Will you get the second covid 19 vaccine booster?

[MamaBee]

I just emailed my doctor this morning. She usually answers within a day or two depending on what she has going on. She’s off on Friday...so I hope I hear something soon.
My husband wants to go to football games in October/November. He’s wondering if he should delay getting his so he will be better protected then. I convinced him to get an antibody test. He will wait a week or so and get tested…He got the 50mcg..I got the 100mcg…
I‘m not happy about him going to games but who knows what it will be like in October and November.

 

[victoriangurl96]

FWIW, this is from the CDC website (re: antibody testing - updated 2/22):

Labs

COVID-19 resources and guidelines for labs and laboratory workers.

www.cdc.gov

Our friend, who is being treated for chronic leukemia and is immunocompromised, was told by his specialist not to depend on antibody tests in making vaccination decisions. Again, FWIW (I'm not a doctor).

 

[Demon]

I've already had 3, why not 4? I will get it, but I think I'll wait till cases start heading up again here.

 

[LightBright]

Interesting.

Relative Effectiveness of Four Doses Compared to Three Dose of the BNT162b2 Vaccine in Israel

Objectives The rapid spread of the Omicron variant (B.1.1.529) alongside evidence of a relatively rapid waning of the third dose prompted Israel to administer a fourth dose of the BNT162b2 vaccine on January 2022. Thus far, sufficient real-world evidence demonstrating the effectiveness of a...

www.medrxiv.org

"Conclusions A fourth dose of the BNT162b2 vaccine provided considerable additional protection against both SARS-CoV-2 infection and severe disease relative to three doses of the vaccine. However, effectiveness of the fourth dose against infection wanes sooner than that of the third dose."

To me this study shows a very marginal benefit to the fourth Pfizer shot, and suggests that over 60s with co-morbidities and over 70s are benefited slightly and VERY temporarily but what about the general population?

This large study from Israel was conducted on individuals over 60. Severe disease in BOTH vaccine groups aggregated was 0.3% authors called severe disease in both groups ”a relatively rare event” but having a fourth dose of the vaccine had a relative protection of 86% versus three doses.

Data suggests that the fourth vaccine is marginally effective in preventing death for over 60s as compared to three shot series, but death rates are already far under 1% for both groups.

67% of the people with serious disease had three doses versus 23% four doses 382 (0.00196) versus 192 (0.000985) out of 194,906 PCR tested people.


Relative vaccine efficacy against disease (4 shot versus 3 shot) never gets over 64% better relative efficacy, and peaks at three weeks, but drops to 30% by week 8.

This Israeli data shows that protective sheltering of over 70s lowers their rates of COVID and serious disease/mortality. For example those living in nursing homes show a protective effect on infection: nursing home of care facility living reduced incidence of COVID to OR 0.54 versus unsheltered. Things other than a fourth vaccine show benefit. In this study, people who had regular PCRs had lower rates of COVID. This indicates tracking/tracing, awareness and aggressive sheltering can also help. (Wanted to mention that another thing my immunompromised friend is waiting for is Evusheld).

“The recipients of the fourth dose were overall more chronically ill, possibly correlated to targeted vaccination campaigns and stronger compliance to recommendations. These differences stress the need for the performed adjustment.”

“The fourth-dose marginal effectiveness against infection largely increased in the second week after inoculation until peaking during the third week, with a VE of 64% (95% confidence interval [CI]: 62.04%, 65.85%) compared to those vaccinated with only three doses in the multiple-tests analysis and similar results for the matched analysis (Table 2). However, vaccine effectiveness began to decline four weeks after inoculation, with relative effectiveness on week 8 roughly dropping back to levels observed during the first week, and reaching 29.2% (95% CI: 17.74%, 39.07%) by week 9. Similar results were obtained with the matched analysis, although fewer observations led to wide confidence intervals during the last week.”

“There were 194,906 cases and controls included in the multiple-test analysis of severe disease, of which 574 (0.3%) were either hospitalized or died as a result of COVID- 19; 406 cases and their matched controls were included in the matched analysis (Table S2). There were 106 deaths during the follow-up period, of which 77 were among third-dose-only recipients, and 23 were among fourth-dose vaccinees during the first three weeks after inoculation.”

