Messaging on the bivalent vaccines as reported from sources across the political spectrum was a fail. These new vaccines should not have been associated with phrases such as "not tested on humans" or "only tested on lab mice." Instead, they should have been associated with other truths such as "... having passed the same, thorough safeguards the annual flu vaccines have undergone for decades."
Agree 100%! As a family physician I am advising every eligible patient to get the bivalent booster. I would guess 60-75% of my patients have no idea there is a new booster when I bring it up. We have utterly failed our public health response to the pandemic. So grateful for spaces like this trying to rectify that.
I am also surprised at the number of intelligent, generally aware people in my university town who do not understand the bivalent booster is new/different and that everyone over 12 can get one! Messaging has failed miserably. Are savvy communications firms involved at all? I feel like we are almost at the point of needing a clever jingle, and I’m only partially kidding about the jingle. ;)
Messaging is so important, and we, in the public health community (let's just ignore the politicians for now) didn't do well. There are shining points of light where clarity and content have worked (thanks, Katelyn!) but efforts to get the correct information out have been muddled or just derailed. I know I've struggled to explain my thoughts in a large forum, but I've done pretty well when I was able to slow down and go one-on-one or in a small group and encourage questions rather than make it seem like a lecture.
There's one option missing from the poll: "Waiting on availability". Where I am (NYC), they only do the bivalent booster by appointment, and the appointments are booked anywhere from a week to 3 weeks in advance depending on the location. The places I've gotten my last 3 shots (2 primary + 1 booster) either were closed or don't have the bivalent booster in stock (and say they won't until October). My appointment is just a few days away at this point, but if it were up to me I'd have gotten it a week or two ago.
I love these comments, feel like dispatches from another land. I'm in a deep-red small city in a deep red state. No issue with availability or supplies here, sadly!
I was recently in Columbus IN. This meets the criteria you cite (DEEP red). I had no trouble booking my appointment and getting my bivalent booster but the pharmacist wouldn't give me the flu shot because she'd heard... from somewhere... they couldn't be given together. I did a bit of one-on-one in-service education and with the help of my phone and CDC's website, she's now willing to do both.
I noted no fewer than 6 others who came in for their boosters while I was there. I was truly surprised to see that.
Doesn't "waiting on availability" fit under the category "Waiting for closer to Winter/event", the event, in this case, being availability?
It would be nice if those of us waiting for an event were waiting for a fun one, like a holiday party, but I suspect many of us are waiting on un-fun events, like scheduling and availability.
It certainly could, sure. There's an implied "voluntary" aspect to the way it's phrased, and in my case I'm waiting only because I couldn't get it sooner. :)
It is public messaging fail to drop all NPIs as unnecessary and to publicly state “the pandemic is over” while urging everyone to get a fall booster. What sense are people supposed to make of completely contradictory messages.
Dr. Jetelina, I am curious about your opinion on this:
My doctor said that now that I'm two weeks post-bivalent booster, it's no longer necessary (or helpful) to wear a mask. Up to now, I've been continuing to mask in public places (supermarket, etc. -- anywhere indoors, really) but if doing so wouldn't really add much protection in addition to the booster, I guess I could skip it (never infected, to my knowledge).
Part of me feels really exposed without a mask, but practically no one in my community is wearing them anymore (I live in a highly vaccinated area) and I wonder if it's just my psychological roadblocks that prevent me from unmasking. Just like I followed the science and wore a mask when they were first recommended, I'd like to follow the science now and would be willing to unmask if it's no longer necessary.
I would love your take on this (I trust my doctor, but I am interested in another credible opinion). Thank you!
My opinion is that it’s levels of risk mitigation. Is it “necessary” to continue masking would be based on your risk tolerance. Masking, in addition to boosters, adds to your protection. I continue masking in areas where I could be exposed just to limit my risk. Other situations, like family events, I accept the increase in risk and choose not to mask.
I’d love to get Dr. Jetelina’s opinion on this as well!
So, my question is really whether the addition of a mask makes a measurable difference in lowering your risk of infection after the bivalent booster.
