Please please! With regard to vaccination of children There is an additional very important epidemiological reason that must be always mentioned. It is often overlooked both by advocates and naysayers: Young kids are carriers of infection and bring it home from school. I am a high risk 82 year old person in a very COVID cautious family. My 5 year old grandson brought it home from school on 2 separate occasions and infected the whole family The first time we all caught it before he even got sick (and had to be hospitalized).
Thank you for addressing Novavax. As someone who has had extremely tough days after the other vaccines, I'm going to try that one this time around. I so appreciate the work you and your team do.
Thanks for all the updated info. Given the two-waves per year COVID pattern, along with its frequent mutation pattern, do you think the government will ever get to the point where they allow the mRNA vaccine manufacturers to do more rapid updates? By the time the decision was made to allow this most recent fall version, we already knew it was out of date for the most recent COVID strain. As I understand it, the companies could actually do a much quicker update but for the slowness of the regulatory approval process. Or am I wrong about that?
Thank you for the information, I read parts 2-3 times! I depend on your information and guidance to protect myself. You are a blessing to us all to so clearly filter the confusing information.
Agree. I think one area of improvement would be to get better (more detailed and timely) information to GP’s and PCP’s. Part of the issue is their time and capacity to process the information, and so any work that can be done to communicate clearly and concisely, possibly via Public Health Officers, might be helpful?
Once again, thank you for your clear and helpful info! I have one question: I have not had a recent infection or vaccine and will be traveling soon. So, if I were to get the vaccine in early September, could I theoretically get another one just before Christmas? Pros and cons of that approach? Thanks!!
I have the same question around fall travel and then protection over holidays/into the winter! Would it be possible to get the new MRNA now, and then a “boost” with Novavax in December/January/February? We are looking at fall travel, holidays, then late winter or early spring travel.
It's so important for as many people as possible to get vaccinated, to help save infants and the elderly. I recall a study from Japan from many years ago, when that country briefly required children to be vaccinated for flu. The death rate from flu among the elderly -- grandparents -- dropped precipitously. Unfortunately, Japan then halted the requirement, and the elderly death rate returned to previous levels.
I will say I had a bad reaction to getting the flu and MRNA Covid vaccines at the same time two years and won’t do it again. I had severe flu like symptoms for several days with a high fever. I don’t know how they studied this but no one asked me! I will get them separately.
My reaction was not as severe, but similar. I won't be doing flu and COVID together again, if I can avoid it. Just got my two jabs on Friday afternoon, and I'm very happy to have the whole holiday weekend to recover (low fever, fatigue, body aches, headache). Not nearly as bad as real COVID, but a maybe little tougher than my first jabs, and the decline in side effects I
I'd seen with successive boosters was dramatically reversed. BTW, I usually have little to no side effects from the flu jab by itself.
This is a great question. And I don't know! There are RSV antigen tests avaliable other places in the world (like Australia), but I don't know why FDA is slow with this. They were kind of anti-RAT (rapid antigen test) for a long time, which seems to be changing.
I am age 70, with both autoimmune issues and immune deficiencies - so high risk. I’ve had 4 Pfizer Covid vaccines spaced appropriately apart - last one this past June. In July I got Covid (from grandson) for the 1st time. The recovery from Covid was much easier than the weeks long, flare inducing reaction I’d been having after the June vax with fatigue and muscle etc etc problems. At this point, I’m actually afraid of getting another Covid vaccination. (I had suspected a similar reaction, though milder, after the previous vax 6 mos earlier). So, two questions - is there data to suggest that some immune compromised individuals can get overwhelmed with repeated vax? Would immediate Paxlovid if Covid positive, supply a similar benefit without yet another Vaccination?
Thanks for your always helpful information- you are a beacon!
A middle aged friend of mine had pretty rough reactions to her first COVID vaccinations (flu-like symptoms for several days), but her first real COVID infection was like a mild cold. Unfortunately, her second COVID infection was much tougher and had difficult long COVID symptoms following for about a year (only recently diminishing). She's continuing to keep up with her boosters, in spite of the side effects (which have slightly diminished, in her case)
I'm guessing that the short answer to side effects and risk question is that is that it's always a roll of the dice. One can make general population predictions based on studies, and that can help inform your best guesses for your choices. But, one's individual experience will be very... individual. And, it may evolve in unexpected, difficult to predict ways. Maybe new technologies for individualized medicine will eventually allow better individual predictions, but I don't expect it to be that granular for a long time. I certainly don't think I'll live long enough to see that generally available at an affordable price.
Thanks for responding, LB. I agree that all of us carry individual variables that make it difficult to decipher the risk vs benefit in these cases and many others.
