Coronavirus prep
Replies
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Re: vaccine availability, not all doctor offices give them. My GP office is physically co-located at a major urban hospital. At my annual physical yesterday, he said they weren't giving covid shots. (I took my CDC card just in case.) As of yesterday, the hospital was still eligibility screening boosters to 65+ and those with vulnerabilities (i.e. had not updated their system with latest CDC guidance.)
My pharmacy has an online appointment system, but the one time I used it was the single longest time I have ever waited -- 45 minutes. I was told there was zero coordination between online scheduling and whether the pharmacy has the vaccines or administrators available at the time confirmed. Plus, the online system only offers 9-5 appointments even though the pharmacy is open and able to do shots earlier & later. FWIW they show booked until Saturday (which is a terribly day to go because its busy). Conversely just walking at 9pm has always been quick for me. We're trying it tonight. My GP advised the booster and was doing so before the omicron developments. On the whole, I think high demand for shots is probably a good thing.6 -
Towards the end of this TWIV epi, something came up that's been kind of discussed here before so I thought I'd mention it. Dr Alan Dove (a microbiologist) said that he doesn't think the endgame is contant boosters. Considering the history of other coronaviruses he thinks that in a well-vaccinated community, new variants may continue to pop up and spread. Each new variant will basically serve as a "booster", being easily handled by some and causing mild illness in others.
No one else really responded to this, so I'm not so sure this is something they all agree on. I thought it was a nice little tidbit to file away though
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Looks like boosters will be approved for my age group (50+) today. But I read that Moderna says they will have a booster tailored to Omicron variant by March. So not sure now whether to get the regular booster, or wait for that? My 6 months is up December 6.
Same age group. My 6 months date is January 17 so I have a bit more time to see how things pan out with omicron.
I'm just a bit concerned that the threshold for "fully vaccinated" will move to 3 shots from 2 and I'll be scrambling at the last minute to meet the standard if I delay too long.3 -
SuzySunshine99 wrote: »At the very least, this whole Covid pandemic has created awkward and unexpected moments in our lives; giving us a new outlook on etiquette, etc.
We didn't celebrate Christmas with anyone last year. This year we thought we'd invite a few people and keep it intimate(our adult children, my sister and her dd, and our niece and her bf). Well, we did. However, we probably should've stated vaccinations mandatory or some such thing because 2 of our relatives are not and will not. So, very awkwardly, we uninvited them. I'll have to talk with dh about it but maybe if we request masks and pre-Christmas negative test??? It just feels so awkward and impolite the whole way around. But with my ds coming who has diabetes, and my sister and I both working with elderly people, I just do NOT want to risk it ya know? I just assumed they were vaccinated and I'm not sure why. I *know* the vaccinated are not immune to this virus but after seeing what fear my sister went through by being exposed to a couple of her friends that she assumed had been vaccinated and were not, then a day after being together, her 2 friends came down with Covid. I felt her friends should've let her know they weren't vaccinated; my sister was working with them often for God's sake.
Argh. IDK. Ready to crawl in a cave and hibernate with the bears.
I am thinking about buying some of the rapid tests from the pharmacy that we can use the day of holiday gatherings. I should probably get them soon, though...my CVS has them right now, but I bet they sell out as the holidays get closer.
I have been using these periodically as well. I plan to travel (by car) across the sputh east US in another week (TX to FL to TN to KY and back to TX... going through all states in between). So I'll be careful with that.1 -
33gail33 - I already have my booster---- but if I were you- I would go on and get my booster when time-- then worry abut If we will need another shot for the new variant later -- because it seems that if we are vaxxed and boosted we may be ok--- just my thoughts8
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Maybe it's finally time to put out some PSAs about taking steps to improve one's health, lose weight, etc. to help improve outcomes when one gets Covid (which unfortunately most will) along with vaxing, masking, distancing, etc.
