This week ACIP—CDC’s external advisory group of scientists—met to discuss all vaccines. This was part of their regularly scheduled meeting (i.e., these happen with or without a pandemic). This morning they focused on COVID-19 vaccines. This discussion was much anticipated because it follows the VRBPAC meeting in which the FDA discussed the future of boosters in the U.S. We had a lot of
Enormously grateful to Dr. Jetelina, yet once again, for her dedication to and brilliance at clear public-facing communications. Here’s what take from this, for those of us who need to stay clear of infection (older, immunocompromised):
>the data do not seem to support the idea that one booster per year is sufficient for us. I recognize that the CDC’s approach is focused on avoiding hospitalization, but as an older couple, who, like we did, got a rough case of Covid that was debilitating for a month+, said, “who wants to be this sick?”
>this also suggests to me that older and immunocompromised folks will continue to be sidelined much more than others in the ability to live some semblance of even Covid era normal life, even though we are a VERY large and growing group.
Am I missing something here? If anyone else has a thought on this, I would welcome it.
“CDC further clarified the goal of the vaccine program: Prevention of severe disease.” Sure glad we didn’t just have “prevention of severe disease” for polio, small pox, measles, etc. I am disappointed with that low bar goal. It should be to develop better vaccines that can eliminate this damaging disease.
Susan Scheid. We too are elderly and have comorbidities. I had the same question about a booster. We are fully vaccinated and had the bivalent in Sept. I agree I do not want to get Covid even if is mild which I suspect it would not be due my cardiac status and age. We continue to wear an N95 mask whenever we leave our home and have escaped Covid but are seriously considering a booster before the fall as we hope to do some traveling before then. The one day of sore arm and fatigue is better than a month or more of fatigue and the chance of death. It seems to me that a higher level of immunity would be better than our current level to prevent infection. While there is not yet data the study will need to be done between folks who get a second bivalent booster and those with only one of the bivalent and that study will take a lot of subjects and some time for results which may be too late for us.
ACIP is currently permitting even old folks like me and my husband just one bivalent vaccination per year, until or unless they see "signals of waning vaccine effectiveness of bivalent vaccines."
What’s meant by “waning,” of course, is people like us getting hospitalized and dying. Rather than contribute to statistical changes that will save others' lives, two weeks ago my husband and I visited a pharmacy where we're unknown, bringing along only our cards from monovalent vaccinations.
We got our 2nd bivalent doses! Maybe they won't help at all; maybe they'll harm us somehow. The latter seems unlikely, since monovalents did us no harm at the 4-month interval and we're well into the 5th month since our 1st bivalent.
I swear, this process felt like trying to score marijuana in 1967.
Thank you! In the survey we did last summer we had a random sample of US adults look at CDC info on benefits of vaccination and risk, then asked them to compare the risks and benefits of vaccination after looking at the CDC website. We asked simple questions such as "according to the CDC, what is riskier" a) COVID-19 infection b) COVID-19 vaccination c) equally risky d) I don't know. The writing level of the CDC website is so high that many people who trusted CDC(another question we asked) had trouble understanding risks versus benefits after looking at the way the data was presented. If I could help change CDC website that is what I'd try to do!
Thank you K Jetelina. But, the CDC has not helped my concern. I'm over 70, don't have underlying issues and am not worried about death or hospitalization. I'm worried about post-covid syndromes and long term covid. We got our bivalent on 09/15 and would like some protection against transmission, especially because we are surrounded by people, including loved ones, who don't give a s*it. So frustrating that our lives must be circumscribed because others refuse to wear masks in indoor public spaces. (Even our rural medical system is a bad role model--they wear surgical masks and not respirators when they see patients.So, how can we reduce risk of transmission in this context? I know the old bi-valent had limited efficacy re: transmission. Why isn't the CDC invested in limiting transmission and potential further variations?
Question: If we know that ancestral mRNA vaccines needed two doses, well spaced, to have maximal effectiveness, why do the folks who study this think a SINGLE dose of the NEW part of the bivalent vaccine maximizes the benefit of the new part of the bivalent? Granted, recipients have multiple doses of the ancestral vaccine, but actually and functionally only one dose of the NEW formulation.
Thanks for the great summary as always. I was just starting to wonder about whether I needed another booster, now 6 months past my last one, - this post addressed this concern, thanks!!
What are the ramifications of going to the pharmacy and getting a Covid vaccine shot 6 months after your last shot other than having to pay for it? $130?
Thank you for this excellent summary. I think many people believe they will be better protected getting a booster every 6 months, especially older and immunocompromised people. Perhaps this is because the primary mRNA series was 2 shots and then we've had 3 booster opportunities since then - roughly 5 shots in 2 years (if I'm remembering correctly?). Now that boosters will have an annual frequency going forward, it would be nice if the CDC could clarify whether a 6 month schedule is "okay - no downside" or "not recommended - don't try this at home, folks."
Some people have so much faith in the vaccines/boosters, or are so scared of getting covid, or just want to return to normal, they might be tempted to take matters in to their own hands and get boosted every 6 months. When something is "safe and effective," there's an implicit "only when used as directed."
