S/O booster timing

[MEmama]

2 minutes ago, Syllieann said:

CVS is making you call to schedule it it's under 6 months.  Maybe they changed it once they realized the loophole, or maybe it varies by state.

 

I don't know what to do.  I had Pfizer 5 and a half months ago, two of my kids are too young to vax, and I still won't meet eligibility for Pfizer at 6 months.

At this point I'm ready to get the booster but have to wait until the rules change to simply 6 months without the other medical conditions. Fingers crossed they change before DS comes home in December because I really, really want him to be as protected as possible on a college campus. 
 

Hope your younger kids are eligible soon! 

[Spy Car]

25 minutes ago, MEmama said:

I’m concerned about all of it.
 

My question isn’t “should I get a booster” but “when is the *optimal* time for me to get a booster”. On the other thread most responders seemed to be much higher risk than I am (teachers, healthcare workers, have kids under vax age etc). I *absolutely* wouldn’t hesitate if I checked any of those boxes. I'm concerned about getting the *most* out of my eventual booster— for myself and my community. I think everyone here knows how cautious I am and how seriously I take this. That’s why I’m asking.

There’s a lot of evolving info to keep up with and I admit I don’t always remember all of it. I come here because there are many posters whose opinions and knowledge I trust. 

At this point it seems like I ought to not wait, except I have to because I’m not eligible. Hopefully that changes before winter sets in. 

What I'm trying to suggest is that the consideration of what's "optimal" seems to depend on one's goals.

Many of the advisors on the FDA panel seem to think the first situation above is (accepting breakthroughs so long as hospitalizations and death are mitigated against) vs trying to quash infections by boosting antibodies is their stance. I don't feel the same way.

My best understanding is 5-6 months is optimal for boosting antibodies. Conflicting evidence/lack of evidence for timing for longer term antibody/immune response, as best as I understand it.

Bill

 

 

[goldberry]

1 hour ago, ScoutTN said:

Will your doc write an order for a Pfizer booster for you, based on a high-risk job?

I didn't think of that.  I might check into it if there's no Moderna news by the end of the month.

[MEmama]

18 minutes ago, Spy Car said:

What I'm trying to suggest is that the consideration of what's "optimal" seems to depend on one's goals.

Many of the advisors on the FDA panel seem to think the first situation above is (accepting breakthroughs so long as hospitalizations and death are mitigated against) vs trying to quash infections by boosting antibodies is their stance. I don't feel the same way.

My best understanding is 5-6 months is optimal for boosting antibodies. Conflicting evidence/lack of evidence for timing for longer term antibody/immune response, as best as I understand it.

Bill

 

 

This is the type of info I was looking for. Now that I know, I’ll jump on it as soon as the rules change so I’m eligible (I’m just now at 6 months but don’t qualify under cdc guidelines. Booo). 
 

Thanks! 🙂 

[ktgrok]

2 hours ago, Bootsie said:

I agree with you.  Are we going to trust the FDA and the CDC with their guidance on who should be vaccinated and boosters and encourage others to do the same?  Are we going to trust others not to lie about medical conditions and facts?  

I trust them on the science. That is not the same as going along with the red tape. 

1 hour ago, Syllieann said:

CVS is making you call to schedule it it's under 6 months.  Maybe they changed it once they realized the loophole, or maybe it varies by state.

 

I don't know what to do.  I had Pfizer 5 and a half months ago, two of my kids are too young to vax, and I still won't meet eligibility for Pfizer at 6 months.

In that case I'd schedule online once you hit 6 months. 

38 minutes ago, MEmama said:

This is the type of info I was looking for. Now that I know, I’ll jump on it as soon as the rules change so I’m eligible (I’m just now at 6 months but don’t qualify under cdc guidelines. Booo). 
 

Thanks! 🙂 

BMI is always under 25? No history of cancer, no issues with elevated blood pressure (and what is considered hypertension has changed, the cut off is lower now), never smoked, etc? 

[Corraleno]

42 minutes ago, MEmama said:

At this point I'm ready to get the booster but have to wait until the rules change to simply 6 months without the other medical conditions

I don't think the rules are going to change any time soon, if ever. The FDA is also meeting this week to discuss J&J, as well as mixing vaccines and boosters, and my best guess is that they will approve Moderna and J&J under the same terms as Pfizer, in order to have a simple, standardized booster policy. I think people who fall into the very small percentage of adults who do not meet any of the criteria may have to choose between flexibility in checking a box versus agreeing to be sacrificial lambs who risk their own health so the US can claim we are "only boosting the most vulnerable" (who just happen to comprise like 90% of the population).

I happen to meet the criteria for a Pfizer booster, but my kids, who are exposed through college classes and work/travel/competition technically do not, even though they have far more exposure than many people who do qualify. I have no qualms about checking a box so that they can get a shot that has been proven to be not only safe and effective, but also necessary to protect against infection. They shouldn't have to risk their own health because of a public policy that says the risk of long covid in under 65s, or even "just" missing a few weeks of classes and/or income, is NBD and not worth approving a $20 shot.