I ask because more and more, I find myself in places where I am the only person in the room wearing a mask... which is fine... but while I don't mind masks, per se, I would be okay with skipping it if the booster is just as good at lowering risk. Yes, a mask is an extra layer but if we're finding that the boosters are very effective, then maybe it doesn't matter much. That's why I am interested in the opinions of the experts who are familiar with the data and the science. It's definitely risk mitigation, but is the benefit of the mask with the booster so minimal that it's okay to go without? That's what I would love to know.
Masks do have a moderate, measurable preventative effect. If you and people you meet with regularly are all low risk then your doctor's advice is reasonable. If you or anyone you meet with are higher risk for severe COVID then I'd suggest it's very beneficial to continue masking in indoor or crowded outdoor public places. I'm at higher risk and I'm not masking outdoors nor with family—after we all confirm a negative rapid test as we arrive to meet together. I don't know when I'll not mask at church, at my doctor's office or at other indoor public places. Certainly not until community transmission rates are low. Right now, my community level is low but the transmission rate is just over the high transmission cutoff. I'm going to use community transmission rates to guide my own mask wearing. Or...air pollution or pollen levels, or if someone is smoking outside near me...just like I did before this current pandemic.
I am really not excited to get COVID (for multiple reasons), don’t want to chance long COVID, and certainly don’t want to get COVID from the grocery store, a work meeting, or even eating indoors in a restaurant when outdoors is possible and often preferable. Why not mask indoors for the added protection in such situations? We do see our grandkids unmasked, though we have been testing everyone immediately before.
If your doctor is correct that the bivalent will provide the protection against infection of a quality mask—I’ll be very, very happy! And then I’ll want to know how long that protection lasts.
There are protective benefits to be had from masking, especially if you are using a well-fitted and good quality (N95 preferably, or KN95) mask, but it's pretty well accepted that between immunity conferred by infection, and vaccination, the majority of the population is protected to some extent. The science on immunity isn't a simple "yes, mask" or "no, don't bother" statement. I mask depending on circumstance and best evidence. Crowded internal venues, large meetings, when traveling (but no longer, necessarily, in-flight, but in the airport, and enplaning and deplaning), and at other times when I feel it best. I don't mask, for instance, when I go to a big-box store... unless it's really crowded, or into a grocery store, because I personally have assessed the risk is acceptable because of high ceilings and good air mixing/circulation.
If you're more comfortable wearing a mask (with the caveat above about quality and fit), then feel free to do so. I'd not ever think to encourage someone to stop a disease mitigation process, and I'm not sure what your doctor meant. Perhaps you should ask for more clarification. If you've a good relationship with him/her, they should be happy to expand even in this era of short visits to maximize the number of patients seen.
I'm curious about your thought process in assessing benefit/risk ratio in wearing a mask vs. not.
It seems to me that any "risk" of mask-wearing in an enclosed area (e.g., big-box store) is close to zero (if not, in fact, zero). So while the benefit of wearing a mask may be relatively small given your particular circumstances, given the low to nonexistent risk in doing so, doesn't that make the benefit/risk ratio rather large? Why would someone reject that ratio?
I am all about risk mitigation but also reading about how we're anticipating a bad flu season and other respiratory illnesses because we've been so well-protected by our masks the past few years. And, while I definitely don't want the flu (I had my flu shot already this season, too), I think there is a benefit to having some exposure to certain illnesses (colds, etc.).
Yes, wearing a mask certainly can't hurt -- but if the benefit is negligible once bivalent boosted, then I'd consider leaving it at home. I would definitely wear one in a very crowded situation, as you mentioned, but perhaps it's overzealous to wear it for casual errands like the supermarket or my kids' schools, or whatever.
But that's why I am looking for some experts (like Dr. Jetelina) who can weigh in! I am interested in their thoughts on the question. :)
We have been worried about a "bad flu season" concurrent with the COVID pandemic since 2020. It'll happen, but were I to guess, I'd guess it will happen when we have a period where few are masked and uptake of the flu vaccine is reduced. I've not seen stats on flu vaccine uptake (@Katelyn?) but I've been busy on travel 'til this week and I'm catching up still. In fact, I may well have the flu after 2 weeks in Indiana and airline travel.
