This fall, everyone should get a bivalent COVID-19 booster. And, really, that’s all you need to know: Get a vaccine. Any bivalent vaccine. This fall. But, yes, we can use scientific data to optimize timing and, thus, protection. How long after infection/last vaccine should you booster?
I've been in the ER and ICU 6 out of the last 10 nights. All because of heart problems brought on by CV19. People should, in my estimation, fear this virus enormously.
I am getting the booster as soon as possible. Hospital food isn't all that great.
Thanks KB, it was a bit touch and go in the ICU. You haven't lived until you've had the experience of hearing your room number called out repeatedly on the hall public address with "Tachy Extreme, Tachy Extreme. Room 104!"
On the flip side, the people who work in ICUs are very wonderful folks.
This is the best guidance I’ve ever seen for vaccination/booster. Well done. Wish the CDC could get their act together to gain back their credibility and provide guidance as good as this...or even my PCP.
Hi! Just wanted to say thank you for writing these newsletters. I’m a primary care doctor taking care of adults and kids, and I quote your stats every day as I give patients advice on COVID. I also pass your info on to the whole clinic at our team huddles. Thanks for doing this! It’s a great public service.
Any thoughts on trying to optimize timing for the holidays? Getting a booster now would mean being 4 months out shortly after New Year’s, and there’s a clear waning effect. If you’re in a community that is close to dropping into Substantial community transmission (the old metric, <100 cases per 100k), would it be better to hold off a couple months to maximize the benefit going into the winter? Obviously acknowledging that no one can read the future and there could be another variant of concern any time….thanks as always for your excellent posts!!
Great question, I've been thinking along similar lines! I'm in the 4-6 month "get it at some point" group and I'm a bit torn. Part of me is thinking "it's here, just get it" (I don't have an event but I do have some dr appointments scheduled so more interaction than I've had recently), but part of me is thinking that the protection might be more important a bit later in the year when there are fewer opportunities to be outside (where I live anyway) and holidays and general peak cold/flu time.
Thank you for another set of objective and properly cautionary pearls of wisdom. Never been sick with COVID (that I am aware of) and am in a sales job where I mingle and interact with all sorts of folks so I prefer to be proactive and careful within reason. Got my 2nd booster in late June - so am thinking Sept for an annual Flu shot and Oct/Nov for a bivalent COVID vaxx.
Many thanks for all this useful info - very helpful and answers many of my own questions. That said, what are your thoughts on monitoring antibody levels to time the booster? I saw Michael Mina mention this in one of his threads recently. I just did my Labcorp antibody test (4 shots, last one in early June, no confirmed infection), and I have close to 20,000 antibodies. Should this affect the timing of my next booster?
Do they measure antibodies specifically that will react to BA.5 or all covid antibodies? I would think that if they aren’t measuring Omicron specific protection it may be worth it to get the increased breadth of protection a BA.5 specific booster offers.
For the Novavax booster issue, I know all indications show that it doesn't show any greater efficacy than the standard mRNA booster. My wife had a pretty severe reaction to the 3 P + 1 M on various systems (she has medical conditions and is extremely sensitive). Her last booster was Moderna and it had some impacts that lasted about 2 months. Does it make sense for her to get Novavax when it is approved for a booster?
Appreciate this! Very clear. Any comments at all on differences (if there are) between Pfizer and Moderna, based on data presented, dosage amounts, etc.?
question: now that kid bi-valents are out. for a kid who received a booster (3rd total shot) in late July, okay to get the bivalent now? or would you wait a bit more before getting it? (9 yo)
Not sure what to do for my 2nd booster. I am an adult female who developed recurrent pericarditis after my 2nd Pfizer shot and again within a week after my 1st booster. I also got Covid in June. You mentioned young males who developed myocarditis get the Pfizer booster but Pfizer caused my pericarditis. Is getting a booster worth the risk with a confirmed vaccine induced pericarditis?
You didn't mention old folks like my husband and me (ages 75 & 77). Our most recent boosters were about 5 months ago. We both have comorbidities. I'm thinking we should get the new vaccination ASAP, rather than (I forget your words) pretty soon. Correct?
