Covid 19 Booster Shot

[BLADEMDA]

Pfizer CEO: Covid vaccine booster shots may be needed by September

The CEO of Pfizer says that a Covid-19 vaccination booster could be needed “somewhere between eight and twelve months” after receiving the shot, “but that remains to be seen.”

www.nbcnews.com

Moderna says its Covid vaccine booster works well against variants

A third dose, given six to eight months after the first round, appeared to be effective against variants first found in Brazil and South Africa.

www.nbcnews.com

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[Lawpy]

Remember when we thought nsaids and acei also made covid worse?

That was total fake news from the very start. Aceis did nothing wrong!!!!!

 

[Airway]

I'm surprised at the responses lambasting @BLADEMDA . It seems like there are tons of vaccine doses available (because Americans are dumb and vaccine uptake has slowed - of course ignoring outside of America). I've definitely thought about getting another vaccine with a different moa ...

 

[GassYous]

I just like how we are talking about how to get a booster shot when most of the world hasn't even gotten a sniff at a single injection while the em forums is still up in arms lambasting face masks and social distancing.

 

[Airway]

I just like how we are talking about how to get a booster shot when most of the world hasn't even gotten a sniff at a single injection while the em forums is still up in arms lambasting face masks and social distancing.

You are absolutely right of course, but me taking another vaccine wont effect other countries availability. Also I'm still masking because I'm not an idiot. (Or I am an idiot but a true believer)

 

[BLADEMDA]

I am pretty certain that the CDC will recommend a booster for almost everyone reading this thread by October 2021. All the naysayers on here are just plain wrong about the need for a booster and in just a few months this will become quite obvious.

I prefer the modified booster shot from Moderna (1/2 dose) but the science seems pretty clear that high levels of antibodies from the current Pfizer or Moderna vaccines are protective against all the known variants. IMHO, nobody working in the ER or Anesthesia should settle for anything less than the mRNA based vaccines.

 

[BLADEMDA]

"A person who skipped a booster is placing themselves at higher risk of getting infected, and getting disease from the SARS-Coronavirus-2, but I would also expect that they're going to have some partial immunity and so they may be protected against more severe disease," Moss said. SARS-CoV-2 is the virus that causes Covid-19.
"It's just a function of how much their immunity has waned or how different a variant is," he said. "They're just at higher risk of infection and disease than someone who got the booster, but they have more immunity than someone who was never vaccinated."

Covid-19 vaccine boosters may be necessary at some point. Here's what you need to know | CNN

Vaccine makers are preparing for a next possible phase of the Covid-19 vaccine rollout: booster doses.

www.cnn.com

The biotechnology company Novavax has developed a coronavirus vaccine that its chief executive officer Stanley Erck believes could be used as a booster shot for people who have already been vaccinated. The company plans to apply for emergency use authorization of its vaccine in the United States in the third quarter of 2021.
"In the US, I think it will be the booster for everyone, particularly if we get it out late in the third quarter," Erck told CNN last week. "It's going to be time to start boosting -- whether it's six months or at a year point."

 

[BLADEMDA]

Fauci: COVID-19 booster shot will likely be needed within year of being vaccinated

Dr. Anthony Fauci said Wednesday that those who have received the COVID-19 vaccine will likely need a booster shot within eight to 12 months. "I think we will almost certainly require a booster sometime within a year or so after getting the primary because the durability protection against...

www.wpxi.com

 

[BLADEMDA]

COVID-19 Vaccines: Overview, Immunization Schedule 2023-2024, SARS-CoV-2 Vaccine Development and History

Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV); it was first identified during an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China...

emedicine.medscape.com

Two Covid shots effective against India variant, English health body says

The study found the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease from the variant two weeks after the second dose.

www.cnbc.com

 

[BobLoblaw78]

You can put every study, CDC guideline, recommendation, newstory, etc up but I have reservations about any of them. Medicine's reputation has been hurt. I can't read one of these without thinking whether the information I am reading is valid or not. To list a few: shut down the country vs xenophobia, shut down the country vs save the economy, mask vs no mask vs triple mask, mask + vacc vs no mask + vacc, ACEi vs steroids, vit D vs melatonin vs ivermectin vs hydroxychloroquine , racism vs virus characteristic, lab origin vs bat origin, Fauci in flip flops, CDC change rec's vs gripe about rollout, etc.

I guess you/we should always evaluate the quality of the information. The experts don't have the transparency to acknowledge that they don't know and then have a sincere discussion on the available information. It seems the best way to win an argument is to blast your information across all media and hope your information reaches more than the opposing side. (I'm not sure why there are opposing sides since we are all just looking for answers)

I will probably get the booster when necessary. Ideally, we should be able to test for antibody levels and not give boosters for those who are still making antibodies adequately.

