Yesterday, the White House announced a new plan: one COVID-19 shot per year. The idea is this will decrease public confusion and increase booster uptake by aligning with the flu vaccine campaign. Reading between the lines, I think this is also a political signal to shift out of the SARS-CoV-2 emergency phase.
Expecting more than a "one size fits most" from the CDC and FDA would be asking too much. Patient self-advocacy is something that many people aren't aware of. It take a lot of reading but you can acquire sufficient knowledge to question your doctor's guidance and chart your own course. At 70 years of age, 1 booster/yr will not give me sufficient neutralizing antibodies to prevent infection from covid.
My goal is to avoid Long Covid. The only way to achieve that is to avoid infection. Until there is a booster that can achieve that, I'll continue wearing a KN-95 mask when indoors and plan on more than 1 booster/yr.
YLE is absolutely right - we need Operation Warp Speed 2.0. Right now, I am told we have <$50 million for vaccine R&D + distribution of vaccines and tests for preparedness. Under Warp Speed we had $18 billion.
The Biden administration requested $22.5 Billion and $15 billion in COVID money was stripped out by congress. Most of this money was intended to pay for a new focus on vaccine research, testing and treatment. This funding, in my opinion, would have supported "Warp Speed 2.0." Given the lessons we have learned from Covid-19, I consider it congressional malpractice for congress to withhold this critically needed funding as 4-500 Americans continue to die each day. There is now a funding bill in the works, with a September 30 deadline, that has the real potential for restoring much of this funding.
Katelyn is right on target - "money will move mountains in science and research" and "we just need to fight for it." This new funding bill offers us a last chance to restore this funding for FY23 (which begins October 1). I'm writing to my Senators and U.S. representative and will learn about what APHA is doing about this. Again, we "need to fight for it."
Thank you so much for this excellent newsletter, I really upon it for real information!!
I'm ready to fight for a better Covid plan - but how? Which members of Congress are still interested in fighting this disease? I am ready to fight this fight!!
I agree with you - the WH plan is nonsensical unless the goal is to perpetually enrich big pharmaceuticals.
We can't wish Covid away and it appears our national priorities, as reflected by our government's budget, are completely screwed-up. We have billions/trillions for fighting endless foreign wars ($12B recently appropriated to replenish Ukraine depleted DoD weapon/equipment stocks), but crumbs for public health and other public goods.
Just looking around, the majority are acting as if COVID is over. Labor Day weekend in the US had more passengers than Labor Day in 2019. People for the most part aren't getting booster shots, aren't wearing masks, schools aren't updating ventilation systems. As more people have gotten infected in 2022, it has become more of the "yeah I was sick but it wasn't that bad" outnumbering the "I got sick and it was horrible."
It seems that this is more of a pragmatic approach than anything. It the "how can we get people to at least get one booster shot of some sort" when the vast majority of people are operating in the world as if the pandemic doesn't exist. One shot with the flu vaccine can help normalize an annual booster and can then be done at workplaces, community centers more easily. There is also a cost of producing shots. There needs to be a large enough number of people to get shots so they will make enough of them ala flu shots.
It really seems like the horse is way out of the barn, down the road and into the next town. COVID started with "get it and you might die, don't overwhelm hospitals." Now that fewer people die (comparatively to 2020), people just aren't that scared.
I think the big push for "more" will come when businesses are even more impacted with getting employees because long covid will depress the number of workers available. Already it seems to have a 1%-2% impact on worker availability. With a tight job market, that will make employers (and insurance companies) care, which means a push for Government to throw more money into boosters/filtration etc to prevent infection in the first place.
Looking at the situation from a mathematical perspective it is immediately apparent that in a decision-space the virus has the upper hand in that it is not limited in the number of choices it has, but at the society level we have imposed numerous limitations on our choices, mostly irrational. In other words, no Nash equilibrium and the virus has the better of it
Thank you to the call to action to affect public policy and for lifting your voice. We all really need to participate in this with communication to our policy leaders from the local level on up that we need an Operation Warp Speed 2.0 and more attention to COVID, rather than wishing it away and looking through rose colored glasses at what is still a pandemic. I also wonder about the major philanthropy players in the US (and world)—where are they in terms of investing in new tools?
Great review of the state of vaccine development and rationale for use. It is hard to contemplate how much even an omnicompetent vaccine would be accepted in the current irrational environment. We are certainly not out of the woods yet with 500+ people dying each day.
