BA.5 has arrived. An estimated 10-15% of Americans will be infected. Unfortunately, hospitalizations and death will follow, albeit at lower rates than we’ve seen before. There are many reasons to avoid an infection (can’t miss work; don’t want to feel crappy for a week or two; risks of long COVID; high risk for severe disease; live with vulnerable people). But even if you do get infected, you can still help by stopping onward transmission.
Thanks for this! Curious about your advice re: delaying 2nd booster for those under 50. How soon before those of us in our 40s are eligible for a 2nd booster? You say Over 50 should get 2nd booster now and they will still be able to get Omicron booster in the fall. Is that because the Omicron booster won’t be available for 5+ months and so if you get a booster NOW you’ll be eligible again by then? But because Under 50 won’t be eligible for another month or more their window won’t be open again in time for the Omicron booster when it first arrives? I’m trying to figure out just how long I’ll be feeling like a sitting duck. I’m in my 40s and healthy but it’s been 8 months since my 1st booster…
Hoping you will cover Novavax soon? Some folks on Twitter are very high on it due to “no signs of waning” and “protection to all variants”.
As someone who has had 2x Pfizer and a Moderna booster and never infected, I’m highly considering that as my next course (because I want to avoid getting C19 ever) but haven’t seen the data to support the above claims.
Thanks for this update. We've been watching what others in the field have been saying about this for weeks now and this is right in line with what we have been reading.
One caveat: I don't think it's a good idea to say things like "Another booster now will not only prevent infection but will prevent severe disease." Too many people seem to translate this as "vaccination is a magic shield offering a 100% guarantee" (some out of ignorance, some out of malice) and then insist that "vaccination doesn't work" because vaccinated people can still get sick. I'd rather see statements like ""Another booster now will substantially reduce your chances of infection and severe disease." We have data to back that up, after all.
Thanks for reminder about the importance of proper masking, though. Too many people still seem not to understand that a properly fitted KN/N95 or equivalent is your best first line of defense. It's like a Medieval walled city with a standing army inside. Any invader that gets past the wall still has to deal with the army, but you really want to just keep the enemy out in the first place.
It’s my understanding the US has purchased 3.2 million Noravax Covid vaccines (enough for less than 0.5% of our country’s population), and that these vaccines will only be made available to those who have not yet opted to be vaccinated with Pfizer, Moderna and/or J&J. In other words, because I followed the CDC’s vaccine and booster guidance, I’m not eligible for what many claim is a superior vaccine, even though my second booster was months ago and is longer providing me with meaningful protection.
So while it’s possible that people who opt for a second booster now will still be eligible for the omicron booster this fall, it wouldn’t surprise me if the double-boosted folks aren’t relegated to the back of the line.
A question from a grateful subscriber: My daughter just tested positive (after having avoided it for 2 1/2 years, living in Mississippi and working full time in the restaurant industry). Though she is quite symptomatic, her rapid tests over 3 days were negative. Her main symptoms are: sore throat, headache, aches and fatigue -- no runny nose/typical cold symptoms. When she talked to her doctor, he said to do another test but swab the back of her throat (as for strep). That test was immediately positive. We've all been told many times that the rapid tests aren't always accurate and can take several days/repeated tests to show positive. But I don't believe I've heard the advice of swabbing the throat before. According to her doctor, he's seen the same thing happen many times. Why is this advice not given regularly -- as an alternative if symptomatic and getting negative results -- on the rapid tests? Thanks for any insights about what seems to be an oversight. At least I know now that this should be in the testing repertoire. I appreciate so much your contribution to our understanding and management of Covid -- thank you.
Thank you for the invaluable information! I have been holding off getting my second booster because I thought waiting until fall would provide "better" protection and was hopeful that the more specific Omicron booster would be available. Will be looking for an appointment today. Also, just want you to know how much I appreciate your newsletter. I have been meaning to obtain a paid subscription - well today I did. Thank you!