Imagine the potential reduction of severe Covid issues if someone that was morbidly obese would have lost a pound a week since this all started.9 -
I'm not in any way a virologist or other relevant expert, just a regular ignorant bozo, so I'll throw this speculation out there to see what others, especially those more knowledgeable, think:
I'm thinking that if it turns out we do need a different vax because of Omicron, it would be surprising if they specified a loooong required interval between current booster and new formulation.
Thought process:
I haven't seen much that suggested getting vaccine doses "too close together" would be particularly injurious to healthy people (or to immune suppressed ones, for that matter), where "too close together" was less than the 6 months between second vax and booster, or even less than the X weeks between dose 1 and dose 2, if it wasn't like subsequent days or something really silly.
What I've understood was more that close doses wouldn't be as effective in stimulating the immune system in the useful ways. Most other vaccines (of different types) don't seem to need long separations (like the Covid booster and flu, or flu and shingles, etc.).
What is making y'all think that if one gets a booster now, there's a meaningful risk that you won't be able to get this speculative new vax when it comes out in March, given what you know at this point?0 -
Theoldguy1 wrote: »Maybe it's finally time to put out some PSAs about taking steps to improve one's health, lose weight, etc. to help improve outcomes when one gets Covid (which unfortunately most will) along with vaxing, masking, distancing, etc.
Imagine the potential reduction of severe Covid issues if someone that was morbidly obese would have lost a pound a week since this all started.
I'm coming around to that way of thinking, too, though for kind of cynical reasons.
I still don't think it would be very effective, given the number of people who don't think they're fat (BMI lies, big boned, just too muscular from that 15 minutes trudging on the treadmill twice a week, whatever), think they're "too old" to get fitter, aren't going to let the gubmint or those corrupt medical people tell them what to do ("Mah FreeDumb!!") . . . or, more defensibly, literally don't know what to do with themselves under stress except stress eat, or are under extremes of financial or time-availability stress because of personal pandemic-induced circumstances.
Still, if there's a way to do that with modest expenditure, without causing huge stupid public push-back, even a tiny dent in the so-called obesity crisis could be a good thing, for Covid mortality and other reasons.2 -
Just learned that Pfizer & Moderna (maybe others, too) actually did develop boosters for a number of prior variants (beta, delta) in the event it was deemed to be necessary (a la warp speed). In the end, the CDC determined existing vaccines are sufficiently effective against those variants not to warrant investment in clinical trials, regulatory process, etc. to bring the variant specific boosters to market. Omicron is being handled similarly. Teams are developing omicron specific boosters but that does not mean they will eventually come to market. More data needed.8
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I'm not in any way a virologist or other relevant expert, just a regular ignorant bozo, so I'll throw this speculation out there to see what others, especially those more knowledgeable, think:
I'm thinking that if it turns out we do need a different vax because of Omicron, it would be surprising if they specified a loooong required interval between current booster and new formulation.
Thought process:
I haven't seen much that suggested getting vaccine doses "too close together" would be particularly injurious to healthy people (or to immune suppressed ones, for that matter), where "too close together" was less than the 6 months between second vax and booster, or even less than the X weeks between dose 1 and dose 2, if it wasn't like subsequent days or something really silly.
What I've understood was more that close doses wouldn't be as effective in stimulating the immune system in the useful ways. Most other vaccines (of different types) don't seem to need long separations (like the Covid booster and flu, or flu and shingles, etc.).
What is making y'all think that if one gets a booster now, there's a meaningful risk that you won't be able to get this speculative new vax when it comes out in March, given what you know at this point?
I think that what they're saying (because I have the same thought, with my booster due in a month) is that perhaps it's better to wait another 2 weeks or a month and get an OMICRON booster if that comes out and is recommended. Otherwise, you get your booster and then may have to get another one in a short time.
However, from what the experts are saying here, the regular booster should be fine. Our OMICROM family is being tested and results will be out in 2 weeks. We'll see if there are other indications.1 -
News out of Southampton, Uni research, UK this morning. They looked into the best timing distance between the 2 vaccines and then the booster, it seems to be coming out at 3 months! I'll take more notice to the news again later and see what I hear more. Oh, Modena and Pfizer were thought to be the better options but there are others closely placed.