[mommyoffive]

1 minute ago, Corraleno said:

I don't think the rules are going to change any time soon, if ever. The FDA is also meeting this week to discuss J&J, as well as mixing vaccines and boosters, and my best guess is that they will approve Moderna and J&J under the same terms as Pfizer, in order to have a simple, standardized booster policy. I think people who fall into the very small percentage of adults who do not meet any of the criteria may have to choose between flexibility in checking a box versus agreeing to be sacrificial lambs who risk their own health so the US can claim we are "only boosting the most vulnerable" (who just happen to comprise like 90% of the population).

I happen to meet the criteria for a Pfizer booster, but my kids, who are exposed through college classes and work/travel/competition technically do not, even though they have far more exposure than many people who do qualify. I have no qualms about checking a box so that they can get a shot that has been proven to be not only safe and effective, but also necessary to protect against infection. They shouldn't have to risk their own health because of a public policy that says the risk of long covid in under 65s, or even "just" missing a few weeks of classes and/or income, is NBD and not worth approving a $20 shot.

What would you do if your kids were teens?  I have a 13 and 15 year old that are at 4 months with Pfizer.  What the heck do I do with that?  

[Spy Car]

2 hours ago, Bootsie said:

I agree with you.  Are we going to trust the FDA and the CDC with their guidance on who should be vaccinated and boosters and encourage others to do the same?  Are we going to trust others not to lie about medical conditions and facts?  

I ended up watching most of the pertinent parts of the FDA advisory group video online (multiple hours worth).

And on the science, there was fairly strong unanimity on the evidence. Where there were differences was on policy.

Much of the panel was willing to accept waning antibodies and breakthrough infections (and infectiousness) so long as there was fairly high protection from hospitalization and death as an adequate situation. Maybe a better situation than they might have expected prior to the vaccines being developed.

The actual vaccines have surpassed expectations. That's a great thing. But the panel all agreed that with waning antibodies that people who are fully vaccinated become vulnerable to infection (and becoming infectious) given the very high transmissibility of Delta. The science is not in question.

The policy decision was whether or not boosting antibodies through boosters is the best public health policy. No one on the panel seemed to suggest boosters are unsafe (aside from the rare risk of heart inflammation in [mosty] young men, that's a lower risk than Covid infection).

Not all the panelists agreed that leaving people open to infection was a good idea and supported wide spread boosters.

These are broad judgement calls that don't take into consideration individual risk factors.

Bill

Edited October 13, 2021 by Spy Car

[Corraleno]

1 minute ago, mommyoffive said:

What would you do if your kids were teens?  I have a 13 and 15 year old that are at 4 months with Pfizer.  What the heck do I do with that?  

Unfortunately, I think the only option for under 18s will be to find a doctor who will prescribe a Pfizer booster off label (which is legal), as none of the boosters will be approved for under 18s. 

[wendyroo]

9 minutes ago, mommyoffive said:

What would you do if your kids were teens?  I have a 13 and 15 year old that are at 4 months with Pfizer.  What the heck do I do with that?  

I plan to ask DS12's pediatrician for a booster when we are in for his annual appointment. He will be 8 months post-vaccination (2nd shot).

[Spy Car]

16 minutes ago, Corraleno said:

I have no qualms about checking a box so that they can get a shot that has been proven to be not only safe and effective, but also necessary to protect against infection. 

Great post (as usual).

Just highlighting this one point for emphasis. The entire FDA advisory panel did seem in agreement that with Delta that boosters are necessary if the goal is to stop infections.

Doing the utmost to stop infections is not the bar they set for the vaccination guidelines. Unfortunately, IMO.

Bill

[MEmama]

55 minutes ago, ktgrok said:

 

BMI is always under 25? No history of cancer, no issues with elevated blood pressure (and what is considered hypertension has changed, the cut off is lower now), never smoked, etc? 

I mean, ~17 years ago I had a rare deep tissue cancer; it was removed via Mohs surgery (left me with a pretty 5 inch scar). I don’t really consider it as “having had” cancer; it was caught early and I didn’t have to go under any treatment other than the surgery. I only include it on medical forms because it’s so rare that doctors always find it fascinating. Lol. 
 

I guess if I can use it, I will though. I’m not interested in being a sacrificial lamb, as @Corraleno so gently put it. 🙂 

[Lady Florida.]

I happen to have an appointment with my PCP on Monday for a regular annual visit. I'm going to ask him about prescribing a Pfizer booster even though I got Moderna.

I would qualify for Pfizer on age alone. I'm generally healthy, quit smoking 12 years ago, and barely drink. However, I sometimes worry that due to my age a breakthrough case wouldn't be mild if I got sick. I also live in a low vax and low mask area. While I have the privilege of being able to stay home a lot, I do still have to venture out into the world. Dh and ds both work and though both of their workplaces require masks they could still bring home the virus. Dh is older than me and less healthy so I worry about him more.

