I find it so interesting and bizarre that people today want to drink raw milk. I always remember my Mom saying how grateful people were in her day (the 1930s) to have pasteurized milk for the safety of everyone in the community - to stop the spread of disease. Apparently we have learned nothing - so failure to learn from history means we repeat it! Aarrgg - this NOT rocket science OR maybe it is! Please keep spreading the science!
Thanks for another great post. I think there might be a small typo. If covid peaks first week of January, and if the best time for the vaccine is 2.7 months before peak, wouldn’t that imply that people should get the covid shot in mid-October? Or do I need a third cup of coffee? ☕️
No you’re right. I could have made this clearer. This is tough to generalize because the peaks happen at different times across the U.S. The Sept 15 date was for NY specifically. Nationally, we peak first week of January.
For those who bookmark/save your posts for future reference---I'm guessing that I'm not the only reader who does this---as well as for those who will be reading *only* your original article above (i.e., *not* the comments section), it would be very helpful if you would edit your article to reflect this clarification. I recognize that you're extremely busy, and so I hope my suggestion doesn't come across as presumptuous, but it is a reflection of the importance that I attach to your articles, not only for myself but for others as well.
Thank you for the section on Emergency Department boarding. Here are the comments I submitted:
Regarding Section 6E: Emergency Department Boarding:
I strongly support this proposal. As a nephrologist for over 30 years I have ample experience with hospital based patient care. Emergency Departments are extremely well engineered for providing acute emergent care where the focus is quickly and efficiently gathering information and intervening. They are not engineered for ongoing care when the focus of care shifts to scheduled treatments and non-emergent aspects of care. The latter aspects including but not limited to physical therapy, occupational therapy, chaplaincy, and support from family and friends. A reasonable hypothesis is that there are gaps in the quality of on-going care when patients are boarded in Emergency Departments. The next step in testing this hypothesis is to start gathering the data and I applaud Leapfrog for its consideration of closing this gap in knowledge.
Very useful info on when to get Covid vax following bout with Covid. The spread of months surprised me (having had Covid in August and getting vax in Oct). What would be helpful to know is why that longer than expected delay. Is it to not waste the natural immunity and save the shot till it wears out, or is there a more complex interaction between natural immunity and the vaccine?
A question: if I understand correctly, the CDC has recommended that individuals over 65 years old get a second Covid booster this coming spring (I am over 80 yo). I received my 2024 Covid vaccine on the first day it was available where I live, which was late August. I am departing on a cruise in March and am planning to get another Covid vaccine in early February. I would appreciate your opinion of the proposed timing.
Thank you for the update. Much appreciated. Interesting—and extremely helpful—information about the Covid vaccine timing. I’d be interested in learning more about how that was determined.
Agreed Susan. So I did some AI prompt engineering, fed this study in, and got the following result which I think is valid:
Based on the paper, the researchers used two main data sources to determine optimal vaccination timing:
Projected seasonal COVID-19 incidence patterns from 12 Northern Hemisphere locations, derived from long-term coronavirus data
Antibody waning and reinfection probability data from both SARS-CoV-2 and related coronaviruses
The key methodological steps were:
They adjusted seasonal infection probabilities based on vaccine protection levels
They modeled daily infection probabilities considering both seasonality and vaccine-induced protection
They calculated cumulative yearly infection probability for each possible vaccination date
The date with lowest cumulative yearly probability was deemed optimal
Regarding vaccine effectiveness waning: Yes, the authors explicitly account for waning protection. They model peak protection in the first month post-vaccination, followed by declining protection over the subsequent 2-11 months based on antibody waning data. Specifically, they used data from Pfizer booster trials showing protection levels at 1 week, 2 weeks, and 1 month (peak protection), then incorporated longer-term antibody decline data to model protection beyond the first month.
The core rationale for timing recommendations is to align peak vaccine protection with expected seasonal surge periods, typically recommending vaccination about 2.7 months before anticipated peak infection periods in a given location.
