Pfizer study exit

As you many recall, spouse B, daughter T, and I have all been participants in the Pfizer/BioNTech COVID-19 vaccine Phase III clinical trial since summer of 2020. B and T received the vaccine while I was in the placebo group, although I received the vaccine through the trial after the emergency use authorization came through. All three of us continued in the study of third doses.

I had hoped that Pfizer would extend our study to include fourth doses but they have decided not to do so. After researching and discussion with family and medical practitioners, I have chosen to end my participation in the trial early in order to receive a fourth shot, which I did on Saturday.

In the US at this point, government and public health officials are not making COVID policy as much as providing information for individual decision-making. I admit that this is frustrating as community behavior is so important with pandemics in general and the increasingly contagious omicron variants in particular. Emphasis has also shifted away from individual infection rates and toward making sure there aren’t enough serious infections to cause the health system to collapse.

My priority is still to try to avert infection. I don’t want to be sick if I can help it. While rates of hospitalization and death are low among those vaxxed and boosted, serious cases are still possible. While some are lucky to have no or mild symptoms, many still feel like they are suffering the worst flu/virus ever, being out of commission for at last a week. I am also concerned about the risk of long COVID, estimated to affect as much as thirty percent to over forty percent of total cases. Vaccination is estimated to halve the risk. (Please note that definitions of long COVID and the risk factors are currently in flux. As more data are collected and analyzed, these estimates will likely change.) Due to some factors in my family history, I may be at increased risk for developing long COVID. I also know that COVID infection can cause severe flares in people with interstitial cystitis, which I have.

I am very concerned about the possibility of inadvertently infecting others, including my family. I also have several immunocompromised friends who I want to protect.

Infection rates are high in my county now. I am continuing to mask in public and am back to avoiding crowds, including church services, concerts, and plays. Even with the high case counts here, most people are not taking precautions so I am being extra careful.

The boost to resistance to infection is likely to be short-lived, only a few weeks, but this is a critical time for me to have that extra protection. In mid-May, I am travelling to Northampton, Massachusetts to attend my 40th reunion at Smith College. The protocols there are strict, including mandatory vaccination and boosters, indoor masking, and many outdoor activities, so I feel relatively safe attending.

Ten days after my return, B, T, and I will travel to London, UK to visit daughter E and her family. Again, we will be very cautious with our behavior to avoid infection. We also want to protect our family, especially granddaughters ABC and JG who are too young to be vaccinated. JG is even too young to mask.

I’m happy to report that my side effects from my fourth shot have been mild, mostly a sore arm and a bit of tiredness.

I am grateful to Meridian Clinical Research who handled the trial locally and to Pfizer and BioNTech for developing the vaccine and getting it out to so many people so quickly. I am happy to have been of service by participating in the trial and stand ready to participate in additional clinical trials as they become available.

I will close with my accustomed plea for people to do all they can to end the pandemic with whatever means are available to them – vaccines, distancing, masking, avoiding crowds, increasing ventilation, etc. The pandemic is not over and our lack of attention only increases the possibility of new variants and extends the length of time before SARS-CoV-2 becomes endemic.

Covid red again

Like many places around the world, COVID cases are rising here in Broome County, New York (USA), so much so that we are once again in the highest risk category from the Centers for Disease Control and Prevention. Technically, the high risk category is now orange, not red, but I used red in the title of this post because it seems to be yet another “code red” to me.

Broome County is in one of the red zones with the Covid Act Now site that I use regularly. Our current rating is “very high,” the fourth of five levels. Our seven day average is 50.2 daily cases per 100,000 residents. This figure is likely an undercount, as not all people who test positive with a home test are contacting the health department or a medical professional to report the case or seek advice and treatment. UPDATE 4/19/22: The Covid Act Now site is now using the (much less useful) CDC rating system. Fortunately, the more granular data by neighborhood is still available, as are statistics like percentage of population with booster shots.

There are a number of factors involved in the current rise in cases. Our vaccinated and boosted rate is only 35.5% so we have many vulnerable people. (While it’s true that boosted people are still vulnerable to infection, they are much less likely to fall seriously ill with COVID.) It is also likely that we have cases of two new omicron subvariants that have recently emerged in central New York. While information is still being gathered, these may be even more wildly contagious than the previous versions of omicron.