I'm so on the fence about trying to get a Pfizer booster or waiting until one gets approved from Moderna. I trust my PCP (he's very pro-vaccine and always asks if I got my flu shot each year) so I guess I'll trust what he recommends when I see him next week.

ETA: Actually I do have an autoimmune condition - oral lichen planus - but I've never been told by my doctors that it makes me immunocompromised.

Edited October 13, 2021 by Lady Florida.

[ktgrok]

1 minute ago, MEmama said:

I mean, ~17 years ago I had a rare deep tissue cancer; it was removed via Mohs surgery (left me with a pretty 5 inch scar). I don’t really consider it as “having had” cancer; it was caught early and I didn’t have to go under any treatment other than the surgery. I only include it on medical forms because it’s so rare that doctors always find it fascinating. Lol. 
 

I guess if I can use it, I will though. I’m not interested in being a sacrificial lamb, as @Corraleno so gently put it. 🙂 

You qualify. They are not specifying what cancer, how serious, etc. (heck, come to think of it, I've had skin cancer twice, that plus my BmI makes me extra qualified, lol) The CDC website for boosters says anyone with certain medical conditions, then links to the page listing those conditions. On that page, it says cancer, and has this:

"At this time, based on available studies, having a history of cancer may increase your risk." 

[Spy Car]

5 minutes ago, MEmama said:

I mean, ~17 years ago I had a rare deep tissue cancer; it was removed via Mohs surgery (left me with a pretty 5 inch scar). I don’t really consider it as “having had” cancer; it was caught early and I didn’t have to go under any treatment other than the surgery. I only include it on medical forms because it’s so rare that doctors always find it fascinating. Lol. 
 

I guess if I can use it, I will though. I’m not interested in being a sacrificial lamb, as @Corraleno so gently put it. 🙂 

I'd march in to the nearest vaccination center and declare yourself a cancer survivor. If there was a moments hesitation, I'd channel my inner-LBJ and say, "do you want to see my scar?)

Just do it.

Bill

[mommyoffive]

43 minutes ago, Corraleno said:

Unfortunately, I think the only option for under 18s will be to find a doctor who will prescribe a Pfizer booster off label (which is legal), as none of the boosters will be approved for under 18s. 

Great thought.  Thanks.  

[mommyoffive]

41 minutes ago, wendyroo said:

I plan to ask DS12's pediatrician for a booster when we are in for his annual appointment. He will be 8 months post-vaccination (2nd shot).

Let me know what you hear about that.  We already had annual appointments for the year, but I might just give them a call.

[Bootsie]

3 hours ago, Corraleno said:

Since what the WHO thinks the US should do as a country is irrelevant to my assessment of my personal health risks, I will go with the data over the opinion of a committee that is trying to walk a very thin line between protecting Americans and appeasing the WHO. The fact that the committee members consider protection against hospitalization and death to be "good enough" does not mean that I consider that "good enough" for my own personal heath. The idea that a fit, healthy 18 year old who works the overnight shift stocking grocery shelves qualifies for a booster, but a 64 year old with a BMI of 24 does not, is simply ridiculous.

There is a clear difference between someone who is going above and beyond the recommendations in order to protect themselves and others around them, and someone who is lying in order to defy requirements and put others at risk. Someone who gets booster without strictly meeting the criteria takes a very small personal risk that does not affect others; those who lie to avoid getting a vaccine are risking the lives of others without their knowledge or consent. There is no comparison.

I respect your right to make your own decisions with respect to your own personal health risks.  I also respect your right to decide when CDC and FDA committees are providing good guidance and when you think they are being motivated by outside influences.  I equally respect the rights of others to make their own decisions with respect to their health risks and who is being influenced by whom when choosing whether to vaccinate or not to vacinate.

A lie is a lie.  Perhaps it is OK to lie sometimes, but it is still a lie.  Being untruthful to receive government property is fraudulent.  I am not sure that it is always morally wrong to commit this type of fraud, but that is what it is no matter how much we might want to convince ourselves that it is ssomething else. 

[Lady Florida.]

56 minutes ago, Spy Car said:

G

Just highlighting this one point for emphasis. The entire FDA advisory panel did seem in agreement that with Delta that boosters are necessary if the goal is to stop infections.

Doing the utmost to stop infections is not the bar they set for the vaccination guidelines. Unfortunately, IMO.

Bill

I agree but I also think we tend to forget that the vaccine was never going to 100% prevent Covid-19 but would lessen symptoms and prevent death for most of those who caught it. Just like you can still get a mild case of the flu if you had the flu vaccine you can still get covid if you had the vaccine (any brand). Delta made us all more concerned about it not being a 100% protection against getting sick but this is what we've been told all along. 

No vaccine is 100% effective. We know this but try to hide it from our collective consciousness.