 

[BLADEMDA]

You can put every study, CDC guideline, recommendation, newstory, etc up but I have reservations about any of them. Medicine's reputation has been hurt. I can't read one of these without thinking whether the information I am reading is valid or not. To list a few: shut down the country vs xenophobia, shut down the country vs save the economy, mask vs no mask vs triple mask, mask + vacc vs no mask + vacc, ACEi vs steroids, vit D vs melatonin vs ivermectin vs hydroxychloroquine , racism vs virus characteristic, lab origin vs bat origin, Fauci in flip flops, CDC change rec's vs gripe about rollout, etc.

I guess you/we should always evaluate the quality of the information. The experts don't have the transparency to acknowledge that they don't know and then have a sincere discussion on the available information. It seems the best way to win an argument is to blast your information across all media and hope your information reaches more than the opposing side. (I'm not sure why there are opposing sides since we are all just looking for answers)

I will probably get the booster when necessary. Ideally, we should be able to test for antibody levels and not give boosters for those who are still making antibodies adequately.

The issue isn't the quality of the vaccine but rather the quantity of antibodies. The current evidence strongly suggests that the new variants require higher levels of antibodies to avoid getting ill. Thus, the point behind the "booster" is to protect you from the current and future? variants which are out there in 2021. As your antibody levels fall the effectiveness of the vaccine against these variants does as well. What % would you want that effectiveness to be before getting a booster? IMHO, for me that number is around 70-75% effectiveness against the variants in circulation so the experts speculate that level occurs around the 8 month mark.

Nobody is going to force you to get a booster but I am pretty sure by the Fall of 2021 everyone on this board will be told they should get one.

 

[deleted697127]

Why do we need a booster again? History of SARS infection provided durable immunity vs covid. These variants of COVID are much more similar than SARS and COVID. Pfizer and moderna have an obvious bias towards boosters being necessary to continue making money. Until there is actual published evidence showing it’s necessary, it’s hard not to see boosters as more greed and fear mongering than science.

 

[chessknt]

Why do we need a booster again? History of SARS infection provided durable immunity vs covid. These variants of COVID are much more similar than SARS and COVID. Pfizer and moderna have an obvious bias towards boosters being necessary to continue making money. Until there is actual published evidence showing it’s necessary, it’s hard not to see boosters as more greed and fear mongering than science.

Because in this thread we skip the RCT part of science and go directly to extrapolation-based science.

 

[AMEHigh]

Why do we need a booster again? History of SARS infection provided durable immunity vs covid. These variants of COVID are much more similar than SARS and COVID. Pfizer and moderna have an obvious bias towards boosters being necessary to continue making money. Until there is actual published evidence showing it’s necessary, it’s hard not to see boosters as more greed and fear mongering than science.

Yeah this.
Every time there’s a new variant people have freaked out and every time so far the vaccines that are approved in the US have held up well.
Also, I’m not a virologist but I was reading a scientist talk about how T cell immunity has held up very well for SARS, so think it’ll likely be the same for covid.
And I feel some kind of way that much of the world hasn’t even really begun vaccinations because we’re hoarding vaccines, yet we’re talking about boosters.
I’m very skeptical that it’s be scientifically necessary for a booster in the next couple of months. Def will seem more like a money grab.

ETA: I’m also in a vaccine trial and they monitor us for 2 years and we’re also supposed to still report symptoms and come in for comprehensive testing if we suspect we have covid. Many of the vaccine trials started last March. I’m pretty sure we would’ve heard by Dec 2020 if there was definite major concern about needing boosters ASAP. And it would be unethical if they knew that immunity wasn’t working anymore for those in the trial to not inform the trial participants.

 

[Airway]

I will probably get the booster when necessary. Ideally, we should be able to test for antibody levels and not give boosters for those who are still making antibodies adequately.

What's the antibody level that is necessary for appropriate protection? I don't know, and I don't think anyone knows for sure.

And what does long term humoral response look like?
Re 'natural infection'

SARS-CoV-2 infection induces sustained humoral immune responses in convalescent patients following symptomatic COVID-19 - Nature Communications

A better understanding of longitudinal changes in antibody responses in COVID-19 patients is needed. Here the authors analyze anti-spike and anti-nucleocapsid antibody responses to Sars-CoV-2 over a course of 6 months in a large cohort of patients with COVID-19, showing that IgM is mostly not...

www.nature.com

Although specific IgM-S/N become undetectable 12 weeks after disease onset in most patients, IgG-S/N titers have an intermediate contraction phase, but stabilize at relatively high levels over the 6 month observation period. At late time points, the positivity rates for binding and neutralizing SARS-CoV-2-specific antibodies are still >70%. These data indicate sustained humoral immunity in recovered patients who had symptomatic COVID-19, suggesting prolonged immunity.

Also I'm not an immunologist and don't really understand this topic.