After you're boosted, you will likely see a significant increase in neutralizing antibodies for a period of time. You will also likely see B-cell training consistent with the different spike representations assuming you've not already been infected with BA.4/5. How LONG you retain the new neutralizing antibodies, however, remains a matter of debate, research and physiology. Also, if you have had an infection involving BA.2, or BA.4 or BA.5, and a lot of people have had that happen, the combination of vaccination(s) and infection-conferred immunity, often referred to as hybrid immunity, protects you better than either vaccination, or certainly better than infection-conferred immunity alone.
In areas with high ceilings and good air circulation, e.g., grocery stores and big-box stores, masks may not be as necessary. In your kids' schools, however, where conditions are more crowded and unless your schools actually did upgrade their HVAC systems to improve filtration and airflow, a mask might be prudent.
The bivalent booster isn't a magic bullet meaning the end of the pandemic. The virus will determine when we can relax, and looking at a beta coronavirus, I don't expect it to stop evolving, trying to become more competitive, any time soon.
One more thing... exposure to "colds" means exposure to RSV, coronavirus, rhinovirus or adenovirus, usually, and sometimes influenza. Of these, recall that coronaviruses causing "the common cold" are very similar to SARS-CoV-2, and evolve quickly. Exposure to coronavirus associated with a cold protects you from, generally, that virus, but next year's coronavirus evolutionary target will likely not present the same antigenic signature, although the core should be close enough to allow the cellular immune system to think about fighting it. Trying to obtain immunity to the common cold is a losing proposition in general terms because of the diversity of viruses that cause that syndrome.
Thank you for asking this. I, too, have also wondered if I’ll ever be able to feel comfortable, say, getting my hair cut and nails done without wearing an N95, or if I’ll be able to take the mask off my ice hockey helmet cage.
All weekend appointments are booked up in the DC area. Marginalized communities can’t pull their kids from school for a 1p Tuesday appointment. They also can’t necessarily plan 2 weeks out.
I wish the poll had another category for "scheduled soon." For some stupid reason, doctors and pharmacies in my community weren't authorized to proceed with the bivalent vaccinations until this week. I'm scheduled for tomorrow.
There seem to be a lot of people on this thread who are waiting for availability. The bivalent boosters may have been authorized a few weeks ago, but apparently they aren't available everywhere yet.
I selected "Waiting for closer to Winter/event" because of ragweed season. I know it's medically safe to receive these vaccinations while feeling slightly ill (from, say, a cold or allergies), but this ragweed season, I'm barely hanging onto shreds of sanity by my fingernails, and I'm responsible for three kids six and under.
I've read that "experts say people can expect to have generally the same reaction to the new bivalent vaccines as they did the first generation COVID-19 vaccines."
My reactions to previous COVID shots ranged from a few days of malaise to "flu from hell". Still happy to have gotten the shots, of course! But irritants are said to have a synergistic effect on asthma and allergies, and vaccines must irritate the immune system to do their job. When I'm already sneezing and wheezing due to pointless immune activity (thanks, ragweed), goosing that activity even more seems pretty bleak.
I will get it done -- I have so far, after all. But, since this ragweed season is effectively already "cold from hell" for me, it seems irresponsible to schedule the booster without downtime to handle the possibility of that flaring to "flu from hell" after the booster.
I wonder if there are important practical insights on how the immune system functions in the range of "common" reactions to the vaccines (i.e., from practically no reaction to 'flu from hell')? I've had 4 now and the worst reaction was a couple hours of minor sore arm. Is that a good or a bad sign immunologically? Whereas occasionally people report long-lasting nastiness, even a bit similar to long Covid (couple articles in New Engl J in March had a hypothesis about that).
I believe stronger reactions than no symptoms or a mild sore arm are due to the immune system overreacting somewhat. Unless it's a true allergic reaction, these strong vaccine reactions are "merely uncomfortable" and not at all dangerous. Of course, my advice to anyone questioning their reaction is my standard, "when in doubt, check it out" (i.e., talk with your healthcare professional).
Request: When you put up a graph or chart, please explain enough of it so that us non medical researchers can understand it. If I say I read your article and you presented data, I feel it is a false sense of "knowing" if I don't understand the data you present.
Thank you for the report! I will scan the two preprints you cited to see if I can glean more insight into what that chart means.
