To Vaccinate or Not---The Rat Flu Odyssey Continues

[Mazderati]

Holy irony.

[NW_SKIER]

Holy irony.

Heh. At least SJG can type something we can read. I'll give him that.

[Ted Striker]

Sorry, just making the point that we should be taking a close look at what actually worked to control the spread, and what didn't. The mask wars are so far in the rearview in Montana that it is strange to read about people still dealing with that stuff.

Oh, I agree. Much of what we did was window dressing, although I do appreciate that for the most part people in this town actually put some effort in. The mask wars were in détente here too, but there's been a recent resurgence. Along the same lines, the number of 2 foot wide "Fuck Inslee" decals on pickups has increased dramatically over the last few months.

[Hopeless Sinner]

My doctor's latest missive:

"IS A SECOND BOOSTER INDICATED?

For those that are immunocompromised the answer is unequivocally yes. For the rest of you it’s just not that clear.

So many variables and uncertainties exist and any presumptions for or against another booster are just that — presumptions. When will the next wave hit, how long will our current immunity remain effective and what level of immunity is sufficient, will the next surge be “significant” and what criteria (case numbers, hospitalizations or deaths) should define that term and lastly, will the current formulations even be effective against a new viral mutation or potentially precipitate further “vaccination fatigue” if a third booster is needed.

The FDA is expected to make its formal recommendation this week and the CDC will follow thereafter. There is currently no clear consensus in the scientific community and a “neutral” recommendation currently being considered proving the option to booster without formal recommendations is a slippery slope if it moves forward. It also sows more confusion and angst at an inopportune time.

The early data shows that immunity against severe disease from the first booster generally wanes in three to six months, but that is to be expected. How much more it will do so, over what time period and what level of decline will clinically justify yet another booster remain the defining questions.

Clearly, those 65 or older have borne the brunt of hospitalizations and deaths throughout the pandemic. The conundrum is that while the recent Omicron surge led to a significant rise in both of these end points in that demographic, it remains difficult to tease out definitively if it was primarily due to waning immunity. Omicron generally caused a much milder illness than previous variants, but its much higher infectivity rate led a surge in hospitalized patients just by the sheer numbers of cases it generated. This muddles the picture.

In a recent British agency release, vaccine effectiveness against hospitalization for those 65 or older only dropped from 91 to 85 percent 15 weeks or more after the booster when compared to just weeks after receiving it. Whether this reduction is statistically significant remains unclear. In addition, another study released just last week by Israel claims a “notable” reduction in mortality after a second booster for those 60 or older, but has yet to be peer reviewed.

Should we just err on the side of caution and proceed now? Could another surge this fall or winter lead to a novel variant and potential need of a third booster that could be reconfigured and more directed? Should we await more data and preserve our current stockpile of vaccines and focus on ramping up access and supply to viable treatment options?

Another consideration is the ramifications of Long covid. Long covid—or post-covid conditions—is a wide range of new, returning or ongoing health problems people may experience more than four weeks after being first infected. Even people who did not have any symptoms can experience long covid, which can present as different types and combinations of health problems and can range in lengths of time. We are still trying to understand exactly how this interplay between immune system and inflammatory markers work, but there's no doubt that that is a group of symptoms because of a combination of ramped up immunity and inflammatory system responses.

It is estimated that anywhere from 10% to 30% of patients might experience Long covid after recovering—even if they weren’t very sick or at all in the first place. Recent studies have shown that an increased percentage of females, as compared to males, develop Long covid syndrome. What is reassuring is that patients who were vaccinated, in those rare instances where they got a breakthrough infection, were 50% less likely to develop Long covid.

So where does this leave us? Likely, those 65 or older should proceed with a second booster once it becomes available. Statistically, this group is most at risk of hospitalization and death and if another surge occurs with a highly infectious agent (similar to Omicron) the benefits could prove to be substantial.

As to those 65 or younger, I would consider awaiting the data and more formal recommendations unless you are a frontline worker. I will continue to follow this topic closely and offer recommendations and updates moving forward."

[riser4]

My doctor's latest missive:

"IS A SECOND BOOSTER INDICATED?[/FONT]

For those that are immunocompromised the answer is unequivocally yes. For the rest of you it’s just not that clear.

So many variables and uncertainties exist and any presumptions for or against another booster are just that — presumptions. When will the next wave hit, how long will our current immunity remain effective and what level of immunity is sufficient, will the next surge be “significant” and what criteria (case numbers, hospitalizations or deaths) should define that term and lastly, will the current formulations even be effective against a new viral mutation or potentially precipitate further “vaccination fatigue” if a third booster is needed.

The FDA is expected to make its formal recommendation this week and the CDC will follow thereafter. There is currently no clear consensus in the scientific community and a “neutral” recommendation currently being considered proving the option to booster without formal recommendations is a slippery slope if it moves forward. It also sows more confusion and angst at an inopportune time.