You would think that our government officials would be re-instituting indoor mask mandates, but they have yet to do so. This is what I feared would happen. When the mandates were lifted, politicians and public health experts said they were doing it to give people a break while cases were relatively low so that they could bring mandates back if we had another surge, but only a few jurisdictions, like the city of Philadelphia, are actually following through.

Instead, government officials are relying on individuals to make their own decisions. The problem is that the majority of people in the US are not seeking out credible information about the risks in their localities. As a participant in the Pfizer/BioNTech COVID vaccine trial, I have been following the science closely. Discussions with my personal medical team have reinforced the wisdom of trying to avoid or, at least, continue to postpone infection. Nearly all the public health goals at this point are aimed at reducing serious infection, hospitalization, and mortality, but I also want to avoid illness, infecting others, experiencing long-COVID, and developing complications. I had continued to wear a KF94 mask in public and avoid crowds as much as possible, including singing masked for this performance and this video. With our current infection levels, we will most likely return to take-out dining only.

I did attend Easter Vigil last night, as I knew that it would not be very crowded, unlike the services today. I was masked but the majority of attendees were not. I admit that I cringed when I heard some very loud coughing jags near the back of the church. I was sitting near the front, so I was very far away from them, but I realize that many people are infected without knowingly being in close contact.

The ease of the spread of COVID was brought home to us over the last couple of weeks. B had gone into the office for the first time in over two years because they were having a new product launch. There was only a fraction of the workforce there, all of whom were vaxxed and boosted. Despite that, B got a message three days later that a co-worker with whom he had been conversing had developed symptoms and tested positive. B immediately masked at home and kept his distance from T and I. He did not go out in public and did self-testing. I am happy to report that we are now over ten days from his exposure with no symptoms or positive test, so he is in the clear, but the story illustrates how easily one can be exposed and risk unwittingly infecting others.

I’m not sure what additional actions I may need to take for my and my family’s protection. If the numbers stay this high, I may forgo attending mass in person and return to televised or recorded services until the numbers are better. I will probably try to speak to the local researchers in charge of the Pfizer vaccine trial to see if they are planning to offer a fourth shot to those fifty and older. The CDC has opened the option for our age group to receive a fourth dose but we need to follow the study protocols to remain enrolled in the study which is still ongoing with weekly symptom checks and periodic blood draws to check antibody levels, etc. B and daughter T received their third dose last July, while I received mine in October. We are all well beyond the four-month interval to be eligible for a fourth shot, although T is not old enough to qualify. At this point, we probably have decent protection against hospitalization but not not much against infection. It’s hard to say for sure, though, because B and T are part of the data set on which such findings are based. (I’m a bit behind them because I was part of the placebo group in the initial phase of the study, so I was vaccinated and boosted later than they were.)

I am hoping that this wave in the Northeast will pass quickly. I always hope for surges to pass quickly to reduce suffering but I have an additional personal reason this time. I am scheduled to attend my 40th reunion at Smith College beginning on May 12th. It’s the first time since 2019 the event will be held in person. It’s planned in a cautious way, with all participants required to be vaxxed and boosted, many events being held outdoors, and indoor masking requirements in place except while eating or drinking. Even with a surge, we should be okay to go ahead but it will be less stressful if the surge has passed by then.

So, once again, fingers crossed. I’m doing what I can to keep myself, my family, and my community safe. I urge all of you to stay informed from credible sources in your area and take whatever steps you can with vaccination, masks, testing, medications, etc. to get the virus levels down and protect public health and your own.

We know what can happen if we don’t pay attention and act. The United States is closing in on a million known COVID-19 deaths. It’s already a stunning level of tragedy here and around the world. Please do all you can.

still masked

Last Friday, the US Centers for Disease Control and Prevention (CDC) changed their methods of assessing COVID risk to include the strain on the health care system, resulting in about 70% of the population now being classified as being in low or medium risk areas, meaning that indoor masking in public places and distancing measures can be rolled back.

