The newest Omicron variant, BA.4/5, is gaining traction, causing case, hospitalization, and death curves to trend upwards in many countries. This variant was first detected in South Africa in early 2022 and caught our attention because it had several mutations on the spike protein. Two mutations in particular, called L452R and F486V, caught our attention because we had seen them on previous variants of concern. Recent lab and epidemiological data show BA.4/5 to be driving this wave, in part due to reinfections and infections after vaccination.
Here in Oregon, wastewater surveillance and spot testing are indicating sharp rises in both BA.4 and .5. indoor masking is now being again recommended (not mandated yet) in several counties where the per capita infection rate seems high.
26 months since infection with either the original west coast "A" or "B" strains from some California visitors, I still am dealing with some lingering symptoms and as always caution against contracting the long version..you really, really don't want to risk it.
PCR will capture viral fragments; longer-chain antigens are caught by the antigen testing. There's a difference. Virtually all the antigen tests (perhaps 2 exceptions I'm familiar with) are not as sensitive as PCR so they don't catch low-viral-load states, and often miss early infection or asymptomatic infections. PCR can remain positive for months (I prefer to not retest for 90 days post positive PCR), but antigen testing will subside when the level recedes.
Positive, especially in the omicron era, has to be treated as infected and contagious. Sorry, that's the calculus of the disease.
There is no real disagreement here. I was attempting to explain the basis for the use of either methodology. Both of these essentially summarize what I've been saying.
Mike Mena has been pretty adamantly in favor of frequent at-home RAg testing for some time and he is correct that with DAILY testing it's a useful tool. Unfortunately, very few public health operations have a mechanism to receive reports of home testing, and there are some that interpret the only legal testing to have been performed in a CLIA certified lab. For a period of time some states were reporting lab-reported antigen testing , e.g., pharmacy-based testing (CVS, Walgreens and some others were granted temporary CLIA certification for this). For the organization I'm working with, CLIA clamped down pretty hard on our use of home testing to evaluate participation in training events, especially those where larger cohorts were remaining overnight. Eventually, despite official positions that we couldn't do so, activity directors, believing they understood how RAg tests worked, adopted them and we've seen some cases where they were misused. We've also seen cases where our training events were happening outside the normal range to get NAAT testing for definitive purposes, and they've been invaluable. As we raise the understanding in our organization, their use is becoming more standardized and useful. (I was a proponent of a block of training specific to our organization and the ongoing use of no more than 3 home RAg tests, limited to simplify training, for our activities).
I don't see a misunderstanding, and apologize if you did.
We travelled from West Texas to the YMCA of the Rockies in Estes Park. NOBODY wore masks there, and masks were rare in Santa Fe, Colorado Springs, Las Cruces and El Paso. It’s a weird feeling be the only two people amongst 100’s who are “ so over it”.
Is it still the case that outdoor transmission is very very low? My wife is upset I was within 6ft of unmasked people outside for no more than 20 minutes earlier today and said I'm taking unnecessary risks.
Related: What is the risk of catching the new variant in a situation where I am unmasked with other unmasked people as described above?
I would also welcome any new/updated information about transmission outdoors. There are several studies about the original strain and perhaps even Delta, but I would really appreciate some sources for recent studies of Omicron and variants. I’m particularly interested in how it relates to backyard-type gatherings, outdoor restaurants, and community events (as opposed to large sporting events or concerts).
Thank you, Dr Jetelina, for your remarkable work. I'm not as learned as some of your readers, yet I am a nurse who worked 37 yrs in ICU. My most burning question concerns the safety of the vaccine, esp for young women in their childbearing years. This has plagued me and now listening to family members who claim that there are reports that the mRna vax causes miscarriages, reproductive abnormalities, etc. What sources do you suggest to find some true answers? I have never posted anything, so hope I don't offend or cause any discord. Thank you.
It seems with each month that goes by, fewer and fewer people care? much less know about variants. The people I know who followed information about COVID have now moved from worried about getting infected and getting sick to either (1) Not worried about getting infected at all as they see it as mild or (2) Concerned about COVID but only because the issue of long COVID. This seems to be also what is the deciding factor for many parents I know about vaccinating their under 5 kids.