We need to be honest about we don’t know and what is conjecture. It is great that you point to a study, standard practice is to replicate the study multiple times.
This is really “optimization of risk”, a critical component is timing as to when you are most likely to be exposed to a COVID variant. IF there is no COVID around or I am only in outdoor settings, there is no need for the vaccine. If I plan to be in crowded gyms as a spectator for high school basketball, I might want to time the vaccine for this situation. Hoping to get 6 months is not science.
The failure to recognize any risk from the booster is a communication mistake.
"IF there is no COVID around or I am only in outdoor settings, there is no need for the vaccine." Unless you're living in a cabin in the woods somewhere and never see another human being, this would seem to be rather difficult to achieve. So the relevance of his escapes me.
"The failure to recognize any risk from the booster is a communication mistake." And where would this be taking place? I read Dr. Jetelina's blog on a regular basis and have never seen any indication that she has ever done this. Perhaps you have it confused with something else?
The point is not "optimization of risk," it's a risk/benefit analysis. What are the risks of this or any other vaccine vs. the benefits of not getting the disease or of getting a much milder case? At this point the data heavily favor the benefits of vaccination.
And by the same token, the data are equally clear on the serious risks of not getting vaccinated vs. the benefits, if any.
Assuming, of course, that one is using actual data for one's decisions.
Thank you for your continued work and guidance. Can you speak on fall booster considerations regarding any data that may be available for those who have experienced Myocarditis from either a previous Covid infection or vaccination? Thank you for your time.
For those of us with the J&J shot, is there any guidance or even any studies for what we should be doing? I got the Pfizer booster, thinking I should go Moderna, but also I just don't know what it is I should be concerned about other than the length of time since the last booster, and the usual covid protocols in public.
Wondering this too. My 18 year old son got the J&J and then a Moderna booster. He just recovered from COVID a couple of weeks ago. After reading this, I am thinking he should not get a booster for now.
I've been in the ER and ICU 6 out of the last 10 nights. All because of heart problems brought on by CV19. People should, in my estimation, fear this virus enormously.
I am getting the booster as soon as possible. Hospital food isn't all that great.
Thanks KB, it was a bit touch and go in the ICU. You haven't lived until you've had the experience of hearing your room number called out repeatedly on the hall public address with "Tachy Extreme, Tachy Extreme. Room 104!"
On the flip side, the people who work in ICUs are very wonderful folks.
Oh gosh, that sounds very difficult. I hope you are soon home!
Thanks SD! I'm back home counting my blessings and the ever growing number of pill bottles I've been prescribed 🙂
This is the best guidance I’ve ever seen for vaccination/booster. Well done. Wish the CDC could get their act together to gain back their credibility and provide guidance as good as this...or even my PCP.
Hi! Just wanted to say thank you for writing these newsletters. I’m a primary care doctor taking care of adults and kids, and I quote your stats every day as I give patients advice on COVID. I also pass your info on to the whole clinic at our team huddles. Thanks for doing this! It’s a great public service.
Any thoughts on trying to optimize timing for the holidays? Getting a booster now would mean being 4 months out shortly after New Year’s, and there’s a clear waning effect. If you’re in a community that is close to dropping into Substantial community transmission (the old metric, <100 cases per 100k), would it be better to hold off a couple months to maximize the benefit going into the winter? Obviously acknowledging that no one can read the future and there could be another variant of concern any time….thanks as always for your excellent posts!!
Great question, I've been thinking along similar lines! I'm in the 4-6 month "get it at some point" group and I'm a bit torn. Part of me is thinking "it's here, just get it" (I don't have an event but I do have some dr appointments scheduled so more interaction than I've had recently), but part of me is thinking that the protection might be more important a bit later in the year when there are fewer opportunities to be outside (where I live anyway) and holidays and general peak cold/flu time.
Thank you for another set of objective and properly cautionary pearls of wisdom. Never been sick with COVID (that I am aware of) and am in a sales job where I mingle and interact with all sorts of folks so I prefer to be proactive and careful within reason. Got my 2nd booster in late June - so am thinking Sept for an annual Flu shot and Oct/Nov for a bivalent COVID vaxx.