Ryan, first off, your ability to use A1 usefully is impressive (this coming from someone (me) who hasn't the first idea how to do that. This is what confuses me about the timing: since peak vax protection is at 1 month, why wouldn't the optimal vax timing be 1 month before the anticipated peak infection? (Allied to that, did the A1 analysis confirm what Matt indicates below that the infection peak is early January?)
I have spoken with many people who are confused on this, and we would really appreciate Ms. Jetelina”s input. If peak production is a month—what does it serve by having it 2.7 mo in advance? Could you please explain? Also for those of us immune compromised (and please do not let this question take away from the original of why 2.7 mo when peak vaccine is 1 mo)-/CDC has said to be boosted again every 3 to 6 months. This study does not address that suggestion. What should the immune compromised and those over 65 being doing? Should we boost a second or third time a year? If so when? Im still confused about Sept 15 (or Oct)—so the first question needs to be answered to know when we even count out from fir a second booster in 24/25? I’ve just had mine this week, couldn’t turn back time with Sept recommendation—went by what we have been told since boosters that they peak at 1 month and last about 3 or 4, so therefore did Dec as always (albeit a few weeks later than normal). Many boosted in Nov for that Holiday. I am very confused. I thought Dec would protect best for winter surge based on all previous advice. I’m very concerned being immune compromised. I would like an explanation if possible, respectfully, and advice on my next booster timing as immune compromised. Or is it all useless now that I didn’t boost in Sept/Oct?
If Parvovirus rate is increasing, how can it be because of lack of herd immunity, considering that it’s been YEARS where the great majority of the country ended most Covid protocols including school lock downs? For the states that kept up protocols longer (think WA state), do you see more parvovirus from these states? Wouldn’t you expect that the rise in this illness was more to do with reduced immunity/immune system depletion from repeated Covid infections vs 3-6 month shutdowns from almost 5 years ago????
"If you haven’t been recently infected, early autumn is optimal for your Covid vaccine.
The best time to get a booster is 2.7 months before the peak of a wave (assuming no recent infections). It can lead to a five-fold lower risk of infection.
In the U.S., the winter peak has consistently been the first week of January. This means an annual booster on September 15th provides the lowest yearly probability of infection."
This kind of succinctly-stated, reliable information and advice regarding crucial COVID-related matters is so very valuable to me (and many others, I'm sure). Thank you!
I complete the LeapFrog submission about boarding.👍 thank you, as always, for your excellent data, comments, and assessments!!! (including co- authors)
Thank you for this update. I write a covid column in Knoxville, Tn. We are the largest metropolitan area in America to fail to monitor our wastewater for pathogens. We had the largest outbreak of LaCrosse Virus in the world last years with multiple children hospitalized for meningitis. Our Board of Health has been disbanded and our Health Department stripped of it's leadership. We will almost certainly lose children to this year's disease cocktail simply because we refuse to acknowledge it's existence and issue common sense warnings. We won't know what hits us until its too late. Today I wrote a column considering the moral implications to unethical and immoral decisions in regard to general public health. Of course it was taken down. Here it is,"I suppose now is as good a time as any to ask ourselves,"Will this shooting help America?" I woke up this morning thinking about Addie, as I sometimes do. Yesterday, some old man at the eye doctors office expressed a thought that covid was a hoax and no worse than the common cold and I had to explain to the whole waiting room in graphic detail what it's like to have a Mayor and Commissioner who, like Jacobs and Ward did to me, march right into your neighborhood, assassinate a child whose death you had predicted as a result of a pandemic response designed to kill as many as possible, right under your nose and in your face, and get clean away with premeditated murder. I described the exact means of infection and how they achieved the viral load necessary to induce death in a child. I described the propaganda campaigned used to brainweash a cult and intimidate the general population by insisting that misinformation was fact. The exposure was, by all indications, massive. When I stopped there was silence in the room. I cried some.