I do wish all countries had had the benefit of being able to offer the same numbers of vaccines so there could be a greater chance of variation being less able to procreate.
The booster availability here in the UK may be improving at long last. The medical profession are again taking over most of the vaccines and boosters from the government. The practices were told to prioritise the day to day testing and treatments needed by their local populations. Our local practice is how we will have ours on the 17th. I will try to keep an eye on the general situation.
Somehow all twice vaccinated persons over the age of 18 are to be offered boosters by the end of January '22. this is said to include those 6 months plus and those 3 months out from their second vaccine! If it happens this will be some major achievement. Because we are not in any form of lock down large venues are not available to be taken over as centres and because people are "back at work" there are fewer to volunteer to be vaccinators or clerical supports. Time will tell.
Better news locally, the UK county of Dorset may be getting a vaccination hub but how convenient it will be for the population with areas of high density and the more dispersed rural communities I don't know. The testing centre is half a mile away from us on one edge of the largest conurbation in a council shuttle bus carpark.
As it is nationally we are living with high rates of delta variant. I think my son said we lost 144 people within 28 days of testing positive yesterday. It did not reach the news headlines so I missed it. Had these lives been lost because of an airline, or rail incident or even an ocean liner sinking it would have made the headlines. Its as if we are suppose to believe its all over. Carry on as if its Christmas.....
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Just my thoughts but even if a variant specific booster was developed by March, would it be months after that before any of us general public had it available? Not sure how much trial and data would have to be collected before it was approved. Sort of an interesting discussion tho? Is it like the flu shot which is tailored every year to whatever strain is thought to be coming? I don't think that has to go thru approval/testing cycles each year? Would the booster for a specific COVID strain require it? Seems like by the time it was tested and available we would already be moving on to another variant anyway.5
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Towards the end of this TWIV epi, something came up that's been kind of discussed here before so I thought I'd mention it. Dr Alan Dove (a microbiologist) said that he doesn't think the endgame is contant boosters. Considering the history of other coronaviruses he thinks that in a well-vaccinated community, new variants may continue to pop up and spread. Each new variant will basically serve as a "booster", being easily handled by some and causing mild illness in others.
No one else really responded to this, so I'm not so sure this is something they all agree on. I thought it was a nice little tidbit to file away though
I think he's right that there will be a time where sufficient people are immune (through recent vaccination or infection) such that we will reach a steady state of infections - likely with a seasonal trend, rather than the 'waves' we are seeing now.
But there are a number of questions or issues:
1. The range of severity of illness that SARS-CoV-2 can cause is broader than that caused by other endemic coronaviruses. MERS (likely due to poor transmissibility between humans) and SARS (due to a combination of poorer transmission and that transmission occurring when people were more obviously unwell) never spread in the same way, while 229E, HKU and OC43 almost never cause severe illness, even in very vulnerable people: so we don't have an ideal virus to compare against.
2. This means that even in a steady state (of either fully vaccinated or recently infected population) some people are likely to be severely affected (death or ITU admission). The number is very hard to know.
Deaths are politically unacceptable, sort of (although we seem to accept a number of flu deaths each year) but even less acceptable is the effect of healthcare systems. Even at a minimum steady-state, covid infections in winter could grind essential high-dependency services to a halt: this remains to be seen, but there will be a major desire to avoid this (hence the offer of boosters in countries with good vaccine supply before most of Africa has had even a single dose).
3. I think this means that it would be a political risk for a country with access to pay for vaccines to not advise/require repeated vaccination - particularly if there is a rapid approval process for changing the vaccine formulation as per flu (which contains a different set of strains each year or so), and there is evidence of new variants becoming the dominant strain as we have seen with omicron.