Thank you for another great post. By asking the right questions, you make the process better.
I’m confused why determining the future schedule for Covid boosters would now be under the purview of The White House. Is Biden himself the one making the decision to move to an annual schedule? Do the CDC and medical community agree? Is this an election year maneuver to make it appear that the pandemic is more under control than it really is?
Unfortunately, this looks like a decision backed by political - not medical - reasoning.
Pretty good summary. I think the WH announcement is anticipatory, though, of events that haven't happened. I fear we're creating a false sense of expectation for a virus that hasn't shown us a recent variant. There are too many in the public who fail to grasp your point that SARS-CoV-2 is mutating 4x faster than influenza, and worse, your comment regarding random vs directed (ladder-like) mutation is totally foreign to them. Limited by their experience, "it's obvious" the pandemic's over, and those of us who focus on the epidemiological aspects are fear-mongering.
The release of Convidecia Air is encouraging, but I wonder about the approval process and testing rigor. I strongly concur we need a combined flu-COVID vaccine to increase, hopefully, acceptance.
I thought it was interesting that he was suggesting that we get our flu shots and covid shots at the same time at the beginning of the season. It's by no means obvious to me that it makes sense for everyone to be getting vaccinated at the same time. Surely, if part of the goal is to reduce the strain on public health systems, then we should be carefully choreographing our shots so that our antibodies aren't all waning at the same time.
For instance, in a household it might make more sense to stagger shots throughout the year. I hope that people research this kind of thing!
That's the only way I could imagine a world in which one shot a year would be enough.
Thanks for this one. It's great to see you laying out the "magical" thinking that the "powers that be" are engaging in. I hope the Republicans who have been blocking more Covid spending will reconsider and I hope that Moderna and Pfizer will share some of their patented information so that researchers will be able to test the development of nasal and other vaccines. If not, the Congress should threaten them with the loss of patent protection entirely for the mRNA drugs. Watch them jump!
Expecting more than a "one size fits most" from the CDC and FDA would be asking too much. Patient self-advocacy is something that many people aren't aware of. It take a lot of reading but you can acquire sufficient knowledge to question your doctor's guidance and chart your own course. At 70 years of age, 1 booster/yr will not give me sufficient neutralizing antibodies to prevent infection from covid.
My goal is to avoid Long Covid. The only way to achieve that is to avoid infection. Until there is a booster that can achieve that, I'll continue wearing a KN-95 mask when indoors and plan on more than 1 booster/yr.
YLE is absolutely right - we need Operation Warp Speed 2.0. Right now, I am told we have <$50 million for vaccine R&D + distribution of vaccines and tests for preparedness. Under Warp Speed we had $18 billion.
The Biden administration requested $22.5 Billion and $15 billion in COVID money was stripped out by congress. Most of this money was intended to pay for a new focus on vaccine research, testing and treatment. This funding, in my opinion, would have supported "Warp Speed 2.0." Given the lessons we have learned from Covid-19, I consider it congressional malpractice for congress to withhold this critically needed funding as 4-500 Americans continue to die each day. There is now a funding bill in the works, with a September 30 deadline, that has the real potential for restoring much of this funding.
Katelyn is right on target - "money will move mountains in science and research" and "we just need to fight for it." This new funding bill offers us a last chance to restore this funding for FY23 (which begins October 1). I'm writing to my Senators and U.S. representative and will learn about what APHA is doing about this. Again, we "need to fight for it."
Thank you so much for this excellent newsletter, I really upon it for real information!!
I'm ready to fight for a better Covid plan - but how? Which members of Congress are still interested in fighting this disease? I am ready to fight this fight!!
I agree with you - the WH plan is nonsensical unless the goal is to perpetually enrich big pharmaceuticals.
We can't wish Covid away and it appears our national priorities, as reflected by our government's budget, are completely screwed-up. We have billions/trillions for fighting endless foreign wars ($12B recently appropriated to replenish Ukraine depleted DoD weapon/equipment stocks), but crumbs for public health and other public goods.
Mind boggling.
Just looking around, the majority are acting as if COVID is over. Labor Day weekend in the US had more passengers than Labor Day in 2019. People for the most part aren't getting booster shots, aren't wearing masks, schools aren't updating ventilation systems. As more people have gotten infected in 2022, it has become more of the "yeah I was sick but it wasn't that bad" outnumbering the "I got sick and it was horrible."
