Thank you for your continued efforts. Have you seen any information/guidance for Long Covid patients? Our family cannot find any information outside of the anti-vax or vaccine suspicious (for lack of another word) community. We are not anti vax and have stayed fully vaccinated for Covid but have legitimate, pressing questions now. My fully vaccinated 22 yo daughter who used Plaxovid due to asthma developed Long Covid 14 months ago and developed severe dysautonomia, including POTS and was recently diagnosed with 2 more syndromic conditions which often co-occur with dysautonomia. Her immune system is now also compromised (which has also been shown in some Long Covid studies). She had a second Covid infection in May (despite near-perfect masking hygiene), followed by a severe rebound (after using Paxlovid again). Given that some studies have shown vaccination was associated with Long Covid in a small percentage of the vaccinated, and "the science" is incomplete about what causes Long Covid, our family is perplexed on guidance for her. (We've also seen anecdotal reports that some Long Covid sufferers have relief from some symptoms after a round of vaccination.) Our question is not about timing, but about whether or not there are unique considerations for people with Long Covid. Should she vaccinate again? Would one vaccine type perhaps be "better" than another given current knowledge? We wish some of the leading investigators of Long Covid and the CDC would collaborate to address the concerns of Long Covid patients on the question of continued vaccination. Even if there were no clear conclusions, having *any* information from experts would help us make an informed decision. Crickets. Long Covid sufferers are estimated to be a significant (10 - 13 +% of those who've had a Covid infection in some estimates) population and one that will only grow given that Covid infection and reinfection is now so commonplace. (Meaning, it's in everyone's interest to have answers -- or investigations -- into this question.)
How exactly are vaccines,that don't prevent infection or transmission, supposed to help high-risk communities without Covid precautions like mask mandates? Vulnerable communities can no longer safely participate in public life. I can only get new shots, I can't get extra boosters because my conditions and status as high-risk caregiver don't qualify me to get them even though protection wanes. A single infection, even vaccinated and boosted, could permanently disable me and I cannot take that chance. I no longer see a future where I will ever be comfortable in public spaces again. Everyone seems fine with letting us die or be hostages in our own homes because public spaces aren't safe anymore. I'm so sick of this weak messaging even from people like yourself.
Hate to complicate things but if half or so of infections are asymptomatic, many of us will get (and have gotten) vaxxed and have less efficacy. Not much we can do about that but at a populational level, I would think that must affect efficacy. Is anyone taking this into consideration?
This is not an argument to not boost—I am just curious about it.
Thank you Katelyn for these clear and complete recommendations (as usual!). One piece of additional info would be helpful for those considering Novavax-- what's the latest forecast on when this might become available? Thanks!
My husband got Covid in August and I didn't get it even though we were in close contact until he tested positive. My elderly mother who spent a brief time with us in the car before he started experiencing symptoms got it. So we know he was infectious. It's safe to assume I was exposed and fought it off. Did I likely derive some protection from that exposure that didn't result in illness? Should I delay getting the booster because of this?
"Under 65 and not high risk: Wait at least 6 months. Ideally, get vaccinated once a winter wave starts taking off. (Getting it by Halloween is a good bet.) This is what I will be doing with my family. But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed."
Especially, this line: "But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed"
I was infected around the beginning of August, so can I expect some protection from my recent infection through the winter? It seems like any time before next spring would be too early to get the booster if I adhere to the 6-month minimum wait time rule.
Hello, and thank you for the thoughtful, informative breakdown (as usual).
I personally know so many people who were infected in the last 4-6 weeks. For them (<65yo), waiting 6 months would mean boosting in February, which seems far too late for a winter surge. Would you still recommend boosting at that time? Getting it at < 6 months? Or waiting to 12 months post infection, which aligns somewhat with next autumn?
Katelyn: First of all, THANKS! You have been a source of great information for me since the beginning of the pandemic! I am a medical director at a boys sleep away camp and have used your information many times to get what I want!! Question, are you still waiting for Novovax? Just trying to decide what to do. I had very bad Covid in March of 2020 and have had all the Moderna vaccines but the knock the S$%t out of me. Would rather not have another reaction. Thanks for your response!!
Thank you so much for all that you do. You've helped me and my patients through the pandemic!