With my own immunological and autoimmune conditions I keep a daily record of symptoms/problems to help track some of my trends and variables. I was able to revisit what I recorded after the previous Covid vax 7 months earlier, and it was nearly exactly the same - just slightly milder and not nearly as prolonged.
Having an actual Covid infection just one month after the latest vaccination seems to further raise the question of risk vs benefit.
The infection itself resolved in 10 days with relative ease and without much carryover.
I am wondering if I now have better resistance to Covid than what the vaccination provided, and how long that may persist.
I don’t know what I’ll do when it’s time again to decide vax or no vax - other than maybe get a Covid antibody test prior to, weigh some outside opinions, and then follow my best instinct.
It will be past my time, but I do hope “Star Trek” medicine will morph from fantasy to reality. I guess in some ways, it’s already in process.
I’m confused. What happened to vaccine waning in ~2 months? That seems inconsistent with longer waiting = greater benefit….sort of. Is waning reduced after multiple jabs? I could understand if we weren’t in a surge. Please unpack this.
My hazy understanding is that protection from infection wanes due to a steep decrease in antibodies. But the deeper immune response is better if you wait a while between vaccinations (or vaccinations and infections).
My main concern (which I know is shared by a substantial segment of people on this substack) is avoiding infection — multiple people here, over the years, have asked why we can’t just keep boosting (3-4 X/year) to get more antibodies — or why we can’t use monoclonal antibodies.
That one guy in Germany had hundreds of vaccines and is fine and has never had Covid. Sure, that’s extreme…but it also begs the question:
****Like…is that dangerous? Expensive? Knowing the reasoning for the advice about waiting, from the specific lens of people who need to avoid infection but also really really need their normal lives back, would be very helpful. ****
Doctors seem really focused on propping up the deeper immune response, but doing so seems to require us to fly without a net (= no protection against infection) for months and months. Which, if you don’t have reason to be afraid of an infection, may be a totally reasonable risk, but if you do need to be careful, requires unacceptable alterations to one’s life.
I would really love it if YLE would explain what this balancing act is all about, because it’s confusing to non-scientists.
After getting the last booster when it came out, I then caught covid over Christmas break and was out of it for a week+. "You'll recover in 5 days!" What a joke - I could leave bed at 5 days. I was still recovering a month later.
I don't understand how preventing absences and sickness isn't a consideration. At my kid's elementary school, everybody remarks on how much sicker the kids are now. I can only assume this is a post-covid reaction of some sort. We went from no absences with masking to falling into the level of getting a truancy letter for number of days out sick! Surely someone can collate the changes in sick days out in a school district over the last five years.
It seems really clear that even people who aren’t high-risk are much better off avoiding infection. You’re not the only healthy person I know who’s taken a month to get better.
As a practical matter, kids need to learn, adults need to work. Our national and personal economic health can’t easily absorb people being under-productive for 4-8 weeks a year. The US labor market just doesn’t have that kind of wiggle room. Even if only 20% of people are hit that hard, that’s a lot of lost productivity. (It goes without saying that those who develop long Covid are losing so much more, and they’re being largely abandoned, which is a national disgrace.)
Really good comment, C.T.B. The prevailing wisdom seems to be that vaccination is supposed to keep one out of the hospital, but not necessarily from getting sick. But, that doesn't really seem to account for how different COVID is from, say, the flu. COVID seems to be the perfect storm; not that bad for most people, certainly not bad enough to have bodies lying in the streets (anymore, for current variants). But, it's much more debilitating and costly (short and long term) than endemic first -world infections have been for maybe more than a century. Unfortunately, misinformation and extreme polarization don't make already difficult risk and cost-benefit choices any easier...
Similar to Rachel’s question, if I’m traveling out of country next April, should I get vaccine asap and then again 2 weeks before plane travel? Would it be better to get Novovax shot first and then mRNA shot in spring
Please please! With regard to vaccination of children There is an additional very important epidemiological reason that must be always mentioned. It is often overlooked both by advocates and naysayers: Young kids are carriers of infection and bring it home from school. I am a high risk 82 year old person in a very COVID cautious family. My 5 year old grandson brought it home from school on 2 separate occasions and infected the whole family The first time we all caught it before he even got sick (and had to be hospitalized).
Yes! Great addition. They are fantastic viral vectors
Agreed! Also for kids’ sake!
COVID-19 vaccine is tied to a 40-50% lower risk of long COVID in kids
Long Covid is estimated to affect 0.5 - 2% of children. Doesn’t sound that bad, but multiply that by 73 million children under age 18 in the U.S…
Could you please provide your sources? That’s really important info and I’d like to read more. Thnx.
