Elderly person here! My wife and I have had 2 MRNA vaccinations + 2 boosters + the Bivalent shots.. But despite all that help, we still think lo-tech behavioral habits: masking, social distancing, and hand washing are our best protection against all known strains, and any and all unknown super-strains that may arise!
I haven't reviewed the recommendations for all European countries, but compared to these countries, the US is taking a very different approach by recommending a 2nd booster for all adults and a 1st booster for children. Can you offer some insight into why our approach is so much more pro-booster than in these other countries?
Thank you for another informative post. We can always count on your posts for the latest data and clear interpretation.
I'm confused by two aspects of the CDC's real world data that was published last Friday:
1) Why wasn't the "left box" (fall booster + 1-4 mRNA shots) compared to a (hypothetical) "1-4 mRNA shots but no fall booster" box? This would answer the question of whether people who have already received 1-4 mRNA shots actually benefit from the fall booster, which is perhaps the more relevant question. It's unlikely that somebody who is still unvaccinated will be motivated by this study's conclusion to go get multiple mRNA shots just to so they can get the fall booster. (My best guess is the CDC did perform the analysis on this hypothetical "1-4 mRNA shots but no fall booster" box, and for whatever reason, they aren't publishing the data).
2) It's possible the data could be skewed if, for some reason, vaccinated people are more likely to have "false negatives" on covid tests. It would be interesting to know whether any studies have been conducted on this.
Yeah this was bugging me too. I’m not sure why they did it this way. We could calculate the difference between 4 shots and 4 shots+ bivalent given the numbers they provide in the article, but I haven’t had the time to do it yet.
I think it’s also noteworthy that it didn’t matter how many monovalent vaccines someone got. The protection against infection was the same. So they sort of addressed this in an indirect way
Thank you for your reply. The CDC’s study - or at least the conclusion presented - seems to be aimed at convincing non-vaccinated people to go get the fall booster. This would require them to first get the primary series. Since they’ve gone this long without getting a single shot, the odds they’ll take all necessary steps to get the fall booster are probably zero. With all due respect to the CDC, if the study’s conclusion motivates nobody to do nothing - why publish the study?
Because this is the only efficacy data anyone has (and is willing to publish)? Would you rather we have 0 idea how effective boosters are in the real world?
I don't agree with you that this is the only efficacy data we have on the fall boosters, yet I do agree with you that this is the only data that the CDC is willing to publish.
The fall booster is ONLY an option for those who have already had the primary series. So using the unvaxed as the comparison group does NOTHING to answer the question of whether vaccinated people would benefit from the new fall booster. There is nothing ACTIONABLE in this study - so why publish it?
Recently there have been a few articles cropping up that suggest that vaccinated people are more likely to catch covid than the unvaccinated, so perhaps the CDC is publishing this study as a retort to these articles and doubling down on the (flawed?) notion of "pandemic of the unvaccinated."
Oh I see your point now. I think waned 1-3 shots have 0% efficacy against Omicron infection though.
But yeah, obfuscation from the CDC, and outright silence from Pfizer/Moderna, who just pop up once in a while to crow about antibodies. No pressure from anyone for them to release the efficacy data they surely have, as "experts" seem more like social media influencers these days.
Feels like we're in a post-efficacy world where data doesn't matter.
Exactly, well said! I don’t see how this study informs important decisions the CDC needs to make in terms of what goals to prioritize, who to hire, how to invest their budget and what recommendations to make to the public.
I did see a comment up above from one of the doctors stating this study makes him feel better about recommending vaccines and boosters in the first place. That’s a valuable comment! I’m glad he shared his perspective because that would have been lost on me. But in terms of informing *new* decisions and recommendations today, December 2022, this study is a nothingburger.
So, clearly Pfizer and Moderna have efficacy data in their own trials unless they were completely negligent right? Yet why is the CDC the first to release efficacy data? We know Pfizer isn't shy about low sample sizes (their children' booster study had ~10 kids in it and confidence intervals went to 0 but they paraded it around), so it seems to me they just sat on disappointing data.
Also, imo experts would have more credibility if you could just admit that 20-30% (for elderly) efficacy is quite disappointing. Of course it's "better than nothing" but would you say that if efficacy dropped to 10%? 1%?