If there is an omicron based booster in the fall I wonder what the vaccination rates will be as people view COVID as less and less of an immediate issue.
The American public has a short attention span. They also selectively heard that getting vaccinated would end the pandemic and you'd never get COVID. We saw the short attention span with the pandemic outbreak that started in 1918 and lasted for several years. We have also suffered from misinformation (or worse, intentional disinformation) about the safety and efficacy of the vaccines leading to hesitancy or a sense of false wellbeing. There are a lot of pundits but few experts out there who understand how a pandemic "works", but thanks to polarization, we've a lot of people who want to throw the infectious disease and public health experts under the bus, claiming they (we) don't know what we're talking about.
If we do see an omicron derived booster, while some of us will get it, I'll go out on a limb and predict less than 25% uptake. There will be too many people casting aspersions about its efficacy.
Agreed. I think one thing that is an unknown and am watching and I think has the potential to have an impact is the financial cost to businesses due to long covid. Disability claims are up. COVID treatment is the costliest (or right at the top) for insurers. https://pascdashboard.aapmr.org/ uses 30% as the number for symptoms after 6 months and puts the number at 25 million with long covid. Even if the number is 5% or less that is still millions (and doesn't account for those under 18 who will be entering the workforce). So at some point (perhaps now), this is very much a business/bottom line decision. Large businesses and government seem to take a more proactive approach when it hits the bottom line. So we very well might see "rewards" for vaccinations etc. But I will be shocked if this isn't a major issue by the end of the year in the business community (Meaning that it isn't simply being talked about in business circles but we see it as one of the new "hot" topics).
Early in the vaccination game, we saw lawsuits against businesses including hospitals who mandated or even rewarded employees for vaccinations. Now issues with mis/disinformation have clouded the issue. Assuming big business has adequate and effective medical advice on the benefits of vaccination perhaps we'll see something here. However, a bunch of the big-business folks are among the camp that didn't see COVID as a serious threat... you know, something like the flu.
My daughter's employer, which is a medium sized business, does give incentives to people to get the flu vaccine. They are small - they bring a clinic to the workplace to give the vaccine there for free, and you get a paid day off if you get the vaccine - but probably cost enough that there must be some measurable benefit to the employer.
Where I used to work, they did the in-house clinic. I doubt a similar clinic for COVID vaccines would be met with as strong a positive response. Then again, I worked with a couple people who told me they didn't get influenza because they didn't take that evil vaccine every year.
I would love to know what research is going on to determine the driving factor for "illness". My Mom died from Covid February 2020. In March all three of us caught it - my husband suffered terribly and my son and I barely a sniffle for a day. My son and I caught it January of 2021 - he was positive - I was negative and he was sick with a cold and fever for 10 days. I had two days of extreme lethargy and shallow breathing. On Mother's Day I tested positive after a visiting friend came over for dinner. She has had 4 shots. all Pfizer. Her last one was April 15th. She was unknowingly sick. Calls me two days later to tell me she was positive. Both of us were sick for 13 days. My son tested positive and was fine in three days. It was the worst flu I have ever had. Not mild by any means. Now I have long covid issues - stabbing kidney pain. Random muscle pains and headaches. I have unvaxxed friends who have never caught it once, vaxxed and boosted friends who catch it bad and those with comorbidities who have minor symptoms. It appears to me that there is something else that drives this. I live in NYC and am super careful now. Even though I apparently have immunity for a few months. I do not want to get sick like that again - let alone every 3 or 4 months. I wish that on no one. I asked our Family Dr. what we can do. She said no one knows. She told me she prays for answers. Also - my Mom was 73 and in excellent health. She held on for 47 days. Doctors at Sinai told me they wouldn't even know how to test for Covid - that it was in China. I personally pray they are looking at everything right now, because the vaccine is not a shield against this new variant - at least not for me.
Seems like we need to up mitigations! Speaking of which, can you speak to the safety and efficacy of using Nitric Oxide Nasal Sprays (Enovid/Sanotize) for prevention?? I've also heard of Xlear, but only NONS seems to have actual research behind it (and is approved in Israel and other countries for prevention), does it work and, if so, why don't we have that here? And any updates on nasal vaccines? (seems that's possible our best hope left of stopping the virus in the nasal cavity and preventing the damage it does when it reaches other cells?)