I actually wanted to add this!! But substack will only allow 5 responses (for some odd reason). I figured people could pick one of the other options instead
I haven't been able to get it yet due to availability in my area (Seattle). Appointment scheduled in two weeks, but pharmacies do not seem to know when or if they are getting it, even when appointments are available to schedule. At least for us, supply and distribution still seem to be big issues.
Do you know the name @DrEricDing? He's on Twitter claiming that there are much more dire variants, perhaps the ones you cited today, that could be extremely dangerous and that many more precautions should be being practiced. Is he an extremist or just someone who's aware of future dangers?
I do know him! And he follows this newsletter too :) I appreciate how quickly he gets information out, but he’s more alarmist than I prefer. His tweets aren’t necessarily wrong, but I think are sometimes missing important context. For example, I responded to his tweet yesterday on Twitter: https://twitter.com/dr_kkjetelina/status/1574790675349925888?s=46&t=C0h00uAtghZfi9FAaaJLog
In the survey, I had to choose Waiting for closer to winter/event, but that isn't really why I am waiting. I live in the UK where not everyone is allowed to get the bivalent booster. (Ours is original and BA.1, not as effective as what much of the USA is using.) My invitation to book the jab just arrived yesterday. I now have an appointment so that's what I'm waiting for.
We are holding our breath about whether I will have to reschedule. Last week my wife got heavy exposure to COVID at work. The hospital where she works had everyone stop masking months ago except in direct clinical situations. About 2/3 of her medical secretary group is now down with COVID. She is self-isolating in the bedroom and we are waiting to see whether we're going to magically escape this exposure.
Best wishes for a full and speedy recovery for your wife and I hope that you avoid infection. I will say, anecdotally, that I know several families who have avoided infection by isolating, mask wearing, and ventilation.
And I want to say that I’m a bit horrified by the decisions by medical providers not to mask. I just read the other day that as rates are rising in UK, your hospitals/clinics are returning to masking?
I should add, my wife and I isolated from each other because she had such a definite exposure. She has come through without getting symptomatic and without testing positive. We're okay. But if we got sick at the same time, that would have been very difficult to handle.
As of last night, 3 of the 4 in her work group who were at home with symptoms still have negative lateral flow (rapid home) tests. It was decided that their symptoms were reactions to jabs. My wife and I stopped isolating.
This hospital still wants masks worn only in face to face clinical settings. My wife wore a mask anyway this week. The couple of coworkers who were still in saw her do that and did the same, despite management preferences. She will be home soon from her last day in the NHS. Her work group there have been wonderful and she will miss them terribly, but her next job (already lined up) will be remote from home, like mine.
In the UK, we are in the post-pandemic era. People like me who still wear face masks when indoors with someone other than my wife or outdoors too close to other people are weirdos. People like me who still watch the Office for National Statistics prevalence survey (the only still-good data about prevalence that we still have) are weirdos. Even friends who used to be careful aren't being careful any more. I got a lecture a couple of weeks ago from one of them who was telling me that I've got to loosen up and stop masking.
I wanted to wait closer to four months out from my fourth shot. I have to say, Paul Offit is probably why people maybe pausing. I have to remember though he was against boosters in 2021, and I got a booster anyway. I am getting the shot on Friday. I am really not looking forward to the 36 hours of headache, body aches and fever.
Messaging on the bivalent vaccines as reported from sources across the political spectrum was a fail. These new vaccines should not have been associated with phrases such as "not tested on humans" or "only tested on lab mice." Instead, they should have been associated with other truths such as "... having passed the same, thorough safeguards the annual flu vaccines have undergone for decades."
Agree 100%! As a family physician I am advising every eligible patient to get the bivalent booster. I would guess 60-75% of my patients have no idea there is a new booster when I bring it up. We have utterly failed our public health response to the pandemic. So grateful for spaces like this trying to rectify that.