 

[BLADEMDA]

Because in this thread we skip the RCT part of science and go directly to extrapolation-based science.

A recent study of the Moderna vaccine found that antibodies capable of neutralizing the variant B.1.351 decayed in nearly half of people below a laboratory test’s level of detection over six months. But such lab tests can’t predict what will happen if those vaccine recipients encounter that variant.

One possibility is that those people would get sick, but another is that even if protection wanes, the immune system “is going to recognize the virus quickly upon infection and still protect,” said John R. Mascola, director of NIAID’s Vaccine Research Center.
But Mascola cautioned “we don’t know that for sure.”

“And if you take a less-than-optimal scenario, someone who didn’t respond optimally to the vaccine for whatever reason, and we add on top of that they get exposed to a variant of concern,” Mascola said, it could prove problematic.

John P. Moore, an immunologist at Weill Cornell Medicine, said public health officials and scientists will decide if and when boosts are necessary — not drug companies.

“We’re entering a data-poor zone here — we don’t have the data,” Barton Haynes, a professor of immunology at Duke University School of Medicine, said about the questions he has been getting about boosters. Haynes is developing a next-generation coronavirus vaccine and testing it as a booster to a messenger RNA vaccine, the technology used in the Moderna and Pfizer-BioNTech shots.

He said his experience with messenger RNA vaccines tested in monkeys against HIV and Zika found that while antibodies do drift downward, they then plateau and remain stable for nearly a year. If that happens with the coronavirus, it might mean boosters aren’t needed as soon as some people think. But many factors are in play. Haynes said researchers will need to consider the level of antibodies required to thwart variants and the extent of protection people get from other parts of the immune response

https://www.washingtonpost.com/health/2021/05/27/covid-vaccine-booster-shots/

 

[chessknt]

A recent study of the Moderna vaccine found that antibodies capable of neutralizing the variant B.1.351 decayed in nearly half of people below a laboratory test’s level of detection over six months. But such lab tests can’t predict what will happen if those vaccine recipients encounter that variant.

One possibility is that those people would get sick, but another is that even if protection wanes, the immune system “is going to recognize the virus quickly upon infection and still protect,” said John R. Mascola, director of NIAID’s Vaccine Research Center.
But Mascola cautioned “we don’t know that for sure.”

“And if you take a less-than-optimal scenario, someone who didn’t respond optimally to the vaccine for whatever reason, and we add on top of that they get exposed to a variant of concern,” Mascola said, it could prove problematic.

John P. Moore, an immunologist at Weill Cornell Medicine, said public health officials and scientists will decide if and when boosts are necessary — not drug companies.

So are you refuting your own position that you should do it sans evidence? Antibody levels naturally decline after all initial novel disease exposures but this is not universally directly related to increased susceptibility.

 

[BLADEMDA]

What's the antibody level that is necessary for appropriate protection? I don't know, and I don't think anyone knows for sure.

And what does long term humoral response look like?
Re 'natural infection'

SARS-CoV-2 infection induces sustained humoral immune responses in convalescent patients following symptomatic COVID-19 - Nature Communications

A better understanding of longitudinal changes in antibody responses in COVID-19 patients is needed. Here the authors analyze anti-spike and anti-nucleocapsid antibody responses to Sars-CoV-2 over a course of 6 months in a large cohort of patients with COVID-19, showing that IgM is mostly not...

www.nature.com

Also I'm not an immunologist and don't really understand this topic.

I started this thread to discuss a booster shot for those at high risk of getting sick from Covid. Since many of my patients are Covid + and refuse to take the vaccine I am in that category. I do not think N95 masks for the next 2-3 years is the answer. IMHO, for me the answer is to maintain high antibody levels against the variants so I stay healthy and at work while minimizing risk to my family members.

If you personally don't want a booster shot then don't get one. I prefer to wear a standard surgical mask and maintain high antibody levels until the pandemic has run its course.

One last thing is I greatly appreciate the newly minted Billionaires at Moderna and BIONTEC for saving hundreds of millions of lives.

Peace.

 

[BLADEMDA]

So are you refuting your own position that you should do it sans evidence? Antibody levels naturally decline after all initial novel disease exposures but this is not universally directly related to increased susceptibility.

What I am saying is the evidence, if there is any, will be forthcoming this summer per the vaccine manufacturers. For most people a booster isn't necessary for at least 1 year following the vaccine. Many of us are not "most people" and engage in high risk activities daily with Covid + patients. I suspect at least 40% of my patients will never get vaccinated leaving me at risk of getting ill and missing work at a minimum. What each of you chooses to do to protect yourself is a personal decision.

 

[chessknt]

What I am saying is the evidence, if there is any, will be forthcoming this summer per the vaccine manufacturers. For most people a booster isn't necessary for at least 1 year following the vaccine. Many of us are not "most people" and engage in high risk activities daily with Covid + patients. I suspect at least 40% of my patients will never get vaccinated leaving me at risk of getting ill and missing work at a minimum. What each of you chooses to do to protect yourself is a personal decision.