4. It looks like immunity to infection wanes (from any source of immunity) to even the same strains of virus. If this is the case then there is a risk of a year with few infections, perhaps due to a high rate of immunity in the prior year leading to fewer cases, and therefore less re-exposure to boost immunity. If this is combined with a new variant that causes a more severe illness, or partially escapes the vaccine protection then there is a high risk of a seasonal peak becoming a new pandemic or a 'wave' type spread.
I think switching to an approach where we rely on prior vaccination campaigns and ongoing spread to boost and sustain immunity is going to be considered politically risky.
As to whether it would actually work: I think it's a cost/benefit analysis. More vaccinations and higher frequency of vaccination is a big cost (financial and political), but the risk of not vaccinating frequently is significant and, based on evidence so far, would likely lead to excess deaths and use of healthcare resources.
For flu the determination has historically been (in the UK) to vaccinate the most vulnerable (older, immunosuppressed) and some of the younger kids, but allow the virus to spread in the community otherwise and manage the negative outcomes. This has been achieved with variable success due to particularly novel strains (2009 swine flu for example) and variable vaccine efficacy.
Given this variable success with flu, I can't see a world where we don't have continuous development of vaccines, and, if we see vaccine breakthrough by a strain, polyvalent vaccines, which should be doable with the RNA/vector based technology, and is definitely doable with the recombinant or inactivated virus based vaccines.
Of course, if it were up to me we would remove the vaccine production from private hands and make them freely available everywhere prioritising availability of the first dose globally: not just because of the obvious moral responsibility, but also this is likely to be the approach which gets us to a steady-state fastest, and reduces the rate of new variants occurring and spreading in large vulnerable populations.
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I haven't seen much that suggested getting vaccine doses "too close together" would be particularly injurious to healthy people (or to immune suppressed ones, for that matter), where "too close together" was less than the 6 months between second vax and booster, or even less than the X weeks between dose 1 and dose 2, if it wasn't like subsequent days or something really silly.
What I've understood was more that close doses wouldn't be as effective in stimulating the immune system in the useful ways. Most other vaccines (of different types) don't seem to need long separations (like the Covid booster and flu, or flu and shingles, etc.).
What is making y'all think that if one gets a booster now, there's a meaningful risk that you won't be able to get this speculative new vax when it comes out in March, given what you know at this point?
I agree with this. It is common to get multiple vaccines at the same time, either of the same pathogen (flu is three or four strains. Strep. pneumo is 13 or 21 strains) or of different pathogens (MMR, DTaP). There is no specific harm: the question is can you get enough of each specific target in to get good efficacy without lots of adverse events (mainly fevers, local or systemic inflammation). And the answer to this is generally yes. With the new technologies being used there is not a substantial body of evidence to support this yet, which may be a barrier to implementation polyvalent vaccines.
And I agree about durations: the longer delay allows more maturation for the T and B cells that have been positively selected during the initial challenge. This makes the response after boosting more specific against the antigen and therefore better. There are diminishing returns over time, then a cliff when the specific memory cell populations are lost (how long this takes is different for different infections and for different people - a great example is in untreated HIV where the B-memory cells are not retained as long because they lack the costimulation by T-cells which are killed by HIV, and therefore vaccine efficacy often limited)
The only risk I see is that a healthcare authority may determine that the old formulation is good enough for people that have recently had a dose, but update to a delta/omicron/next variant specific immunisation for people who are due further vaccination.
But either a variant specific vaccine is going to have a markedly higher efficacy (in which case it will be offered to everyone, and probably best to boost off 3 doses rather than 2) or it's not going to be much more effective in which case there is no point in getting it over the current vaccine formulation.
With all that said: I think the risk of waiting is significant and the benefit is essentially non-existant, while the benefit of boosting is quite clear and the risks are negligible.4 -
Looks like boosters will be approved for my age group (50+) today. But I read that Moderna says they will have a booster tailored to Omicron variant by March. So not sure now whether to get the regular booster, or wait for that? My 6 months is up December 6.