I am also surprised at the number of intelligent, generally aware people in my university town who do not understand the bivalent booster is new/different and that everyone over 12 can get one! Messaging has failed miserably. Are savvy communications firms involved at all? I feel like we are almost at the point of needing a clever jingle, and I’m only partially kidding about the jingle. ;)
Messaging is so important, and we, in the public health community (let's just ignore the politicians for now) didn't do well. There are shining points of light where clarity and content have worked (thanks, Katelyn!) but efforts to get the correct information out have been muddled or just derailed. I know I've struggled to explain my thoughts in a large forum, but I've done pretty well when I was able to slow down and go one-on-one or in a small group and encourage questions rather than make it seem like a lecture.
There's one option missing from the poll: "Waiting on availability". Where I am (NYC), they only do the bivalent booster by appointment, and the appointments are booked anywhere from a week to 3 weeks in advance depending on the location. The places I've gotten my last 3 shots (2 primary + 1 booster) either were closed or don't have the bivalent booster in stock (and say they won't until October). My appointment is just a few days away at this point, but if it were up to me I'd have gotten it a week or two ago.
I love these comments, feel like dispatches from another land. I'm in a deep-red small city in a deep red state. No issue with availability or supplies here, sadly!
I was recently in Columbus IN. This meets the criteria you cite (DEEP red). I had no trouble booking my appointment and getting my bivalent booster but the pharmacist wouldn't give me the flu shot because she'd heard... from somewhere... they couldn't be given together. I did a bit of one-on-one in-service education and with the help of my phone and CDC's website, she's now willing to do both.
I noted no fewer than 6 others who came in for their boosters while I was there. I was truly surprised to see that.
Doesn't "waiting on availability" fit under the category "Waiting for closer to Winter/event", the event, in this case, being availability?
It would be nice if those of us waiting for an event were waiting for a fun one, like a holiday party, but I suspect many of us are waiting on un-fun events, like scheduling and availability.
It certainly could, sure. There's an implied "voluntary" aspect to the way it's phrased, and in my case I'm waiting only because I couldn't get it sooner. :)
It is public messaging fail to drop all NPIs as unnecessary and to publicly state “the pandemic is over” while urging everyone to get a fall booster. What sense are people supposed to make of completely contradictory messages.
Dr. Jetelina, I am curious about your opinion on this:
My doctor said that now that I'm two weeks post-bivalent booster, it's no longer necessary (or helpful) to wear a mask. Up to now, I've been continuing to mask in public places (supermarket, etc. -- anywhere indoors, really) but if doing so wouldn't really add much protection in addition to the booster, I guess I could skip it (never infected, to my knowledge).
Part of me feels really exposed without a mask, but practically no one in my community is wearing them anymore (I live in a highly vaccinated area) and I wonder if it's just my psychological roadblocks that prevent me from unmasking. Just like I followed the science and wore a mask when they were first recommended, I'd like to follow the science now and would be willing to unmask if it's no longer necessary.
I would love your take on this (I trust my doctor, but I am interested in another credible opinion). Thank you!
The higher the transmission level, the more important masking becomes.
My opinion is that it’s levels of risk mitigation. Is it “necessary” to continue masking would be based on your risk tolerance. Masking, in addition to boosters, adds to your protection. I continue masking in areas where I could be exposed just to limit my risk. Other situations, like family events, I accept the increase in risk and choose not to mask.
I’d love to get Dr. Jetelina’s opinion on this as well!
So, my question is really whether the addition of a mask makes a measurable difference in lowering your risk of infection after the bivalent booster.
I ask because more and more, I find myself in places where I am the only person in the room wearing a mask... which is fine... but while I don't mind masks, per se, I would be okay with skipping it if the booster is just as good at lowering risk. Yes, a mask is an extra layer but if we're finding that the boosters are very effective, then maybe it doesn't matter much. That's why I am interested in the opinions of the experts who are familiar with the data and the science. It's definitely risk mitigation, but is the benefit of the mask with the booster so minimal that it's okay to go without? That's what I would love to know.
Masks do have a moderate, measurable preventative effect. If you and people you meet with regularly are all low risk then your doctor's advice is reasonable. If you or anyone you meet with are higher risk for severe COVID then I'd suggest it's very beneficial to continue masking in indoor or crowded outdoor public places. I'm at higher risk and I'm not masking outdoors nor with family—after we all confirm a negative rapid test as we arrive to meet together. I don't know when I'll not mask at church, at my doctor's office or at other indoor public places. Certainly not until community transmission rates are low. Right now, my community level is low but the transmission rate is just over the high transmission cutoff. I'm going to use community transmission rates to guide my own mask wearing. Or...air pollution or pollen levels, or if someone is smoking outside near me...just like I did before this current pandemic.