But I woke up this morning wondering if I hadn't been thinking about one of the greatest acts of self defense in mankind's history. How many lives will this action actually save? Where do we balance the scales of justice? If the killing of an insurance exectutive saves a thousand lives, you're actually defending that thousand when action is taken. If this hero came to town and took out the four people who got rid of our Health Department and Board of Health, Ward, Jacobs, Zachary and Daniel, would the thousands of lives already lost and the thousands we can save by bringing back the Board of Health and returning the Health Department to function be worth their sacrifice? I mean, they don't have any problem sacrificing human lives to achieve their goals, should we haver a moral dilema in sacrificing theirs for the greater good? The more one looks at it, the more one realizes that it's really a pragmatic view of personal survival. Like I said, if these guys had marched into your neighborhood and assassinated the child you would wave to and slow down for when driving to work, it would affect you too.
So I'm kind of seeing yesterday's street action as absolutly predictable and necessary in order to start to rebalance a system gone hopelessly out of balance. Bring death back to those who would deliver it to us. It's pretty simple, are we better off with Ward, Jacobs, Zachary and Daniel actively engaged in activity that will knowingly have casualities they could prevent, or are we better off keeping the innocents alive and sacricing those trying to kill them? It's a philosophical question more than anything, but if this is ther start of a corporate war, then we absolutely must have a Board of Health and functioning Health Departmenbt in order to insure the welfare of our community. In light of knowing that the shots have now been fired, we have to ask ourselves how to best serve the public health interests of Knox Coiunty. Destroying it isn't working out too well."
Yikes. That is a very dark universe you are embracing. I don't see this as "pretty simple." It sounds more like societal breakdown. We all have choices - we can't entirely overcome bad leadership, but that doesn't mean we should embrace the lowest common denominator when it comes to behavior.
Quoting you: "If the killing of an insurance exectutive saves a thousand lives, you're actually defending that thousand when action is taken."
But that's not what's happening. All that's going to happen is these execs are going to harden their personal security. They're already beefing up their security details. The phones at private security firms are ringing off the hooks. These guys will only retreat deeper into their metaphorical (and physical) bunkers, ever more insulated from us peons. Murdering an insurance company exec won't change that.
The fact that the (non)health-(non)care in this country is vile and predatory and responsible for the deaths of thousands of people doesn't make it ok to go out and blow someone's brains out. Please rethink your stance.
As I said, once you watch these folks assassinate a child strictly to advance their political and financial position, one views the situation differently.
Everyone has been saying that. The internet is bursting with similar statements.
And I still say, just as reader "Jaya" also did in this thread, that you are encouraging a very dark, dangerous view.
Assassination isn't the answer. It's wrong.
Murdering a CEO will do NOTHING to help people who are being screwed over by this rapacious industry. All it will do is increase the distance between these wealthy sociopaths and the rest of us.
I'm acknowledging it exists. I've been writing about covid, on a nearly daily basis since January 2020. I'm an insignificant force yet somehow I ended up with people threatening to kick my teeth in, break my legs and come after my dog. No telling what they were saying on Parler. My point is this, I am neither condoning nor condemning this behavior, but rather acknowledging it's growing influence. We've dismantled our hospital and public healthcare system here and we were already at the point of riots during the height of covid. Ignoring this problem won't make it go away. When ones healthcare systems turn into battlegrounds for profit, these are the sorts of things that happen. Just because I don't like it is no reason to stay silent about this very real issue. As to the results of this action, our people are telling us from the inside that prescriptions weren't getting turned down in the aftermath of the shooting. The act has already saved more lives than were spent. There aren't really ethics and morality questions about whose killing is more detestible. At this point, there is no morality, just a pile of circumstances. That's what intensive misinformation and propaganda campaigns do to shared community values. We no longer have any. Like it or not, the more of this we see, the quicker the change will come. That's just the way it works in the street.
These people and their raw milk. Idiots (sorry, not sorry). There's a reason Louis Pasteur is so celebrated.
Thank you so much for the chart about COVID infection date and when to get vaccinated. It answered a question I’ve had.
I find it so interesting and bizarre that people today want to drink raw milk. I always remember my Mom saying how grateful people were in her day (the 1930s) to have pasteurized milk for the safety of everyone in the community - to stop the spread of disease. Apparently we have learned nothing - so failure to learn from history means we repeat it! Aarrgg - this NOT rocket science OR maybe it is! Please keep spreading the science!