Is there any data on how long the 4th shot (2nd booster) lasts? Does it fade similarly to the other shots? People over 50 or immunocompromised had their 2nd boosters early this year - they will be hitting the 6 month post-booster mark soon ... there's been no discussion of a 5th shot (3rd booster) or waiting if the protection lasts longer after 2nd?
Thank you for this information. Most people have become so relaxed it’s kinda scary. I’m on Day 9 of infection after vaccinations and a booster and still positive. I’m still in isolation and waiting it out for a negative because I don’t want to infect my daughter. I truly hope people will listen and try to help stop the spread. I will share your work. Thank you!
I keep hearing on anecdotal outdoor transmission lately - has anyone seen any reliable info? We’ve eaten outside 1x on a patio where were were the only family during the pandemic and we were hoping to do that again on an upcoming road trip spot, this increase in transmissibility and huge increase in cases has me concerned we should just not. I’d love some insight on outdoor transmission in this wave.
The OHA is recommending but not mandating indoor masking again. Our hospitalization rates are going up again and so also are our new infections. We all just have to keep up our guard. Thanks to the medical community (including our good doctor KJ) for their efforts at keeping us safe.
On a related note: a number of performing arts organizations here in St. Louis now have mandatory masking policies for all staff and audience members. I don't know if this is happening in other cities, but I would be surprised.
On getting a booster now will preclude eligibility for fall: Jha was reported as saying it won't but the quote is less clear: The bottom line: Jha noted that overall, it is up to the FDA and the CDC to confirm that people who get boosted now can do so again in the fall, but that the data so far suggests that "getting vaccinated will not preclude you from getting a variant-specific vaccine later this fall or winter."
Thank you for this article. My husband and I are on day 10 of what seems to be BA 5 (we're in the SF Bay Area), and are still testing *very* positive, strong red lines. I've seen reports of people testing positive for 20 days. This article seems to say we should quarantine until we have a negative test, no matter how long, and I wanted to confirm that. I don't want to get anyone sick, but I also feel bad for our cooped up (healthy) 7 year old.
Thanks for this! Curious about your advice re: delaying 2nd booster for those under 50. How soon before those of us in our 40s are eligible for a 2nd booster? You say Over 50 should get 2nd booster now and they will still be able to get Omicron booster in the fall. Is that because the Omicron booster won’t be available for 5+ months and so if you get a booster NOW you’ll be eligible again by then? But because Under 50 won’t be eligible for another month or more their window won’t be open again in time for the Omicron booster when it first arrives? I’m trying to figure out just how long I’ll be feeling like a sitting duck. I’m in my 40s and healthy but it’s been 8 months since my 1st booster…
Thanks for the update!
Hoping you will cover Novavax soon? Some folks on Twitter are very high on it due to “no signs of waning” and “protection to all variants”.
As someone who has had 2x Pfizer and a Moderna booster and never infected, I’m highly considering that as my next course (because I want to avoid getting C19 ever) but haven’t seen the data to support the above claims.
Thanks for this update. We've been watching what others in the field have been saying about this for weeks now and this is right in line with what we have been reading.
One caveat: I don't think it's a good idea to say things like "Another booster now will not only prevent infection but will prevent severe disease." Too many people seem to translate this as "vaccination is a magic shield offering a 100% guarantee" (some out of ignorance, some out of malice) and then insist that "vaccination doesn't work" because vaccinated people can still get sick. I'd rather see statements like ""Another booster now will substantially reduce your chances of infection and severe disease." We have data to back that up, after all.
Thanks for reminder about the importance of proper masking, though. Too many people still seem not to understand that a properly fitted KN/N95 or equivalent is your best first line of defense. It's like a Medieval walled city with a standing army inside. Any invader that gets past the wall still has to deal with the army, but you really want to just keep the enemy out in the first place.