Always appreciate these updates. Of course it leads to more questions. In my state of Ohio local media reported that 90% of deaths in Ohio between June and October 2022 were age 60 and over. This according to ODH making it the “highest rate for those over 60 since the beginning of the pandemic.” Of course they never provide the percent of those deaths that were unvaccinated/boosted/natural immunity. In my opinion, as a person in this age group, reporting partial information seems counterproductive, if the statistics for covid(due to vs with) covid) aren’t reported at the same time. When are we going to see responsible, professional reporting and less fear mongering type of data?
Thank you for the Fall Booster update, Dr. Jetalina. This is encouraging. When, do you think, we might learn how soon a second bivalent booster might be needed to help shore up protection against severe disease? Every six months? I'd love for the protection to last until next fall, but it seems likely at least we older folks will need another booster sooner.
The WH certainly thinks we just need one shot per year, but Im unconvinced. Just have to follow the data and see how this virus mutates. I think we are all just worried about this winter first
I’m older and got my booster in early September. Leaves me feeling vulnerable right now with a coming wave. What is your guess on when Covid will have a seasonal pattern? It’s a good feeling to get a flu vaccine in October that hopefully protects until the flu season ends in the early spring.
I sympathize. I got my bivalent booster in early September because I had grand jury duty coming up (nobody gets out of grand jury duty in NYC, and it's four weeks with lots of random strangers). That being said: I can't begin to describe the peace of mind that comes from getting >25,000 u/mL on a spike antibody test (they currently have them at Labcorp for a little over $40). Antibody levels aren't a perfect correlate of protection, but they're pretty darn good.
What method do you recommend for getting boosted more the the recommended number of doses? Lying outright or just by omission of past history? This is a serious question, not a criticism.
Well the bivalent one was a reset for everyone. Currently I'm not planning on getting boosted any time soon, because of my antibody tests being off the charts (>25000 u/mL)
But to answer your question - pharmacists just don't seem to be verifying on the fly. When they ask whether it's first, second, or booster, I say "booster" and when they ask to see my CDC card I say I left it at home.
I am making no attempt to hide the extra boosters from my state immunization registry. It's all there, on my Excelsior pass.
It might not just be the boosters though. I may be benefiting from heterologous immunity from several other relatively recent (all since 2019) non-Covid boosters including MMR, PCV20, TDAP, polio and of course flu.
I should also add that I could, conceivably, get in trouble if my insurance company decides these shots shouldn't have been paid for. If that happened, they would probably recoup from the providers by shorting them on future claims. And then the providers could, theoretically, bill me. That being said, I think that's the worst thing that could happen.
I realized a strange thing about people. For many the pandemic is becoming normal, but what most are normalizing are the rates of death and handicaps from it, while masking has not been normalized in many locations and groups. WHY is it easier to normalize death and handicaps than a small inconvenience?
Would you please discuss when immunocompromised people who got bivalent booster this fall should get a booster? And is the recommendation the bivalent booster? I'm at 3 months now.
Leana Wen recently published an opinion piece in the Washington Post arguing that the military vaccine mandate no longer makes sense (https://www.washingtonpost.com/opinions/2022/12/09/military-covid-vaccine-mandate-should-end/). If her logic holds, I would think that organizations such as churches, social clubs, etc., would also be OK dropping their vaccination and booster requirements to attend indoor events. I’d love your take on Dr. Wen’s article. Thanks!
Can you expound on the pharmacy COVID test data? So a pharmacy asks a person getting a test for their COVID shot history and writes it all down? Who is collecting and adding up all the data from the pharmacies?
I can only speak for my state, but we have a state database of vaccinations (including COVID). It’s not perfect (if someone gets a dose out of state, for example), but it does capture a lot. Also, I work for a health department and when calling positive cases (yes we still do that!), we ask about vaccination status, reinfection, etc and that info also goes into a state database. We only call cases with lab confirmed positives.
Thanks again, as always, for your timely and thoughtful updates.
Vaccine effectiveness as a function of time in relation to waning effectiveness of most recent vaccination can use more clarification, if possible given the paucity of "real-world" data at this time given this information from this update (12/8):
Among those ages 65 and older, for example, effectiveness was 43% if they got their last mRNA dose more than 8 months ago, compared to 28% if they got their last dose 2 months ago.
• If the last vaccine was 6 months ago, should the >65 year old get vaccinated now or wait 2 months, given that the most recent @ 6 months may have waned to a level of much less than 28% effectiveness?
• If previously infected, should patient follow the CDC “wait 3 months guidance” or should the wait be expanded to 8 months?