The early data shows that immunity against severe disease from the first booster generally wanes in three to six months, but that is to be expected. How much more it will do so, over what time period and what level of decline will clinically justify yet another booster remain the defining questions.

Clearly, those 65 or older have borne the brunt of hospitalizations and deaths throughout the pandemic. The conundrum is that while the recent Omicron surge led to a significant rise in both of these end points in that demographic, it remains difficult to tease out definitively if it was primarily due to waning immunity. Omicron generally caused a much milder illness than previous variants, but its much higher infectivity rate led a surge in hospitalized patients just by the sheer numbers of cases it generated. This muddles the picture.

In a recent British agency release, vaccine effectiveness against hospitalization for those 65 or older only dropped from 91 to 85 percent 15 weeks or more after the booster when compared to just weeks after receiving it. Whether this reduction is statistically significant remains unclear. In addition, another study released just last week by Israel claims a “notable” reduction in mortality after a second booster for those 60 or older, but has yet to be peer reviewed.

Should we just err on the side of caution and proceed now? Could another surge this fall or winter lead to a novel variant and potential need of a third booster that could be reconfigured and more directed? Should we await more data and preserve our current stockpile of vaccines and focus on ramping up access and supply to viable treatment options?

Another consideration is the ramifications of Long covid. Long covid—or post-covid conditions—is a wide range of new, returning or ongoing health problems people may experience more than four weeks after being first infected. Even people who did not have any symptoms can experience long covid, which can present as different types and combinations of health problems and can range in lengths of time. We are still trying to understand exactly how this interplay between immune system and inflammatory markers work, but there's no doubt that that is a group of symptoms because of a combination of ramped up immunity and inflammatory system responses.

It is estimated that anywhere from 10% to 30% of patients might experience Long covid after recovering—even if they weren’t very sick or at all in the first place. Recent studies have shown that an increased percentage of females, as compared to males, develop Long covid syndrome. What is reassuring is that patients who were vaccinated, in those rare instances where they got a breakthrough infection, were 50% less likely to develop Long covid.

So where does this leave us? Likely, those 65 or older should proceed with a second booster once it becomes available. Statistically, this group is most at risk of hospitalization and death and if another surge occurs with a highly infectious agent (similar to Omicron) the benefits could prove to be substantial.

As to those 65 or younger, I would consider awaiting the data and more formal recommendations unless you are a frontline worker. I will continue to follow this topic closely and offer recommendations and updates moving forward."

FFS. Removed the color coding. Post things that are readable.

[Hopeless Sinner]

FFS. Removed the color coding. Post things that are readable.

Yeah, white background or blue?

Btw, it looks fine on a blue background

[Danno]

FFS. Removed the color coding. Post things that are readable.

On my laptop it looks fine. And that shit happens when people cut/paste, and people view this forum in a variety of ways, so don't assume that just because it looks a certain way to you, that it looked the same to the OP or to others. I get the frustration that you couldn't read it, but chiding him for that was a little much.

EDIT: "TGR Blue", the old school viewing format.

[skiJ]

double holy irony, Batman. (skiJ )

[GoldMember]

Left it in the original black, but users w blue background can't read it.

You can read it in the blue background if you highlight it as though you're going to copy. It's not that hard.

[Hopeless Sinner]

^ Thanks

[riser4]

On my laptop it looks fine. And that shit happens when people cut/paste, and people view this forum in a variety of ways, so don't assume that just because it looks a certain way to you, that it looked the same to the OP or to others. I get the frustration that you couldn't read it, but chiding him for that was a little much.

EDIT: "TGR Blue", the old school viewing format.

Good points. However if you don't specify any Color then it appears to work on all viewing formats. Copy paste is a special problem. Polite patrons please wipe the color off the equipment. I use Metro mobile black and white on the phone and TRG Blue on a desktop.

[Mazderati]

There is only one background which should be considered: TRG Blue. Do not enable users of the white background. Rebuke their errant choice at every opportunity.

[Ted Striker]

^^^ this is the way

[frorider]

So a 50 yr old who had Pfizer booster in Oct or Nov and got Covid some time afterwards probably doesn’t need to consider yet another booster until this October yeah? I know several people in this situation. I hear the term super immunity albeit temporary.

[PNWbrit]

So a 50 yr old who had Pfizer booster in Oct or Nov and got Covid some time afterwards probably doesn’t need to consider yet another booster until this October yeah? I know several people in this situation. I hear the term super immunity albeit temporary.

What's the benefit of waiting?

I just booked one for Friday. Not that I have this so-called "super immunity" AKAIK.

[Trackhead]

What's the benefit of waiting?

I just booked one for Friday. Not that I have this so-called "super immunity" AKAIK.

Typically will have a 2 month bump in antibodies after vax/infection, then waning sterilizing immunity. If you just had covid, can wait to vax for a few months as you likely have that amount of time with higher antibody titers for sterilizing immunity. After that, you still have robust protection, but you might be a bit more symptomatic.