I have a technical question (I'm a psychiatrist not an immunologist). I've seen some papers that indicate the mRNA vaccines lead to an increase in IgG4 levels, which may impair our immunologic responsiveness to COVID-19 if we've had repeated boosters. What is your take on this? Thanks!
I’m a preschool teacher in Austin. I Tried to get vaccine on Monday since many in my school comminity are starting to get the new strain. I instead for THE FIRST TIME got symptoms and a positive test Monday night. Mostly lung congestion -not sore throat or headache. but it wasn’t available yet. Very mild and I’m up to date on my mRNA vaccines. Should his be enough to get me through until 6 months (March 15th) or should I risk lower immunity memory and get it sooner? Thanks so much about helping the teachers!
My husband and I are in our late 70s with comorbidities. I keep reading that new latest vaccine will be available "sometime this week." This is Thursday. We're terribly eager to find out WHEN!!
I am in need of timing advice. My kids both had covid in the last 2 weeks. While I felt unwell during that time frame, I never tested positive. I never have. I plan to get the kids vaccinated in December. My youngest and I have a trip to Paris planned for March. Does it make any sense for me to wait until December to have more protection in March? I mask everywhere except home, don’t go out to eat, etc…
"Under 65 and not high risk: Wait at least 6 months. Ideally, get vaccinated once a winter wave starts taking off. (Getting it by Halloween is a good bet.) This is what I will be doing with my family. But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed."
So now you are saying that if you are not high risk and have been vaccinated and infected, that within six months from last infection, we have "very little/no protection against infection until" we get another boost? Healthy people with hybrid immunity are not typically getting another infection within six months. And the "other layers" you are talking about is masking? So someone who has been vaccinated and boosted and gets an infection and decides to wait six months to get another booster is supposed to be masking? That guidance seems off.
Considerations for your fall Covid-19 vaccine
Thank you for your continued efforts. Have you seen any information/guidance for Long Covid patients? Our family cannot find any information outside of the anti-vax or vaccine suspicious (for lack of another word) community. We are not anti vax and have stayed fully vaccinated for Covid but have legitimate, pressing questions now. My fully vaccinated 22 yo daughter who used Plaxovid due to asthma developed Long Covid 14 months ago and developed severe dysautonomia, including POTS and was recently diagnosed with 2 more syndromic conditions which often co-occur with dysautonomia. Her immune system is now also compromised (which has also been shown in some Long Covid studies). She had a second Covid infection in May (despite near-perfect masking hygiene), followed by a severe rebound (after using Paxlovid again). Given that some studies have shown vaccination was associated with Long Covid in a small percentage of the vaccinated, and "the science" is incomplete about what causes Long Covid, our family is perplexed on guidance for her. (We've also seen anecdotal reports that some Long Covid sufferers have relief from some symptoms after a round of vaccination.) Our question is not about timing, but about whether or not there are unique considerations for people with Long Covid. Should she vaccinate again? Would one vaccine type perhaps be "better" than another given current knowledge? We wish some of the leading investigators of Long Covid and the CDC would collaborate to address the concerns of Long Covid patients on the question of continued vaccination. Even if there were no clear conclusions, having *any* information from experts would help us make an informed decision. Crickets. Long Covid sufferers are estimated to be a significant (10 - 13 +% of those who've had a Covid infection in some estimates) population and one that will only grow given that Covid infection and reinfection is now so commonplace. (Meaning, it's in everyone's interest to have answers -- or investigations -- into this question.)
How exactly are vaccines,that don't prevent infection or transmission, supposed to help high-risk communities without Covid precautions like mask mandates? Vulnerable communities can no longer safely participate in public life. I can only get new shots, I can't get extra boosters because my conditions and status as high-risk caregiver don't qualify me to get them even though protection wanes. A single infection, even vaccinated and boosted, could permanently disable me and I cannot take that chance. I no longer see a future where I will ever be comfortable in public spaces again. Everyone seems fine with letting us die or be hostages in our own homes because public spaces aren't safe anymore. I'm so sick of this weak messaging even from people like yourself.
For those waiting to get Novavax, it would be nice to know now whether the wait is weeks or months.
