Question: My medical provider has an electronic records system. The patient logs into an online portal to keep track of appointments, test results, etc. When I log on, it says I have received “three of four” COVID-19 vaccinations and lists the date after which my fourth vaccination is “due.” I’m OK with getting a fourth vaccination. However, I was not aware of any protocol that calls for a fourth vaccination. I am 76 years old and have an underlying condition making it riskier for me to contract COVID-19. Is the fourth vaccination specially addressed to my underlying condition? Age? Is there a published protocol?

Answer: Yes, there is a published protocol. The U.S. Centers for Disease Control and Prevention recommends a fourth shot of COVID-19 vaccine for adults who are moderately to severely immunocompromised and who completed their primary vaccine series of Moderna or Pfizer-BioNTech COVID-19 vaccine at least five months ago. The primary vaccine series of Pfizer-BioNTech or Moderna for this group is three shots, not two. The fourth shot is a booster.

The third shot for this group was authorized in August, so five months have passed for the earliest recipients. Many who received the third shot then referred to it as a booster and ask now whether they can get a “second booster.” To be clear, the CDC defines the third shot as an “additional primary shot” for moderately to severely immunocompromised people and the fourth shot as a booster shot. The additional primary shot was recommended because these folks may not have responded to the standard two doses of mRNA COVID-19 vaccine.

The CDC says people are moderately or severely immunocompromised if they have been receiving active cancer treatment for tumors or cancers of the blood; received an organ transplant and are taking medicine to suppress the immune system; received a stem cell transplant within the past two years or are taking medicine to suppress the immune system; have moderate or severe primary immunodeficiency, such as DiGeorge syndrome or Wiskott-Aldrich syndrome; have advanced or untreated HIV infection; or are being treated with high-dose corticosteroids or other drugs that might suppress immune response.

To answer your other questions, the recommendation is not based on your age, but on your condition. Children age 5 and up who are moderately to severely immunocompromised also should get an additional primary shot, the CDC says, but only those 12 and older should also get a booster, which, as for adults in this category, would be a fourth shot.

Q: Which intersections are enforcing red-light cams?

A: None yet. The state Department of Transportation says it expects to finalize 10 locations after engineering studies are completed in March. The ongoing studies are looking at 14 potential locations in urban Honolulu, taking into account the history of red-light running and crashes at the location, whether it’s feasible to install a stoplight camera there, and whether that deterrent or some other measure would best improve traffic safety. The results of each engineering study will be posted at 808ne.ws/redlight, the DOT said. None were posted as of Tuesday; the studies just began in January.

Enforcement would start with warnings, and even that won’t begin until after the 10 locations are finalized, camera systems are installed and signs are put up telling motorists about the automated system, which would photograph any car that runs a red light and notify its registered owner, the DOT said. So, based on the DOT’s timeline, enforcement is several months away, at least.

Mahalo

My husband and I would like to thank the person who paid for our dinner at Gyotaku in Niu Valley on Jan 21. It was such a surprise when our server told us the bill had been paid for. We asked our server whether they had paid by credit card so we could get a name, but they had paid by cash instead. We are truly appreciative of their kindness and generosity and will gladly pay it forward. — Mahalo, J.K.

Write to Kokua Line at Honolulu Star-Advertiser, 500 Ala Moana Blvd., Suite 7-500, Honolulu, HI 96813; call 808-529-4773; or email kokualine@staradvertiser.com.