[TheReader]

For me, I'm in person with Kindergarten through 2nd Grade at a homeschool hybrid setting, so relatively highish potential exposure. Then I also visit my grandma once/month-ish, and while she's vaccinated as well, still. We lost my grandpa at the start of this, and I just refuse to lose her too.  So, I'll get mine if/when I'm eligible (I had Moderna, so....???). 

DH is working from home, and when he does go out in person, it's mostly also other vaccinated people, so relatively low risk. The kids are in college, but one home, one in person, and really minimal contact, so we'll let them decide. 

Youngest had Pfizer, and is in the same homeschool hybrid setting, plus youth group, social get togethers, etc. (with a small group, but still), and a LOT of his friends are not vaccinated, don't like to wear masks/refuse to wear them, etc. so we will have him get his asap. 

Or, in other words -- I think evaluating risk levels is fine, and go from there. 

[TravelingChris]

6 hours ago, barnwife said:

I am about to say something unpopular. I can't condone the above advice. People complain about healthcare all the time in the US. Committing fraud to attain healthcare does not improve the situation. So, as much as I want those who can to be vaxxed/obtain 3rd doses/get a booster, I just can't support lying in this way. 

It isn't lying.  85 year olds are immuno compromised.  

[Spy Car]

1 minute ago, Lady Florida. said:

I agree but I also think we tend to forget that the vaccine was never going to 100% prevent Covid-19 but would lessen symptoms and prevent death for most of those who caught it. Just like you can still get a mild case of the flu if you had the flu vaccine you can still get covid if you had the vaccine (any brand). Delta made us all more concerned about it not being a 100% protection against getting sick but this is what we've been told all along. 

No vaccine is 100% effective. We know this but try to hide it from our collective consciousness.

And the position of the majority of the advisory panel was fine with breakthrough infections. They did not even like the term "breakthrough" as in their minds that is what was to be expected.

The real world efficacy of the vaccines has surpassed expectations. With high antibodies infection rates can be significantly knocked down--and not just hospitalizations and death.

Delta is highly contagious. Many people have others in their care who are not yet eligible for vaccines and who don't want to become infectious. That's understandable. 

With a booster the vaccines are pretty effective against infection. Without boosting they become less effective against infection, but still pretty good against severe disease.

Either way, miraculous results. But reasonable people may calculate the risks of infection and infectiousness differently, given the option of booster shots.

Bill

 

 

[ktgrok]

26 minutes ago, Bootsie said:

I respect your right to make your own decisions with respect to your own personal health risks.  I also respect your right to decide when CDC and FDA committees are providing good guidance and when you think they are being motivated by outside influences.  I equally respect the rights of others to make their own decisions with respect to their health risks and who is being influenced by whom when choosing whether to vaccinate or not to vacinate.

A lie is a lie.  Perhaps it is OK to lie sometimes, but it is still a lie.  Being untruthful to receive government property is fraudulent.  I am not sure that it is always morally wrong to commit this type of fraud, but that is what it is no matter how much we might want to convince ourselves that it is ssomething else. 

Again, to be clear, I have ZERO disagreement with the CDC or FDA on the science itself. I trust them on the facts. I do not agree with the decision they made for the world as a whole. We agree on the facts, we agree on the benefits of the booster, we agree on the risks. I trust them on the science itself. 

And yup. It is not totally truthful to get the booster/third dose if you don't have exactly the issues they say. However, lying is not always a sin, nor is it always unethical. Stealing milk to feed your child, if you have no other options, isn't wrong, even though stealing isn't on it's own a good thing. Getting a vaccine that may save human lives is not a bad thing either, even if it means breaking the rules. 

Also, from what I remember, the CVS website didn't ask HOW you were immune compromised, just had you check that you were. Compared to other people, my parents are immune compromised. 

[ktgrok]

2 minutes ago, Spy Car said:

And the position of the majority of the advisory panel was fine with breakthrough infections. They did not even like the term "breakthrough" as in their minds that is what was to be expected.

The real world efficacy of the vaccines has surpassed expectations. With high antibodies infection rates can be significantly knocked down--and not just hospitalizations and death.

Delta is highly contagious. Many people have others in their care who are not yet eligible for vaccines and who don't want to become infectious. That's understandable. 

With a booster the vaccines are pretty effective against infection. Without boosting they become less effective against infection, but still pretty good against severe disease.

Either way, miraculous results. But reasonable people may calculate the risks of infection and infectiousness differently, given the option of booster shots.

Bill

 

 

Agree. The world as a whole, and the FDA, may consider my sister's possibly permanent movement disorder and aphasia to be an acceptable loss, statistically. To her and her two kids for whom she is the primary caregiver and breadwinner, it isn't. And it isn't to the thousands of students at the school she is the principal of - she's done AMAZING things for those students, and if she can't work, they lose that. Her breakthrough infection effects literally thousands of lives on some level. That's not okay. Had they allowed boosters earlier she may not have had this happen. (I realized she got her vaccine several weeks before me, so was probably at or beyond 6 months when she got sick)

[TravelingChris]

3 hours ago, Corraleno said:

Since what the WHO thinks the US should do as a country is irrelevant to my assessment of my personal health risks, I will go with the data over the opinion of a committee that is trying to walk a very thin line between protecting Americans and appeasing the WHO. The fact that the committee members consider protection against hospitalization and death to be "good enough" does not mean that I consider that "good enough" for my own personal heath. The idea that a fit, healthy 18 year old who works the overnight shift stocking grocery shelves qualifies for a booster, but a 64 year old with a BMI of 24 does not, is simply ridiculous.

