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I’d like to give a huge shout out to Costco, who now has the Novavax vaccine in stock in many of their pharmacies across the country. When I called their pharmacy yesterday, a live person answered their phone, and was happy to book a Novavax appointment for me even though I’m not a Costco member. I get jabbed this afternoon.

Compare this to the multiple phone calls I’ve made to Rite Aid, CVS and Walgreens where customers get stuck in an “automated customer service maze from hell” and often can’t speak to a real person. The few times I was lucky enough to reach the pharmacist, they either had never heard of Novavax, confused it with Moderna, and had no idea whether their company would be receiving it. And www.vaccines.gov is not up to date - the place to get real-time info, unfortunately, remains Twitter, or X, or whatever it’s now called, where there’s currently a #Novavax frenzy.

I have heard (although this isn’t confirmed) that Rite Aid and CVS will eventually get Novavax, but it could take a week or two. Perhaps it’s Costco’s superior internal distribution system that allows it to distribute fresh salmon to stores across the nation that enables it to be first at distributing Novavax.

After this exceedingly pleasant experience, I am planning to reinstate my Costco membership (even though I still have a huge box of unused, tissue-thin toilet paper in the garage from the early days of lockdown).

Also, Novavax plans to release the results of their Hummingbird (kids) study on October 17.

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Or put the mask on today. We have a chance to reduce community transmission of ILI. The area under the curve indicates cvd is all around us. If we wait to act, we create the surge.

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Oct 12, 2023·edited Oct 12, 2023

Writing from Ohio: It has been hard to find the updated COVID booster for kids under 12. We made 2 appointments on September 22nd, then on September 29th: one at Walgreens and one at CVS. We got turned away after arrival because they "don't vaccine kids". The pharmacist at the CVS made it sound like it was based on his personal belief (he told us that the pharmacist who just ended their shift would have done it). Walgreens says they won't serve kids under 12 until date TBD. We found an appointment at a Kroger Little Clinic for yesterday: both my 6yo and 9yo received the double COVID + Flu shots. But boy, it took us 3 weeks and plenty of determination.

Meanwhile, as a school board member, I asked our superintendent to reach out to our county health department to set up an in-school vaccination campaign (we did that for the primary series when the FDA approved it for kids) and the county HD responded that they did not purchase any updated covid shots because it's not covered by the federal government.

Why does it have to be so hard to get shots in arms for those who want it, you know?!

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"1 in 4 hospitalized are not up-to-date on Covid-19 vaccine" - This is not great support for covid vaccinations. It is very disheartening.

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Dear Dr. Jetelina, Do you have any new statistics on the risk of Guillion-Barre (or afib) with the RSV vaccine? I know once the numbers of vaccines given goes up, the actual risk numbers will change. I also know the risk of significant disease with RSV for folks over 60 outweigh the risks so I am recommending it to my patients but just asking if you have newer info. So grateful for your work!

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I caught the worst “cold” I’ve had in 20 years last month. Brutal! I (and my pcp) kept testing for Covid, but it wasn’t Covid or the flu (I’m fully vaccinated for both), but my pcp did say she was seeing a lot of patients with my symptoms. (I live in North Carolina.)

Also, we here in NC are still having a tough time finding a place that has the latest Covid vaccine. My husband had to drive yesterday to a Walgreens 20 miles away to get his. A friend made an appointment with the local CVS only to be told they didn’t have it when he got there.

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Oct 12, 2023·edited Oct 12, 2023

According to a CDC study from April 2023, about 43% of people age 65 and older have received a bivalent booster shot. My mother-in-law is in a nursing home, and luckily, they held a flu and covid vaccine clinic last week. Hopefully this year more seniors will get the covid booster.

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I'm curious about why respiratory viruses seem to start in the south in the fall? If it's about airborne transmission, then we would expect it to be where people are indoors. In the fall, the north has started to get cold and the south is fairly pleasant, so we would expect northerners to be indoors more than southerners. What else could be going on?

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We were all set for the full range of jabs for Oct 6, but got a call from our Walgreens to cancel because Walgreens pharmacy staff across the Portland, OR metro area are as good as on strike over working conditions. We're now scheduled for 10/31 at a Rite Aid further away. I hope that holds. Interesting about Costco. I might call them today and see what's up! Love this newsletter!

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Two Questions Regarding Excess Mortality:

1. Does the mortality baseline now incorporate Covid deaths as part of the estimate since the pandemic has been going for 3+ years?

2. I have read about a “Harvesting Effect” where a waning pandemic is marked by a drop in excess mortality below the baseline. If my understanding is correct, this is due to the most vulnerable people having already died. Would you say this is an accurate interpretation?

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founding

Fantastic, timely report! Thank you so much. In a future, pre-holiday installment, it would be great if you could also give your recommendations on use of rapid testing before gatherings.

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Any advice on how often people in their 70s should get the newest vaccination? Our immune response is surely small compared to younger people. My husband and I had our first dose about 2 weeks ago, and are considering a re-vax every 4 or 5 months. (We did this for previous versions by going to different pharmacies and pretending each shot was our first.)

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I love all your posts about the impact of the acute phase of Covid and other respiratory viruses. I'd like to read more about Long Covid/Post-acute sequelae of SARS-CoV-2. It is hard to sort out how much of a public health impact this is currently having and is projected to have over the next decades. There is a big difference between a couple months of coughing and the going on 4 years of complete disability that we are reading about.

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founding

Thank you for this exellent update. A question regarding vaccination status: How are you currently defining "up to date"? For example, say someone has been vaccinated five times, including the bivalent booster, but has not been vaccinated in the last six months? Are they "up to date"?

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QUESTION: I am recovering from Covid, including a Paxlovid rebound. Should I hold off on the flu vaccine to give my body a break as well as time it closer to the holidays?

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founding

Not that anyone is looking about now, but I’ll add this for “the record.” To avoid the online problems in obtaining accurate information and making an appointment (of the type that BayDog described in these comments), we opted to get our flu and Covid shots from a local independent pharmacy that does shots on a walk-in basis and which answers the phone with good information about their stock. Here’s what we encountered:

>for both the flu shot (for seniors) and the Covid shot, we encountered supply issues, so had to wait a bit on each. (To avoid side effects, we opted to do the shots separately, spaced about a week apart.)

>no chance of Novovax in our area, so we decided to get whatever was going, which ended up being Moderna.

>the pharmacy does not get big stock of anything, as it is small and, post-emergency status, must pay upfront for supply. As a result, it runs out pretty fast.

>while there, we noticed one older person, but it seems not yet on Medicare, called to the desk to be told his insurance didn’t cover the Covid vax, so he would have to pay up front. They seemed to advise him that he could get reimbursed, but we couldn’t tell for sure. I thought no one should have to pay up front, so I wondered what happened there.

>we are in NYS, and the Qaire we had to fill out for the Covid shots asked whether we’d had a shot in the last five months. This worried us, as we thought we might be refused, and, as we are in our 70s, and following what Dr. Jetelina and others have recommended, we wanted to get the vax on or before four months had passed. Fortunately, this didn’t turn out to bar us, but I thought it weird NYS had this question on its form.

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