"It’s reassuring that all-cause mortality in the U.S. reached pre-pandemic levels from March-May 2022" ... this is good news and I hope it holds statistically when all the data is in!
Hi John, My "quant" sense is that there is something wrong with the CDC numbers. Maybe weighting issues? And/or reporting clearing house issues? It's hard to conceive that midway through the greatest pandemic in the last 100 years, we are actually a healthier people!?
A little HGT with this and some other bad actor and we have a problem.
Long covid as experienced by one poster is no joke
1. Cardiac issues.
2. Pulmonary issues
3. GI issues
4. CNS issues.
Hyperfatigue, lung scarring, shortness of breath, confusion, aperiodic symptoms that recede then come back. A witches brew. Shortened life span for that person and probably millions of others.
We travelled from West Texas to the YMCA of the Rockies in Estes Park. NOBODY wore masks there, and masks were rare in Santa Fe, Colorado Springs, Las Cruces and El Paso. It’s a weird feeling be the only two people amongst 100’s who are “ so over it”.
Kudos to you for the intelligence and well as social courage to remain masked in the face of the rush for the exits. I fall in the covid maximalist camp. The virus has routes besides the ones most frequently noted to become more lethal and the danger is far from being over in my own, somewhat alarmist, view.
Very interesting. I tested positive 8 days ago and definitely had symptoms despite getting my second booster three weeks ago. So far, no one else in my household has tested positive, including someone I spent 2 hours in a car with one day before symptoms and two days before testing positive. Just waiting and seeing.
I wondered if you think Paxlovid will become available to get from a travel clinic or physician to have on hand if you are traveling to a remote region. If so, any idea when?
The rapid emergence of new variants is making me wonder if it might not be better to go for infection induced immunity. We are constantly exposed to cold and flu viruses, which also evolve continuously. But because of our exposure, we stay current with the newest versions and the illnesses caused are usually not severe. Could it be the same with Omicron?
NO. The danger of trying to achieve a population level of immunity via infection has not ever achieved that goal that we are aware of. Perhaps in the time before public health records were kept and when the earth's population was smaller, maybe, but likely not then either.
Now, after that shock, and I'll apologize for being harsh, there are issues. We already know that ancestral variants (those before omicron) afforded some limited neutralizing immunity FOR the ancestral variants in various degrees. Wu-1 and Alpha were somewhat, but not very, effective against delta. Delta was in fact effective against predecessors. Ancestral variant-derived immunity is singularly ineffective against the omicron variants, which is why the BA.1 wave saw so many infections. What was somewhat effective was vaccine-induced immunity, in that those with vaccination were much less likely to be admitted to the hospital, to the ICU with severe disease, and to die as a result than those with incomplete vaccination profiles or who were unvaccinated even if they'd had COVID previously. Now, we're seeing that infection with BA.1, BA.2 and BA.2.212.1 are unlikely to protect you from BA.4/5.
SARS-CoV-2, in fact, virtually all the coronavirus family are prone to rapid variation via substitution and deletion of codons on the spike protein (especially) as well as more limited changes on the plasmid capsule.
The problem is two-fold (at least): 1) infection-induced immunity alone does not confer much protection past a couple of weeks, and infection+vaccine immunity is better, but still short-lived (as is just vaccine immunity at this point). So, all short-lived, thus we need better longer-lasting vaccines; 2) tons of research coming out showing the permanent and long-term damage that infection causes (long covid, cognitive decline, strokes, heart issues, etc, as well as weakening the immune system to future infections and other viral diseases). Getting covid the least amount possible is the best strategy, as any gained period of improved immunity does not outweigh the damage caused by infections.
Um, not quite accurate, unless you define short-lived immunity in terms of months to greater than a year, but in fact the immunity story is much more complicated than you describe.
Yes, of course it's complicated, but my summary is not inaccurate. And yes, "short-lived" is a vague term that can be debated. Other than the flu vaccines, most others last longer than a year - so far, our mRNA vaccines start to wane on protection from disease severity around 5-6 months. That's short-lived for a vaccine compared to most other vaccines.