“Using a test-negative design and performing both a matched analysis and an unmatched multiple-tests analysis, we found a fourth dose provided considerable additional protection against both SARS-CoV-2 infection and severe disease relative to three doses of the vaccine. However, vaccine effectiveness against infection varied over time, peaking during the third week with a VE of 64% (95% CI: 62.0%-65.9%) and declining to 29.2% (95% CI: 17.7%-39.1%) by the end of the 10-week follow-up period.”

“Unlike VE against infection, the relative effectiveness of a fourth dose against severe COVID-19 was maintained at high level (>73%) throughout the 9-week follow-up period, a sustained effect against severe disease that demonstrated in previous doses as well. Importantly, it should be noted that severe disease was a relatively rare event, occurring in <1% of both fourth dose and third dose only recipients.”

Study sponsored by Pfizer.

 

[pearlsngems]

I just scheduled mine at CVS.
Yesterday the website said they were waiting for authorization, but today it's working; you can schedule for a second booster online if your are 50+.

 

[rcjtraveler]

DH and I are scheduled tomorrow through CVS. Traveling to Europe the end of April and wanted the added protection as our boosters were in October.

 

[Daisys and Diamonds]

Yup!

This is how i feel too

it is yet to be signed off by pharmac - the govt drug agency - and im not sure if its going to go as low as 50 in age just yet
i have no idea how you get your antibodies checked here but Gary is 69 and not in great health so i want him to get the 4th one asap (he did only finally got the booster 10 days ago)

Ive had my 3 shots all within 5 months of each other just due to how the vacine roll out worked here) so i would hope my antibodies are still quite high

a lot of my American friends on my other online community (who are all mostly my age and older) have had it already or are about to get it

 

[Lookinagain]

I haven't had an antibody test, and I don't know exactly what they tell you. If you have a high level of antibodies, are they protecting you against all variants? How do you know if they do? We know the vaccines are less effective against Omicron and it's subvariants so is that also true of your antibodies? I'd be interested to know if they can determine that.

 

[Daisys and Diamonds]

Our death toll is now in the mid 300s

A few months ago it was 50
and before that 30

people in rest homes are still dying from covid whoch i think is unforgivable

I hope those residents get the 4th asap

 

[lilmosun]

@missy and @LightBright Thank you for posting. The information from the article (and others similar) is why I am not running out to get the booster even though I've been and continue to exercise more caution than most.

The marginal benefit, smaller period of efficacy, that I am under 65 with no underlying health issues and only had my booster 4 months ago are why it's not a slam dunk decision for me this time despite qualifying. As I said, it's more a question of when to get it, not if. Of course, another surge could hasten my decision.

 

[Austina]

One of my very good friends tested positive on Tuesday morning. She had a bad night on Monday, fever, aches, coughing, but by Tuesday p.m. felt considerably better, and today says she feels almost back to normal. She’s double vaxxed and boostered, (IIRC had her booster in Oct/Nov), so looks like her symptoms have been mitigated by being protected.

 

[Daisys and Diamonds]

One of my very good friends tested positive on Tuesday morning. She had a bad night on Monday, fever, aches, coughing, but by Tuesday p.m. felt considerably better, and today says she feels almost back to normal. She’s double vaxxed and boostered, (IIRC had her booster in Oct/Nov), so looks like her symptoms have been mitigated by being protected.

I had a customer recently out of home isolation as her son had it
5 of them in the house and only he got it

he was however a very naughty 14 year old and purposely coughed on his mother and his sister but that's a whole different issue

So does the vacine makes it harder to pass on the virus to others if one is unfortunate enough to get it ?

 

[Austina]

I think the latest variant is as easily transmissible as the previous one (if not more) and we haven’t heard if her DH has tested positive, so are hoping he’s still fine @Daisys and Diamonds

 

[MamaBee]

One of my very good friends tested positive on Tuesday morning. She had a bad night on Monday, fever, aches, coughing, but by Tuesday p.m. felt considerably better, and today says she feels almost back to normal. She’s double vaxxed and boostered, (IIRC had her booster in Oct/Nov), so looks like her symptoms have been mitigated by being protected.