Links within. Take care :)
https://mccormickmd.substack.com/p/why-im-getting-the-updated-covid
Exactly why we call them Petri Dishes and classrooms are the incubators. :~)
Thank you for addressing Novavax. As someone who has had extremely tough days after the other vaccines, I'm going to try that one this time around. I so appreciate the work you and your team do.
I had much better luck, so hoping you experience the same!
Is there any push towards getting a recommendation for everyone to get 2 covid vaccines a year?
You continue to make the Covid calculus easier. THANK YOU! It really helps to have both advice and the thinking behind it.
Agree!
Thanks for all the updated info. Given the two-waves per year COVID pattern, along with its frequent mutation pattern, do you think the government will ever get to the point where they allow the mRNA vaccine manufacturers to do more rapid updates? By the time the decision was made to allow this most recent fall version, we already knew it was out of date for the most recent COVID strain. As I understand it, the companies could actually do a much quicker update but for the slowness of the regulatory approval process. Or am I wrong about that?
Thank you for the information, I read parts 2-3 times! I depend on your information and guidance to protect myself. You are a blessing to us all to so clearly filter the confusing information.
"Your healthcare provider is an excellent resource for discussing timing!"
IMO, this is not good advice. My healthcare provider is far less well informed that you are.
Agree. I think one area of improvement would be to get better (more detailed and timely) information to GP’s and PCP’s. Part of the issue is their time and capacity to process the information, and so any work that can be done to communicate clearly and concisely, possibly via Public Health Officers, might be helpful?
Once again, thank you for your clear and helpful info! I have one question: I have not had a recent infection or vaccine and will be traveling soon. So, if I were to get the vaccine in early September, could I theoretically get another one just before Christmas? Pros and cons of that approach? Thanks!!
I came here with the same Q. I’d like to get the shot asap and again in 3-4 months since immunity wanes. Is that possible?
I have the same question around fall travel and then protection over holidays/into the winter! Would it be possible to get the new MRNA now, and then a “boost” with Novavax in December/January/February? We are looking at fall travel, holidays, then late winter or early spring travel.
Thanks for answering my question about the younger population--very helpful!!
It's so important for as many people as possible to get vaccinated, to help save infants and the elderly. I recall a study from Japan from many years ago, when that country briefly required children to be vaccinated for flu. The death rate from flu among the elderly -- grandparents -- dropped precipitously. Unfortunately, Japan then halted the requirement, and the elderly death rate returned to previous levels.
I will say I had a bad reaction to getting the flu and MRNA Covid vaccines at the same time two years and won’t do it again. I had severe flu like symptoms for several days with a high fever. I don’t know how they studied this but no one asked me! I will get them separately.
My reaction was not as severe, but similar. I won't be doing flu and COVID together again, if I can avoid it. Just got my two jabs on Friday afternoon, and I'm very happy to have the whole holiday weekend to recover (low fever, fatigue, body aches, headache). Not nearly as bad as real COVID, but a maybe little tougher than my first jabs, and the decline in side effects I
I'd seen with successive boosters was dramatically reversed. BTW, I usually have little to no side effects from the flu jab by itself.
Thanks for addressing the tests! I keep telling my techs "but why didn't they throw RSV testing in there too?"
Thank you for the clear and concise info.
This is a great question. And I don't know! There are RSV antigen tests avaliable other places in the world (like Australia), but I don't know why FDA is slow with this. They were kind of anti-RAT (rapid antigen test) for a long time, which seems to be changing.
I am age 70, with both autoimmune issues and immune deficiencies - so high risk. I’ve had 4 Pfizer Covid vaccines spaced appropriately apart - last one this past June. In July I got Covid (from grandson) for the 1st time. The recovery from Covid was much easier than the weeks long, flare inducing reaction I’d been having after the June vax with fatigue and muscle etc etc problems. At this point, I’m actually afraid of getting another Covid vaccination. (I had suspected a similar reaction, though milder, after the previous vax 6 mos earlier). So, two questions - is there data to suggest that some immune compromised individuals can get overwhelmed with repeated vax? Would immediate Paxlovid if Covid positive, supply a similar benefit without yet another Vaccination?
Thanks for your always helpful information- you are a beacon!
Just commenting in empathy. My reactions to my second and third Moderna were the sickest I have ever been in my life. I am too scared to get another.