I am really not excited to get COVID (for multiple reasons), don’t want to chance long COVID, and certainly don’t want to get COVID from the grocery store, a work meeting, or even eating indoors in a restaurant when outdoors is possible and often preferable. Why not mask indoors for the added protection in such situations? We do see our grandkids unmasked, though we have been testing everyone immediately before.
If your doctor is correct that the bivalent will provide the protection against infection of a quality mask—I’ll be very, very happy! And then I’ll want to know how long that protection lasts.
Would love to hear Dr. Jetelina on this, too.
There are protective benefits to be had from masking, especially if you are using a well-fitted and good quality (N95 preferably, or KN95) mask, but it's pretty well accepted that between immunity conferred by infection, and vaccination, the majority of the population is protected to some extent. The science on immunity isn't a simple "yes, mask" or "no, don't bother" statement. I mask depending on circumstance and best evidence. Crowded internal venues, large meetings, when traveling (but no longer, necessarily, in-flight, but in the airport, and enplaning and deplaning), and at other times when I feel it best. I don't mask, for instance, when I go to a big-box store... unless it's really crowded, or into a grocery store, because I personally have assessed the risk is acceptable because of high ceilings and good air mixing/circulation.
If you're more comfortable wearing a mask (with the caveat above about quality and fit), then feel free to do so. I'd not ever think to encourage someone to stop a disease mitigation process, and I'm not sure what your doctor meant. Perhaps you should ask for more clarification. If you've a good relationship with him/her, they should be happy to expand even in this era of short visits to maximize the number of patients seen.
I'm curious about your thought process in assessing benefit/risk ratio in wearing a mask vs. not.
It seems to me that any "risk" of mask-wearing in an enclosed area (e.g., big-box store) is close to zero (if not, in fact, zero). So while the benefit of wearing a mask may be relatively small given your particular circumstances, given the low to nonexistent risk in doing so, doesn't that make the benefit/risk ratio rather large? Why would someone reject that ratio?
I am all about risk mitigation but also reading about how we're anticipating a bad flu season and other respiratory illnesses because we've been so well-protected by our masks the past few years. And, while I definitely don't want the flu (I had my flu shot already this season, too), I think there is a benefit to having some exposure to certain illnesses (colds, etc.).
Yes, wearing a mask certainly can't hurt -- but if the benefit is negligible once bivalent boosted, then I'd consider leaving it at home. I would definitely wear one in a very crowded situation, as you mentioned, but perhaps it's overzealous to wear it for casual errands like the supermarket or my kids' schools, or whatever.
But that's why I am looking for some experts (like Dr. Jetelina) who can weigh in! I am interested in their thoughts on the question. :)
We have been worried about a "bad flu season" concurrent with the COVID pandemic since 2020. It'll happen, but were I to guess, I'd guess it will happen when we have a period where few are masked and uptake of the flu vaccine is reduced. I've not seen stats on flu vaccine uptake (@Katelyn?) but I've been busy on travel 'til this week and I'm catching up still. In fact, I may well have the flu after 2 weeks in Indiana and airline travel.
After you're boosted, you will likely see a significant increase in neutralizing antibodies for a period of time. You will also likely see B-cell training consistent with the different spike representations assuming you've not already been infected with BA.4/5. How LONG you retain the new neutralizing antibodies, however, remains a matter of debate, research and physiology. Also, if you have had an infection involving BA.2, or BA.4 or BA.5, and a lot of people have had that happen, the combination of vaccination(s) and infection-conferred immunity, often referred to as hybrid immunity, protects you better than either vaccination, or certainly better than infection-conferred immunity alone.
In areas with high ceilings and good air circulation, e.g., grocery stores and big-box stores, masks may not be as necessary. In your kids' schools, however, where conditions are more crowded and unless your schools actually did upgrade their HVAC systems to improve filtration and airflow, a mask might be prudent.