Yes, I am also curious on this. I am vaxxed, boosted(nov '21), and got Covid two days before the Bivalent came out. By the studies in Quatar (if I interpreted it correctly, one group studied showed about 2% reinfected at 6 months, and the other group was about 1% reinfection), I should still have a pretty strong antibody response and a booster may not illicit a good "boost," but numbers are increasing and part of me wants to get boosted with enough time to have more antibodies for Christmas.
To me, this is where or attention should be focused now: optimal booster timing. Because clearly we've been doing it wrong since the beginning (3-4 weeks between initial shots? Ridiculous).
I'm wondering whether it might be a good idea to stagger boosters with others in your "bubble." And maybe monitor one's own Ab half life. Labcorp can detect Ab levels up to 25000 u/mL
Will we need an additional bivalent booster, do you think? We got ours on 9/7, the first day they were available in our area, but are worried that protection will wane during the winter. We are seniors, full-time employed, still masking in crowded indoor setting. We are going to the theater next week - wearing our masks throughout. At the Philharmonic last month, we were among what we calculated to be LESS than 5% of the audience that still masked.
This is about feeling like a lone guinea pig lost in a lab full of other guinea pigs.......
Age 81, fairly good health with stable stage 3 CKD.
Bivalent Sept 27, made me quite sick for two days - a good thing, actually.
Went grocery shopping 3 days ago and visited my Bank yesterday. Double ply mask each time.
Woke this morning at around 4 AM, upper left arm (injection site) very sore, radiating into back of neck. Rest of me fairly OK. I don't have tests at hand, so no certainty either way.
I understand that an N=1 story doesn't do much for science, but for me, telling it is better than kicking the dog.
Thanks for the update. I agree that the real world data is particularly messy. So is it correct to interpret this data as 100vaccinated and boosted(new bivalent) people in a room containing infections individuals, and only 44 of them would avoid being infected?
Thank you for the reply. So explained in a different way, out of the 100 people that tested positive in these locations, 66 of the 100 were boosted with the new bivalent booster? The way the CDC article explains it initially sounds like only 44% of people will not get it, but that can't be true. Because with T-cells, and just the inexplicable people that don't seem to get infected, 44% of general population getting infected in the scenario I mentioned seemed scary high. I am a high school teacher, and we saw very little community spread(that we could realistically track) back when we were distancing, tracking and masking. Now there are no masks or distancing, and numbers are going up, but it isn't like the whole school shuts down when an infected individual shows up. Thanks!
Yes, that's a better way to look at it. Keep in mind that the actual infection rate of the general population rate at any point in time is not anywhere near 44%. What a 44% efficacy rate is telling you is that 44% of the people who otherwise would have been infected at any given point in time were able to avoid infection due to the booster. So if 5% of unvaccinated individuals are infected with COVID, 2.8% of the boosted individuals would be infected.
I really like your explanation. But how many “trips out” (let’s say indoor dining, concerts, flight - all unmasked) until the fully vaxed and boosted person has a 90% chance of catching covid, assuming today’s transmission levels? Probably only 5 - 10 times.
It just means that boosted people's risk of infection is reduced by the efficacy%. So 44% efficacy means a boosted person in that age group has 56% of the risk of the unvaccinated of catching covid. That's literally all it means.
Such a good result, and the CDC is fortunate to have your voice to help spread the word. I feel justified in my recommendations, and will redouble my efforts with our supply of Pfizer. Maybe I should have waited a bit with the predictable holiday wave, since I got my bivalent one mid September. But then again maybe I’m part of the 44% already!
Elderly person here! My wife and I have had 2 MRNA vaccinations + 2 boosters + the Bivalent shots.. But despite all that help, we still think lo-tech behavioral habits: masking, social distancing, and hand washing are our best protection against all known strains, and any and all unknown super-strains that may arise!
Dr. Jetelina, my family and I have all had their primary series, and my wife and I (both in our 40s) both got the 1st booster. When thinking about getting a 2nd booster, we were struck by the fact that other countries were not recommending that healthy adults under the age of 50 or 60 get boosted. In the UK and Denmark, they only recommend it for 50+ or those with certain serious medical conditions (https://www.gov.uk/government/publications/covid-19-vaccination-autumn-booster-resources/a-guide-to-the-covid-19-autumn-booster) (https://sst.dk/en/English/Corona-eng/Vaccination-against-covid-19). The EU is recommending it only for 60+/serious medical conditions (https://www.france24.com/en/europe/20220711-eu-recommends-second-covid-19-booster-dose-for-people-over-60), and Sweden is recommending it for 65+/serious medical conditions (https://sst.dk/en/English/Corona-eng/Vaccination-against-covid-19). These countries also don't recommend boosters for children, and the UK, Denmark, and Sweden have now completely stopped offering even the primary series to children.