Most of the virologists I follow are leaning towards vaxxed and boosted folks not having to worry (probably even just vaxxed), but it will take another couple of weeks to get enough lab data and real world data to know what's what.
Went ahead and booked for me and my husband - getting boosted Dec 15.4 -
33gail33 - I already have my booster---- but if I were you- I would go on and get my booster when time-- then worry abut If we will need another shot for the new variant later -- because it seems that if we are vaxxed and boosted we may be ok--- just my thoughts
Thanks - yes I am getting in Dec 15th. My BIL works in public health and he is getting his today so following his advice and getting it as well.2 -
SummerSkier wrote: »Just my thoughts but even if a variant specific booster was developed by March, would it be months after that before any of us general public had it available? Not sure how much trial and data would have to be collected before it was approved. Sort of an interesting discussion tho? Is it like the flu shot which is tailored every year to whatever strain is thought to be coming? I don't think that has to go thru approval/testing cycles each year? Would the booster for a specific COVID strain require it? Seems like by the time it was tested and available we would already be moving on to another variant anyway.
FWIW, my GP discussed this at my annual physical. In the context of short term flood of antibodies + long term T- & B-cell training, he was advising getting the 3rd shot now because the effectiveness of the antibody aspect is the dominant factor in the decision process for when to boost. He also contemplated combo with annual flu vaccine in the future.
Really, though, there has been work for YEARS on a "universal flu vaccine" that would train immune systems to be smart enough to recognize all flu variants, hence eliminating the need for annual updates. The impediment has been lack of translational funding (from research to clinical). I hope, among the many changes the pandemic is likely to leave in its wake, translational funding will be prioritized for flu the way it has been at "warp speed" for covid. After all, the mRNA vaccines came to market so quickly because the research had been done long ago but there was never funding to take it from basic research to clinical trial. Then *boom* funding. There could be similar development for flu vaccines. Time will tell.5 -
Looks like boosters will be approved for my age group (50+) today. But I read that Moderna says they will have a booster tailored to Omicron variant by March. So not sure now whether to get the regular booster, or wait for that? My 6 months is up December 6.
Same age group. My 6 months date is January 17 so I have a bit more time to see how things pan out with omicron.
I'm just a bit concerned that the threshold for "fully vaccinated" will move to 3 shots from 2 and I'll be scrambling at the last minute to meet the standard if I delay too long.
So far Dougie says that two shots will be considered fully vaccinated and the third is optional - but yeah that doesn't really mean anything they could change that at any time.
I'm pretty upset about the new travel restrictions. Was going to finally get away in January, but now that we have to isolate after arrival again not sure that it going to be feasible for me work wise.
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FWIW, my GP discussed this at my annual physical. In the context of short term flood of antibodies + long term T- & B-cell training, he was advising getting the 3rd shot now because the effectiveness of the antibody aspect is the dominant factor in the decision process for when to boost. He also contemplated combo with annual flu vaccine in the future.
Really, though, there has been work for YEARS on a "universal flu vaccine" that would train immune systems to be smart enough to recognize all flu variants, hence eliminating the need for annual updates. The impediment has been lack of translational funding (from research to clinical). I hope, among the many changes the pandemic is likely to leave in its wake, translational funding will be prioritized for flu the way it has been at "warp speed" for covid. After all, the mRNA vaccines came to market so quickly because the research had been done long ago but there was never funding to take it from basic research to clinical trial. Then *boom* funding. There could be similar development for flu vaccines. Time will tell.
There's another aspect to it: if we assume that a new variant specific vaccination is required because the immune response to the initial vaccination doesn't do a good job recognising it (particularly in the parts of the spike protein responsible to actually binding the host cells) then should we assume that the prior vaccination against the original strain will NOT be boosted, given the substantial differences?
That would mean needing both the original booster AND the new-variant vaccination, unless they can be put together in a single new formulation as they have done with flu strains.