Many parents will know parvovirus B19 by the name "Fifth Disease".
Ooooohhhhhh. Thank you
Thanks for another great post. I think there might be a small typo. If covid peaks first week of January, and if the best time for the vaccine is 2.7 months before peak, wouldn’t that imply that people should get the covid shot in mid-October? Or do I need a third cup of coffee? ☕️
No you’re right. I could have made this clearer. This is tough to generalize because the peaks happen at different times across the U.S. The Sept 15 date was for NY specifically. Nationally, we peak first week of January.
For those who bookmark/save your posts for future reference---I'm guessing that I'm not the only reader who does this---as well as for those who will be reading *only* your original article above (i.e., *not* the comments section), it would be very helpful if you would edit your article to reflect this clarification. I recognize that you're extremely busy, and so I hope my suggestion doesn't come across as presumptuous, but it is a reflection of the importance that I attach to your articles, not only for myself but for others as well.
Thank you for the section on Emergency Department boarding. Here are the comments I submitted:
Regarding Section 6E: Emergency Department Boarding:
I strongly support this proposal. As a nephrologist for over 30 years I have ample experience with hospital based patient care. Emergency Departments are extremely well engineered for providing acute emergent care where the focus is quickly and efficiently gathering information and intervening. They are not engineered for ongoing care when the focus of care shifts to scheduled treatments and non-emergent aspects of care. The latter aspects including but not limited to physical therapy, occupational therapy, chaplaincy, and support from family and friends. A reasonable hypothesis is that there are gaps in the quality of on-going care when patients are boarded in Emergency Departments. The next step in testing this hypothesis is to start gathering the data and I applaud Leapfrog for its consideration of closing this gap in knowledge.
Very useful info on when to get Covid vax following bout with Covid. The spread of months surprised me (having had Covid in August and getting vax in Oct). What would be helpful to know is why that longer than expected delay. Is it to not waste the natural immunity and save the shot till it wears out, or is there a more complex interaction between natural immunity and the vaccine?
A question: if I understand correctly, the CDC has recommended that individuals over 65 years old get a second Covid booster this coming spring (I am over 80 yo). I received my 2024 Covid vaccine on the first day it was available where I live, which was late August. I am departing on a cruise in March and am planning to get another Covid vaccine in early February. I would appreciate your opinion of the proposed timing.
Thank you for the update. Much appreciated. Interesting—and extremely helpful—information about the Covid vaccine timing. I’d be interested in learning more about how that was determined.
Agreed Susan. So I did some AI prompt engineering, fed this study in, and got the following result which I think is valid:
Based on the paper, the researchers used two main data sources to determine optimal vaccination timing:
Projected seasonal COVID-19 incidence patterns from 12 Northern Hemisphere locations, derived from long-term coronavirus data
Antibody waning and reinfection probability data from both SARS-CoV-2 and related coronaviruses
The key methodological steps were:
They adjusted seasonal infection probabilities based on vaccine protection levels
They modeled daily infection probabilities considering both seasonality and vaccine-induced protection
They calculated cumulative yearly infection probability for each possible vaccination date
The date with lowest cumulative yearly probability was deemed optimal
Regarding vaccine effectiveness waning: Yes, the authors explicitly account for waning protection. They model peak protection in the first month post-vaccination, followed by declining protection over the subsequent 2-11 months based on antibody waning data. Specifically, they used data from Pfizer booster trials showing protection levels at 1 week, 2 weeks, and 1 month (peak protection), then incorporated longer-term antibody decline data to model protection beyond the first month.
The core rationale for timing recommendations is to align peak vaccine protection with expected seasonal surge periods, typically recommending vaccination about 2.7 months before anticipated peak infection periods in a given location.
Ryan, first off, your ability to use A1 usefully is impressive (this coming from someone (me) who hasn't the first idea how to do that. This is what confuses me about the timing: since peak vax protection is at 1 month, why wouldn't the optimal vax timing be 1 month before the anticipated peak infection? (Allied to that, did the A1 analysis confirm what Matt indicates below that the infection peak is early January?)