I haven't reviewed the recommendations for all European countries, but compared to these countries, the US is taking a very different approach by recommending a 2nd booster for all adults and a 1st booster for children. Can you offer some insight into why our approach is so much more pro-booster than in these other countries?
I am in the same boat. Moderna x 3. Last booster 11/1/2021. Not sure what to do, especially because I was incapacitated by the booster last year.
Thank you for another informative post. We can always count on your posts for the latest data and clear interpretation.
I'm confused by two aspects of the CDC's real world data that was published last Friday:
1) Why wasn't the "left box" (fall booster + 1-4 mRNA shots) compared to a (hypothetical) "1-4 mRNA shots but no fall booster" box? This would answer the question of whether people who have already received 1-4 mRNA shots actually benefit from the fall booster, which is perhaps the more relevant question. It's unlikely that somebody who is still unvaccinated will be motivated by this study's conclusion to go get multiple mRNA shots just to so they can get the fall booster. (My best guess is the CDC did perform the analysis on this hypothetical "1-4 mRNA shots but no fall booster" box, and for whatever reason, they aren't publishing the data).
2) It's possible the data could be skewed if, for some reason, vaccinated people are more likely to have "false negatives" on covid tests. It would be interesting to know whether any studies have been conducted on this.
Yeah this was bugging me too. I’m not sure why they did it this way. We could calculate the difference between 4 shots and 4 shots+ bivalent given the numbers they provide in the article, but I haven’t had the time to do it yet.
I think it’s also noteworthy that it didn’t matter how many monovalent vaccines someone got. The protection against infection was the same. So they sort of addressed this in an indirect way
Thank you for your reply. The CDC’s study - or at least the conclusion presented - seems to be aimed at convincing non-vaccinated people to go get the fall booster. This would require them to first get the primary series. Since they’ve gone this long without getting a single shot, the odds they’ll take all necessary steps to get the fall booster are probably zero. With all due respect to the CDC, if the study’s conclusion motivates nobody to do nothing - why publish the study?
Because this is the only efficacy data anyone has (and is willing to publish)? Would you rather we have 0 idea how effective boosters are in the real world?
I don't agree with you that this is the only efficacy data we have on the fall boosters, yet I do agree with you that this is the only data that the CDC is willing to publish.
The fall booster is ONLY an option for those who have already had the primary series. So using the unvaxed as the comparison group does NOTHING to answer the question of whether vaccinated people would benefit from the new fall booster. There is nothing ACTIONABLE in this study - so why publish it?
Recently there have been a few articles cropping up that suggest that vaccinated people are more likely to catch covid than the unvaccinated, so perhaps the CDC is publishing this study as a retort to these articles and doubling down on the (flawed?) notion of "pandemic of the unvaccinated."
https://www.washingtonpost.com/politics/2022/11/23/vaccinated-people-now-make-up-majority-covid-deaths/
Oh I see your point now. I think waned 1-3 shots have 0% efficacy against Omicron infection though.
But yeah, obfuscation from the CDC, and outright silence from Pfizer/Moderna, who just pop up once in a while to crow about antibodies. No pressure from anyone for them to release the efficacy data they surely have, as "experts" seem more like social media influencers these days.
Feels like we're in a post-efficacy world where data doesn't matter.
Exactly, well said! I don’t see how this study informs important decisions the CDC needs to make in terms of what goals to prioritize, who to hire, how to invest their budget and what recommendations to make to the public.
I did see a comment up above from one of the doctors stating this study makes him feel better about recommending vaccines and boosters in the first place. That’s a valuable comment! I’m glad he shared his perspective because that would have been lost on me. But in terms of informing *new* decisions and recommendations today, December 2022, this study is a nothingburger.
So, clearly Pfizer and Moderna have efficacy data in their own trials unless they were completely negligent right? Yet why is the CDC the first to release efficacy data? We know Pfizer isn't shy about low sample sizes (their children' booster study had ~10 kids in it and confidence intervals went to 0 but they paraded it around), so it seems to me they just sat on disappointing data.