However, Broome County, New York, where I live, is still in the high risk category. In the even more granular Covid Act Now tracker, our risk level is rated as very high, the fourth of five levels, with 26 daily new cases per 100,000 residents as of today, February 27.

The problem is that, when New York State rescinded its mask mandate, our local government also rescinded theirs. Our local conditions don’t warrant that, but, without a rule in place, the vast majority of people will not be masking in public, which will likely delay further progress in getting our case numbers down. Another thing that would help would be increasing our vaccine booster rate, which has crept up to 34% but is still low for our state, as is the 63% full vaccinated rate.

Earlier this month when New York dropped its mask mandate, I posted that I would continue to wear an N95 in public and to avoid crowds in an effort to stay COVID free. As a participant in the Pfizer/BioNTech vaccine trial, I am supposed to be following CDC protocols. With our county still being at high risk according to the current CDC map, I am still in compliance with my obligations to the trial.

The next decision point for me will be when Broome County finally gets into a lower risk category. In discussions with my personal physicians, they have advised attempting to avoid infection entirely for as long as possible. I share in this viewpoint. Many public health commentators have gone to the less stringent goal of trying to keep out of the hospital or dying from COVID and to prevent strain on the health care system. I, however, want to protect myself, my family and friends, and my community from being infected at all, so they won’t have to deal with the threat of severe illness, long COVID, and long-term cardiovascular, pulmonary, or neurological damage that can follow infection, even in those who didn’t have serious enough symptoms to warrant hospitalization.

The CDC does say in their guidance that “People may choose to mask at any time.” That will probably be me for quite some time yet, unless our county improves dramatically soon.

Lent is about to start. I’m trying to be hopeful that our situation will improve enough that I can safely drop my crowd avoidance in time to participate in some of the Lenten and Holy Week liturgies. We’ll see.

politics and/or science

Over the course of the pandemic, I’ve posted frequently about it, the Pfizer/BioNTech vaccine trial in which B, T, and I are participating, the evolving science on the SARS-CoV-2 virus and its variants, the similarly evolving public health recommendations, and how these are being implemented here in my home state of New York and elsewhere in the United States. I do sometimes comment on the pandemic in the UK and globally, but I know best what happens close to home.

Throughout the pandemic, New York had been in the vanguard of following the recommendations of public health experts, avoiding the tendency we have seen in so many other states to ignore the benefits of masking, distancing, limiting crowds, getting vaccinated, isolating if infected, etc.

That ended this week.

Governor Hochul bowed to public and political pressure and lifted the mask mandate for businesses. While it is true that statewide the peak of the Omicron wave has passed and the vaccination rate is decent, my county’s risk is still rated as very high, with 44.7 per 100,000 daily cases. Technically, New York as a state is also in the very high category with 31.2/100,000 today (February 11), but it is counties like mine that are keeping the state in that risk category rather than dropping into the (merely) high category. Medium and low risk are a long way off at this point.

Meanwhile, the national Centers for Disease Control and Prevention are recommending not only that everyone age two and over wear a mask while in public but also that those masks be N95 or similarly protective types because Omicron is so highly contagious. Alarmingly, an even more contagious omicron sub-variant has reached the US, making protective masks that much more important.

Does this sound like the proper time to end mask mandates for businesses in New York State?

Certainly not, if one is truly following the science.

The problem is that many people are tired of having to deal with the pandemic and are complaining very loudly. The politicians who had been following the science hear them and loosen the rules that had been helping to get their residents through the current wave with as little hospitalization and death as possible. This could extend the current omicron wave and increase the likelihood of yet another new variant that has the potential to be even more transmissible or evade current vaccines and treatments or cause more severe disease.

Regardless of New York State rules, I am continuing to follow medical advice, to avoid crowds, and wear an N95 when in public. Because I am vaccinated and boosted, I will still visit with people who are similarly protected without a mask. I had hoped to return to church services this weekend but have decided that I can’t do so with the daily case rate still being so high; being stationary in a room with that many people for over an hour is too much risk for me, even masked.

Sigh.

At some point, the pandemic will end and I will follow medical and scientific advice on what my “new normal” will be. I had hoped that our state policies would be an aid in this, as they had been through most of these past months, but that remains to be seen.

