Oct 24, 2022Liked by Katelyn Jetelina

It's one ting to say that pharmacies should advertise the availability of boosters. It's something else to actually get them. At Walgreens I asked for a booster and was told I needed to book an appointment. So I asked to book an appointment and was told it could only be done online. Well, that lets out a lot of older people and anyone else who's not computer savvy. Nor was the online experience a cakewalk. The appointment software redirects to a CDC site that explains availability, which is both complicated and ambiguous. The only way it would book me is if I marked the box for immunocompromised. That seems to be their term of art for being over 65, but elsewhere on the site it says you qualify if you're over 12 and it's been more than three months or something since your last injection. In short, if pharmacies would just book you when you're standing there in person, the system would work. Their wooden insistence on online booking is a needless and sometimes insurmountable barrier.

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Oct 24, 2022Liked by Katelyn Jetelina

I think part of the issue is that the public health messaging is so contradictory and difficult to digest. For two years, we were told to "follow the CDC" re: masking. But now, public health experts are telling us that the CDC isn't handling covid and the vaccine campaign effectively or properly. People don't know who to trust, and we (because I include myself) are confused about when the booster would be best for us, particularly if we have hybrid immunity.

I haven't had covid, and I had my bivalent booster in September. But my child (who is age 11 and boosted in May) had covid in late July. Actually, today is her 90-day mark post-infection. But some people are saying she should wait another few months to get the maximum benefit from the bivalent booster.... but she had a very mild covid infection, so I am also reading that some people who have very mild cases don't build as much immunity.

All the experts contradict each other (even people whom I trust very much) and it's nearly impossible to know the right thing to do. I want to get my child her bivalent, but I also want to time it right.

I wish everyone would get on the same page and set forth some bright-line guidance for when people should get their boosters. I think the lack of straightforward messaging on this is making a lot of people hesitant to move forward.

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Oct 24, 2022Liked by Katelyn Jetelina

Doctors at the Baylor system are being told at presentations that the additional booster is superfluous and that as long as they have three shots they have all the protection they need. I am disheartened by the medical community getting subpar advice. They then go and tell non medical personnel not to bother getting the shot. So there are forces within the medical community working against booster uptake.

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With respect to Drs Siegel and Rosenberg, the lack of interest in boosters and childhood covid vaccines isn't due to lack of motivation, eligibility questions, or focused engagement.

The lack of enthusiasm is directly correlated to the perceived lack of benefit.

To the general population a vaccine means "you can't get that thing anymore". This is why we have successfully convinced people to get the vaccines which work - it was self-evident that the thing you were vaccinating against - whether it's polio, measles, or chickenpox went away after you got vaccinated.

If the varicella vaccine didn't reduce odds of getting chickenpox, and only lowered odds of being hospitalized (which are close to zero for children anyway), Drs Siegel and Rosenberg would have had a much harder time increasing routine immunization in Marin County.

Katelyn has been one of the few voices from the beginning pointing out this wasn't a sterilizing vaccine and reminding readers we didn't have enough information on impact of transmission, and for that she should be commended.

Yet Public Health did not present that message. The message was clear and unambiguous - get the vaccine and you can't get covid. Just like lay people would expect of any vaccine. Whether it was Fauci [1], Rachel Maddow [2], the CEO of Pfizer [3], Stephen Colbert [4], or the CDC [5], the message was continuously amplified from all directions - Covid vaccines stop Covid. This was how there was support for business and school vaccine mandates for covid shots - the public believed that herd immunity was in sight thanks to the vaccine.

That is not the case.

Having a Covid vaccine appears to have no correlation to the odds of getting Covid [6].

Walensky getting Covid exactly one month after she got her bivalent booster is just the latest in a string of bad PR for the vaccine and boosters following the repeated high-profile infections for Bourla, Colbert, Fauci, and the Bidens this past year.

Not to mention for many, the vaccine made people sick. Just look at all the schools which had to close because too many teachers fell ill immediately after vaccines. [7] My social media was flooded with friends and family acknowledging how horrible they felt after the first or second dose, but taking comfort how worth it will be knowing they can't get covid anymore. (I'd estimate roughly 1 in 5 to 1 in 10 people in my friend group/family got knocked down a day or two post dose 1 or 2)

For them to go through that and still get Covid anyway - often making them feel terrible yet again - makes it hard to dismiss their reluctance to go through 3rd, 4th, or 5th shot as "antivaxx".

The erosion of confidence by the public at large in the vaccine efficacy is clearly why we have millions of soon to expire shots few are taking. To ignore this feels like sticking our heads in the sand.


[1] https://thehill.com/homenews/sunday-talk-shows/553773-fauci-vaccinated-people-become-dead-ends-for-the-coronavirus/

[2] https://twitter.com/albertbourla/status/1377618480527257606

[3] https://twitter.com/aginnt/status/1475193955704881152

[4] https://www.youtube.com/watch?v=sSkFyNVtNh8

[5] https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm?s_cid=mm7013e3_w

[6] Just look at every highly vaccinated state or country which exploded in covid cases regardless of being leaders in vaccination rates (Denmark, South Korea, Japan, Vermont, California, Australia, etc) - it's hard to reconcile high level country level results with a CDC published case control study claiming otherwise

[7] Quick sampling of headlines I saw immediately following early 2021 rollout: https://www.fox32chicago.com/news/suburban-school-district-cancels-classes-after-125-teachers-staff-called-off-for-vaccine-side-effects





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Last time I posted on FB, a friend of mine posted in response. She has a school-aged son and had a bad inflammation reaction to the second Moderna shot. While the rest of her family has continued receiving vaccines, she was frustrated that it's less talked about who *shouldn't* get the vaccines. We both agreed that public health is HARD because many more people just need to hear that they *should* get it. In Europe they are more specific (e.g., "Hey if you're at risk for myocarditis, talk with your dr or maybe prioritize getting Pfizer instead of Moderna"). On the one hand, that seems to sow doubt, but on the other hand, as my friend pointed out, if the experts don't acknowledge the problems of the vaccine, people will look at less reliable sources and possibly fall down conspiracy theory rabbit holes.

