Sep 12Liked by Katelyn Jetelina

Looking forward to your recommendations about how long to wait post infection. Entire family just finished m recovering from an infection last week, and would like to optimize my protection for the holiday season

Expand full comment

Thank you so much for this information. I'm so impressed with how quickly you put this together! I've noticed that Covid is definitely on the rise where I live and work, so I plan to get the vax this fall. I'm hoping that you will cover information about mixing vaccines...the pros and the cons. All of my vaccines have been Pfizer so far, but I'm considering Novavax this time to switch it up. Not sure if that is a wise decision or not.

Expand full comment
Sep 12·edited Sep 13

I appreciate your writing and this summary greatly. I think it's a bit dangerous to say that "Severe disease is similar to flu for the kiddos" with the threat of long covid in childhood and adolescence. If it weren't for long covid, even the increased risk of heading to the ICU still makes that statement untrue. If you were just skimming this you might walk away thinking "no big deal" for getting COVID in childhood. But we know that every infection reduces T-Cell count and increases risk for long covid. We don't get the flu multiple times in the same year - we don't increase our risk for chronic disease by getting the flu. Met a 17 year old who had a stroke post omicron - no co-morbidity. That's not like the flu at all. Please stop comparing COVID to the flu, it's inaccurate. Other than that, appreciate your work.

Expand full comment

Fabulous summary, thanks!

I listened to part of the meeting and was very pleased that the new CDC Director Mandy Cohen emphasized the importance of public trust and clear communication. Within the first few minutes, the CDC acknowledged Novavax and said there’s an “urgent need” for a non-mRNA vaccine choice. Hip hip hooray!

The doctor from Novavax said their vaccine is manufactured and is ready to be distributed - unclear whether they’ve been able to manufacture enough to meet demand.

Novavax gave two prices: $130 for fully insured and $75 ish for CDC. I’m assuming the lower price is what the Bridge program would pay - their goal is vaccine equity for under- and un-insured. Bridge sites (4,000?) will reach 85% of this population which in the past has had lower uptake and (probably) higher complications with Covid. A non-mRNA vaccine might appeal to this group given their past skepticism, plus Novavax has fewer distribution and storage challenges as compared to mRNA. Novavax could be a perfect vaccine for Bridge!

If Novavax is offered at Bridge sites, FDA will want to double and triple check safety data along demographic lines consistent with target population.

Expand full comment

$120 per shot is going to deter even people who can afford it and be prohibitive for millions more. We are so broken. Glad to hear that the numbers of long COVID cases are declining somewhat, though.

Expand full comment

74M here. Would like specific recommendations on Moderna vs Pfizer or wait for Novavax? Thanks a bunch!

Expand full comment

As someone over 70 years old, do I wait for the Novavax, or do I jump on Moderna/Pfizer as soon as available? I'm fully vaccinated and had boosters previously, and also had COVID once before vaccines and once after

Expand full comment

Just a note about the one nay vote.

"Additionally, clinical trial data presented Tuesday on the effectiveness of the updated vaccines didn’t include children under 12, which left ACIP member Dr. Pablo Sanchez, a pediatrician at Nationwide Children’s Hospital in Ohio, feeling uncomfortable about making a blanket recommendation for everyone 6 months and older. He was the committee’s only no vote.

“I just want to be clear that I am not against this vaccine,” Sanchez said. “The limited data that are available does look great.

“We have extremely limited data on children … and I think that needs to be made available … to the parents,” he said in explaining his discomfort." https://www.cnn.com/2023/09/12/health/cdc-covid-19-vaccines/index.html

In the meanwhile, the CDC does need to message target the 65+, immunocompromised and at risk. These are making up a great majority of hospitalization and death so far.

Though 65+, I am planning to wait for Novavax. It is non inferior to mRNA vaccines and have fewer side effects. Besides, mixing seems to be better in long run. Having primary and boosters, my humoral immunity is matured. Besides, Thymus gland may not be what they used to be but still somewhat functional. Also have a plan for the possibility that SARS.CoV-2 infection turns into COVID-19. Most of us has been infected but our mucosal and humoral has done a great job since introduction of the vaccines.

Expand full comment

I am 71 and very anxious to get this updated vaccine because I'll be getting a hip replacement in 2 1/2 weeks. C-19 in wastewater in my area has risen steeply in past two weeks. I got my RSV vaccine last week, will get my flu shot tomorrow, and hope I can get the updated C-19 shot no later than this coming Monday, the last day my surgeon says I can get it before surgery. Fingers crossed!

Expand full comment
Sep 13·edited Sep 13

Sounds like a lot of questions on Novavax! The major ones being 1) should one wait for the Novavax booster or 2) get the mRNA booster and wait awhile then get the Novavax booster? This twitter thread just yesterday notified me of the possible benefits of the Novavax!


Expand full comment

How can you be so positive that myocarditis is not a risk with repeated boosters for young males when most college aged males did NOT opt for the bivalent? I just don’t see how there is enough data for that age group/bivalent.

Expand full comment

Thanks as always. I managed to listen to about an hour, when the companies presented their data (great timing) and was really excited about the expected efficacy for emerging variants!

I also very much appreciated the person who raised the lack of data for those who are immunocompromised, 3% of the US population. This is still sorely lacking especially as this group represents a high risk population!

FINALLY they did not exclude children! Someone did request that data too, but given the vigorous historical data for prior vaccination, I am feeling comfortable in the meantime.

I cannot agree enough about spacing from prior vaccination as well as recent infection. A range would be more appropriate IMO, such as anywhere from 3-6 months, indicating earliest but then optimal timing.

Thank you, looking forward to Thursday.

FWIW I did listen to the Ezra Klein podcast and you were great. Thank you for all of this communication- it has been invaluable!

Expand full comment

Does this mean once the new Novavax is out it will be available for all ages?

Expand full comment
Sep 12·edited Sep 12

Very important: “Remember, effectiveness is “relative” to some combination of prior vaccination, prior infection, or both. This means the 65% benefit is above and beyond an individual's underlying immunity.” I forget this myself; thanks for the reminder.

“This is the first time the government is not paying for Covid-19 vaccines. Pfzier/Moderna is charging ~$120-129 per dose and Novavax is ~$130. (I think the cost of these vaccines is absurd given taxpayers funded Operation Warp Speed.)”

I think it’s worse. 1. Much (all?) of the mRNA tech development long before Covid was, I am guessing, taxpayer-funded via NIH or NSF grants. 2. Taxpayer-funded Warp Speed. 3. Taxpayer-funded, massive purchases of the winners of Warp Speed. 4. And now, privatized profit (at outrageous prices) in perpetuity.

We will have paid pharma four separate times, it seems to me. That’s appalling—but business as usual in really-existing capitalism.

Expand full comment

Thanks for this excellent round up! Is there any data on how to time the flu vaccine vs the covid vaccine? Is it best to get them at different times?

Expand full comment

Re Op Warp Speed, Pfizer didn't take the money, but Moderna did. Also, NIH designed the critical mRNA sequence changes for Moderna. Moderna got a freebie. We the people should own the vaccine. Whereas Pfizer paid for their vaccine development without any help from OWS.

Expand full comment