I’m just hoping that this latest relaxation of protections doesn’t cause even more cases than we have already suffered.

Update: Almost immediately after publishing this post, I saw reports of this study from the CDC, which shows that booster effectiveness wanes significantly after four months. Given that B, T, and I all had our boosters on the early side due to our participation in the Pfizer/BioNTech vaccine trial, I’m all the more resolute in my vigilance regarding masking, distancing, etc. While we are all still likely to avoid severe disease or hospitalization due to our longer-than-four-months-ago boosters, I prefer to try to avoid infection entirely.

over COVID?

Over the last few weeks, many people here in the United States have said publicly that they are “over COVID” or “through with the pandemic” and are going to “go back to normal” which means living like they did before SARS-CoV-2 appeared.

Guess what? Pandemics don’t disappear just because we are tired or frustrated or in denial. There were 3,622 COVID deaths reported in the US yesterday, adding to the almost 900,000 deaths in the US since the start of the pandemic and 5.7 million deaths worldwide. These staggering totals are almost certainly undercounted, as some regions don’t have the will or capacity to track and report. Also, some deaths result from lasting heart, lung, or neurological damage from COVID rather than from the active infection itself and so may not be identified as COVID related.

Some people are saying we just have to live with COVID, as we do with flu and other viruses. Thus, they are saying that it is now endemic, but here is the problem. There is a specific definition of pandemic, “(of a disease) prevalent over a whole country or the world” (Oxford Languages). Looking at case numbers in the US and around the world, it’s obvious this is still a pandemic. We will get to a point where it is endemic, someday, through a mix of vaccination and immunity from having been infected, although no one yet knows how long immunity acquired through either route will last. Dictionary.com has a handy non-epidemiologist explainer of pandemic, epidemic, and endemic.

The subtext of being “over COVID” seems to be more along the lines of I’m tired of masking and distancing and avoiding crowds, so I’m just going to get back out there because a) I’m vaccinated/boosted so I don’t think I’ll get sick or at least not seriously so; b) I am young/strong/take vitamins/exercise so I’m not going to get sick; c) I don’t believe there is such a thing as this virus; d) you can’t tell me what to do; or e) we have to ease up on restrictions now so that we can re-institute them when the next variant or spike in cases occurs.

The thing is that a virus doesn’t care about your age or status or location. It’s only mission is to live and replicate and it will adapt to make that happen as easily and widely as possible. Exhibit A: the Omicron variant, which is wildly contagious and somewhat able to cause breakthrough infections in the vaccinated.

As regular readers here may recall, spouse B, daughter T, and I are all part of the Pfizer/BioNTech phase three vaccine trial. We are all vaccinated and boosted, although we were boosted on the early side of the curve, B and T as part of the trial that is contributing efficacy data that we see reported out in the news, and I who received a booster through the trial as soon as it was authorized for public use but before most people in my age range were eligible. I am also contributing data for the study, but I’m not on the leading edge like B and T. Therefore, while many of the boosted can get comfort from knowing that their immunity is likely still strong because the data from the trials is showing that, I don’t know if B and T might be showing a decline because there hasn’t been enough time to collect and analyze that data. I’m sure we would all love to know that booster immunity lasts a year or longer but it’s only been about seven months so far, so we can’t know. Likewise, we don’t know how long immunity lasts after infection.

I know that I am unlikely to become seriously ill, to be hospitalized, or to die if I contract COVID, but that doesn’t mean that I’m ready to be cavalier about it. I don’t want to be sick if I can prevent it by continuing with masking, distancing, and avoiding crowds. Even mild cases of COVID can result in months of symptoms, which is termed “long COVID.” As someone who has lived with a person suffering from FM/ME, which causes similar symptoms, I find the prospect of long COVID frightening.

What frightens me even more is the danger of spreading COVID to someone else. I have many friends who are older than I and at higher risk, as well as friends who are immunocompromised. Young children still are not eligible for immunization, although Pfizer/BioNTech has just applied for emergency use authorization for children 6 months-4 years of age, so perhaps that will begin in the coming weeks. I’m sure I also happen upon unvaccinated people because the fully vaccinated rate in my county is 62% and the boosted rate is only 33%. Some of the fully vaccinated are not yet booster eligible but we know that boosted people have the best chance against Omicron, so, if I am out in public, chances are that only 1 in 3 people I encounter will be a similar status to me.

