COVID bivalent boosters

As you may recall, spouse B, daughter T, and I were all participants in the Phase III clinical trial for the COVID-19 vaccine from Pfizer/BioNTech. We then all participated in a follow-on third dose trial. B and I left the trial this spring because we were eligible to receive a fourth dose and wanted the extra protection before travelling. T stayed in the trial until its end earlier this summer.

Here in the United States, a new booster was recently approved which combines the original formulation with a new one designed to better combat the Omicron BA.4 and BA.5 variants. BA.5 is the dominant variant currently in the US, accounting for about 88% of cases. About 11% are caused by BA.4. The new booster is expected to strengthen protection against serious illness/death and, one hopes, cut down on symptomatic infection somewhat, as well.

Given that I am still trying to remain COVID-free and that I have several trips coming this fall, I decided to receive one of the new boosters at my local pharmacy. I chose to receive the Pfizer formulation because all my others have been theirs, although there is a Moderna version which is also a fine choice. This was my first time receiving the vaccine in a pharmacy setting. My prior doses had all been in a medical office or a state vaccination site. I made an appointment online and everything was very fast and efficient.

Dr. Ashish Jha, who is the White House COVID-19 response coordinator, and Dr. Anthony Fauci, the long-time director of the National Institute of Allergy and Infectious Diseases, have said that it is possible that we may have reached a point where an annual booster will be enough to protect the vast majority of Americans from serious illness/death from COVID, similar to annual flu shots. Some people who are especially vulnerable due to age or medical condition might need more frequent boosters. The wild card, though, would be the emergence of a new strain that could evade our antibodies and current vaccines.

So, my message is to receive one of these new boosters as soon as they become available wherever you are. The US has been first to authorize them, but it seems they will become more widely available globally soon. Remember, though, that these are booster doses given to people who have already completed an initial vaccine series. If you haven’t completed an initial vaccine series, start NOW!

Meanwhile, here in Broome County, our community risk level is still medium. While I wait for the new booster to take full effect, I will still mask for indoor gatherings and shopping. I’ll be evaluating what to do after that, although these boosters are so new that data may be hard to come by.

I hope to stay well and hope that you do, too.

vaccine update

Here in the United States, we are continuing to roll out coronavirus vaccines as quickly as possible, although there are a few snags.

The biggest is that the one-shot Johnson & Johnson vaccine is on temporary pause, due to six cases of a rare blood clotting problem that have been reported among women aged 18-48 within two weeks after vaccination. Given that over six million doses have been administered, the percentage affected is tiny, but the two agencies in charge are being cautious, especially as a small number of similar cases have been reported in Europe in connection with the Oxford/AstraZeneca vaccine, which, like the J&J, is an adenovirus-based vaccine. The pause is allowing them to gather and assess data. Additional cases may surface because of the attention this is receiving in the media. It also lets physicians know to ask about vaccine status when a patient presents with blood clot symptoms. This is important because vaccine-related blood clots call for a different treatment regimen. The hope is that the J&J vaccine will again be cleared for distribution within the next two weeks.

The public reaction has been mixed. Some people say that this pause shows how closely public health officials are tracking the various vaccines and their effects, which raises their confidence level. Others are worried that this means the vaccines weren’t sufficiently tested. A few who have received the J&J vaccine are panicking.

As someone who has been involved in vaccine trials, currently the Pfizer/BioNTech coronavirus vaccine but previously trials for flu, adult RSV, and pneumonia vaccines, I can attest that researchers are very careful in how they conduct trials. However, when you have a side effect that seems to appear in such a small number of people, you are unlikely to find it in a trial of thirty thousand people. If it turns out that the blood clot complication does occur, a person is more likely to be struck by lightning than to develop a blood clot after J&J vaccination. I hope this would calm anyone who is panicking, although people often fear rare events while ignoring those that are much more likely to impact them.

I admit that it boggles my mind that, with over thirty-one million known COVID cases in the US and over 565,000 deaths, people would fear an extremely rare side effect more than the virus itself. There are still about 25% of adults who say they will not get vaccinated, which raises the prospect that we won’t be able to stop community spread and end the pandemic because the pool of susceptible people will remain too large. Also, remember that some people who have been vaccinated may still be infected, but their chances of being severely ill are greatly diminished. Still, the way to end the pandemic is to have 85-90% of people vaccinated so that cases of the virus can be contained rather than spreading throughout the community.

It will help when those younger than 16 can be vaccinated. Pfizer has currently asked for permission to add 12-15-year-olds to those eligible after conducting a trial with that age group. Pfizer, Moderna, and others are also conducting research on the best dosages for younger children.

Meanwhile, research is continuing into how long immunity from the vaccine will remain strong. Spouse B and daughter T who received the Pfizer vaccine last August as part of the phase III trial are part of the effort to answer that question. The six month figures showed that immunity remained strong but they will be followed for at least two years to see how that may change with time. The Pfizer CEO Albert Bourla has said that he thinks a yearly booster is a possibility; they have begun studying this with phase I trial participants. We’ll see when B and T have their one-year follow-up in August whether or not they will have extended the booster dose study to phase III participants.

It is my sincere hope that by then we will have been able to fly to the UK to visit our family there and to meet granddaughter JG in person. While we are doing all we can to make that safely possible, it is frustrating to still see so many people not willing to cooperate with public health measures to keep themselves, their loved ones, and their communities safe using masks, distancing, limits on gatherings, vaccines, etc. to end the pandemic.

Yesterday, there was a Congressional hearing at which Dr. Anthony Fauci, one of the leading health officials in the country, was testifying. Rep. Jim Jordan illustrates the dynamic that has resulted in the unfortunate and dangerous politicization of the pandemic. This is a public health issue, not a “freedom” issue. Living in a free society does not mean that everyone is free to do or say whatever they want; we each have a corresponding responsibility not to cause harm to others or damage their rights and human dignity.

This brings me to my last point. The pandemic affects the whole world. Under the prior administration, the United States suffered terrible losses and did not contain the spread of the virus. Under the Biden administration, the US is making progress and has taken some steps to help the rest of the world in the fight against COVID. The US is now part of the COVAX initiative to help distribute vaccines to lower-wealth countries, although this is just getting underway. It has also sent some of its stockpile of the AstraZeneca vaccine, which has not yet been approved for emergency use in the US, to Canada and Mexico where it has been. While I expect the US to retain doses of approved vaccines as boosters, I’m hoping that once everyone who will accept the vaccine in the US has been vaccinated that we will distribute all the other doses to countries that need them, along with whatever other logistical and medical help is needed.

We can never end the pandemic until the virus has nowhere on the globe where it can run rampant. To me, this is a moral imperative. Others may be motivated by economic self-interest. Whatever the reason, it needs to happen.