The bivalent booster isn't a magic bullet meaning the end of the pandemic. The virus will determine when we can relax, and looking at a beta coronavirus, I don't expect it to stop evolving, trying to become more competitive, any time soon.
One more thing... exposure to "colds" means exposure to RSV, coronavirus, rhinovirus or adenovirus, usually, and sometimes influenza. Of these, recall that coronaviruses causing "the common cold" are very similar to SARS-CoV-2, and evolve quickly. Exposure to coronavirus associated with a cold protects you from, generally, that virus, but next year's coronavirus evolutionary target will likely not present the same antigenic signature, although the core should be close enough to allow the cellular immune system to think about fighting it. Trying to obtain immunity to the common cold is a losing proposition in general terms because of the diversity of viruses that cause that syndrome.
Thank you for asking this. I, too, have also wondered if I’ll ever be able to feel comfortable, say, getting my hair cut and nails done without wearing an N95, or if I’ll be able to take the mask off my ice hockey helmet cage.
All weekend appointments are booked up in the DC area. Marginalized communities can’t pull their kids from school for a 1p Tuesday appointment. They also can’t necessarily plan 2 weeks out.
I wish the poll had another category for "scheduled soon." For some stupid reason, doctors and pharmacies in my community weren't authorized to proceed with the bivalent vaccinations until this week. I'm scheduled for tomorrow.
I would’ve liked a “waiting for Novavax” category - cardiac issues after my last booster.
I thought Novavax had been approved? Anybody have an update on that?
Novavax is approved only as a primary series, not a booster.
It sounds like you fit the category "Waiting for closer to Winter/event": the event you're waiting for is Novavax availability.
Elsie sounds like she had to wait on the event of authorization.
I suspect a great many of us will end up waiting on events that aren't the fun kind of event, but various logistical concerns.
There seem to be a lot of people on this thread who are waiting for availability. The bivalent boosters may have been authorized a few weeks ago, but apparently they aren't available everywhere yet.
I selected "Waiting for closer to Winter/event" because of ragweed season. I know it's medically safe to receive these vaccinations while feeling slightly ill (from, say, a cold or allergies), but this ragweed season, I'm barely hanging onto shreds of sanity by my fingernails, and I'm responsible for three kids six and under.
I've read that "experts say people can expect to have generally the same reaction to the new bivalent vaccines as they did the first generation COVID-19 vaccines."
https://www.health.com/news/new-omicron-booster-side-effects
My reactions to previous COVID shots ranged from a few days of malaise to "flu from hell". Still happy to have gotten the shots, of course! But irritants are said to have a synergistic effect on asthma and allergies, and vaccines must irritate the immune system to do their job. When I'm already sneezing and wheezing due to pointless immune activity (thanks, ragweed), goosing that activity even more seems pretty bleak.
I will get it done -- I have so far, after all. But, since this ragweed season is effectively already "cold from hell" for me, it seems irresponsible to schedule the booster without downtime to handle the possibility of that flaring to "flu from hell" after the booster.
I wonder if there are important practical insights on how the immune system functions in the range of "common" reactions to the vaccines (i.e., from practically no reaction to 'flu from hell')? I've had 4 now and the worst reaction was a couple hours of minor sore arm. Is that a good or a bad sign immunologically? Whereas occasionally people report long-lasting nastiness, even a bit similar to long Covid (couple articles in New Engl J in March had a hypothesis about that).
I believe stronger reactions than no symptoms or a mild sore arm are due to the immune system overreacting somewhat. Unless it's a true allergic reaction, these strong vaccine reactions are "merely uncomfortable" and not at all dangerous. Of course, my advice to anyone questioning their reaction is my standard, "when in doubt, check it out" (i.e., talk with your healthcare professional).
Request: When you put up a graph or chart, please explain enough of it so that us non medical researchers can understand it. If I say I read your article and you presented data, I feel it is a false sense of "knowing" if I don't understand the data you present.
Thank you for the report! I will scan the two preprints you cited to see if I can glean more insight into what that chart means.
The poll needs a "Waiting, busy and haven't had an evening and day when I can be mildly sick"
I actually wanted to add this!! But substack will only allow 5 responses (for some odd reason). I figured people could pick one of the other options instead
Finally was able to get it when I had to be home taking care of kids with the flu anyway!