Right but the appeal to scientific reasoning to support your ‘personal decision’ that was broadcasted to this forum is not valid to date. You may end up being right but we won’t know for a while.

The entire point of this thread seemed to be an argument that everyone who was vaccinated early will be in danger soon if they don’t try to secretly get a third shot. It seems a bit alarmist but even if that wasn’t your intent the evidence you are citing to justify that decision is incomplete and not compelling. Your underlying assertion that you are at increased risk for getting ill is an assumption based on potentially flawed extrapolation of unrelated facts. If you decided that wearing a diaper to avoid touching your body was the best way to protect yourself from the virus (based on a study that showed touching your body resulted in higher viral contamination of your clothes and another study that showed washing your clothes was less effective if viral contamination was higher but there was no study to show that your clothes could transmit the virus to actually cause disease ) that is also a personal decision but wouldn’t mean it is a good idea or needs to be adopted en masse.

Doing an unproven science experiment on yourself to intentionally not wear an n95 in a high risk case (which has evidence that it definitely works) seems like a way worse decision to me. I still wear full protective gear around covid patients and always will because that redundancy is important to me despite being vaccinated. I would do it around tb patients even if I was on therapy for tb or people with the flu even if I already had the flu.

 

[BLADEMDA]

Right but the appeal to scientific reasoning to support your ‘personal decision’ that was broadcasted to this forum is not valid to date. You may end up being right but we won’t know for a while.

The entire point of this thread seemed to be an argument that everyone who was vaccinated early will be in danger soon if they don’t try to secretly get a third shot. It seems a bit alarmist but even if that wasn’t your intent the evidence you are citing to justify that decision is incomplete and not compelling. Your underlying assertion that you are at increased risk for getting ill is an assumption based on potentially flawed extrapolation of unrelated facts. If you decided that wearing a diaper to avoid touching your body was the best way to protect yourself from the virus (based on a study that showed touching your body resulted in higher viral contamination of your clothes and another study that showed washing your clothes was less effective if viral contamination was higher but there was no study to show that your clothes could transmit the virus to actually cause disease ) that is also a personal decision but wouldn’t mean it is a good idea or needs to be adopted en masse.

Doing an unproven science experiment on yourself to intentionally not wear an n95 in a high risk case (which has evidence that it definitely works) seems like a way worse decision to me. I still wear full protective gear around covid patients and always will because that redundancy is important to me despite being vaccinated. I would do it around tb patients even if I was on therapy for tb or people with the flu even if I already had the flu

Right but the appeal to scientific reasoning to support your ‘personal decision’ that was broadcasted to this forum is not valid to date. You may end up being right but we won’t know for a while.

The entire point of this thread seemed to be an argument that everyone who was vaccinated early will be in danger soon if they don’t try to secretly get a third shot. It seems a bit alarmist but even if that wasn’t your intent the evidence you are citing to justify that decision is incomplete and not compelling. Your underlying assertion that you are at increased risk for getting ill is an assumption based on potentially flawed extrapolation of unrelated facts. If you decided that wearing a diaper to avoid touching your body was the best way to protect yourself from the virus (based on a study that showed touching your body resulted in higher viral contamination of your clothes and another study that showed washing your clothes was less effective if viral contamination was higher but there was no study to show that your clothes could transmit the virus to actually cause disease ) that is also a personal decision but wouldn’t mean it is a good idea or needs to be adopted en masse.

Doing an unproven science experiment on yourself to intentionally not wear an n95 in a high risk case (which has evidence that it definitely works) seems like a way worse decision to me. I still wear full protective gear around covid patients and always will because that redundancy is important to me despite being vaccinated. I would do it around tb patients even if I was on therapy for tb or people with the flu even if I already had the flu.

The experts will be handling the recommendations this summer as we transition to the Fall. I am finished posting on the this thread and the subject for 3-4 months. By the Fall you will be told that a booster is recommended for frontline healthcare workers but not required. Whether you are satisfied with the science behind that decision isn't my problem.

I would also like to remind you that testing for Covid isn't an exact science with many false negatives and positives. Without high antibody levels every patient is a potentially infected carrier so this requires a N95 mask for every case.

 

[Airway]

IMHO, for me the answer is to maintain high antibody levels against the variants so I stay healthy and at work while minimizing risk to my family member

To be clear I'm in favor for a booster vaccine for me. Unproven experiment or not. Data (lack of) be damned.

Agree with this as well, which is why I'm still wearing an n95 for everyone.

Without high antibody levels every patient is a potentially infected carrier so this requires a N95 mask for every case

Humans don't estimate risk well. Maybe I'm wrong, maybe the rest of the world is wrong.