Lab studies assessing the preliminary impact of our updated fall boosters are trickling in. (We don’t have “real world” data yet, and honestly, it may be a while.) In all, we knew boosters would help given circulating variants, but we didn’t know how
Dr. Jetelina, Thanks again for the helpful update. If you can, I would appreciate your thoughts on whether we will continue to need additional boosters for COVID going forward and whether there may be any long term effects on the immune system with so many boosters. I have now received a total of 5 vaccinations at this point.
Because the new bivalent boosters have been updated for Omicron, there seems to be a misconception among some of the newly boosted that they are now *completely* protected against the current variants. For some, this is their entire motivation for getting the updated booster.
They now have a false sense of security, and take on more risky behavior - indoor dining, flying without masks. Within weeks of their booster, they catch Covid.
For all the people I know who have gotten Covid in the last few weeks (a handful), they are all recently boosted with the bivalent. There’s a communication disconnect that needs to be addressed.
?4th goal would be reduction in long Covid and structural damage to the pulmonary, neurological, and other body systems.
For what is worth, I have not seen any of my patients who received the bivalent booster come down with Covid yet. Anecdotal and sure to change within the next two weeks
I’m in Philly, and the Phillies are energizing this city, and with bars and indoor get togethers we are sure to be a canary in the coal mine for xbb and the rest 😬
But did you see that Castellanos catch? Realmuto hitting a 10th inning game winning home run (with what loooked like a mild concussion to me from a baseball ricocheting off his face earlier)?!
I’m hoping many on this team got their boosters, probably not, but they are surely boosting our morale
I hope that you can shed some light on the problems of the immunosuppressed, particularly on those of us with solid organ transplants. I have a kidney transplant, and am thus immunosuppressed. It's VERY difficult to get any firm guidance from the transplant center, the ID doc, the nephrologist, or my PCP. Somewhere between 2.5 and 3% of the US population is immunosuppressed and we feel very forgotten, The CDC removing the requirement for masking in health care facilities has many of us feeling like our lives are simple not valued.
What causes immunity to 'wear off' over time? Why doesn't it last years/decades (for the same pathogen) like it does for measles, mumps, polio? Or is it more that when the antibodies aren't needed for some time, their production wanes, but blast back up with re-exposure? (Also, what's the timecourse of T-cell capability after initial virus or vaccine exposure? In otherwise healthy people does it drop off with age?)
Really nice summary-thanks! Re: Retooling the B-cell 'factory,' is this reassuring about the concern of 'original antigenic sin,' where the factory wouldn't re-tool - where B-cells better attuned to the new variant wouldn't start being produced? I wish some of these media would invite you on to comment Katelyn - the standard commentators aren't taking that extra "let's dig a little deeper" step.
Thanks for this! Very helpful. I am curious how these studies deal with the mix of immune conditions of the subjects - ie, some people have still never have covid, some had Wuhan, some had Delta, some had Omicron, and so on - plus some were boosted regularly and some were not, etc. I would think all that would make it harder to make sense of the results.
Relatedly, I have been confused by what I've read about how soon one should get the booster after infection. The CDC says 3 months, but I saw a small study that found that those who'd had covid less than 6 months before getting the booster had a "muted" B-cell response compared to those who had never been infected, suggesting that waiting longer would be better. The study was small and only followed subjects for 60 days. In my area, a lot of people are getting sick right now, so the idea boosting is appealing. But if one's current immunity is still very good 5 months out (especially after a bad bout), the boost might be counterproductive - the last thing one wants! [study link: https://www.medrxiv.org/content/10.1101/2022.08.30.22279344v1.full ]
Really appreciate the breakdown that you provide. I run a small meditation center and we have a Covid Task Force, who constantly use your information to help us make decisions about our Covid policies. Just upgraded my subscription. Thanks so much for all you are doing!
Is it possible that if someone was infected, they shouldn't really wait for the optimal 2-3 months after infection to get the max benefit from the fall booster if that lands in the middle of holiday season or after because you can get other flu viruses in the meantime and thus further have to postpone getting the fall booster until you recover from the seasonal flu?
What does this mean for imprinting? Are these studies worrisome in that regard? I read in the Washington Post "For scientists, these data are evidence of immunological imprinting, or antigenic sin — when a person’s first exposure to the virus biases their later responses." https://www.washingtonpost.com/health/2022/10/27/coronavirus-boosters-omicron/
Great summary, as usual. I've been a little busy of late and haven't done my epi due diligence safe for my organization. I've also been watching flu a bit more actively.
Thank you for getting this information out so quickly and so clearly! It’s extraordinarily unfortunate that there is not more visible scientific/medical leadership (FDA? CDC? Moderna/Pfizer?) clearly communicating before headlines run away with a partial message and little context for the public.