There is a clear difference between someone who is going above and beyond the recommendations in order to protect themselves and others around them, and someone who is lying in order to defy requirements and put others at risk. Someone who gets booster without strictly meeting the criteria takes a very small personal risk that does not affect others; those who lie to avoid getting a vaccine are risking the lives of others without their knowledge or consent. There is no comparison.

Just like I am going to get the higher dose of flu vaccine because all my doctors think I should since I am 58 and on lots of immunosuppressants and two of my autoimmune diseases-asthma and Sjogrens- makes it more likely that I get very sick from flu if I get it.

[Dmmetler]

1 hour ago, Corraleno said:

I don't think the rules are going to change any time soon, if ever. The FDA is also meeting this week to discuss J&J, as well as mixing vaccines and boosters, and my best guess is that they will approve Moderna and J&J under the same terms as Pfizer, in order to have a simple, standardized booster policy. I think people who fall into the very small percentage of adults who do not meet any of the criteria may have to choose between flexibility in checking a box versus agreeing to be sacrificial lambs who risk their own health so the US can claim we are "only boosting the most vulnerable" (who just happen to comprise like 90% of the population).

I happen to meet the criteria for a Pfizer booster, but my kids, who are exposed through college classes and work/travel/competition technically do not, even though they have far more exposure than many people who do qualify. I have no qualms about checking a box so that they can get a shot that has been proven to be not only safe and effective, but also necessary to protect against infection. They shouldn't have to risk their own health because of a public policy that says the risk of long covid in under 65s, or even "just" missing a few weeks of classes and/or income, is NBD and not worth approving a $20 shot.

Congregate living counts, so college students should qualify if they are over 18 and live on campus. I fully expect my college kid's school to offer boosters once they're available for Moderna (which is what they offer on campus) and won't be surprised to see boosters required if you are living in dorms once they are available for all three shots, with waivers for students under 18 or who got non-US shot sequences. For a residential women's college, it seems like a fairly low risk thing to require that would likely increase the protection for the campus as a whole dramatically. They already require and administer flu shots to all residential students who don't have a waiver every fall. 

[Corraleno]

1 hour ago, Bootsie said:

I respect your right to make your own decisions with respect to your own personal health risks.  I also respect your right to decide when CDC and FDA committees are providing good guidance and when you think they are being motivated by outside influences.  I equally respect the rights of others to make their own decisions with respect to their health risks and who is being influenced by whom when choosing whether to vaccinate or not to vacinate.

A lie is a lie.  Perhaps it is OK to lie sometimes, but it is still a lie.  Being untruthful to receive government property is fraudulent.  I am not sure that it is always morally wrong to commit this type of fraud, but that is what it is no matter how much we might want to convince ourselves that it is ssomething else. 

I just ran a BMI calculator and apparently my 6'7" 225 lb college athlete does technically meet the booster criteria with a BMI of 25.3, even though he has barely an ounce of fat on him — which is ridiculous. So it's a "lie" if he gets a booster when he weighs 221 lbs, but not at 225? Does an extra 4 lbs have any impact whatsoever on the safety and efficacy of the booster, or his risk of infection?

My 19 yr old was working 15-20 hrs/wk stocking shelves overnight in a grocery store, but one of her classes this semester is at 9 AM and she was having trouble staying awake in that class so she quit. If she goes back to work for a week, gets the shot as a grocery store worker, and then quits the next day, that's not fraud, but if she checks the grocery store worker box because she does Instacart and Postmates, that's fraud even though her exposure risk is actually much higher now than it was when she was stocking shelves?

Someone with a BP of 128/80 who works in a crowded office is not lower risk than someone with a BP of 130/80 who works at home. A retail worker in FL who deals with unmasked, unvaxxed people all day every day has a much higher risk level than someone who stocks grocery store shelves overnight in an area with a mask mandate and high vax rate, yet the latter "qualifies" while the former does not. The regulations are designed to present a certain appearance to the international community, not to provide the best level of protection to the American public.

The functional effect of the FDA's garbled policy has not been to restrict the booster to those who need additional protection but rather to exclude a small percentage of the US population from access to the same protection as everyone else. Half of US adults have hypertension and 3/4 have a BMI of 25 or higher — add in everyone over 65, everyone who's ever had cancer or smoked, everyone with diabetes or asthma, everyone who lives or works in a congregate settling, and all first responders, corrections workers, education staff, everyone who works in food, agricultural, or manufacturing jobs, postal employees, transit workers, and grocery store workers, and it's a very small number of people who don't fall into any of those categories. Why are they being discriminated against? How is it ethically defensible to try to prevent those people from accessing the same protection everyone else can get?

