COVID-19

Updated March 20, 2023

Vanguard Medical Group is here to help you stay safe through this ongoing pandemic. Here are some steps you can take to stay safe with your loved one.

COVID-19 Vaccine and Booster is your best protection!  Most of the patients who are hospitalized are unvaccinated. Even though Omicron breakthrough infections are common, getting vaccinated makes a breakthrough infection less severe. The CDC has approved a bivalent booster that includes both the Omicron and the original strain. This is a different booster from the one previously offered.  COVID vaccines are available by appointment at most Vanguard offices.

COVID Testing: COVID home tests are widely available.  Although not quite as accurate as laboratory tests, these tests are fairly good, particularly if you have symptoms. If your home test is negative you may need to do a daily test for several days in a row to be sure.  The U.S. government offers free home tests.  You can receive up to 4 tests per household.  Click here to order.

COVID Testing at Vanguard: COVID testing is available at all our offices.  Please call the office if you have COVID symptoms or have been exposed or need testing for travel or other reasons.  Depending on your symptoms, a telemedicine visit may be recommended first to determine which tests should be done.

People with COVID who are over 65 or are immunocompromised or have chronic health conditions should schedule a telemedicine visit first so we can determine if anti-viral medication would be recommended.  We also need to have a plan to follow up with you if your illness progresses.

See below for Frequently Asked Questions about COVID-19 testing.

COVID Vaccines and Boosters

Here are the current recommendations for COVID vaccines and boosters

If you are NOT Moderately or Severely Immunocompromised:

	Pfizer-BioNTech	Moderna	J&J/Janssen	Novavax
6 months – 4 years old*	3 dose primary series, 3rd dose is bivalent** (see footnote if child previously received 3 monovalent Pfizer doses) No booster	2 dose primary series 1 bivalent Moderna booster at least 2 months after 2nd dose of primary series	No	No
5-11 years old†	Age 5 years: 2 dose primary series   1 bivalent Pfizer booster at least 2 months after 2nd dose of primary series Age 6-11:2 dose primary series1 bivalent mRNA booster (Pfizer or Moderna) at least 2 months after 2nd dose of primary series dose or last monovalent booster	Age 5 years: 2 dose primary series1 bivalent mRNA (Pfizer or Moderna) booster at least 2 months after 2nd dose of primary series Age 6-11: 2 dose primary series 1 bivalent mRNA booster (Pfizer or Moderna) at least 2 months after 2nd dose of primary series	No	No
12-17 years old	2 dose primary series   1 Bivalent mRNA booster (Pfizer or Moderna) at least 2 months after 2nd dose of primary series in those who have not received any booster doses or at least 2 months after last monovalent booster	2 dose primary series 1 bivalent mRNA booster (Pfizer or Moderna) at least 2 months after completion of primary series in those who never received any booster doses or after last monovalent booster dose	No	2 dose primary series 1 Bivalent mRNA booster (Pfizer or Moderna) 2 months after 2nd dose of primary series
18+ years old	2 dose primary series   1 Bivalent mRNA booster (Pfizer or Moderna) at least 2 months after 2nd dose of primary series in those who have not received any booster doses or at least 2 months after last monovalent booster	2 dose primary series 1 bivalent mRNA booster (Pfizer or Moderna) at least 2 months after completion of primary series in those who never received any booster doses or after last monovalent booster dose	1 J&J and 1 mRNA vaccine 1 Bivalent mRNA booster at least 2 months after completion of primary series or at least 2 months after last monovalent booster	2 dose primary series 1 Bivalent mRNA booster at least 2 months after 2nd dose

**Children in this age group who previously received 3 monovalent Pfizer-BioNTech primary series doses are authorized to receive 1 bivalent Pfizer-BioNTech booster dose at least 2 months after completion of the monovalent primary series.

Source: https://www.cdc.gov/vaccines/covid-19/images/COVID19-vaccination-schedule-immunocompromised.png

If you ARE Moderately or Severely Immunocompromised:

	Pfizer-BioNTech	Moderna	J&J/Janssen	Novavax
6 months – 4 years old*	3 dose primary series, 3rd dose is given with bivalent dose****(see footnote if child previously received 3 monovalent Pfizer doses) No booster	3 dose primary series 1 bivalent Moderna booster at least 2 months after completion of primary series	No	No
5-11 years old†	Age 5 years: 3 dose primary series 1 bivalent Pfizer booster dose at least 2 months after completion of primary series or last monovalent booster dose Age 6-11 years: 3 dose primary series 1 bivalent mRNA booster (Pfizer or Moderna) at least 2 months after completion of the primary series or last monovalent booster dose	Age 5 years: 3 dose primary series 1 bivalent mRNA booster (Moderna or Pfizer) at least 2 months after completion of primary series Age 6-11 years: 3 dose primary series1 bivalent mRNA booster (Moderna or Pfizer) at least 2 months after completion of primary series	No	No
12-17 years old	3 dose primary series 1 bivalent mRNA booster (Moderna or Pfizer) at least 2 months after last primary series dose or last monovalent booster	3 dose primary series 1 Bivalent mRNA booster (Moderna or Pfizer) at least 2 months after last primary series dose or last monovalent booster	No	2 dose primary series 1 Bivalent mRNA (Moderna or Pfizer) booster at least 2 months after last primary series dose
18 years and older	3 dose primary series 1 bivalent mRNA booster (Moderna or Pfizer) at least 2 months after last primary series dose or last monovalent booster	3 dose primary series 1 Bivalent mRNA booster (Moderna or Pfizer) at least 2 months after last primary series dose or last monovalent booster	1 J&J followed by 1 monovalent mRNA vaccine. 1 bivalent mRNA booster (Moderna or Pfizer) at least 2 months after last primary series dose or last monovalent booster	2 dose primary series 1 Bivalent mRNA (Moderna or Pfizer) booster at least 2 months after last primary series dose

** Children in this age group who previously received 3 monovalent Pfizer-BioNTech primary series doses are authorized to receive 1 bivalent Pfizer-BioNTech booster dose at least 2 months after completion of the monovalent primary series.