Also, imo experts would have more credibility if you could just admit that 20-30% (for elderly) efficacy is quite disappointing. Of course it's "better than nothing" but would you say that if efficacy dropped to 10%? 1%?
Always appreciate these updates. Of course it leads to more questions. In my state of Ohio local media reported that 90% of deaths in Ohio between June and October 2022 were age 60 and over. This according to ODH making it the “highest rate for those over 60 since the beginning of the pandemic.” Of course they never provide the percent of those deaths that were unvaccinated/boosted/natural immunity. In my opinion, as a person in this age group, reporting partial information seems counterproductive, if the statistics for covid(due to vs with) covid) aren’t reported at the same time. When are we going to see responsible, professional reporting and less fear mongering type of data?
Just for clarification-I’m fully vaccinated, boosted through Omnicron. Try to “follow the confusing/convoluted science”
Thank you for the Fall Booster update, Dr. Jetalina. This is encouraging. When, do you think, we might learn how soon a second bivalent booster might be needed to help shore up protection against severe disease? Every six months? I'd love for the protection to last until next fall, but it seems likely at least we older folks will need another booster sooner.
The WH certainly thinks we just need one shot per year, but Im unconvinced. Just have to follow the data and see how this virus mutates. I think we are all just worried about this winter first
The White House and, even more unfortunately, the CDC, seem to be more interested in political messaging than in giving the best logical advice.
I’m older and got my booster in early September. Leaves me feeling vulnerable right now with a coming wave. What is your guess on when Covid will have a seasonal pattern? It’s a good feeling to get a flu vaccine in October that hopefully protects until the flu season ends in the early spring.
I sympathize. I got my bivalent booster in early September because I had grand jury duty coming up (nobody gets out of grand jury duty in NYC, and it's four weeks with lots of random strangers). That being said: I can't begin to describe the peace of mind that comes from getting >25,000 u/mL on a spike antibody test (they currently have them at Labcorp for a little over $40). Antibody levels aren't a perfect correlate of protection, but they're pretty darn good.
Thanks for the tip about the antibody test. I’ll try to get one!
What method do you recommend for getting boosted more the the recommended number of doses? Lying outright or just by omission of past history? This is a serious question, not a criticism.
Well the bivalent one was a reset for everyone. Currently I'm not planning on getting boosted any time soon, because of my antibody tests being off the charts (>25000 u/mL)
But to answer your question - pharmacists just don't seem to be verifying on the fly. When they ask whether it's first, second, or booster, I say "booster" and when they ask to see my CDC card I say I left it at home.
I am making no attempt to hide the extra boosters from my state immunization registry. It's all there, on my Excelsior pass.
It might not just be the boosters though. I may be benefiting from heterologous immunity from several other relatively recent (all since 2019) non-Covid boosters including MMR, PCV20, TDAP, polio and of course flu.
I should also add that I could, conceivably, get in trouble if my insurance company decides these shots shouldn't have been paid for. If that happened, they would probably recoup from the providers by shorting them on future claims. And then the providers could, theoretically, bill me. That being said, I think that's the worst thing that could happen.
I realized a strange thing about people. For many the pandemic is becoming normal, but what most are normalizing are the rates of death and handicaps from it, while masking has not been normalized in many locations and groups. WHY is it easier to normalize death and handicaps than a small inconvenience?
What do you think about adults getting a second bivalent booster in mid-winter if it's been 5+ months since the initial one?
Would you please discuss when immunocompromised people who got bivalent booster this fall should get a booster? And is the recommendation the bivalent booster? I'm at 3 months now.
Leana Wen recently published an opinion piece in the Washington Post arguing that the military vaccine mandate no longer makes sense (https://www.washingtonpost.com/opinions/2022/12/09/military-covid-vaccine-mandate-should-end/). If her logic holds, I would think that organizations such as churches, social clubs, etc., would also be OK dropping their vaccination and booster requirements to attend indoor events. I’d love your take on Dr. Wen’s article. Thanks!
Can you expound on the pharmacy COVID test data? So a pharmacy asks a person getting a test for their COVID shot history and writes it all down? Who is collecting and adding up all the data from the pharmacies?
I can only speak for my state, but we have a state database of vaccinations (including COVID). It’s not perfect (if someone gets a dose out of state, for example), but it does capture a lot. Also, I work for a health department and when calling positive cases (yes we still do that!), we ask about vaccination status, reinfection, etc and that info also goes into a state database. We only call cases with lab confirmed positives.