Hello!
You forgot to include "It's not yet available to me where I live" in your survey... And by the way, not all of your readers live in the US ;)
Keep up the good work!
Your poll should probably have a "scheduled but don't have it yet" option. That's me!
That is my status as well.
I haven't been able to get it yet due to availability in my area (Seattle). Appointment scheduled in two weeks, but pharmacies do not seem to know when or if they are getting it, even when appointments are available to schedule. At least for us, supply and distribution still seem to be big issues.
Wendy
Do you know the name @DrEricDing? He's on Twitter claiming that there are much more dire variants, perhaps the ones you cited today, that could be extremely dangerous and that many more precautions should be being practiced. Is he an extremist or just someone who's aware of future dangers?
I do know him! And he follows this newsletter too :) I appreciate how quickly he gets information out, but he’s more alarmist than I prefer. His tweets aren’t necessarily wrong, but I think are sometimes missing important context. For example, I responded to his tweet yesterday on Twitter: https://twitter.com/dr_kkjetelina/status/1574790675349925888?s=46&t=C0h00uAtghZfi9FAaaJLog
Good response to Eric.
Wendy Thank you sooo much for your quick and reassuring reply!
I've seen some of his comments and been alarmed by them, too, but I've also seen a lot of articles that claim he's not so credible. A lot of his dire warnings have not foreshadowed actual crises: https://www.mcgill.ca/oss/article/covid-19-medical-critical-thinking/eric-feigl-ding-epidemiologist-who-moves-fast-and-breaks-things
Thanks so much, Melissa — very helpful — and Katelyn replied to me too — so promptly. She’s amazing!
In the survey, I had to choose Waiting for closer to winter/event, but that isn't really why I am waiting. I live in the UK where not everyone is allowed to get the bivalent booster. (Ours is original and BA.1, not as effective as what much of the USA is using.) My invitation to book the jab just arrived yesterday. I now have an appointment so that's what I'm waiting for.
We are holding our breath about whether I will have to reschedule. Last week my wife got heavy exposure to COVID at work. The hospital where she works had everyone stop masking months ago except in direct clinical situations. About 2/3 of her medical secretary group is now down with COVID. She is self-isolating in the bedroom and we are waiting to see whether we're going to magically escape this exposure.
She's leaving the NHS at the end of this week.
Best wishes for a full and speedy recovery for your wife and I hope that you avoid infection. I will say, anecdotally, that I know several families who have avoided infection by isolating, mask wearing, and ventilation.
And I want to say that I’m a bit horrified by the decisions by medical providers not to mask. I just read the other day that as rates are rising in UK, your hospitals/clinics are returning to masking?
I should add, my wife and I isolated from each other because she had such a definite exposure. She has come through without getting symptomatic and without testing positive. We're okay. But if we got sick at the same time, that would have been very difficult to handle.
As of last night, 3 of the 4 in her work group who were at home with symptoms still have negative lateral flow (rapid home) tests. It was decided that their symptoms were reactions to jabs. My wife and I stopped isolating.
This hospital still wants masks worn only in face to face clinical settings. My wife wore a mask anyway this week. The couple of coworkers who were still in saw her do that and did the same, despite management preferences. She will be home soon from her last day in the NHS. Her work group there have been wonderful and she will miss them terribly, but her next job (already lined up) will be remote from home, like mine.
In the UK, we are in the post-pandemic era. People like me who still wear face masks when indoors with someone other than my wife or outdoors too close to other people are weirdos. People like me who still watch the Office for National Statistics prevalence survey (the only still-good data about prevalence that we still have) are weirdos. Even friends who used to be careful aren't being careful any more. I got a lecture a couple of weeks ago from one of them who was telling me that I've got to loosen up and stop masking.
This is going to be soooo bad...
I suspect that your readership is skewed toward folks who would be eager to get the new vaccine as soon as they can.
I wanted to wait closer to four months out from my fourth shot. I have to say, Paul Offit is probably why people maybe pausing. I have to remember though he was against boosters in 2021, and I got a booster anyway. I am getting the shot on Friday. I am really not looking forward to the 36 hours of headache, body aches and fever.