Source: https://www.cdc.gov/vaccines/covid-19/images/COVID19-vaccination-schedule-immunocompromised.png

COVID vaccines are available at most Vanguard offices at selected days and times.  Please call your office for availability or contact the Patient Access Team at patientaccessteam@vanguardmedgroup.com or 973-559- 0081

You can also find information from the Centers for Disease Control and Prevention and New Jersey Department of Health websites.

COVID-19 Testing

When should you get tested?

Ask yourself these questions to see if you should get tested for COVID-19. If you answer “yes”, contact the Patient Access Team at patientaccessteam@vanguardmedgroup.com or 973-559- 0081 to request a COVID-19 test appointment.

• Do you have any of these symptoms of COVID-19?
  Fever, cough, chills, unexplained muscle pain, shortness of breath, sore throat, loss of taste/smell

The CDC offers this interactive self-checker tool, which can help you decide whether or not you need to be tested.

COVID-19 PCR and Rapid Testing

• The PCR test is very sensitive and can detect the virus within your system even before you have any symptoms. This test is sent out to a laboratory for processing.   PCR results take 1-2 days on average.
• The Rapid test as its name indicates can provide results the same day. It is most accurate when you are having symptoms.  Home rapid tests are fairly accurate if you are having symptoms.  They are less accurate when you are asymptomatic or testing after an exposure.

Your primary care provider will determine which test is right for you based on your potential exposure, medical history, and symptoms. He or she may also recommend testing for flu, strep, or other illnesses when you get your COVID-19 test. Please call your local office to schedule your appointment today!

*COVID-19 tests are billed according to your individual insurance company’s policy. Medicare and major insurance plans are accepted.

Frequently Asked Questions:

Q: Am I eligible to receive the bivalent COVID-19 booster?

A: Depending on your age, you may be eligible to receive a bivalent booster at least 2 months after completion of your primary series or last booster dose.

Q: Which bivalent mRNA booster should I receive, Pfizer or Moderna?

A: Your age will dictate which mRNA booster you or your child can receive. Moderna has a bivalent booster indicated for use in patients as young as 6 months old and Pfizer has a bivalent booster authorized for those as young as 5 years old. Please review the tables above.

Q: I recently had COVID infection.  How long should I wait to receive the bivalent booster?

A: After COVID infection you generally have antibody protection for several months.  The CDC recommends delaying a primary series or booster by about 3 months from symptom onset or positive test.

Q: I was going to get the previous booster.  Should I do that and then get the bivalent booster?

A: No, the previous boosters are no longer being used and have been replaced by the bivalent booster.

Q: I recently received my very first dose of Pfizer or Moderna.  Should I get the bivalent booster for my second dose?

A: No, you should complete your first two doses of the original Pfizer or Moderna vaccine and then two months later you can receive the bivalent booster.

Q: I have some COVID symptoms and I did a home test and it’s positive.  What do I need to do?

A: If you are younger than 65 yrs. old, in generally good health and not immunocompromised, and are not feeling out of breath, you can self-manage at home. (video from CDC on managing at home). The home tests are very accurate when you have symptoms, and you probably don’t need an additional test. Up and down fevers are common in the first 3-5 days and can be managed with Tylenol.  Keep hydrated by drinking plenty of liquids.  Honey or over the counter cough medicine may help reduce the cough.  You should isolate from others to prevent spreading the infection. If you have had no fever for 24 hours and your symptoms are improving, you can come out of isolation after 7 days but should continue to wear a mask for another 3 days. (Day 0 is the first day of your symptoms.)  Our recommendation is a little more conservative than the CDC.  The CDC allows for return to work after 5 days with additional recommendations on masking and follow up testing.  This guidance makes sense for essential workers during a worker shortage, but does have a little more risk for infection spread.

Q: How long do I need to isolate if I have COVID?  I’m hearing different recommendations and am confused about which I should follow.

A: People with COVID are most contagious from 2 days before their symptoms start through 3-4 days after their symptoms start.  By day 8 (Day 0 is the first day of your symptoms) most people with COVID are no longer contagious.  Those who are immunocompromised or had a severe case of COVID may have trouble getting rid of the virus and may be contagious for longer and should speak with their healthcare provider.

If you have COVID with symptoms, we recommend you isolate for 7 days (the first day of your symptoms is day 0.)  If you have not had a fever (temp of 100.4 or more) in the previous 48 hours and your symptoms are improving, you can end isolation after day 7 but should wear a mask around others for another 3 days (so a 10-day total).  If you are an essential worker, then the CDC guideline may make more sense for you.