Those are not great odds, especially with a variant as contagious as Omicron accounting for 99% of US cases. I have recently upped my mask protection to N95s, as I wrote about here. I’m learning how to deal with them as someone who needs progressive lenses in her glasses. The tighter fit of the N95 masks makes it difficult for my glasses to be in the correct position, so I can get a headache from eyestrain if I try to do close work for any length of time. Still, I’m trying to wear the N95s when I have to go out with a surgical mask/good quality cloth mask combo if I have to take the N95 off.

I used this site, https://covidactnow.org/us/new_york-ny/county/broome_county/?s=28791756, to find today’s Broome County statistics. (You can use it to find statistics in your area in the US. International data may be found here: https://coronavirus.jhu.edu/.) It rates our risk level as “Extremely High.” While other may be “over COVID,” I am not ready to take that much risk for myself, my family, and my community.

As conditions change, I will re-evaluate and adjust my behavior as I see fit. Until then, I hope that those I meet will respect my viewpoint.

I’m not “over COVID” yet.

N95s

With the immensely transmissible Omicron variant so prevalent, I’ve decided to try to get N95 masks to wear when I have to go out in public. I have been double-masking with a surgical mask under a very good quality cloth mask made by medicalwear producer Jaanuu but thought that I should probably go to an N95 mask which is designed to fit more closely and filter out 95% of particles under NIOSH standards. (NIOSH is the US National Institute for Occupational Safety and Health.)

It’s somewhat difficult to find N95 masks in stores here. We did get a few from a home improvement store which stocks them because they are protective against dust and other particles for people doing construction or renovating. The problem is that they only carry one size which is too large for my petite face. I was able to find N95s in a size small online and a second fold-flat style that people complained about in the comments as running small, so I have ordered some. They won’t arrive until late this week or early next but I think I’ll be safe with my current mask set-up until then.

Or safe enough…

Masking is just one piece of our strategy. The three doses of Pfizer/BioNTech vaccine is my primary protection. The masks, avoiding crowds, distancing, etc. are additional measures to stay as safe as possible but, especially with Omicron, there are no guarantees.
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the pandemic – year 3

My first post about the pandemic was February 29, 2020, a Stream of Consciousness Saturday post, no less! COVID-19, the illness caused by the SARS-CoV-2 virus, was already killing people in China, other parts of Asia, and Europe but had just begun to sicken and kill people in the United States, where I live.

I’ve written dozens of posts since then about the impact of the pandemic on our lives and about spouse B, daughter T, and my participation in the Pfizer/BioNTech vaccine trial. Yesterday, B and T, who are being followed currently on the efficacy of the third dose, had an appointment for blood work to add to the data on the longevity of antibodies and other immune markers six months after their third dose. I am also boosted and remain part of the trial, although, as someone who was in the placebo group initially, I am now part of the group who received their third dose later, so I am not on the leading edge in terms of data. There is a possibility that, when Pfizer/BioNTech develop an Omicron-specific booster, we may be asked to participate in that phase of the trial as well. Meanwhile, we continue to do weekly check-ins via app and do testing if symptoms that could be COVID appear.

I am grateful that we are able to help advance the science on the vaccines which have averted millions of hospitalizations and deaths. Even though the Omicron variant causes more breakthrough cases among vaccinated and boosted individuals than earlier variants, the vast majority are still protected from serious complications and death. I’m just sad that so many people around the world, by personal choice or by lack of availability, remain unprotected.

While Omicron tends to cause less severe symptoms than some of the earlier variants, it can still be deadly. The case numbers in the US, almost all caused by Omicron at this point, are staggering, reaching record numbers. On January 11, the US reported 1.35 million new cases with 136,604 hospitalizations, both records. The case count is somewhat elevated by the fact that some states don’t report new cases over the weekend, making the Monday numbers higher, but the seven-day average is over 700,000, so there are extraordinary levels of infection in evidence. Some hospital systems are overwhelmed, especially because staffing is a challenge. Many health care workers are exhausted by the sheer volume of patients and length of the pandemic and some have left the field. Right now, there are also a lot of vaccinated and boosted staff who have developed breakthrough cases; even if they are asymptomatic, they could still be contagious, so they have to isolate until they test clear of the virus.