Hate to complicate things but if half or so of infections are asymptomatic, many of us will get (and have gotten) vaxxed and have less efficacy. Not much we can do about that but at a populational level, I would think that must affect efficacy. Is anyone taking this into consideration?
This is not an argument to not boost—I am just curious about it.
Thank you Katelyn for these clear and complete recommendations (as usual!). One piece of additional info would be helpful for those considering Novavax-- what's the latest forecast on when this might become available? Thanks!
With all the political interference and static regarding Covid as well as all vaccines, the healthcare setting got no love and attention.
In the northeast, it’s common for flu vaccine to be mostly mandatory in healthcare.
There have not been comments yet about Covid.
From an epidemiologist perspective, thoughts on healthcare providers and vaccination?
My husband got Covid in August and I didn't get it even though we were in close contact until he tested positive. My elderly mother who spent a brief time with us in the car before he started experiencing symptoms got it. So we know he was infectious. It's safe to assume I was exposed and fought it off. Did I likely derive some protection from that exposure that didn't result in illness? Should I delay getting the booster because of this?
I'm a little confused about this part:
"Under 65 and not high risk: Wait at least 6 months. Ideally, get vaccinated once a winter wave starts taking off. (Getting it by Halloween is a good bet.) This is what I will be doing with my family. But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed."
Especially, this line: "But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed"
I was infected around the beginning of August, so can I expect some protection from my recent infection through the winter? It seems like any time before next spring would be too early to get the booster if I adhere to the 6-month minimum wait time rule.
Hello, and thank you for the thoughtful, informative breakdown (as usual).
I personally know so many people who were infected in the last 4-6 weeks. For them (<65yo), waiting 6 months would mean boosting in February, which seems far too late for a winter surge. Would you still recommend boosting at that time? Getting it at < 6 months? Or waiting to 12 months post infection, which aligns somewhat with next autumn?
Katelyn: First of all, THANKS! You have been a source of great information for me since the beginning of the pandemic! I am a medical director at a boys sleep away camp and have used your information many times to get what I want!! Question, are you still waiting for Novovax? Just trying to decide what to do. I had very bad Covid in March of 2020 and have had all the Moderna vaccines but the knock the S$%t out of me. Would rather not have another reaction. Thanks for your response!!
Any ACIP insight on when Novavax us tobr reviewed for recommended approval?
Dear Dr. Jetelina,
Thank you so much for all that you do. You've helped me and my patients through the pandemic!
I have a technical question (I'm a psychiatrist not an immunologist). I've seen some papers that indicate the mRNA vaccines lead to an increase in IgG4 levels, which may impair our immunologic responsiveness to COVID-19 if we've had repeated boosters. What is your take on this? Thanks!
I’m a preschool teacher in Austin. I Tried to get vaccine on Monday since many in my school comminity are starting to get the new strain. I instead for THE FIRST TIME got symptoms and a positive test Monday night. Mostly lung congestion -not sore throat or headache. but it wasn’t available yet. Very mild and I’m up to date on my mRNA vaccines. Should his be enough to get me through until 6 months (March 15th) or should I risk lower immunity memory and get it sooner? Thanks so much about helping the teachers!
My husband and I are in our late 70s with comorbidities. I keep reading that new latest vaccine will be available "sometime this week." This is Thursday. We're terribly eager to find out WHEN!!
I am in need of timing advice. My kids both had covid in the last 2 weeks. While I felt unwell during that time frame, I never tested positive. I never have. I plan to get the kids vaccinated in December. My youngest and I have a trip to Paris planned for March. Does it make any sense for me to wait until December to have more protection in March? I mask everywhere except home, don’t go out to eat, etc…
"Under 65 and not high risk: Wait at least 6 months. Ideally, get vaccinated once a winter wave starts taking off. (Getting it by Halloween is a good bet.) This is what I will be doing with my family. But remember, we have very little/no protection against infection until we do. So, other layers of protection are especially needed."
So now you are saying that if you are not high risk and have been vaccinated and infected, that within six months from last infection, we have "very little/no protection against infection until" we get another boost? Healthy people with hybrid immunity are not typically getting another infection within six months. And the "other layers" you are talking about is masking? So someone who has been vaccinated and boosted and gets an infection and decides to wait six months to get another booster is supposed to be masking? That guidance seems off.