 

 

Edited October 13, 2021 by Corraleno

[Roadrunner]

I am the only idiot here who expected protection from infection from vaccines. I didn’t think the vaccines would just be mostly a protection from severe illness. So I went from feeling like a Superman to terrifyingly checking breakthrough infection rates, which right now run about half of unvaccinated. Locally the cases are low. The breakdown goes 9 cases per 10k for unvaccinated and 5 for vaccinated per week.  
so as soon as the Moderna  booster is approved, I am getting one. 
 

[Clarita]

Apparently I'm a minority here but I'm just going to wait until I legitimately qualify for a booster (healthy under 40 J&J). As a homeschool mom, I do not count myself in the same category as a teacher of 20-40 kids/class. If I am to trust CDC, FDA, WHO, etc. on getting the vaccine for the safety of others I should also trust them on the distribution.

We take all the precautions masking everywhere. For our group activities we are required to mask even when outdoors. We have people that we've been a "family" (or pod) with, when their kid got the cold we quarantined/isolated ourselves until no was sick anymore and confirmed not COVID. The thing is I'm pretty sure my family got Alpha back in Feb/March 2020 before they "knew" it was in the US. For us, the most we felt was a regular case of the cold/flu. So, it's likely we are asymptomatic carriers; I'm extra cautious because of this. 

On a side note if you want to people around you to mask, I've had a great deal of success by telling people that I'm pretty sure I'm going to be an asymptomatic carrier (when asked about why I'm wearing a mask). 

[sassenach]

I'm unconvinced about the need for boosters for most of my family, for reasons that are based on the data but I'm not really in the mood to parse out here. My at-risk kiddo who got Pfizer is scheduled for next week. I need to talk to FIL (80) about getting his. For sure will not be boosting my teens. I'm on the fence with dh and I. 

[Spy Car]

4 hours ago, MEmama said:

This is the type of info I was looking for. Now that I know, I’ll jump on it as soon as the rules change so I’m eligible (I’m just now at 6 months but don’t qualify under cdc guidelines. Booo). 
 

Thanks! 🙂 

My pleasure. I wasn't trying to make it complicated earlier, I was only trying to fairly represent that there is a split as to what's considered "optimal." And that's in large measure dependent on one's goals.

At some point keeping antibodies high enough to (hopefully) quash infections is a strategy that will run out. But with a Delta surge ongoing and with winter and the holidays upon us, this looks like a good time to be "primed" to me.

Bill

 

 

 

[KSera]

I haven't seen this posted yet from today. Interesting data on which combo of boosters works best. Looks like Moderna followed by Moderna was best, then Pfizer followed by Moderna, then Moderna booster by Pfizer. J&J recipients were better off getting booster by one of the mRNA vaccines. I haven't looked at the actual data yet, only the summary. More here:

A study of COVID vaccine boosters suggests Moderna or Pfizer works best

 

 

[KSera]

9 hours ago, ktgrok said:

That's fine. I'd rather have my mom alive, with you disapproving than dead with your approval. She has COPD and low oxygen saturation all the time now. Getting Covid will kill her.

Definitely seems that would make her immune compromised. And wouldn't her doctor okay a Pfizer off label any way due to her circumstances?

9 hours ago, JennyD said:

I have been wondering about this too.   It seems like there just isn't good evidence on this yet, although some have theorized that later is better.  

My parents were vaccinated with Pfizer in January and just got their boosters, which I'm delighted about.   DH and I were vaccinated in April, the the older kids were May.  Our family has very little exposure and will stay that way until DS11 is fully vaccinated -- presumably mid-December -- so I think we're going to just hold off on the boosters until then.  Hopefully we'll learn more about optimal timing in the coming months. 

Thanks for that Atlantic article. I've been trying to weigh timing as well, and your thought is similar to mine that I will likely wait to try to have optimal protection in December. We had Moderna and have very little exposure. I'm my adult kid in congregate living can get theirs sooner, that would make sense, though (though them being done later would be better protection to us against infection when they come home for Christmas).

 

8 hours ago, wendyroo said:

For those who are uncomfortable with that, my understanding is that doctors can now "prescribe" Pfizer doses to anyone they want since it has full use authorization. So people who have many health conditions, but do not meet the immunocompromised definition, could see if their doctor will give them a dose of Pfizer despite them having been initially vaccinated with Moderna.

That's what I would (will) do if Moderna doesn't get approved for boosters and I feel like I should have one. I do have a health condition I think I could qualify under, but my dh does not, so that sucks (lol, I just realized that sounds ridiculous. I'm very glad my dh does not have a health condition!)

1 hour ago, Roadrunner said:

I am the only idiot here who expected protection from infection from vaccines. I didn’t think the vaccines would just be mostly a protection from severe illness.