The difficult thing for me to accept is that so many people in the US have chosen not to be vaccinated, despite the risks to themselves, their families, and their communities. Because Omicron is so transmissible, the safest course of action is to be vaccinated and boosted, while continuing to mask in indoor public spaces, to distance from non-household members, to avoid crowds, to sanitize appropriately, and to test before (small) social gatherings. By combining all those measures, B, T, and I were able to travel to London, where Omicron was running rampant, and get home virus-free.

Yes, going into year three of this, we are all tired of having to think about COVID safety all the time, but the virus doesn’t get “tired” of mutating and infecting people. We need to do everything we can to promote public health and to protect those who because of age or health condition can’t develop vaccine protection. We have to continue to study the virus, including all variants, to assess their impacts, including how long and strong immunity is from vaccines and from infection. Unfortunately, many viruses don’t tend to confer long-lasting immunity. If they did, we wouldn’t continue to get common colds repeatedly. Current research on SARS-CoV-2 shows immunity extending to about eight months. Some suggest that immunity could stretch to five years but we can’t know that yet, as this virus hasn’t been around that long. It also looks like some of the variants, like Omicron, are better at evading immunity, whether from prior infection or vaccines. We also have to be prepared for further variants that could be even more transmissible and/or cause more severe disease.

We are still in the pandemic phase with COVID-19. The world is unlikely to be able to rid itself of the virus totally. At some point, we will reach an endemic phase, where the virus is in circulation but not causing widespread serious illness/deaths through some combination of vaccines, natural immunity, and treatments. Will year three be the final year of this pandemic? No one knows for sure, but I am trying to hang onto hope that it will be.
*****
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travel in Omicron time

In October, we made plans to visit daughter E, son-in-law L, granddaughters ABC and JG, and L’s parents with whom they live in London, UK for the holidays. I hadn’t shared much about our plans here for fear that we would have to cancel, as we did with a planned visit in November 2020. At the time we made our plans, vaccination rates and COVID rates looked amenable for travel for three people who had had three doses of Pfizer vaccine, due to our participation in the clinical trials.

And then, in November, the Omicron variant appeared.

Travel and testing policies changed. Everyone wanted to know how virulent it is, if vaccines are protective, how severe it is, where it is spreading – and they wanted to know right away. Unfortunately, science doesn’t work that way. It takes time to gather and analyze data.

It actually was to our advantage that there were several weeks before our trip for some preliminary conclusions to be discerned. Yes, Omicron is more transmissible than the very contagious Delta but tends to cause less severe disease and to run a shorter course. Vaccines were less effective than against other variants but having a booster greatly increased protection.

And Omicron was rapidly spreading almost everywhere.

My home state of New York in the US was experiencing a spike in Omicron on top of a spike in Delta. In London, Omicron was taking over with over 90% of new COVID cases caused by it.

Still, travel was open for vaccinated people to enter the UK, we had our required testing scheduled both in the US and the UK, and the UK had not imposed restrictions on gatherings in private homes, so we were good to go, scheduled to fly out of Newark on Monday night, Dec. 20.

On Thursday, Dec. 16, L tested positive for COVID. He had been testing at home every day before going to work in the schools and didn’t have symptoms. He immediately had a follow-up test with a medical facility to confirm, then went into isolation in a bedroom. He developed symptoms which were like having a bad cold, which seems more typical with Omicron. In accord with UK protocol, the adults in the house tested themselves every morning. If they were negative, they could go out for the day. The children would only need to be tested if they had symptoms.

Obviously, this was scary news a few days before our trip, but, being used to uncertainty by now, we decided to go ahead with our plans.

On Saturday morning, we did COVID tests at the local pharmacy. The results were supposed to be available by noon on Monday and our flights wasn’t until 10 PM, so no problem, right?

