COVID-19 vaccines: medical concerns and recommendations

[Ed L]

I get the feeling that the US approved the third Covid-19 shot at the 8 month mark out of logistical considerations to allow production to ramp up, and to keep the system from being overwhelmed by a flood of people seeking their third vaccinations. I read various reports about breakthrough infections and declining protection of vaccines over time, so I decided I needed to get my third shot pronto. In Israel they have been doing a third dose 6 months after the second. So far 1.5 million Israelis have received their third shot. I did check with my doctors, who while not officially were able to condone it, did not think that there would be a danger with it.

I got my original doses of Pfizer at a central location back in Feb & March when the vaccine was not available in nearly as many places. My regular pharmacy now offers Pfizer on a walk-in basis. So I asked for my *ahem* second dose and showed them a copy of my Vaccine card that I scanned when I only had one dose listed. The pharmacist typed my info into a computer and informed me that I was listed as having received two doses. I told her that there must be some mistake because I never showed up for my second appointment at the place where I got my vaccine. She said that she would have to check with her supervisor. I said “okay, no problem.” The next day she called me and told me that they had checked with the vaccine hub where I got my vaccine, and I would have to come back for my *third* dose in November. I thanked her for her professionalism and diplomacy. I told her that I knew some anti-vaxers whose names I could use to register elsewhere and get a copy of their ID to get vaccinated. She laughed and said that I would not need to go to those levels and that some places were not checking carefully and not every place was connected to the same computer that hers was.

Now I was more determined than ever to get that third dose, because I actually do have some vulnerability factors. So I found another pharmacy near me that I am not affiliated with and registered to get my *first* dose of the Pfizer vaccine with them. Yesterday, slightly more than 5 months after I got my second dose of Pfizer, I got my third dose. They did not run me through any computer. or even ask to see my ID. If they did and turned me down, I had some backup places set up, along with identification with the name Danny Trejo on it. If someone confronted me and said, "You're not Danny Trejo," my response would have been, "Hey, you got something against Mexicans, Holmes?"

It's been about 15 hours since I got the third dose. One thing I noticed within a few hours was that my arm feels much sorer than it did when I got either of my earlier doses. It's not just my upper arm, but also my bicep. At aoput the 12 hour mark I also feel a bit achy and have a headache. So far it seems to be less symptoms than when I got my first two doses.

I am very relieved to have gotten the third dose. Even though I got it early, it's not like they are going to send the Covid Police after me.

[0ddl0t]

As I understand the booster from Pfizer is tailored against the delta variant though, correct?
This one:
https://www.reuters.com/world/us/pfi...er-2021-08-25/

No, the Pfizer booster you can get now is just a third dose of the original vaccine (which has been shown to increase antibodies against both the alpha and delta variants).

Pfizer does have a delta-specific booster, but it is currently in clinical trials and isn't what your pharmacy has on hand. https://www.cnbc.com/2021/07/08/pfiz...a-variant.html

In Israel they have been doing a third dose 6 months after the second. So far 1.5 million Israelis have received their third shot.

Yep. They're even down to 5 months now for everyone over age 30: https://www.reuters.com/world/middle...ry-2021-08-24/ I definitely think the "8 month" recommendation has more to do with logistics than science.

[Hambo]

It's been about 15 hours since I got the third dose. One thing I noticed within a few hours was that my arm feels much sorer than it did when I got either of my earlier doses. It's not just my upper arm, but also my bicep. At aoput the 12 hour mark I also feel a bit achy and have a headache. So far it seems to be less symptoms than when I got my first two doses.

I am very relieved to have gotten the third dose. Even though I got it early, it's not like they are going to send the Covid Police after me.

If they end up giving a 4th shot as a booster, you've got an open spot on your new card. My "friend" told me that if you get shot #3 in one arm, and flu vax in the other, it's no big deal.