As everything is in due whatever you want mode people should have the right to determine if they feel they need a second vaccination every year. A politician should not have control over my body. Most of them have shown how incompetent they are
Here in Boston, the city is recommending another shot if it has been six months since the last one. And they are providing free vaccination sites. I’m not sure how they are paid for.
Interesting how the primary series is now referred to as mRNA primary series. There was also the J&J in the US, which seems to be getting shoved down the memory hole.
I am a 68 year old woman, who when I heard J&J had developed a shot using a more traditional adenovirus formula, opted to wait for it. Plan was if all went well with it during the first month after roll out, I would get it.
We all know what happened; J&J was temporarily pulled from the market, then returned. 18-49 women were advised to avoid it; men and over fifties had no apparent issues with it. So I got it, and the second shot that fall. I have often wondered if an interaction between the shot and birth control was the cause of the clotting issues for 18-49 women; never saw anything online indicating that was even investigated.
In January 2021, Omicron came through the office. Employer had on site clinics offering Pfizer the previous spring, so that is what every one got. Most were boosted. And every one of them got covid, some for the second time, having had it before the shots.
Despite my supposedly inferior J&J shots, I never got it.
In May of 2022, after much debate with myself, I got a Moderna booster. There was no indication of when Novavax would be available , so out of concern about another wave, I got it. Had no issues, but bothered by what seemed to be a push by the CDC toward the mRNA shots only. J&J just….disappeared from discussion and data. Novavax had started their review process, but it seemed to be proceeding more slowly than warp speed Pfizer and Moderna.
Finally Novavax arrived. I called a pharmacy to arrange a booster and was told I could not have it, since I already had a Moderna shot. Thanked them, and that was that. No fall booster, and still no covid. Still no long term data from the CDC on the effectiveness of the J&J. Are they even tracking that?
The whole push to Pfizer and Moderna feels like it is driven by money concerns as much or more than the data. I have been wary of our for profit health care industry and cash cow big pharma for years, and this seeming effort to push everyone into getting mRNA shots does nothing to alleviate my wariness.
I am hoping a Novavax booster does get approved for any adult who wants one. If not, I will continue to pass on the Pfizer and Moderna offerings.
Exceptionally well presented, but it appears that the group I am most interested in, the immunocompromised/immunosuppressed, was not addressed. As a transplant recipient over 65 years of age, I feel marginalized yet again. I know there are studies out there tracking us, but I'm seeing less and less information about what they are finding. It's now been three years since I have been unable to live the relatively normal life that I'd planned for post- transplant, and am segueing from resigned to angry that a significant percentage of the population has not been taken into account regarding vaccine boosters.
Enormously grateful to Dr. Jetelina, yet once again, for her dedication to and brilliance at clear public-facing communications. Here’s what take from this, for those of us who need to stay clear of infection (older, immunocompromised):
>the data do not seem to support the idea that one booster per year is sufficient for us. I recognize that the CDC’s approach is focused on avoiding hospitalization, but as an older couple, who, like we did, got a rough case of Covid that was debilitating for a month+, said, “who wants to be this sick?”
>this also suggests to me that older and immunocompromised folks will continue to be sidelined much more than others in the ability to live some semblance of even Covid era normal life, even though we are a VERY large and growing group.
Am I missing something here? If anyone else has a thought on this, I would welcome it.
“CDC further clarified the goal of the vaccine program: Prevention of severe disease.” Sure glad we didn’t just have “prevention of severe disease” for polio, small pox, measles, etc. I am disappointed with that low bar goal. It should be to develop better vaccines that can eliminate this damaging disease.
Susan Scheid. We too are elderly and have comorbidities. I had the same question about a booster. We are fully vaccinated and had the bivalent in Sept. I agree I do not want to get Covid even if is mild which I suspect it would not be due my cardiac status and age. We continue to wear an N95 mask whenever we leave our home and have escaped Covid but are seriously considering a booster before the fall as we hope to do some traveling before then. The one day of sore arm and fatigue is better than a month or more of fatigue and the chance of death. It seems to me that a higher level of immunity would be better than our current level to prevent infection. While there is not yet data the study will need to be done between folks who get a second bivalent booster and those with only one of the bivalent and that study will take a lot of subjects and some time for results which may be too late for us.
ACIP is currently permitting even old folks like me and my husband just one bivalent vaccination per year, until or unless they see "signals of waning vaccine effectiveness of bivalent vaccines."
What’s meant by “waning,” of course, is people like us getting hospitalized and dying. Rather than contribute to statistical changes that will save others' lives, two weeks ago my husband and I visited a pharmacy where we're unknown, bringing along only our cards from monovalent vaccinations.
We got our 2nd bivalent doses! Maybe they won't help at all; maybe they'll harm us somehow. The latter seems unlikely, since monovalents did us no harm at the 4-month interval and we're well into the 5th month since our 1st bivalent.
I swear, this process felt like trying to score marijuana in 1967.
