, and we ask, ‘Is it time that we do this?'”

With the range of vaccines available to the public — Pfizer, pediatric Pfizer, Moderna and Johnson & Johnson — Gamble said it would require additional study as to which vaccines would necessitate more doses, as well as getting clearance not just from the CDC, but the manufacturers and the Food and Drug Administration.

“There’s a lot of plans that need to be worked out, and this would need the support of both the manufacturer of the vaccine and the regulatory agency, in this case the FDA, as well as the CDC who approves the vaccine for use in the population. There’s a lot of things to consider prior to doing this.”

An additional concern, Gamble said, lay with who is eligible to receive the dose if West Virginia authorizes a fourth dose while other states do not. The health department, he said, has several employees who live in Ohio, but work in West Virginia. The eligibility of employees who commute into the state, he said, was yet another factor to consider.

“We have medical centers on all of our borders — how are they eligible if they live in Ohio, Virginia, Pennsylvania, Maryland? There’s a lot of things to consider, but it’s probably where we, as a country, need to begin moving in order to address the pandemic correctly.”