Except that they didn’t come. We headed to Newark airport, which is about three hours away, hoping to get a rapid test there, but the testing center closed early, so we waited for our results to come in. As it turned out, only mine came through in time, so I flew to Heathrow by myself. This was the first time I had ever flown internationally without being part of a group, but I managed, admittedly with a lot of helpful staff and fellow travellers who could probably tell that this silver-haired woman wasn’t quite up to snuff, especially after a sleepless night on a plane. E met me at the train station and helped me get settled – and do my COVID test that the UK required. I needed to stay in isolation until I got a negative result.

Meanwhile, B and T re-booked their flight for the next evening, stayed at a hotel overnight, and went to the airport bright and early to go to the rapid test center. They had finally gotten their negative results from the Saturday tests but, because they were now flying on Tuesday, that test was too old to meet the requirements. Fortunately, I was already checked in to the hotel so they could start their UK isolation/testing bit, too. I’m happy to say that the UK results came much more quickly, so we were out of isolation by the time we moved to our Airbnb in E’s neighborhood on Thursday.

When you are browsing through Airbnb’s site, you can’t see the exact address. We knew we were in the neighborhood, but were pleased to find out we are only about three blocks from their house. Given that we are trying to limit our exposure to crowds, it’s nice to just have a short walk between the two places. It’s also nice to have our own kitchen. We even have an enclosed back garden, although it’s been too rainy to use it.

We benefited from a change in UK policy. Instead of having to isolate for ten days, people are allowed to leave isolation sooner if they have two negative test 24 hours apart. This meant that L was able to get out of isolation in time to have Christmas Day together. (You can read about the menu here.)

In deference to the wild spread of Omicron, we are not going to church or other kinds of crowded venues, like museums, during this visit. We are pretty much going back and forth between the two houses. While B, T, and I and L’s parents were all boosted, E and L were scheduled to get their boosters on Sunday, three days after Larry tested positive. E’s COVID exposure delayed her getting a booster until Dec. 24; L can get his in several weeks. For the record, E and L were not negligent in scheduling their boosters. Rather, they were following the UK protocols, which are different than the US ones.

All of us are trying to be protective of ABC and JG, who are too young to be vaccinated. Realistically, B, T, and I also need to stay COVID-free to be able to travel back to the US in January. Fingers crossed that the travel and visiting policies stay stable so that there are no more glitches, delays, or restrictions.

But, hey, we’ve already shown we are flexible, if need be.

Pfizer booster

As part of my ongoing participation in the Pfizer/BioNTech COVID-19 vaccine phase III trial, yesterday I received a third vaccine injection, seven and a half months after my second. There was a blood draw to test levels of antibodies, T cells, etc. and the blood work will be repeated in a year. I will continue a weekly symptom check through a phone app and have a couple of phone appointments over the next year, too. The data collected will be used to inform on-going decisions about how often boosters may be needed in the future.

I’m fortunate that my side effects have been milder than they were with the second injection. I have a very sore arm, which is obviously from the shot. I’m tired and have a bit of a headache, which could be side effect and could be just life in general these days. Today is the one-month anniversary of Paco’s death, so how I am feeling could be attributable to that rather than to vaccine side effects. When spouse B and daughter T, who are also study participants, received their third doses, they both lost a day to fever, body aches, and fatigue; because I had had a similar reaction to my second dose, I was expecting a similar experience, but apparently have lucked out.

In the United States, a third dose of the Pfizer vaccine is approved for those aged 65 and up, people who have medical risk, and those in certain professions that have close contact with vulnerable populations. It’s possible that the third dose will be recommended more generally in the future as more data become available. It’s also likely that emergency use authorization for children aged 5-11 will come soon, with shots in arms starting in early November.

Recommendations on booster doses for Moderna and Johnson & Johnson are expected soon, as well as the possibility of mixing manufacturers, for example, someone who had the J&J vaccine having a booster from Pfizer. All the companies are continuing to study the vaccines for long-term efficacy and side effects, as well as safety, efficacy, and dosage for children six months through seventeen years. Currently, in the United States, only Pfizer is approved for ages 12-17.