Since there hasn't been a new post to this thread in a while, I hope Katelyn will tolerate an off-topic post anticipating the Supreme Court's anticipated abortion rights ruling. Here in Oregon, the Democrats who control both legislative chambers as well as the governorship are getting ready for a restrictive ruling and today issued a press release about our state's efforts to protect and expand choice:
Thank you for sharing and Way To Go Oregon. As a nurse in Virginia, I am just waiting for our new governor to follow SCOTUS lead. The only roadblock he will be up against is our state senate, the only pro-choice body left in the state legislature. This shouldn't be a political issue but, sadly, it is. Elections matter. Every time.
Sorry to be off topic. Not sure if this is the place to write this comment but I am kind of freaking out. Mom of 3 here. Just took my 2.5 year old to get her fist COVID vaccine. And found out after the shot that we accidentally got phizer instead of the moderna shot we so wanted for her. I don’t know why I didn’t double check before he gave her the shot. So so upset and wondering what the best thing to do at this point is.
Can I switch her to Moderna at this point? And still get two moderna vaccines? I’m guessing the answer is no. Should I just stick to getting her the rest of the phizer series? I really wanted her to have better coverage that moderna offers. Her father and brother have a rare genetic blood disorder that may put them at increased risk for severe illness/hospitalization. I am just so upset about this. Any information you can share would be appreciated so much. Thanks in advance!
For the initial series, you should continue with Pfizer. It will require 3 doses but it is deemed safe and effective (I need to review the data myself but I do trust the committee). As KB notes below, the 3-8 week spacing recommendation gives some leeway. Earlier administration will ramp up immunity faster, but I am in the camp that it doesn't provide the optimum immunity ramp-up. Consult with your pediatrician and see what they think about a 6-8 week interval but go with their recommendation.
Here in Oregon, wastewater surveillance and spot testing are indicating sharp rises in both BA.4 and .5. indoor masking is now being again recommended (not mandated yet) in several counties where the per capita infection rate seems high.
26 months since infection with either the original west coast "A" or "B" strains from some California visitors, I still am dealing with some lingering symptoms and as always caution against contracting the long version..you really, really don't want to risk it.
@Katelyn: https://www.researchsquare.com/article/rs-1749502/v1, and Eric Topol's discussion of it... FYI
Writing something up. Hoping to get it out by Friday.
Looking forward to it. I'm writing up something for my organization, too.
PCR will capture viral fragments; longer-chain antigens are caught by the antigen testing. There's a difference. Virtually all the antigen tests (perhaps 2 exceptions I'm familiar with) are not as sensitive as PCR so they don't catch low-viral-load states, and often miss early infection or asymptomatic infections. PCR can remain positive for months (I prefer to not retest for 90 days post positive PCR), but antigen testing will subside when the level recedes.
Positive, especially in the omicron era, has to be treated as infected and contagious. Sorry, that's the calculus of the disease.
There is no real disagreement here. I was attempting to explain the basis for the use of either methodology. Both of these essentially summarize what I've been saying.
Mike Mena has been pretty adamantly in favor of frequent at-home RAg testing for some time and he is correct that with DAILY testing it's a useful tool. Unfortunately, very few public health operations have a mechanism to receive reports of home testing, and there are some that interpret the only legal testing to have been performed in a CLIA certified lab. For a period of time some states were reporting lab-reported antigen testing , e.g., pharmacy-based testing (CVS, Walgreens and some others were granted temporary CLIA certification for this). For the organization I'm working with, CLIA clamped down pretty hard on our use of home testing to evaluate participation in training events, especially those where larger cohorts were remaining overnight. Eventually, despite official positions that we couldn't do so, activity directors, believing they understood how RAg tests worked, adopted them and we've seen some cases where they were misused. We've also seen cases where our training events were happening outside the normal range to get NAAT testing for definitive purposes, and they've been invaluable. As we raise the understanding in our organization, their use is becoming more standardized and useful. (I was a proponent of a block of training specific to our organization and the ongoing use of no more than 3 home RAg tests, limited to simplify training, for our activities).
I don't see a misunderstanding, and apologize if you did.