It seems that this is more of a pragmatic approach than anything. It the "how can we get people to at least get one booster shot of some sort" when the vast majority of people are operating in the world as if the pandemic doesn't exist. One shot with the flu vaccine can help normalize an annual booster and can then be done at workplaces, community centers more easily. There is also a cost of producing shots. There needs to be a large enough number of people to get shots so they will make enough of them ala flu shots.
It really seems like the horse is way out of the barn, down the road and into the next town. COVID started with "get it and you might die, don't overwhelm hospitals." Now that fewer people die (comparatively to 2020), people just aren't that scared.
I think the big push for "more" will come when businesses are even more impacted with getting employees because long covid will depress the number of workers available. Already it seems to have a 1%-2% impact on worker availability. With a tight job market, that will make employers (and insurance companies) care, which means a push for Government to throw more money into boosters/filtration etc to prevent infection in the first place.
Thank you so much for these Newsletters. Without them, I would feel lost in the world of uneducated opinions and wishful thinking.
Looking at the situation from a mathematical perspective it is immediately apparent that in a decision-space the virus has the upper hand in that it is not limited in the number of choices it has, but at the society level we have imposed numerous limitations on our choices, mostly irrational. In other words, no Nash equilibrium and the virus has the better of it
Well, no matter what the future holds, I'm celebrating the present, with a Moderna bivalent booster in my arm since 9:05 AM!
Thanks for all your efforts to educate. I've actually had some of my own patients quote you recently!
May I humbly present to you this sticker of appreciation, as I'm awash in the good will of science and public health again, on yet another vax night!
https://bucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com/public/images/5303605f-9dda-4764-85b4-2fa76c1edb14_1080x1080.png
(From my substack - these image URLs look shady. Anyway, also on my front page...
Good night, off to let my immune factories do their thing overnight :)
Thank you for your honesty not only in this post, but throughout the trying past few years.
Thank you to the call to action to affect public policy and for lifting your voice. We all really need to participate in this with communication to our policy leaders from the local level on up that we need an Operation Warp Speed 2.0 and more attention to COVID, rather than wishing it away and looking through rose colored glasses at what is still a pandemic. I also wonder about the major philanthropy players in the US (and world)—where are they in terms of investing in new tools?
Great review of the state of vaccine development and rationale for use. It is hard to contemplate how much even an omnicompetent vaccine would be accepted in the current irrational environment. We are certainly not out of the woods yet with 500+ people dying each day.
Thank you for another great post. By asking the right questions, you make the process better.
I’m confused why determining the future schedule for Covid boosters would now be under the purview of The White House. Is Biden himself the one making the decision to move to an annual schedule? Do the CDC and medical community agree? Is this an election year maneuver to make it appear that the pandemic is more under control than it really is?
Unfortunately, this looks like a decision backed by political - not medical - reasoning.
The usa is done with sarscov2- even if it is not done with Americans.
Only the respiratory therapists see its daily toll.
And they are quitting in droves.
This is the American way- pretend things we don’t want to address don’t exist.
Pretty good summary. I think the WH announcement is anticipatory, though, of events that haven't happened. I fear we're creating a false sense of expectation for a virus that hasn't shown us a recent variant. There are too many in the public who fail to grasp your point that SARS-CoV-2 is mutating 4x faster than influenza, and worse, your comment regarding random vs directed (ladder-like) mutation is totally foreign to them. Limited by their experience, "it's obvious" the pandemic's over, and those of us who focus on the epidemiological aspects are fear-mongering.
The release of Convidecia Air is encouraging, but I wonder about the approval process and testing rigor. I strongly concur we need a combined flu-COVID vaccine to increase, hopefully, acceptance.
I thought it was interesting that he was suggesting that we get our flu shots and covid shots at the same time at the beginning of the season. It's by no means obvious to me that it makes sense for everyone to be getting vaccinated at the same time. Surely, if part of the goal is to reduce the strain on public health systems, then we should be carefully choreographing our shots so that our antibodies aren't all waning at the same time.
For instance, in a household it might make more sense to stagger shots throughout the year. I hope that people research this kind of thing!
That's the only way I could imagine a world in which one shot a year would be enough.
Thanks for this one. It's great to see you laying out the "magical" thinking that the "powers that be" are engaging in. I hope the Republicans who have been blocking more Covid spending will reconsider and I hope that Moderna and Pfizer will share some of their patented information so that researchers will be able to test the development of nasal and other vaccines. If not, the Congress should threaten them with the loss of patent protection entirely for the mRNA drugs. Watch them jump!