The entire argument for a fourth booster now is pretty much, are you getting a booster to avoid getting symptomatic covid for a few month window? Because that's about all you can expect from it at this point. Might not even get that. I had booster in Oct, had symptomatic covid two months later. Still robust protection from severe disease.

Vaxing to avoid mild symptoms seems like hysteria. I'll get a 4th shot when there's evidence that without it, people my age/comorbidities are not fairing well. Until then, the benefit is slim.

[skiJ]

how do you determine who will experience 'mild symptoms' and who will experience 'severe (covid)' ?

with ~5,000 people dying weekly and >150,000 people being diagnosed covid positive weekly, and
waning immunity known to occur with covid, I don't understand how trying to maintain immunity is 'hysteria' .

Easter is one of the main traveling holidays in usofa; though in my home region, not as big as Fourth of July.

my goal is to prevent disease, reduce transmission, and further reduce deaths ;
I don't consider that 'hysteria' .
it is not my understanding that current immunity to covid provides sterilizing immunity ( preventing someone from transmitting covid. If there is new information about 'sterilizing immunity' or if that term is being used differently, that's information I am interested in ( Thank you )

again - If there is a way to definitively determine who will only develop 'mild symptoms', that's information I am very interested in.

Thank you. skiJ

[riser4]

There is only one background which should be considered: TRG Blue. Do not enable users of the white background. Rebuke their errant choice at every opportunity.

Blue doesn't work on the phone so well, lots of horizontal scrolling. Best is to not set any color and let each choice go to default. It's the easiest solution.

[Buzzworthy]

Until you can communicate like a real person, no one is going to answer your questions because no one is reading your dribble.
This is 100% your choice.

[PNWbrit]

Typically will have a 2 month bump in antibodies after vax/infection, then waning sterilizing immunity. If you just had covid, can wait to vax for a few months as you likely have that amount of time with higher antibody titers for sterilizing immunity. After that, you still have robust protection, but you might be a bit more symptomatic.

The entire argument for a fourth booster now is pretty much, are you getting a booster to avoid getting symptomatic covid for a few month window? Because that's about all you can expect from it at this point. Might not even get that. I had booster in Oct, had symptomatic covid two months later. Still robust protection from severe disease.

Vaxing to avoid mild symptoms seems like hysteria. I'll get a 4th shot when there's evidence that without it, people my age/comorbidities are not fairing well. Until then, the benefit is slim.

I still don't see the downside to getting it. And I certainly disagree about it being "hysteria"

Especially given that, as I mentioned, I haven't as far as I know had C19 (testing every week for work).

I had booster in Oct, had symptomatic covid two months later

Ah... I see what's going on here.

[Trackhead]

I still don't see the downside to getting it. And I certainly disagree about it being "hysteria"

There may not be one, or perhaps there is.

Hysteria = bad choice of words. Perhaps over-zealous. Covid mania?

A covid shot every four months to 'maybe' avoid a symptomatic infection? I wouldn't argue with my 79yr old mother getting a 4th, but I question the necessity of most middle-age, otherwise healthy people needing one until evidence suggests a change significant change in outcome.

[uglymoney]

Totally agree with Trackhead. The expert on NPR this morning also agreed for 50ish healthy people..

Biggest disadvantage for me would be I possibly give up the opportunity to boost this fall with my flu shot if covid numbers go wild again as they have the last two winters. My plan is to boost our family in September.

Easy decision for us though, as PNW alludes to, since we had exposure to Omicron starting in early January, then again in late February, which is like a natural booster.

I'd suggest a lot of people were exposed and don't know it.

Also, my wife, and later my stepson, both asthmatics, catching and recovering from Omicron A was a huge weight lifted, even if the relief might be temporary. Vaccinating against mild symptoms doesn't come with such a tangible reward.

Anyway, personal decision based on personal situations Everybody is going to see it differently.

[TG]

Easy decision for us though, as PNW alludes to, since we had exposure to Omicron starting in early January, then again in late February, which is like a natural booster.

I'd suggest a lot of people were exposed and don't know it.

what do you mean by exposed? are you saying you caught it in January and February?

or are you saying you were near people that caught it in Jan & Feb and that proximity naturally boosted your immunity without you actually catching it?

[uglymoney]

what do you mean by exposed? are you saying you caught it in January and February?

or are you saying you were near people that caught it in Jan & Feb and that proximity naturally boosted your immunity without you actually catching it?

Wife/stepson had confirmed PCR positives. I never had symptoms after extensive exposure to them.

So, I may have caught it, or not, I don't know how I couldn't have had a brush with it, but I never tested positive. Either way, I either had a natural boost to my vaccine booster, or had nothing to worry about in the first place. I was never worried about me anyway, wife and stepson are the ones that seem to nearly die every time they get a respiratory virus.

[PNWbrit]

There may not be one, or perhaps there is.

What downside do you think there perhaps could be?