To be fair, you and everyone else who got vaccines before about June were correct, because the vaccines did give very high protection from infection. Then it mutated and we got Delta here, and it does not provide such a high level of protection from infection (although, Moderna at 6 months still is looking pretty protective against infection, though not as high as it starts out).

 

For myself, I'd love to see more about whether the amount of protection from a booster increases more with more time after 6 months, or if after 6 months it's all the same, or if there's even a point when the booster doesn't work as well if you wait too long. At this point, boosters haven't been used long enough to answer any of that though.

[ktgrok]

8 minutes ago, KSera said:

Definitely seems that would make her immune compromised. And wouldn't her doctor okay a Pfizer off label any way due to her circumstances?

 

It does not make her immune compromised according to certain criteria used by the FDA, but in her mind it does, so she had no qualms checking that box on the online appointment form. Was easier than getting an appointment to discuss it and having exposure in the doctor's office, and since she already knew how her body reacted to Moderna she felt better doing the same again. Also, it appears to have better protection than Pfizer. 

[wendyroo]

29 minutes ago, Clarita said:

Apparently I'm a minority here but I'm just going to wait until I legitimately qualify for a booster (healthy under 40 J&J). As a homeschool mom, I do not count myself in the same category as a teacher of 20-40 kids/class. If I am to trust CDC, FDA, WHO, etc. on getting the vaccine for the safety of others I should also trust them on the distribution.

If there was a shortage of vaccine in my community, then I would absolutely wait my turn. I know that I am at much lower risk than many other people. 

But there isn’t a shortage - in fact, there is so much surplus that vaccine is getting thrown away every day.  

The science is clear; immunity wanes considerably by six months. The CDC has decided that I only marginally qualify for a booster because a breakthrough infection probably wouldn’t be too severe for me. I probably wouldn’t end up in the hospital or dead. And I’m grateful for that, I really am, but I’m really shooting for the stars and trying not to kill my kids either. They are too young to be vaccinated, one has a medical condition that would make COVID more dangerous for him, and a breakthrough infection in me would almost certainly spread to them.

I’m “lucky” in that I truly, honestly have one toe over the qualification line, so on my 6 month shot-versery next week I am in the clear to get a booster. But that just further emphasizes how the restrictions are political and not medical. As I said, I am not particularly high risk, either to myself or the greater community, but I get a shot. But there are plenty of others who are at much higher risk themselves and pose more risk to others who don’t qualify. From a medical or community health standpoint it doesn’t make sense.

During this whole pandemic my family has bent over backward, sometime at great personal sacrifice, to act in ways that served the greater good. But this isn’t one of those cases. If I weighed 5 pounds less, and did not legitimately qualify for a booster, me refraining from getting one would actually be detrimental to the community. It would mean increased risk that I could end up taking up a hospital bed or ventilator, increased risk of my kids needing those resources, and increased risk of me being an asymptotic carrier infecting others. The only way me not getting the shot would benefit the community is by keeping the trash collectors in business as they haul away all the wasted doses. 

[Roadrunner]

8 minutes ago, KSera said:

Definitely seems that would make her immune compromised. And wouldn't her doctor okay a Pfizer off label any way due to her circumstances?

Thanks for that Atlantic article. I've been trying to weigh timing as well, and your thought is similar to mine that I will likely wait to try to have optimal protection in December. We had Moderna and have very little exposure. I'm my adult kid in congregate living can get theirs sooner, that would make sense, though (though them being done later would be better protection to us against infection when they come home for Christmas).

 

That's what I would (will) do if Moderna doesn't get approved for boosters and I feel like I should have one. I do have a health condition I think I could qualify under, but my dh does not, so that sucks (lol, I just realized that sounds ridiculous. I'm very glad my dh does not have a health condition!)

To be fair, you and everyone else who got vaccines before about June were correct, because the vaccines did give very high protection from infection. Then it mutated and we got Delta here, and it does not provide such a high level of protection from infection (although, Moderna at 6 months still is looking pretty protective against infection, though not as high as it starts out).

 

For myself, I'd love to see more about whether the amount of protection from a booster increases more with more time after 6 months, or if after 6 months it's all the same, or if there's even a point when the booster doesn't work as well if you wait too long. At this point, boosters haven't been used long enough to answer any of that though.

That’s very true, but I was most definitely under what seems now a rather idiotic assumption that vaccines were going to prevent the infection for much longer than six month. 

I get they didn’t know. I get we didn’t know. I get it. I am still surprised that nobody else feels as let down as I am. 
 

Hospitalization rates locally for unvaccinated are 1.3 per 10k and 0.2 for vaccinated. So vaccines are most definitely helping, but I am convinced that if I get this damn virus, I will be in that 0.2. So I guess I don’t feel as calm with “don’t worry, you won’t die” I am hearing now from everybody. 