A middle aged friend of mine had pretty rough reactions to her first COVID vaccinations (flu-like symptoms for several days), but her first real COVID infection was like a mild cold. Unfortunately, her second COVID infection was much tougher and had difficult long COVID symptoms following for about a year (only recently diminishing). She's continuing to keep up with her boosters, in spite of the side effects (which have slightly diminished, in her case)
I'm guessing that the short answer to side effects and risk question is that is that it's always a roll of the dice. One can make general population predictions based on studies, and that can help inform your best guesses for your choices. But, one's individual experience will be very... individual. And, it may evolve in unexpected, difficult to predict ways. Maybe new technologies for individualized medicine will eventually allow better individual predictions, but I don't expect it to be that granular for a long time. I certainly don't think I'll live long enough to see that generally available at an affordable price.
Thanks for responding, LB. I agree that all of us carry individual variables that make it difficult to decipher the risk vs benefit in these cases and many others.
With my own immunological and autoimmune conditions I keep a daily record of symptoms/problems to help track some of my trends and variables. I was able to revisit what I recorded after the previous Covid vax 7 months earlier, and it was nearly exactly the same - just slightly milder and not nearly as prolonged.
Having an actual Covid infection just one month after the latest vaccination seems to further raise the question of risk vs benefit.
The infection itself resolved in 10 days with relative ease and without much carryover.
I am wondering if I now have better resistance to Covid than what the vaccination provided, and how long that may persist.
I don’t know what I’ll do when it’s time again to decide vax or no vax - other than maybe get a Covid antibody test prior to, weigh some outside opinions, and then follow my best instinct.
It will be past my time, but I do hope “Star Trek” medicine will morph from fantasy to reality. I guess in some ways, it’s already in process.
Two years ago I got flu and covid shots back to back and the next day was not pretty. If no issues in the population at large I must be an outlier.
The information about this is that you got an extra boost of immunity from the double vaccination. 👍🏽
?
I’m confused. What happened to vaccine waning in ~2 months? That seems inconsistent with longer waiting = greater benefit….sort of. Is waning reduced after multiple jabs? I could understand if we weren’t in a surge. Please unpack this.
My hazy understanding is that protection from infection wanes due to a steep decrease in antibodies. But the deeper immune response is better if you wait a while between vaccinations (or vaccinations and infections).
My main concern (which I know is shared by a substantial segment of people on this substack) is avoiding infection — multiple people here, over the years, have asked why we can’t just keep boosting (3-4 X/year) to get more antibodies — or why we can’t use monoclonal antibodies.
That one guy in Germany had hundreds of vaccines and is fine and has never had Covid. Sure, that’s extreme…but it also begs the question:
****Like…is that dangerous? Expensive? Knowing the reasoning for the advice about waiting, from the specific lens of people who need to avoid infection but also really really need their normal lives back, would be very helpful. ****
Doctors seem really focused on propping up the deeper immune response, but doing so seems to require us to fly without a net (= no protection against infection) for months and months. Which, if you don’t have reason to be afraid of an infection, may be a totally reasonable risk, but if you do need to be careful, requires unacceptable alterations to one’s life.
I would really love it if YLE would explain what this balancing act is all about, because it’s confusing to non-scientists.
After getting the last booster when it came out, I then caught covid over Christmas break and was out of it for a week+. "You'll recover in 5 days!" What a joke - I could leave bed at 5 days. I was still recovering a month later.
I don't understand how preventing absences and sickness isn't a consideration. At my kid's elementary school, everybody remarks on how much sicker the kids are now. I can only assume this is a post-covid reaction of some sort. We went from no absences with masking to falling into the level of getting a truancy letter for number of days out sick! Surely someone can collate the changes in sick days out in a school district over the last five years.
It seems really clear that even people who aren’t high-risk are much better off avoiding infection. You’re not the only healthy person I know who’s taken a month to get better.
As a practical matter, kids need to learn, adults need to work. Our national and personal economic health can’t easily absorb people being under-productive for 4-8 weeks a year. The US labor market just doesn’t have that kind of wiggle room. Even if only 20% of people are hit that hard, that’s a lot of lost productivity. (It goes without saying that those who develop long Covid are losing so much more, and they’re being largely abandoned, which is a national disgrace.)
Really good comment, C.T.B. The prevailing wisdom seems to be that vaccination is supposed to keep one out of the hospital, but not necessarily from getting sick. But, that doesn't really seem to account for how different COVID is from, say, the flu. COVID seems to be the perfect storm; not that bad for most people, certainly not bad enough to have bodies lying in the streets (anymore, for current variants). But, it's much more debilitating and costly (short and long term) than endemic first -world infections have been for maybe more than a century. Unfortunately, misinformation and extreme polarization don't make already difficult risk and cost-benefit choices any easier...
Similar to Rachel’s question, if I’m traveling out of country next April, should I get vaccine asap and then again 2 weeks before plane travel? Would it be better to get Novovax shot first and then mRNA shot in spring