So disappointed in NPR . What a misleading, destructive headline.
Dr. Jetelina, Thanks again for the helpful update. If you can, I would appreciate your thoughts on whether we will continue to need additional boosters for COVID going forward and whether there may be any long term effects on the immune system with so many boosters. I have now received a total of 5 vaccinations at this point.
Thank you! Great info. Will share with those I know who are currently refusing to get the Fall booster!
Because the new bivalent boosters have been updated for Omicron, there seems to be a misconception among some of the newly boosted that they are now *completely* protected against the current variants. For some, this is their entire motivation for getting the updated booster.
They now have a false sense of security, and take on more risky behavior - indoor dining, flying without masks. Within weeks of their booster, they catch Covid.
For all the people I know who have gotten Covid in the last few weeks (a handful), they are all recently boosted with the bivalent. There’s a communication disconnect that needs to be addressed.
?4th goal would be reduction in long Covid and structural damage to the pulmonary, neurological, and other body systems.
For what is worth, I have not seen any of my patients who received the bivalent booster come down with Covid yet. Anecdotal and sure to change within the next two weeks
I’m in Philly, and the Phillies are energizing this city, and with bars and indoor get togethers we are sure to be a canary in the coal mine for xbb and the rest 😬
But did you see that Castellanos catch? Realmuto hitting a 10th inning game winning home run (with what loooked like a mild concussion to me from a baseball ricocheting off his face earlier)?!
I’m hoping many on this team got their boosters, probably not, but they are surely boosting our morale
I hope that you can shed some light on the problems of the immunosuppressed, particularly on those of us with solid organ transplants. I have a kidney transplant, and am thus immunosuppressed. It's VERY difficult to get any firm guidance from the transplant center, the ID doc, the nephrologist, or my PCP. Somewhere between 2.5 and 3% of the US population is immunosuppressed and we feel very forgotten, The CDC removing the requirement for masking in health care facilities has many of us feeling like our lives are simple not valued.
What causes immunity to 'wear off' over time? Why doesn't it last years/decades (for the same pathogen) like it does for measles, mumps, polio? Or is it more that when the antibodies aren't needed for some time, their production wanes, but blast back up with re-exposure? (Also, what's the timecourse of T-cell capability after initial virus or vaccine exposure? In otherwise healthy people does it drop off with age?)
Really nice summary-thanks! Re: Retooling the B-cell 'factory,' is this reassuring about the concern of 'original antigenic sin,' where the factory wouldn't re-tool - where B-cells better attuned to the new variant wouldn't start being produced? I wish some of these media would invite you on to comment Katelyn - the standard commentators aren't taking that extra "let's dig a little deeper" step.
Thanks for this! Very helpful. I am curious how these studies deal with the mix of immune conditions of the subjects - ie, some people have still never have covid, some had Wuhan, some had Delta, some had Omicron, and so on - plus some were boosted regularly and some were not, etc. I would think all that would make it harder to make sense of the results.
Relatedly, I have been confused by what I've read about how soon one should get the booster after infection. The CDC says 3 months, but I saw a small study that found that those who'd had covid less than 6 months before getting the booster had a "muted" B-cell response compared to those who had never been infected, suggesting that waiting longer would be better. The study was small and only followed subjects for 60 days. In my area, a lot of people are getting sick right now, so the idea boosting is appealing. But if one's current immunity is still very good 5 months out (especially after a bad bout), the boost might be counterproductive - the last thing one wants! [study link: https://www.medrxiv.org/content/10.1101/2022.08.30.22279344v1.full ]
Is boosting with Novavax an option?
Really appreciate the breakdown that you provide. I run a small meditation center and we have a Covid Task Force, who constantly use your information to help us make decisions about our Covid policies. Just upgraded my subscription. Thanks so much for all you are doing!
Is it possible that if someone was infected, they shouldn't really wait for the optimal 2-3 months after infection to get the max benefit from the fall booster if that lands in the middle of holiday season or after because you can get other flu viruses in the meantime and thus further have to postpone getting the fall booster until you recover from the seasonal flu?
Thank you for the explanation about B cells' "factory update" that happens over time rather than instantly.
What does this mean for imprinting? Are these studies worrisome in that regard? I read in the Washington Post "For scientists, these data are evidence of immunological imprinting, or antigenic sin — when a person’s first exposure to the virus biases their later responses." https://www.washingtonpost.com/health/2022/10/27/coronavirus-boosters-omicron/
Great summary, as usual. I've been a little busy of late and haven't done my epi due diligence safe for my organization. I've also been watching flu a bit more actively.
Thank you for getting this information out so quickly and so clearly! It’s extraordinarily unfortunate that there is not more visible scientific/medical leadership (FDA? CDC? Moderna/Pfizer?) clearly communicating before headlines run away with a partial message and little context for the public.