I’m sorry she got Covid @Austina..but that’s wonderful she is doing so well…

 

[Daisys and Diamonds]

I think the latest variant is as easily transmissible as the previous one (if not more) and we haven’t heard if her DH has tested positive, so are hoping he’s still fine @Daisys and Diamonds

I just wish that we could all go to bed tonight and wake up tomorrow and covid is gone (and peace in Ukrain too)

 

[MamaBee]

I had a customer recently out of home isolation as her son had it
5 of them in the house and only he got it

he was however a very naughty 14 year old and purposely coughed on his mother and his sister but that's a whole different issue

So does the vacine makes it harder to pass on the virus to others if one is unfortunate enough to get it ?

How horrible that he coughed on his mother and sister on purpose.

I don’t know the answer but I would really like to know. I think you have less of a viral load if you get Covid after being vaccinated..I’m not positive though..

 

[MamaBee]

I just wish that we could all go to bed tonight and wake up tomorrow and covid is gone (and peace in Ukrain too)

Me too..

 

[Daisys and Diamonds]

Me too..

Socially distanced of course

 

[Karl_K]

Now I have to decide if I'm going to do Pfizer or moderna for the second booster. All of them up to now have been Pfizer.

 

[DRSAMURAI]

Now I have to decide if I'm going to do Pfizer or moderna for the second booster. All of them up to now have been Pfizer.

Current medical literature supports your decision as either way you win. MRNA mechanisms of action are identical and safety and efficacy profiles are virtually identical. Furthermore, mixing of Pfizer and Moderna has been recognized as medically acceptable. Hope this resolves your dilemma.

 

[missy]

Now I have to decide if I'm going to do Pfizer or moderna for the second booster. All of them up to now have been Pfizer.

I mixed Moderna with Pfizer and I believe that was part of the reason for my robust response. JMO of course. I would not hesitate mixing the mrna vaccines.

 

[missy]

Opinion piece from Medscape.

We Need to Clarify the Goal of Our COVID Booster Strategy​

— The focus should be on stopping severe disease and expanding our vaccine arsenal​

by Monica Gandhi, MD, MPH, and Michael Daignault, MD March 30, 2022

"
The advent of mRNA vaccines against SARS-CoV-2 have been nothing short of a modern medical marvel. Billions of doses have been safely administered and countless lives saved. But a recent request by Moderna to the FDA to authorize a second booster -- or fourth dose -- for all adults has been met with skepticism by many of us in public health and medicine.

Multiple countries, including the U.S., recently joined Israel in authorizing a fourth dose of the mRNA vaccines for older members of their populations and others at risk of severe COVID-19. While this makes immunological sense -- as older people and the immunocompromised can lack the ability to quickly mobilize B cells to produce neutralizing antibodies when faced with new variants -- a fourth dose in younger, healthy groups (<65 years) has minimal effect in both boosted effectiveness against infection or reducing viral loads. The FDA's recent authorization of a fourth shot for those over 50 (citing "significant medical comorbidities" in those 50-65) is not in line with our available data nor other countries' policies. This unilateral decision by the FDA was also made without consulting its committee of independent vaccine experts, who are slated to meet April 6 to discuss our overall booster strategy.


As the COVID-19 vaccine campaign continues, we are concerned that despite continued promises to "follow the science," our health agencies, including the FDA and CDC, and the Biden administration continue to act without clearly articulating strategic, evidence-based goals for both the vaccine and subsequent boosters.

Clarify the Goal

First and foremost, our country needs to specify the goal of our vaccination and booster campaign. Is it to continually boost neutralizing antibody protection against infection? Or is it to prevent severe illness and thus reduce the burden on our healthcare system? The former strategy is logistically difficult, will lack buy-in from a pandemic-weary public, and does not make long-term immunogenic sense. The latter is a much more feasible and public health-focused strategy.

While President Biden has mentioned the booster goal of preventing severe COVID-19 in speeches, this has not been formally articulated and advertised as the primary aim. In alignment with this goal, we need to expand our vaccine and booster arsenal to prepare for variants that could cause more widespread severe illness.


Expand the Vaccine Arsenal

In the U.S., our COVID vaccine arsenal is limited to two mRNA vaccines and one adenovirus vector-based vaccine, all showing our immune systems a piece of the SARS-CoV-2 spike protein. For future boosters, given the inevitable emergence of new variants of concern (VOC) with mutations across the virus, including many in the spike protein, we need to show our immune system something more broad ranging. The FDA needs to conduct more research on and approve an inactivated whole virion vaccine.