The universal flu vaccine development is complex due to the flu virus's modular chromosomal structure and seasonal trend - allowing for these big and small antigenic changes. A further issue is that we rely almost entirely on a relatively small number of massive pharma companies to do the translation. And in most vaccine cases there is a disincentive to create a functional universal vaccine: why spend billions doing trials on a novel, difficult to produce vaccine to compete with a well tolerated, well recognised product that is licensed and that you are already selling, every year?
It's likely to cost you more money in lost sales than it will make after the R&D and marketing costs. Interestingly A Phase 3 trial of a nanoparticle based flu vaccine has just published. They still used the proteins from circulating strains but are hoping the way the vaccine is made will give broader immunity: which the biochemical assays of immunity suggest it might: but there is still no clinical data regarding efficacy, as the primary outcomes were immune measurements, not incidence.
At least it shows someone is trying...5 -
Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??6 -
Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??
Yeah, I waited the 10 minutes after my first shot, but not my second or third.
Yes, the timing of the information doesn't make sense from a logical point of view, but in terms of not creating a barrier to "closing the deal" it makes perfect sense
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kshama2001 wrote: »Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??
Yeah, I waited the 10 minutes after my first shot, but not my second or third.
Yes, the timing of the information doesn't make sense from a logical point of view, but in terms of not creating a barrier to "closing the deal" it makes perfect sense
@kshama2001 very true that there may be a goal of not providing more reasons to not get the shot.
Other interesting moments from my visit (not this is Publix grocery in the Florida Keys). The pharmacist thanked me for "believing that the vaccine works", then after as I was walking past people checking out with my bandaid on my arm, a gentleman nodded towards the bandaid and said "nice job!".
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I'm not in any way a virologist or other relevant expert, just a regular ignorant bozo, so I'll throw this speculation out there to see what others, especially those more knowledgeable, think:
I'm thinking that if it turns out we do need a different vax because of Omicron, it would be surprising if they specified a loooong required interval between current booster and new formulation.
Thought process:
I haven't seen much that suggested getting vaccine doses "too close together" would be particularly injurious to healthy people (or to immune suppressed ones, for that matter), where "too close together" was less than the 6 months between second vax and booster, or even less than the X weeks between dose 1 and dose 2, if it wasn't like subsequent days or something really silly.
What I've understood was more that close doses wouldn't be as effective in stimulating the immune system in the useful ways. Most other vaccines (of different types) don't seem to need long separations (like the Covid booster and flu, or flu and shingles, etc.).
What is making y'all think that if one gets a booster now, there's a meaningful risk that you won't be able to get this speculative new vax when it comes out in March, given what you know at this point?
Just saw this now. Vaccine rollout is a little slower here, and we have a little less freedom of choice. For example we are just offering boosters to 50+ beginning December 13th, younger age groups will be in the new year, and we are only eligible after 6 months.
When I posed the question of waiting it actually never occurred to me that I won't be able to get another booster if I take one now, just not really wanting to get more shots than I need. But now that you mention it I would imagine if a new booster comes out people who already had a recent 3rd dose would probably be last on the list to get it.0 -
autobahn66 wrote: »Towards the end of this TWIV epi, something came up that's been kind of discussed here before so I thought I'd mention it. Dr Alan Dove (a microbiologist) said that he doesn't think the endgame is contant boosters. Considering the history of other coronaviruses he thinks that in a well-vaccinated community, new variants may continue to pop up and spread. Each new variant will basically serve as a "booster", being easily handled by some and causing mild illness in others.
No one else really responded to this, so I'm not so sure this is something they all agree on. I thought it was a nice little tidbit to file away though
I think he's right that there will be a time where sufficient people are immune (through recent vaccination or infection) such that we will reach a steady state of infections - likely with a seasonal trend, rather than the 'waves' we are seeing now.
But there are a number of questions or issues:
1. The range of severity of illness that SARS-CoV-2 can cause is broader than that caused by other endemic coronaviruses. MERS (likely due to poor transmissibility between humans) and SARS (due to a combination of poorer transmission and that transmission occurring when people were more obviously unwell) never spread in the same way, while 229E, HKU and OC43 almost never cause severe illness, even in very vulnerable people: so we don't have an ideal virus to compare against.