Another helpful development is that Merck has applied for emergency use authorization of molnupiravir, an oral anti-viral to combat COVID. It would be given to patients in the early stages in hopes of keeping their illness from becoming severe. While it is already possible to give treatments by injection or infusion, such as monoclonal antibodies, this medication would be easy to prescribe and administer for home use. A decision by the FDA is expected within weeks.

Meanwhile, over the summer, COVID cases were devastating parts of the US, especially states with low vaccination rates. Total fatalities are over 700,000 with over 44 million cases recorded. In some areas, hospitals were so overwhelmed that they had to send patients out of state to receive care. This applied to COVID patients and also to patients suffering from other serious conditions. Two states, Idaho and Alaska, had to implement crisis standards of care, which means that whether or not an individual receives treatment beyond comfort care is determined by the likelihood of survival as there is not enough capacity to treat everyone that needs help. This resulted in non-COVID deaths from heart attack, stroke, etc. – patients who ordinarily would have been treated successfully but who died because there were not personnel, equipment, and space available to treat them due to intensive care units being filled with COVID patients.

The delta variant was the power behind the summer surge, but, at least, the fear of it encouraged more people to seek vaccination. The increase in vaccination rates is helping the case numbers to fall at this point. Still, the current rate of fully vaccinated people is only 57% with 66% receiving at least one dose. I am hopeful that the Pfizer vaccine being approved for elementary age children in the coming weeks will add significantly to our vaccination totals, at least in states where the vaccination rate among adults is higher.

There are still terrifying amounts of misinformation floating around about the vaccines that are keeping some people from taking them. Unfortunately, this is keeping the pandemic alive, resulting in illness, death, lack of access to medical care, and the possibility of even more dangerous new variants developing.

We are all in this together. Please, everyone, get vaccinated if you are eligible and follow reputable public health guidelines on masking, avoiding crowds, handwashing, etc. Your choices affect your family, friends, neighbors and community directly and your nation and the world, as well. We can’t truly end this pandemic until there’s no population anywhere still vulnerable to COVID-19.

If you won’t do it for yourself, do it for someone you love.

Pfizer vaccine approval

Today, August 23, 2021, the United States Food and Drug Administration has announced the full approval of the Pfizer/BioNTech vaccine against SARS-CoV2, the virus that causes COVID-19, for people aged 16 and up. People aged 12-15 are still being immunized under the emergency use authorization. It is also expected that, in the coming weeks, Pfizer will apply for emergency use authorization for children aged 5-11. Research is ongoing on children 6 months-4 years. Also, most adults will become eligible for a third dose to boost immunity, given from 8-12 months after the second dose.

Meanwhile, both Moderna and Johnson & Johnson, the other two vaccines available under emergency use authorization in the US, are continuing their research and applications to expand their age ranges and gain full approval, too.

It’s possible that, for some people who have been reluctant to be vaccinated, the full approval of the Pfizer vaccine might be enough to convince them to receive it. The US has seen many more shots being administered in recent weeks as the delta variant has surged and people realize that nearly all the people being hospitalized and dying are those who were unvaccinated. Unfortunately, it takes several weeks to build immunity from the vaccine so the delta surge will likely continue into the coming months.

The other expected impact of the full approval of the Pfizer vaccine is that more employers may mandate that their workers be immunized before returning to in-person work and more businesses may require immunization (or alternatively a recent negative test) for their patrons.

As regular readers may remember, my spouse B, daughter T, and I are all part of the Pfizer Phase III trial for the vaccine. B and T were lucky enough to receive the actual vaccine in August 2020 while I wound up being in the placebo group. When the vaccine received emergency use authorization, the study was unmasked so that people in the placebo group could receive the vaccine, which I did in February 2021. I will continue to be followed as part of the original study through August 2022. B and T, meanwhile, have entered into the third dose phase of the study. They will be providing data for the continued study of how much immunity boost occurs with the third dose and how long it lasts.

I continue to mourn for all those who are suffering as a result of the pandemic. Please, everyone, listen to the public health specialists in your area, receive the vaccine as soon as it is available to you, and mask, distance, and wash hands as directed. Please, do everything you can to protect the health of yourself, your loved ones, and your community.

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