I found out how the data was collected by reading the linked CDC study.
Thanks again, as always, for your timely and thoughtful updates.
Vaccine effectiveness as a function of time in relation to waning effectiveness of most recent vaccination can use more clarification, if possible given the paucity of "real-world" data at this time given this information from this update (12/8):
Among those ages 65 and older, for example, effectiveness was 43% if they got their last mRNA dose more than 8 months ago, compared to 28% if they got their last dose 2 months ago.
• If the last vaccine was 6 months ago, should the >65 year old get vaccinated now or wait 2 months, given that the most recent @ 6 months may have waned to a level of much less than 28% effectiveness?
• If previously infected, should patient follow the CDC “wait 3 months guidance” or should the wait be expanded to 8 months?
Any thoughts?
Yes, I am also curious on this. I am vaxxed, boosted(nov '21), and got Covid two days before the Bivalent came out. By the studies in Quatar (if I interpreted it correctly, one group studied showed about 2% reinfected at 6 months, and the other group was about 1% reinfection), I should still have a pretty strong antibody response and a booster may not illicit a good "boost," but numbers are increasing and part of me wants to get boosted with enough time to have more antibodies for Christmas.
To me, this is where or attention should be focused now: optimal booster timing. Because clearly we've been doing it wrong since the beginning (3-4 weeks between initial shots? Ridiculous).
I'm wondering whether it might be a good idea to stagger boosters with others in your "bubble." And maybe monitor one's own Ab half life. Labcorp can detect Ab levels up to 25000 u/mL
Will we need an additional bivalent booster, do you think? We got ours on 9/7, the first day they were available in our area, but are worried that protection will wane during the winter. We are seniors, full-time employed, still masking in crowded indoor setting. We are going to the theater next week - wearing our masks throughout. At the Philharmonic last month, we were among what we calculated to be LESS than 5% of the audience that still masked.
This is about feeling like a lone guinea pig lost in a lab full of other guinea pigs.......
Age 81, fairly good health with stable stage 3 CKD.
Bivalent Sept 27, made me quite sick for two days - a good thing, actually.
Went grocery shopping 3 days ago and visited my Bank yesterday. Double ply mask each time.
Woke this morning at around 4 AM, upper left arm (injection site) very sore, radiating into back of neck. Rest of me fairly OK. I don't have tests at hand, so no certainty either way.
I understand that an N=1 story doesn't do much for science, but for me, telling it is better than kicking the dog.
Best
Heinz
Thanks for the update. I agree that the real world data is particularly messy. So is it correct to interpret this data as 100vaccinated and boosted(new bivalent) people in a room containing infections individuals, and only 44 of them would avoid being infected?
Close. So if 100 people in a room got *infected*, 44 of those could have been prevented with a vaccine.
Thank you for the reply. So explained in a different way, out of the 100 people that tested positive in these locations, 66 of the 100 were boosted with the new bivalent booster? The way the CDC article explains it initially sounds like only 44% of people will not get it, but that can't be true. Because with T-cells, and just the inexplicable people that don't seem to get infected, 44% of general population getting infected in the scenario I mentioned seemed scary high. I am a high school teacher, and we saw very little community spread(that we could realistically track) back when we were distancing, tracking and masking. Now there are no masks or distancing, and numbers are going up, but it isn't like the whole school shuts down when an infected individual shows up. Thanks!
Yes, that's a better way to look at it. Keep in mind that the actual infection rate of the general population rate at any point in time is not anywhere near 44%. What a 44% efficacy rate is telling you is that 44% of the people who otherwise would have been infected at any given point in time were able to avoid infection due to the booster. So if 5% of unvaccinated individuals are infected with COVID, 2.8% of the boosted individuals would be infected.
I really like your explanation. But how many “trips out” (let’s say indoor dining, concerts, flight - all unmasked) until the fully vaxed and boosted person has a 90% chance of catching covid, assuming today’s transmission levels? Probably only 5 - 10 times.
It just means that boosted people's risk of infection is reduced by the efficacy%. So 44% efficacy means a boosted person in that age group has 56% of the risk of the unvaccinated of catching covid. That's literally all it means.
Such a good result, and the CDC is fortunate to have your voice to help spread the word. I feel justified in my recommendations, and will redouble my efforts with our supply of Pfizer. Maybe I should have waited a bit with the predictable holiday wave, since I got my bivalent one mid September. But then again maybe I’m part of the 44% already!