Enter Covaxin. There are currently three inactivated whole virus vaccines approved by the World Health Organization (WHO): Covaxin, which was originally developed in India but now has a U.S. manufacturer called Ocugen, and Chinese-developed Sinopharm and Sinovac. Of these three, WHO has deemed Covaxin the most immunogenic. Covaxin's advantage could be due to its adjuvant, Alhydroxiquim-II, developed with funding by the NIH. Alhydroxiquim-II plays a key role in activating lymph node receptors, which boosts the immune response and enhances the vaccine's effectiveness.

Because Covaxin shows the immune system the entire virus, the vaccine elicits a broad immunologic response not only against spike, but also against the receptor-binding domain, the nucleocapsid protein of SARS-CoV-2, and other parts of the virus. The vaccine also elicits strong cellular T-cell mediated immune responses, which are vital for long-term protection. Because these immune responses are so broad, they are active against known variants of concern (VOC). The phase III study of this vaccine in India showed a high protective efficacy against SARS-CoV-2, with 93.4% protection against severe disease -- healthcare workers in India who received Covaxin well into the Delta variant era have continued to be highly protected. While the two mRNA vaccines showed reduced effectiveness against Omicron (for mild disease) due to Omicron's 32 mutations across its spike protein, immune responses from the Covaxin vaccine continued to neutralize the Omicron variant.

Covaxin has also been tested in a younger cohort of participants (2-18 years old) in India. A phase II/III, open-label, multicenter study was conducted from May 2021 to July 2021, to evaluate the safety, reactogenicity, and immunogenicity of the vaccine in this group. The results showed excellent immune responses across the entire cohort. Moreover, among the 526 study subjects in the pediatric clinical trial, no serious adverse effects were reported. Safety evaluations in adults after the administration of over 59 million doses or children 15-17 after over 36 million doses have similarly found no major adverse effects. Seemingly due to a lack of U.S. research on Covaxin, the FDA rejected an application by Ocugen to approve Covaxin for those 2-18 years old earlier this month.


A VOC can develop mutations across multiple parts of its surface, often to increase transmissibility. As we continue to manage SARS-CoV-2 into the future, given the inability to eradicate the virus, we will need to see the whole virus to boost our immunity against variants. Whole virion vaccines, like Covaxin, can neutralize the Delta and Omicron variants.

We strongly recommend our public health agencies and the Biden administration closely follow the recently launched U.S.-based study on the safety and efficacy of whole virion vaccines as a booster. If the results are positive, we must add these vaccines to the U.S. vaccine arsenal, as both a booster for those who have received mRNA vaccines and also as a strong primary series vaccine for those yet to be inoculated.

Another important tool the U.S. should add to its vaccine arsenal is Novavax. Novavax is a protein subunit vaccine, similar to flu vaccines and those for many routine childhood immunizations -- this more traditional vaccine technology could help some overcome vaccine hesitancy. In the U.S., vaccine hesitancy ranges from less than 2% to more than 20% depending on zip code and county. In some states, 14% of those hesitant are concerned about possible side effects and approximately 6% cited "planning to wait and see if it's safe" as of February 2022. Expanding our arsenal to include non-genetic material platform vaccines would go a long way toward addressing these concerns, however unfounded they are. In a phase III trial in adults, two doses of the Novavax vaccine were 90.4% effective against symptomatic infection and 100% effective against moderate and severe disease, although more study in the Delta and Omicron era are needed. Novavax is approved by the WHO and is awaiting U.S. EUA.

The FDA should seriously consider these other vaccine technology platforms. For this evolving virus, showing the immune system the entire virion may be indicated sooner rather than later to prepare for future variants, and more familiar technology can protect our hesitant populations from severe COVID-19 disease.

Monica Gandhi, MD, MPH, is a professor of medicine in the school of medicine at University of California, San Francisco. Michael Daignault, MD, is an emergency physician at Providence Saint Joseph Medical Center in Burbank, California.