It’s my understanding the US has purchased 3.2 million Noravax Covid vaccines (enough for less than 0.5% of our country’s population), and that these vaccines will only be made available to those who have not yet opted to be vaccinated with Pfizer, Moderna and/or J&J. In other words, because I followed the CDC’s vaccine and booster guidance, I’m not eligible for what many claim is a superior vaccine, even though my second booster was months ago and is longer providing me with meaningful protection.
So while it’s possible that people who opt for a second booster now will still be eligible for the omicron booster this fall, it wouldn’t surprise me if the double-boosted folks aren’t relegated to the back of the line.
A question from a grateful subscriber: My daughter just tested positive (after having avoided it for 2 1/2 years, living in Mississippi and working full time in the restaurant industry). Though she is quite symptomatic, her rapid tests over 3 days were negative. Her main symptoms are: sore throat, headache, aches and fatigue -- no runny nose/typical cold symptoms. When she talked to her doctor, he said to do another test but swab the back of her throat (as for strep). That test was immediately positive. We've all been told many times that the rapid tests aren't always accurate and can take several days/repeated tests to show positive. But I don't believe I've heard the advice of swabbing the throat before. According to her doctor, he's seen the same thing happen many times. Why is this advice not given regularly -- as an alternative if symptomatic and getting negative results -- on the rapid tests? Thanks for any insights about what seems to be an oversight. At least I know now that this should be in the testing repertoire. I appreciate so much your contribution to our understanding and management of Covid -- thank you.
Thank you for the invaluable information! I have been holding off getting my second booster because I thought waiting until fall would provide "better" protection and was hopeful that the more specific Omicron booster would be available. Will be looking for an appointment today. Also, just want you to know how much I appreciate your newsletter. I have been meaning to obtain a paid subscription - well today I did. Thank you!
Is there any data on how long the 4th shot (2nd booster) lasts? Does it fade similarly to the other shots? People over 50 or immunocompromised had their 2nd boosters early this year - they will be hitting the 6 month post-booster mark soon ... there's been no discussion of a 5th shot (3rd booster) or waiting if the protection lasts longer after 2nd?
Thank you for this information. Most people have become so relaxed it’s kinda scary. I’m on Day 9 of infection after vaccinations and a booster and still positive. I’m still in isolation and waiting it out for a negative because I don’t want to infect my daughter. I truly hope people will listen and try to help stop the spread. I will share your work. Thank you!
Thank you for this article. It convinced someone close to me to get the fourth shot.
I keep hearing on anecdotal outdoor transmission lately - has anyone seen any reliable info? We’ve eaten outside 1x on a patio where were were the only family during the pandemic and we were hoping to do that again on an upcoming road trip spot, this increase in transmissibility and huge increase in cases has me concerned we should just not. I’d love some insight on outdoor transmission in this wave.
The OHA is recommending but not mandating indoor masking again. Our hospitalization rates are going up again and so also are our new infections. We all just have to keep up our guard. Thanks to the medical community (including our good doctor KJ) for their efforts at keeping us safe.
On a related note: a number of performing arts organizations here in St. Louis now have mandatory masking policies for all staff and audience members. I don't know if this is happening in other cities, but I would be surprised.
Also curious about outdoor spread of BA.5. Any thoughts welcome. Thank you!!!
If only the CDC put out this kind of clear guidance. Sigh.
On getting a booster now will preclude eligibility for fall: Jha was reported as saying it won't but the quote is less clear: The bottom line: Jha noted that overall, it is up to the FDA and the CDC to confirm that people who get boosted now can do so again in the fall, but that the data so far suggests that "getting vaccinated will not preclude you from getting a variant-specific vaccine later this fall or winter."
Thank you for this article. My husband and I are on day 10 of what seems to be BA 5 (we're in the SF Bay Area), and are still testing *very* positive, strong red lines. I've seen reports of people testing positive for 20 days. This article seems to say we should quarantine until we have a negative test, no matter how long, and I wanted to confirm that. I don't want to get anyone sick, but I also feel bad for our cooped up (healthy) 7 year old.