[Corraleno]

Here is the preprint with the data on different vaccine/booster combos: https://www.medrxiv.org/content/10.1101/2021.10.10.21264827v1.full.pdf

It's unfortunate that they used a full 100 µg dose of Moderna for the booster instead of the 50 µg dose Moderna plans to actually use, since it's not clear how the results for the full dose would compare to a half-dose. It's also super frustrating that they published this without the 4 week neutralizing antibody data for subjects who originally had J&J or Pfizer. Between those two issues, it's difficult to determine whether boosting Pfizer with 50 µg of Moderna would provide a statistically significant advantage over just boosting Pfizer with Pfizer. Another weakness of the study is that it was less than 6 months between 2nd shots and boosters (the authors do not specify what the interval was), so the actual effectiveness of boosters at 6-plus months may be more (or less) effective than their data show.

One data point that I found interesting was that the antibody levels for those boosted with Moderna peaked at two weeks and then declined between 2 and 4 weeks, while levels rose between 2 & 4 weeks for those boosted with J&J (although they ended up with lower levels overall). In all three of the booster groups, subjects who had originally had Moderna had pre-boost antibody levels that were roughly double those of Pfizer recipients.

It will be interesting to see if they approve mixing vaccines and boosters. The data for boosting J&J with an mRNA vaccine is pretty clear cut, so I certainly hope they at least do that, although IMO it would make the most sense just to remove the prohibition on mixing vaccines entirely, since there has never been any evidence suggesting that mixing doses causes any issues. And it may encourage more people to get a booster if they can choose which one to get — e.g. people who had J&J may want to choose a stronger one, and maybe some who had a really unpleasant experience w/Moderna might prefer to boost with a lower dose of Pfizer.

 

[KSera]

6 minutes ago, Corraleno said:

It's unfortunate that they used a full 100 µg dose of Moderna for the booster instead of the 50 µg dose Moderna plans to actually use, since it's not clear how the results for the full dose would compare to a half-dose. It's also super frustrating that they published this without the 4 week neutralizing antibody data for subjects who originally had J&J or Pfizer. Between those two issues, it's difficult to determine whether boosting Pfizer with 50 µg of Moderna would provide a statistically significant advantage over just boosting Pfizer with Pfizer. Another weakness of the study is that it was less than 6 months between 2nd shots and boosters (the authors do not specify what the interval was), so the actual effectiveness of boosters at 6-plus months may be more (or less) effective than their data show.

 

Oh, darn. I hadn't looked at the data yet, and that's disappointing that it doesn't match up with what we're looking at doing in the real world.

7 minutes ago, Corraleno said:

One data point that I found interesting was that the antibody levels for those boosted with Moderna peaked at two weeks and then declined between 2 and 4 weeks, while levels rose between 2 & 4 weeks for those boosted with J&J (although they ended up with lower levels overall).

Seems like the non mRNA vaccines--J&J, AZ--have had that pattern of having a slower increase in effectiveness that peaks later. It also sounds like since they ended the study at 29 days post boost, it's unknown if the J&J levels would continue to rise from there. Regardless, it doesn't look like there's good reason to recommend a J&J boost unless someone has a medical contraindication to Moderna or Pfizer.

 

Interesting that Moderna ab levels were 3 times higher than Pfizer at pre-boost. That lends further data to the body suggesting it's not fading quick enough to meet the 4 fold increase due to a boost (the higher dose third shot does look to get it there, though).

[Clarita]

4 hours ago, wendyroo said:

The science is clear; immunity wanes considerably by six months. The CDC has decided that I only marginally qualify for a booster because a breakthrough infection probably wouldn’t be too severe for me. I probably wouldn’t end up in the hospital or dead. And I’m grateful for that, I really am, but I’m really shooting for the stars and trying not to kill my kids either. They are too young to be vaccinated, one has a medical condition that would make COVID more dangerous for him, and a breakthrough infection in me would almost certainly spread to them.

I think everyone does have to make their own decisions, because everyone situation is not the same. What I want is to send our surplus shots to parts of the world that want and need it. The fact that so many doses are just going to trash is just wrong.

[Corraleno]

3 minutes ago, Clarita said:

I think everyone does have to make their own decisions, because everyone situation is not the same. What I want is to send our surplus shots to parts of the world that want and need it. The fact that so many doses are just going to trash is just wrong.

The US has already pledged to send more than one billion doses of Pfizer to poor countries, more than all other countries combined. That is separate from what is being purchased for use in the US. The mRNA vaccines are shipped in specially designed containers to keep them at the required temperature, and one container can hold up to 5000 doses. That makes it difficult to just send a few doses here and there, so some pharmacies, especially in areas with a lot of vaccine resistance, end up with a lot more doses than they can use just because of shipping and storage constraints. Plus each vial contains multiple doses — Moderna's vials can contain up to 15 doses — and they have to be used within 6 hours once they're opened. If they use two doses out of a vial and no one else shows up that day then the other 13 doses are wasted. There's no way to instantaneously transport those doses from a pharmacy in the US into an arm in a 3rd world country in the minutes before they expire. The "surplus" doses in the US wouldn't be surplus if so many Americans hadn't fallen victim to lies and misinformation.