Outstanding analysis, as usual, Dr. Jetelina. You are really spoiling us :-)
We travelled from West Texas to the YMCA of the Rockies in Estes Park. NOBODY wore masks there, and masks were rare in Santa Fe, Colorado Springs, Las Cruces and El Paso. It’s a weird feeling be the only two people amongst 100’s who are “ so over it”.
Is it still the case that outdoor transmission is very very low? My wife is upset I was within 6ft of unmasked people outside for no more than 20 minutes earlier today and said I'm taking unnecessary risks.
Related: What is the risk of catching the new variant in a situation where I am unmasked with other unmasked people as described above?
I would also welcome any new/updated information about transmission outdoors. There are several studies about the original strain and perhaps even Delta, but I would really appreciate some sources for recent studies of Omicron and variants. I’m particularly interested in how it relates to backyard-type gatherings, outdoor restaurants, and community events (as opposed to large sporting events or concerts).
Thank you, Dr Jetelina, for your remarkable work. I'm not as learned as some of your readers, yet I am a nurse who worked 37 yrs in ICU. My most burning question concerns the safety of the vaccine, esp for young women in their childbearing years. This has plagued me and now listening to family members who claim that there are reports that the mRna vax causes miscarriages, reproductive abnormalities, etc. What sources do you suggest to find some true answers? I have never posted anything, so hope I don't offend or cause any discord. Thank you.
It seems with each month that goes by, fewer and fewer people care? much less know about variants. The people I know who followed information about COVID have now moved from worried about getting infected and getting sick to either (1) Not worried about getting infected at all as they see it as mild or (2) Concerned about COVID but only because the issue of long COVID. This seems to be also what is the deciding factor for many parents I know about vaccinating their under 5 kids.
If there is an omicron based booster in the fall I wonder what the vaccination rates will be as people view COVID as less and less of an immediate issue.
The American public has a short attention span. They also selectively heard that getting vaccinated would end the pandemic and you'd never get COVID. We saw the short attention span with the pandemic outbreak that started in 1918 and lasted for several years. We have also suffered from misinformation (or worse, intentional disinformation) about the safety and efficacy of the vaccines leading to hesitancy or a sense of false wellbeing. There are a lot of pundits but few experts out there who understand how a pandemic "works", but thanks to polarization, we've a lot of people who want to throw the infectious disease and public health experts under the bus, claiming they (we) don't know what we're talking about.
If we do see an omicron derived booster, while some of us will get it, I'll go out on a limb and predict less than 25% uptake. There will be too many people casting aspersions about its efficacy.
Agreed. I think one thing that is an unknown and am watching and I think has the potential to have an impact is the financial cost to businesses due to long covid. Disability claims are up. COVID treatment is the costliest (or right at the top) for insurers. https://pascdashboard.aapmr.org/ uses 30% as the number for symptoms after 6 months and puts the number at 25 million with long covid. Even if the number is 5% or less that is still millions (and doesn't account for those under 18 who will be entering the workforce). So at some point (perhaps now), this is very much a business/bottom line decision. Large businesses and government seem to take a more proactive approach when it hits the bottom line. So we very well might see "rewards" for vaccinations etc. But I will be shocked if this isn't a major issue by the end of the year in the business community (Meaning that it isn't simply being talked about in business circles but we see it as one of the new "hot" topics).
Early in the vaccination game, we saw lawsuits against businesses including hospitals who mandated or even rewarded employees for vaccinations. Now issues with mis/disinformation have clouded the issue. Assuming big business has adequate and effective medical advice on the benefits of vaccination perhaps we'll see something here. However, a bunch of the big-business folks are among the camp that didn't see COVID as a serious threat... you know, something like the flu.
I'd love to see vaccination rates ramp up.
My daughter's employer, which is a medium sized business, does give incentives to people to get the flu vaccine. They are small - they bring a clinic to the workplace to give the vaccine there for free, and you get a paid day off if you get the vaccine - but probably cost enough that there must be some measurable benefit to the employer.
Where I used to work, they did the in-house clinic. I doubt a similar clinic for COVID vaccines would be met with as strong a positive response. Then again, I worked with a couple people who told me they didn't get influenza because they didn't take that evil vaccine every year.
Were this an orthopox virus with high transmissibility I would wager politics would disappear and there would be a general stampede to get vaccinated.