"

 

[Lula]

“First and foremost, our country needs to specify the goal of our vaccination and booster campaign. Is it to continually boost neutralizing antibody protection against infection? Or is it to prevent severe illness and thus reduce the burden on our healthcare system? The former strategy is logistically difficult, will lack buy-in from a pandemic-weary public, and does not make long-term immunogenic sense. The latter is a much more feasible and public health-focused strategy.”

Ironically, Monica Gandhi’s controversial anti-mask stance is a big reason why we are all forced to live in this dystopian world of mutating variants.

 

[Lookinagain]

I don't know anything about this website, but I did see this article which seems to encourage mixing vaccines, especially if you go Pfizer

Pfizer, Moderna vaccines aren’t the same; study finds antibody differences

The findings add further weight to the idea of mix-and-match boosting.

arstechnica.com

 

[missy]

“First and foremost, our country needs to specify the goal of our vaccination and booster campaign. Is it to continually boost neutralizing antibody protection against infection? Or is it to prevent severe illness and thus reduce the burden on our healthcare system? The former strategy is logistically difficult, will lack buy-in from a pandemic-weary public, and does not make long-term immunogenic sense. The latter is a much more feasible and public health-focused strategy.”

Ironically, Monica Gandhi’s controversial anti-mask stance is a big reason why we are all forced to live in this dystopian world of mutating variants.

I wish everyone would just wear their masks. I don't understand why it's such a big hardship. The reason we are still in this mess IMO is because people are crying their rights are being trampled on...it's a sad commentary about humans in general. IMO.

 

[MamaBee]

I don't know anything about this website, but I did see this article which seems to encourage mixing vaccines, especially if you go Pfizer

Pfizer, Moderna vaccines aren’t the same; study finds antibody differences

The findings add further weight to the idea of mix-and-match boosting.

arstechnica.com

My husband and I both got Moderna. We’re going to do Pfizer next.

 

[tyty333]

Missy...I don't even think the CDC is recommending/requiring/suggesting that people wear a mask unless their community is designated
at a HIGH level, or, if they are at a MEDIUM level with a high risk of illness (comorbidity). Fill me in if you see something different. My
county is currently designated LOW but it looks like a good portion of the US is designated LOW.

You can check your state/county Covid designation here:

COVID by County

COVID-19 Community Levels help you decide your prevention steps.

www.cdc.gov

This page has lots of info on current covid data...haven't had time to look at it all...

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

 

[Calliecake]

@tyty333 . Thank you very much for posting the tracker by state and county.


@MamaBee, Have you had Moderna for all your previous shots? My husband I both have only had Moderna shots and boosters and were wondering if we should get the Pfizer shot this time. We just sent an email to our doctor asking what they recommend.

 

[seaurchin]

Missy...I don't even think the CDC is recommending/requiring/suggesting that people wear a mask unless their community is designated
at a HIGH level, or, if they are at a MEDIUM level with a high risk of illness (comorbidity). Fill me in if you see something different. My
county is currently designated LOW but it looks like a good portion of the US is designated LOW.

You can check your state/county Covid designation here:

COVID by County

COVID-19 Community Levels help you decide your prevention steps.

www.cdc.gov

This page has lots of info on current covid data...haven't had time to look at it all...

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

That is a nice surprise. Thank you.

I am still a bit leery about the levels rising again with the recommendations lowered/gone and/or new variants mutating.

Also, I think I have gotten so used to wearing a mask that I feel strange out in public without it now!

 

[Lookinagain]

Missy...I don't even think the CDC is recommending/requiring/suggesting that people wear a mask unless their community is designated
at a HIGH level, or, if they are at a MEDIUM level with a high risk of illness (comorbidity). Fill me in if you see something different. My
county is currently designated LOW but it looks like a good portion of the US is designated LOW.

You can check your state/county Covid designation here:

COVID by County

COVID-19 Community Levels help you decide your prevention steps.

www.cdc.gov

This page has lots of info on current covid data...haven't had time to look at it all...

COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

covid.cdc.gov

That's true and I've been following my county on that link, but I am still wearing a mask indoors even though my county is low (unless I'm somewhere like my office where I'm not spending time close to anyone else). The reason is that it seems that when the masks aren't worn, we end up with a new uptick in positive cases and then the next thing we know, a new variant that takes over. Watching Europe, I'm erring on the side of caution.