Many thanks for all this useful info - very helpful and answers many of my own questions. That said, what are your thoughts on monitoring antibody levels to time the booster? I saw Michael Mina mention this in one of his threads recently. I just did my Labcorp antibody test (4 shots, last one in early June, no confirmed infection), and I have close to 20,000 antibodies. Should this affect the timing of my next booster?
Do they measure antibodies specifically that will react to BA.5 or all covid antibodies? I would think that if they aren’t measuring Omicron specific protection it may be worth it to get the increased breadth of protection a BA.5 specific booster offers.
I am not an expert on this. As far as I understand it’s antibodies against the spike protein so probably not against omicron-specific parts…
Perfect info. Thanks.
For the Novavax booster issue, I know all indications show that it doesn't show any greater efficacy than the standard mRNA booster. My wife had a pretty severe reaction to the 3 P + 1 M on various systems (she has medical conditions and is extremely sensitive). Her last booster was Moderna and it had some impacts that lasted about 2 months. Does it make sense for her to get Novavax when it is approved for a booster?
Appreciate this! Very clear. Any comments at all on differences (if there are) between Pfizer and Moderna, based on data presented, dosage amounts, etc.?
question: now that kid bi-valents are out. for a kid who received a booster (3rd total shot) in late July, okay to get the bivalent now? or would you wait a bit more before getting it? (9 yo)
Not sure what to do for my 2nd booster. I am an adult female who developed recurrent pericarditis after my 2nd Pfizer shot and again within a week after my 1st booster. I also got Covid in June. You mentioned young males who developed myocarditis get the Pfizer booster but Pfizer caused my pericarditis. Is getting a booster worth the risk with a confirmed vaccine induced pericarditis?
You didn't mention old folks like my husband and me (ages 75 & 77). Our most recent boosters were about 5 months ago. We both have comorbidities. I'm thinking we should get the new vaccination ASAP, rather than (I forget your words) pretty soon. Correct?
Thank you for pulling together this information.
We need to be honest about we don’t know and what is conjecture. It is great that you point to a study, standard practice is to replicate the study multiple times.
This is really “optimization of risk”, a critical component is timing as to when you are most likely to be exposed to a COVID variant. IF there is no COVID around or I am only in outdoor settings, there is no need for the vaccine. If I plan to be in crowded gyms as a spectator for high school basketball, I might want to time the vaccine for this situation. Hoping to get 6 months is not science.
The failure to recognize any risk from the booster is a communication mistake.
"IF there is no COVID around or I am only in outdoor settings, there is no need for the vaccine." Unless you're living in a cabin in the woods somewhere and never see another human being, this would seem to be rather difficult to achieve. So the relevance of his escapes me.
"The failure to recognize any risk from the booster is a communication mistake." And where would this be taking place? I read Dr. Jetelina's blog on a regular basis and have never seen any indication that she has ever done this. Perhaps you have it confused with something else?
The point is not "optimization of risk," it's a risk/benefit analysis. What are the risks of this or any other vaccine vs. the benefits of not getting the disease or of getting a much milder case? At this point the data heavily favor the benefits of vaccination.
And by the same token, the data are equally clear on the serious risks of not getting vaccinated vs. the benefits, if any.
Assuming, of course, that one is using actual data for one's decisions.
Thank you for your continued work and guidance. Can you speak on fall booster considerations regarding any data that may be available for those who have experienced Myocarditis from either a previous Covid infection or vaccination? Thank you for your time.
For those of us with the J&J shot, is there any guidance or even any studies for what we should be doing? I got the Pfizer booster, thinking I should go Moderna, but also I just don't know what it is I should be concerned about other than the length of time since the last booster, and the usual covid protocols in public.
Wondering this too. My 18 year old son got the J&J and then a Moderna booster. He just recovered from COVID a couple of weeks ago. After reading this, I am thinking he should not get a booster for now.
Thank-you.