I suspect you're correct.
I would love to know what research is going on to determine the driving factor for "illness". My Mom died from Covid February 2020. In March all three of us caught it - my husband suffered terribly and my son and I barely a sniffle for a day. My son and I caught it January of 2021 - he was positive - I was negative and he was sick with a cold and fever for 10 days. I had two days of extreme lethargy and shallow breathing. On Mother's Day I tested positive after a visiting friend came over for dinner. She has had 4 shots. all Pfizer. Her last one was April 15th. She was unknowingly sick. Calls me two days later to tell me she was positive. Both of us were sick for 13 days. My son tested positive and was fine in three days. It was the worst flu I have ever had. Not mild by any means. Now I have long covid issues - stabbing kidney pain. Random muscle pains and headaches. I have unvaxxed friends who have never caught it once, vaxxed and boosted friends who catch it bad and those with comorbidities who have minor symptoms. It appears to me that there is something else that drives this. I live in NYC and am super careful now. Even though I apparently have immunity for a few months. I do not want to get sick like that again - let alone every 3 or 4 months. I wish that on no one. I asked our Family Dr. what we can do. She said no one knows. She told me she prays for answers. Also - my Mom was 73 and in excellent health. She held on for 47 days. Doctors at Sinai told me they wouldn't even know how to test for Covid - that it was in China. I personally pray they are looking at everything right now, because the vaccine is not a shield against this new variant - at least not for me.
Seems like we need to up mitigations! Speaking of which, can you speak to the safety and efficacy of using Nitric Oxide Nasal Sprays (Enovid/Sanotize) for prevention?? I've also heard of Xlear, but only NONS seems to have actual research behind it (and is approved in Israel and other countries for prevention), does it work and, if so, why don't we have that here? And any updates on nasal vaccines? (seems that's possible our best hope left of stopping the virus in the nasal cavity and preventing the damage it does when it reaches other cells?)
p.s. by "here," I mean the United States (realize readers are from all over the world). Thanks.
"It’s reassuring that all-cause mortality in the U.S. reached pre-pandemic levels from March-May 2022" ... this is good news and I hope it holds statistically when all the data is in!
Hi John, My "quant" sense is that there is something wrong with the CDC numbers. Maybe weighting issues? And/or reporting clearing house issues? It's hard to conceive that midway through the greatest pandemic in the last 100 years, we are actually a healthier people!?
If you want something truly scary from mmwr then this:
https://wwwnc.cdc.gov/eid/article/28/7/21-2315_article.
A little HGT with this and some other bad actor and we have a problem.
Long covid as experienced by one poster is no joke
1. Cardiac issues.
2. Pulmonary issues
3. GI issues
4. CNS issues.
Hyperfatigue, lung scarring, shortness of breath, confusion, aperiodic symptoms that recede then come back. A witches brew. Shortened life span for that person and probably millions of others.
We travelled from West Texas to the YMCA of the Rockies in Estes Park. NOBODY wore masks there, and masks were rare in Santa Fe, Colorado Springs, Las Cruces and El Paso. It’s a weird feeling be the only two people amongst 100’s who are “ so over it”.
Kudos to you for the intelligence and well as social courage to remain masked in the face of the rush for the exits. I fall in the covid maximalist camp. The virus has routes besides the ones most frequently noted to become more lethal and the danger is far from being over in my own, somewhat alarmist, view.
Very interesting. I tested positive 8 days ago and definitely had symptoms despite getting my second booster three weeks ago. So far, no one else in my household has tested positive, including someone I spent 2 hours in a car with one day before symptoms and two days before testing positive. Just waiting and seeing.
I wondered if you think Paxlovid will become available to get from a travel clinic or physician to have on hand if you are traveling to a remote region. If so, any idea when?
The rapid emergence of new variants is making me wonder if it might not be better to go for infection induced immunity. We are constantly exposed to cold and flu viruses, which also evolve continuously. But because of our exposure, we stay current with the newest versions and the illnesses caused are usually not severe. Could it be the same with Omicron?
Let me try to put this succinctly:
NO. The danger of trying to achieve a population level of immunity via infection has not ever achieved that goal that we are aware of. Perhaps in the time before public health records were kept and when the earth's population was smaller, maybe, but likely not then either.