2. This means that even in a steady state (of either fully vaccinated or recently infected population) some people are likely to be severely affected (death or ITU admission). The number is very hard to know.
Deaths are politically unacceptable, sort of (although we seem to accept a number of flu deaths each year) but even less acceptable is the effect of healthcare systems. Even at a minimum steady-state, covid infections in winter could grind essential high-dependency services to a halt: this remains to be seen, but there will be a major desire to avoid this (hence the offer of boosters in countries with good vaccine supply before most of Africa has had even a single dose).
3. I think this means that it would be a political risk for a country with access to pay for vaccines to not advise/require repeated vaccination - particularly if there is a rapid approval process for changing the vaccine formulation as per flu (which contains a different set of strains each year or so), and there is evidence of new variants becoming the dominant strain as we have seen with omicron.
4. It looks like immunity to infection wanes (from any source of immunity) to even the same strains of virus. If this is the case then there is a risk of a year with few infections, perhaps due to a high rate of immunity in the prior year leading to fewer cases, and therefore less re-exposure to boost immunity. If this is combined with a new variant that causes a more severe illness, or partially escapes the vaccine protection then there is a high risk of a seasonal peak becoming a new pandemic or a 'wave' type spread.
I think switching to an approach where we rely on prior vaccination campaigns and ongoing spread to boost and sustain immunity is going to be considered politically risky.
As to whether it would actually work: I think it's a cost/benefit analysis. More vaccinations and higher frequency of vaccination is a big cost (financial and political), but the risk of not vaccinating frequently is significant and, based on evidence so far, would likely lead to excess deaths and use of healthcare resources.
For flu the determination has historically been (in the UK) to vaccinate the most vulnerable (older, immunosuppressed) and some of the younger kids, but allow the virus to spread in the community otherwise and manage the negative outcomes. This has been achieved with variable success due to particularly novel strains (2009 swine flu for example) and variable vaccine efficacy.
Given this variable success with flu, I can't see a world where we don't have continuous development of vaccines, and, if we see vaccine breakthrough by a strain, polyvalent vaccines, which should be doable with the RNA/vector based technology, and is definitely doable with the recombinant or inactivated virus based vaccines.
Of course, if it were up to me we would remove the vaccine production from private hands and make them freely available everywhere prioritising availability of the first dose globally: not just because of the obvious moral responsibility, but also this is likely to be the approach which gets us to a steady-state fastest, and reduces the rate of new variants occurring and spreading in large vulnerable populations.
I would respectfully disagree that deaths are politically unacceptable, at least here in the US, I'm sorry to say. I know more people than I care to admit who say that they are tired of masks and restrictions and we should just accept that a few thousand people will die every yr from covid just like they do from flu. I also know far too many people who got their initial two shots but now point to advice to get a third shot and a variant that might require another as proof this is all a money grab or scam and they are done participating.
I believe the individual risk for a vaccinated person will come down largely to percentage vaxxed in their community. It seems to me like a vaxxed person's chances of running into the virus, and the virulence of the viral particles, is greatly affected by the immune status of the people around them. There is also a not zero chance that a variant that is more fit than Delta but milder will take over, theoretically at least lowering risk further. Although that's all based on my self-led internet immunity education lol.
Regardless I think it's literally impossible that the US govt will be able to mandate annual covid boosters. They may very well be available so those at high risk or otherwise willing can update their coverage so to speak, but for reasons I can't go into without breaking rules about discussing politics, I can't see any sort of mandate going farther than a third shot.
You mentioned the flu - isn't the reason we get flu shots every year because there are different flu viruses active every year, not for booster purposes? That's what I thought was the case.