I have the same question. Would love an explanation.
I have spoken with many people who are confused on this, and we would really appreciate Ms. Jetelina”s input. If peak production is a month—what does it serve by having it 2.7 mo in advance? Could you please explain? Also for those of us immune compromised (and please do not let this question take away from the original of why 2.7 mo when peak vaccine is 1 mo)-/CDC has said to be boosted again every 3 to 6 months. This study does not address that suggestion. What should the immune compromised and those over 65 being doing? Should we boost a second or third time a year? If so when? Im still confused about Sept 15 (or Oct)—so the first question needs to be answered to know when we even count out from fir a second booster in 24/25? I’ve just had mine this week, couldn’t turn back time with Sept recommendation—went by what we have been told since boosters that they peak at 1 month and last about 3 or 4, so therefore did Dec as always (albeit a few weeks later than normal). Many boosted in Nov for that Holiday. I am very confused. I thought Dec would protect best for winter surge based on all previous advice. I’m very concerned being immune compromised. I would like an explanation if possible, respectfully, and advice on my next booster timing as immune compromised. Or is it all useless now that I didn’t boost in Sept/Oct?
Thank you. I sincerely appreciate you.
If Parvovirus rate is increasing, how can it be because of lack of herd immunity, considering that it’s been YEARS where the great majority of the country ended most Covid protocols including school lock downs? For the states that kept up protocols longer (think WA state), do you see more parvovirus from these states? Wouldn’t you expect that the rise in this illness was more to do with reduced immunity/immune system depletion from repeated Covid infections vs 3-6 month shutdowns from almost 5 years ago????
RFK Jr will not be confirmed.
I think I speak for many of us here when I say I sure hope you're right.
Minor detail, but I think there is an error in the date subtractions.
>> The best time to get a booster is 2.7 months before the
>> peak of a wave (assuming no recent infections).
>> In the U.S., the winter peak has consistently been the first week
>> of January. This means an annual booster on September 15th...
By my calculation, 2.7 months before the first week of January would put the optimal date for vaccination as **October** 15th, not September 15th.
"If you haven’t been recently infected, early autumn is optimal for your Covid vaccine.
The best time to get a booster is 2.7 months before the peak of a wave (assuming no recent infections). It can lead to a five-fold lower risk of infection.
In the U.S., the winter peak has consistently been the first week of January. This means an annual booster on September 15th provides the lowest yearly probability of infection."
This kind of succinctly-stated, reliable information and advice regarding crucial COVID-related matters is so very valuable to me (and many others, I'm sure). Thank you!
perhaps Mr. Kennedy should drink this stuff.
I complete the LeapFrog submission about boarding.👍 thank you, as always, for your excellent data, comments, and assessments!!! (including co- authors)
Thank you for this update. I write a covid column in Knoxville, Tn. We are the largest metropolitan area in America to fail to monitor our wastewater for pathogens. We had the largest outbreak of LaCrosse Virus in the world last years with multiple children hospitalized for meningitis. Our Board of Health has been disbanded and our Health Department stripped of it's leadership. We will almost certainly lose children to this year's disease cocktail simply because we refuse to acknowledge it's existence and issue common sense warnings. We won't know what hits us until its too late. Today I wrote a column considering the moral implications to unethical and immoral decisions in regard to general public health. Of course it was taken down. Here it is,"I suppose now is as good a time as any to ask ourselves,"Will this shooting help America?" I woke up this morning thinking about Addie, as I sometimes do. Yesterday, some old man at the eye doctors office expressed a thought that covid was a hoax and no worse than the common cold and I had to explain to the whole waiting room in graphic detail what it's like to have a Mayor and Commissioner who, like Jacobs and Ward did to me, march right into your neighborhood, assassinate a child whose death you had predicted as a result of a pandemic response designed to kill as many as possible, right under your nose and in your face, and get clean away with premeditated murder. I described the exact means of infection and how they achieved the viral load necessary to induce death in a child. I described the propaganda campaigned used to brainweash a cult and intimidate the general population by insisting that misinformation was fact. The exposure was, by all indications, massive. When I stopped there was silence in the room. I cried some.