Thank you! In the survey we did last summer we had a random sample of US adults look at CDC info on benefits of vaccination and risk, then asked them to compare the risks and benefits of vaccination after looking at the CDC website. We asked simple questions such as "according to the CDC, what is riskier" a) COVID-19 infection b) COVID-19 vaccination c) equally risky d) I don't know. The writing level of the CDC website is so high that many people who trusted CDC(another question we asked) had trouble understanding risks versus benefits after looking at the way the data was presented. If I could help change CDC website that is what I'd try to do!
Thank you K Jetelina. But, the CDC has not helped my concern. I'm over 70, don't have underlying issues and am not worried about death or hospitalization. I'm worried about post-covid syndromes and long term covid. We got our bivalent on 09/15 and would like some protection against transmission, especially because we are surrounded by people, including loved ones, who don't give a s*it. So frustrating that our lives must be circumscribed because others refuse to wear masks in indoor public spaces. (Even our rural medical system is a bad role model--they wear surgical masks and not respirators when they see patients.So, how can we reduce risk of transmission in this context? I know the old bi-valent had limited efficacy re: transmission. Why isn't the CDC invested in limiting transmission and potential further variations?
Question: If we know that ancestral mRNA vaccines needed two doses, well spaced, to have maximal effectiveness, why do the folks who study this think a SINGLE dose of the NEW part of the bivalent vaccine maximizes the benefit of the new part of the bivalent? Granted, recipients have multiple doses of the ancestral vaccine, but actually and functionally only one dose of the NEW formulation.
Thanks for the great summary as always. I was just starting to wonder about whether I needed another booster, now 6 months past my last one, - this post addressed this concern, thanks!!
Ron Wiesman (below) asked a great question. Would it be detrimental for those who have had one bi-valent 6 months ago to get another?
What are the ramifications of going to the pharmacy and getting a Covid vaccine shot 6 months after your last shot other than having to pay for it? $130?
Thank you for this excellent summary. I think many people believe they will be better protected getting a booster every 6 months, especially older and immunocompromised people. Perhaps this is because the primary mRNA series was 2 shots and then we've had 3 booster opportunities since then - roughly 5 shots in 2 years (if I'm remembering correctly?). Now that boosters will have an annual frequency going forward, it would be nice if the CDC could clarify whether a 6 month schedule is "okay - no downside" or "not recommended - don't try this at home, folks."
Some people have so much faith in the vaccines/boosters, or are so scared of getting covid, or just want to return to normal, they might be tempted to take matters in to their own hands and get boosted every 6 months. When something is "safe and effective," there's an implicit "only when used as directed."
As everything is in due whatever you want mode people should have the right to determine if they feel they need a second vaccination every year. A politician should not have control over my body. Most of them have shown how incompetent they are
Here in Boston, the city is recommending another shot if it has been six months since the last one. And they are providing free vaccination sites. I’m not sure how they are paid for.
Interesting how the primary series is now referred to as mRNA primary series. There was also the J&J in the US, which seems to be getting shoved down the memory hole.
I am a 68 year old woman, who when I heard J&J had developed a shot using a more traditional adenovirus formula, opted to wait for it. Plan was if all went well with it during the first month after roll out, I would get it.
We all know what happened; J&J was temporarily pulled from the market, then returned. 18-49 women were advised to avoid it; men and over fifties had no apparent issues with it. So I got it, and the second shot that fall. I have often wondered if an interaction between the shot and birth control was the cause of the clotting issues for 18-49 women; never saw anything online indicating that was even investigated.
In January 2021, Omicron came through the office. Employer had on site clinics offering Pfizer the previous spring, so that is what every one got. Most were boosted. And every one of them got covid, some for the second time, having had it before the shots.
Despite my supposedly inferior J&J shots, I never got it.
In May of 2022, after much debate with myself, I got a Moderna booster. There was no indication of when Novavax would be available , so out of concern about another wave, I got it. Had no issues, but bothered by what seemed to be a push by the CDC toward the mRNA shots only. J&J just….disappeared from discussion and data. Novavax had started their review process, but it seemed to be proceeding more slowly than warp speed Pfizer and Moderna.
Finally Novavax arrived. I called a pharmacy to arrange a booster and was told I could not have it, since I already had a Moderna shot. Thanked them, and that was that. No fall booster, and still no covid. Still no long term data from the CDC on the effectiveness of the J&J. Are they even tracking that?
The whole push to Pfizer and Moderna feels like it is driven by money concerns as much or more than the data. I have been wary of our for profit health care industry and cash cow big pharma for years, and this seeming effort to push everyone into getting mRNA shots does nothing to alleviate my wariness.
I am hoping a Novavax booster does get approved for any adult who wants one. If not, I will continue to pass on the Pfizer and Moderna offerings.
Exceptionally well presented, but it appears that the group I am most interested in, the immunocompromised/immunosuppressed, was not addressed. As a transplant recipient over 65 years of age, I feel marginalized yet again. I know there are studies out there tracking us, but I'm seeing less and less information about what they are finding. It's now been three years since I have been unable to live the relatively normal life that I'd planned for post- transplant, and am segueing from resigned to angry that a significant percentage of the population has not been taken into account regarding vaccine boosters.
I am so grateful for your clear, timely information! A thousand thankyous are not enough.