Another question just going out to the internet here, do you have to get infected to get an immune response to get a "boost"? Or does the mere presence of the virus in your body activate your immune system to throw it out before it actually infects you? Not sure if that is a stupid or an insightful question 4 -
@SModa61 I got my booster a couple of days ago at Walgreen's. The vaccine information (ingredient name, common uses, cautions, side effects, etc) was printed on the receipt that they always give out for prescriptions which I got prior to the shot. I remember the first two shots I was provided multiple sheets of information but it was via a Kroger pharmacy. They didn't even suggest that I wait 15 minutes so I left. Since I had no issues for the first two shots I figured I was fine.
Each pharmacy must do things slightly different.2 -
Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??
Weird...when I made my appointment with CVS, that packet was all right there online when I was making the appointment. I didn't get any packet afterwards and they asked me if I had any issues with the first two shots...I said no and they told me I could hang out for a few minutes if I wanted or had any concerns, but was otherwise free to go. I was there for about ten minutes anyway because I had to pick up some shaving butter and a few other things, but otherwise I would have just left given no issues whatsoever with my first two shots either at site or afterwards.1 -
I got mine through the hospital system and got a big packet of info at my first vaccination, including info on where to register any problems with the vaccine. There was less info at the next two. I had to wait 30 minutes after the first shot because I had a prior history of anaphylactic reactions (to penicillin and some thing unknown in the garden). The next two times I waited 15, using a timer.1
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Just saw this now. Vaccine rollout is a little slower here, and we have a little less freedom of choice. For example we are just offering boosters to 50+ beginning December 13th, younger age groups will be in the new year, and we are only eligible after 6 months.
When I posed the question of waiting it actually never occurred to me that I won't be able to get another booster if I take one now, just not really wanting to get more shots than I need. But now that you mention it I would imagine if a new booster comes out people who already had a recent 3rd dose would probably be last on the list to get it.
Exactly. Existence of an omicron-specific vaccine doesn't mean that our public health authorities will immediately make it available to anyone and everyone, at least not without imposing a lapse of time after one's last shot.0 -
cwolfman13 wrote: »Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??
Weird...when I made my appointment with CVS, that packet was all right there online when I was making the appointment. I didn't get any packet afterwards and they asked me if I had any issues with the first two shots...I said no and they told me I could hang out for a few minutes if I wanted or had any concerns, but was otherwise free to go. I was there for about ten minutes anyway because I had to pick up some shaving butter and a few other things, but otherwise I would have just left given no issues whatsoever with my first two shots either at site or afterwards.
I also got mine at a CVS, and same re the packet. They also asked me about issues with the first two shots but since I was getting Moderna and had had Pfizer before they asked me to stay there for 10 mins and I did (rule follower). I then did some Halloween shopping, so it worked out well.1 -
Got my booster 4 hours ago. Process is a little odd. Arrive at scheduled appointment and fill out form by checking off lots of various boxes. A few minutes later, you get the shot. Then you are told to go wait 10 minutes, after which you will receive back your vaccination card ( a clever way to make sure people do not leave prematurely :P ). So at the 10 minutes, I get handed a whole packed, including my card.
10 minutes ago, i opened the packet to see if it is anything I need to keep or recycle. Page two of the packet has a section titled "What you need to know before you get this vaccine". Page four has a section titled "What are the risks of the vaccine". Page six contains "what if I decide not to get the comirnaty (COVID-19 Vaccine, mRNA) or the Pfizer-Biotech COVID-19 Vaccine?" Seems like this process could stand for a little improvement. Shouldn't this packet be being given out BEFORE the shot??
As others said, not my experience either. Vax #1, I got all the info before the shot, with plenty of time to review. (First, it was online when I signed up. Then, it was given to me on paper when I entered the wait line for drive-through vax.) Later shots were less structured (but the info was always online at signup), and every instance had a 15 minute wait. (It was more self-monitored on the booster and 2nd, but they wrote a time on our windshield with glass marker, and we waited in queue until our time was up, with staff people along the sidewalk keeping an eye on us).
Card was updated indoors, part of the vax process, but before the wait.
I think this is just variation by site, maybe tempered by state requirements.2
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