But I woke up this morning wondering if I hadn't been thinking about one of the greatest acts of self defense in mankind's history. How many lives will this action actually save? Where do we balance the scales of justice? If the killing of an insurance exectutive saves a thousand lives, you're actually defending that thousand when action is taken. If this hero came to town and took out the four people who got rid of our Health Department and Board of Health, Ward, Jacobs, Zachary and Daniel, would the thousands of lives already lost and the thousands we can save by bringing back the Board of Health and returning the Health Department to function be worth their sacrifice? I mean, they don't have any problem sacrificing human lives to achieve their goals, should we haver a moral dilema in sacrificing theirs for the greater good? The more one looks at it, the more one realizes that it's really a pragmatic view of personal survival. Like I said, if these guys had marched into your neighborhood and assassinated the child you would wave to and slow down for when driving to work, it would affect you too.
So I'm kind of seeing yesterday's street action as absolutly predictable and necessary in order to start to rebalance a system gone hopelessly out of balance. Bring death back to those who would deliver it to us. It's pretty simple, are we better off with Ward, Jacobs, Zachary and Daniel actively engaged in activity that will knowingly have casualities they could prevent, or are we better off keeping the innocents alive and sacricing those trying to kill them? It's a philosophical question more than anything, but if this is ther start of a corporate war, then we absolutely must have a Board of Health and functioning Health Departmenbt in order to insure the welfare of our community. In light of knowing that the shots have now been fired, we have to ask ourselves how to best serve the public health interests of Knox Coiunty. Destroying it isn't working out too well."
Yikes. That is a very dark universe you are embracing. I don't see this as "pretty simple." It sounds more like societal breakdown. We all have choices - we can't entirely overcome bad leadership, but that doesn't mean we should embrace the lowest common denominator when it comes to behavior.
Quoting you: "If the killing of an insurance exectutive saves a thousand lives, you're actually defending that thousand when action is taken."
But that's not what's happening. All that's going to happen is these execs are going to harden their personal security. They're already beefing up their security details. The phones at private security firms are ringing off the hooks. These guys will only retreat deeper into their metaphorical (and physical) bunkers, ever more insulated from us peons. Murdering an insurance company exec won't change that.
The fact that the (non)health-(non)care in this country is vile and predatory and responsible for the deaths of thousands of people doesn't make it ok to go out and blow someone's brains out. Please rethink your stance.
As I said, once you watch these folks assassinate a child strictly to advance their political and financial position, one views the situation differently.
Everyone has been saying that. The internet is bursting with similar statements.
And I still say, just as reader "Jaya" also did in this thread, that you are encouraging a very dark, dangerous view.
Assassination isn't the answer. It's wrong.
Murdering a CEO will do NOTHING to help people who are being screwed over by this rapacious industry. All it will do is increase the distance between these wealthy sociopaths and the rest of us.
I'm acknowledging it exists. I've been writing about covid, on a nearly daily basis since January 2020. I'm an insignificant force yet somehow I ended up with people threatening to kick my teeth in, break my legs and come after my dog. No telling what they were saying on Parler. My point is this, I am neither condoning nor condemning this behavior, but rather acknowledging it's growing influence. We've dismantled our hospital and public healthcare system here and we were already at the point of riots during the height of covid. Ignoring this problem won't make it go away. When ones healthcare systems turn into battlegrounds for profit, these are the sorts of things that happen. Just because I don't like it is no reason to stay silent about this very real issue. As to the results of this action, our people are telling us from the inside that prescriptions weren't getting turned down in the aftermath of the shooting. The act has already saved more lives than were spent. There aren't really ethics and morality questions about whose killing is more detestible. At this point, there is no morality, just a pile of circumstances. That's what intensive misinformation and propaganda campaigns do to shared community values. We no longer have any. Like it or not, the more of this we see, the quicker the change will come. That's just the way it works in the street.