I can see an advantage to being open about who shouldn't get the vaccine, too. If the posters in CVS, say, displayed "Should you get the fall booster? - If you had an unusual reaction to a previous booster, talk to your doctor first. - If you're a male under age 29 [or whatever] with no extra risk factors, talk to your doctor first. - If you received another covid vaccine or had a covid infection in the last 90 days, wait until three months is up." The implication being, if you *don't* fall into one of those three categories, step right up!

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Oct 24, 2022·edited Oct 24, 2022

Bringing the vaccines to people rather than having the people come to the vaccines is also quite successful. As a health department, we go on the road...to farms, to assisted living, to workplaces...we bring the vaccine, and quite a lot of people get one. We bring flu shots, and quite a lot of people get both. Thank you for introducing me to the IIFF Model though.

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I initially had a favorable attitude toward the mRNA vaccines, but I have had extended systemic reactions to all 3 of the doses I got, and I no longer trust that technology. So I've been waiting patiently for the Novavax vaccine - but now I've read that if you've already had one mRNA booster, you cannot get the Novavax booster! WTF! Those of us with autoimmune diseases (who are NOT on immunosuppressive drugs) and those of us with on-going Chronic Fatigue (ME/CFS) from herpes-family viruses have been systematically gaslighted by the medical establishment for decades. I'm losing hope.

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The NYT article basically said what anyone who knows Marin County already understood: vaccination rates started to climb when people perceived it as a political issue and they could use vaccination status as a way to distinguish themselves from Republicans. This is not a good solution!

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Is it still true that we should wait three months to get bivalent booster after a Covid infection? All the commentary about low booster uptake seems to ignore this. My husband and I had Covid in mid September, so we plan to wait to get booster until December. We aren’t slackers!

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I think one of the recent failures of sci-comm is speaking of the previous vaccines in absolutes ("you won't get sick") when they needed a caveat ("unless the virus evolves"). Because of that, a significant amount of people I know feel like "why should I get the bivalent booster, does it even do anything?" Related to that, one thing I've been telling people is that I've anecdotally seen (and I bookmark these if people want examples) plenty of people getting the bivalent and attending a conference masked and avoiding it. But also people getting a breakthrough by attending something unmasked, however those breakthroughs resolve much faster (3-5 days positive instead of 10-14 days).

So the messaging I'm using when friends/family bring it up is 1) it's not perfect but it definitely helps 2) combine it with a mask in crowded indoor spaces and they're a formidable shield together 3) if you do get a breakthrough, it hugely cuts down on time/severity.

Anyone here have other messaging that works better? Or further anecdotal evidence about how well the bivalent is holding up?

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I had bad reactions to no. 3 and 4 that I’m leary of no 5. I am also leary of Covid so I’ll do no.5. You i spired me again. Thanks.

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Herd immunity has been a failed strategy with coronavirus. Vaccination for corona must now be considered a personal risk/benefit decision, and always should have been. It’s no different from the public health approach to smoking - ultimately it’s an individual choice. We can give advice and setup incentive structures, but to do more than that is crossing a line into people’s personal lives that they will resent us for. People do risky things every day, always have, always will. Public health needs to move on from its one dimensional thinking - the law of diminishing returns applies.

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It is discouraging that people still get covid even after getting vaccinated and boosted. Yes, the formal vaccination goal is to prevent hospitalizations and death. Even so, when people get vaccinated and then get covid anyway, and feel terrible even while at home, it seems (to them and their friends) that the vaccination failed. Maybe we could get to a better vaccine.

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Just got the whole family Vaxxed this past week. It took longer because we had to make an appointment. I get it at our local Safeway and scheduling it took a week. Also had to make a separate appointment for each family member. I can see how someone more ambivalent than me might not get it done for a while.

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Oct 24, 2022·edited Oct 26, 2022

Interesting. These insights seem very applicable to voter turnout in elections in the US. I’m sure I’m not the first person to think that… So many parallels here with the “passive positive” voter who has low motivation to turn out to the polls on Election Day

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Oct 24, 2022·edited Oct 25, 2022

How are you defining which people * currently * have "favorable attitudes" yet are "passive positives"?

There are people who * initially * had favorable attitudes. They got the primary vaccine series. Some may have even gotten one or more boosters. But why aren't they getting the latest booster? Is it simply because they lack motivation - or has their attitude changed from "favorable" to "skeptical"?

For people in the "skeptical" camp, the spectrum is wide and includes those who never got the primary series in the first place - despite mandates, (threats of) job loss and other forms of government sponsored coercion and shaming.

Now that the vaccinated-yet-skeptical group has been lumped together with the anti-vaxers, they will be met with a certain level of scorn and derision by a small yet vocal faction of "active positives," which only makes the skeptics more entrenched in their position not to get boosted.

It doesn't help that President Biden has declared that the "pandemic is over." It doesn't help that the CEO of Pfizer comes down with Covid twice in the space of a month. It doesn't help that the CDC Director gets Covid only a month after she received her bivalent booster.

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