Now, after that shock, and I'll apologize for being harsh, there are issues. We already know that ancestral variants (those before omicron) afforded some limited neutralizing immunity FOR the ancestral variants in various degrees. Wu-1 and Alpha were somewhat, but not very, effective against delta. Delta was in fact effective against predecessors. Ancestral variant-derived immunity is singularly ineffective against the omicron variants, which is why the BA.1 wave saw so many infections. What was somewhat effective was vaccine-induced immunity, in that those with vaccination were much less likely to be admitted to the hospital, to the ICU with severe disease, and to die as a result than those with incomplete vaccination profiles or who were unvaccinated even if they'd had COVID previously. Now, we're seeing that infection with BA.1, BA.2 and BA.2.212.1 are unlikely to protect you from BA.4/5.
SARS-CoV-2, in fact, virtually all the coronavirus family are prone to rapid variation via substitution and deletion of codons on the spike protein (especially) as well as more limited changes on the plasmid capsule.
The problem is two-fold (at least): 1) infection-induced immunity alone does not confer much protection past a couple of weeks, and infection+vaccine immunity is better, but still short-lived (as is just vaccine immunity at this point). So, all short-lived, thus we need better longer-lasting vaccines; 2) tons of research coming out showing the permanent and long-term damage that infection causes (long covid, cognitive decline, strokes, heart issues, etc, as well as weakening the immune system to future infections and other viral diseases). Getting covid the least amount possible is the best strategy, as any gained period of improved immunity does not outweigh the damage caused by infections.
Thanks Vnza. Clear and concise.
Um, not quite accurate, unless you define short-lived immunity in terms of months to greater than a year, but in fact the immunity story is much more complicated than you describe.
Yes, of course it's complicated, but my summary is not inaccurate. And yes, "short-lived" is a vague term that can be debated. Other than the flu vaccines, most others last longer than a year - so far, our mRNA vaccines start to wane on protection from disease severity around 5-6 months. That's short-lived for a vaccine compared to most other vaccines.
Since there hasn't been a new post to this thread in a while, I hope Katelyn will tolerate an off-topic post anticipating the Supreme Court's anticipated abortion rights ruling. Here in Oregon, the Democrats who control both legislative chambers as well as the governorship are getting ready for a restrictive ruling and today issued a press release about our state's efforts to protect and expand choice:
http://www.oregonlegislature.gov/Pages/pressrelease.aspx
Katelyn, please delete immediately if this isn't the appropriate time or place to go off topic.
Thank you for sharing and Way To Go Oregon. As a nurse in Virginia, I am just waiting for our new governor to follow SCOTUS lead. The only roadblock he will be up against is our state senate, the only pro-choice body left in the state legislature. This shouldn't be a political issue but, sadly, it is. Elections matter. Every time.
Let's hope that the rest of the country follows Oregon's lead. What a sad day to be an American.
Sorry to be off topic. Not sure if this is the place to write this comment but I am kind of freaking out. Mom of 3 here. Just took my 2.5 year old to get her fist COVID vaccine. And found out after the shot that we accidentally got phizer instead of the moderna shot we so wanted for her. I don’t know why I didn’t double check before he gave her the shot. So so upset and wondering what the best thing to do at this point is.
Can I switch her to Moderna at this point? And still get two moderna vaccines? I’m guessing the answer is no. Should I just stick to getting her the rest of the phizer series? I really wanted her to have better coverage that moderna offers. Her father and brother have a rare genetic blood disorder that may put them at increased risk for severe illness/hospitalization. I am just so upset about this. Any information you can share would be appreciated so much. Thanks in advance!
For the initial series, you should continue with Pfizer. It will require 3 doses but it is deemed safe and effective (I need to review the data myself but I do trust the committee). As KB notes below, the 3-8 week spacing recommendation gives some leeway. Earlier administration will ramp up immunity faster, but I am in the camp that it doesn't provide the optimum immunity ramp-up. Consult with your pediatrician and see what they think about a 6-8 week interval but go with their recommendation.
Thanks so much for your reply and thoughts! Will be clicking on all the links you included 👍