[Hot Sauce]

I don't have nearly as good a data set for looking at antibodies in people who recover from infection. We had small number of repeat donors in the convalescent plasma study, and their antibody levels were definitely dropping. I didn't know the clinical history of some samples at the time we ran them. I had one that was just above the cutoff value for my assay. I called it as "positive" but with the caveat that I should probably have an "equivocal" result for the assay. Turns out the sample was from a person who'd had diagnosed infection last summer. Based on these observations, I'd say the decay rates are roughly the same. The basis for this number involves a lot of cellular immunology, so the kinetics are more complex than just the half life of antibody in blood. Unfortunately, it looks like B cells don't transition to the kind of cells that stick around for a long time and make a lot of antibody (long-lived plasma cells) after infection or vaccination.

The mRNA vaccine encodes the spike protein from the virus. After vaccination, your cells make that one part of the virus. Your immune system recognizes that protein as being something foreign and carries out an immune response against it. Vaccines definitely have a dose effect, and you can increase the dose to a certain point. However, if you start putting too much stuff in the vaccine, it'll become more "reactogenic" which discourages people from getting vaccinated. The small pox vaccine is a good example. With it you get live cow pox virus and a nasty sore on your arm, which can be very unpleasant (especially if you get it in your right arm and you like to sleep on your right side). My thinking is that these mRNA vaccines will get us through the intermediate term, but for the longer term, we'll need a more conventional vaccine with a better adjuvant. Adjuvants are components of vaccines that aren't part of what your trying to protect against but function to increase the immune response to the vaccine. Having said that, maintaining vaccine-mediated protection indefinitely is probably not realistic. We can't do it for flu. We can't do it for RSV. I'll be very surprised if we manage it for SARS-CoV-2. Get the vaccine. Get the boost. Get the virus. Get well.

We've run some samples from a small handful of breakthrough cases now, and these people have very high antibody levels. The titer in one sample was >8x higher than the previous record high titer I'd recorded for that assay. I'm speculating now, but if vaccination protects for ~6 months, I wouldn't be surprised if breakthrough infection protects for two years.

Thanks a lot, lots of useful info to chew on.

@Sensei, thanks for jumping in as well.

[Hot Sauce]

As I understand the booster from Pfizer is tailored against the delta variant though, correct?
This one:
https://www.reuters.com/world/us/pfi...er-2021-08-25/

Just FYI, that article doesn't mention a delta-tailored booster specifically. I do remember about one being developed, but I haven't seen any info on it actually being deployed/available.

[KeeFus]

Just happened across this thread.

I got Moderna vaccination in February and March. Wife brought home COVID August 4. I stayed home and took care of her. Tested negative three (3) times during the two weeks she was home coughing, hacking, shortness of breath, etc.

She returned to work and so did I. Tuesday last week around 1530 i started sneezing and just had an overall feeling of not feeling well. Got tested…it was positive. Tuesday thru Thursday I had what I want to call was a type of summer cold symptoms (headache, congestion, sore throat, and low grade fever). Friday came and I started feeling better…no more fever, slight congestion, minor sore throat. Saturday no more symptoms. I go back to work Monday.

I watched my wife struggle to breathe walking to the bathroom, take a shower, and even eat. We almost went to the hospital a few times. She weathered the virus but it was a lonnnngggg two weeks. I will take a 3-day head cold over two weeks of hell any day. Glad I got the vaccine…and I will be getting the booster when available.

[Totem Polar]

Just happened across this thread.

I got Moderna vaccination in February and March. Wife brought home COVID August 4. I stayed home and took care of her. Tested negative three (3) times during the two weeks she was home coughing, hacking, shortness of breath, etc.

She returned to work and so did I. Tuesday last week around 1530 i started sneezing and just had an overall feeling of not feeling well. Got tested…it was positive. Tuesday thru Thursday I had what I want to call was a type of summer cold symptoms (headache, congestion, sore throat, and low grade fever). Friday came and I started feeling better…no more fever, slight congestion, minor sore throat. Saturday no more symptoms. I go back to work Monday.

I watched my wife struggle to breathe walking to the bathroom, take a shower, and even eat. We almost went to the hospital a few times. She weathered the virus but it was a lonnnngggg two weeks. I will take a 3-day head cold over two weeks of hell any day. Glad I got the vaccine…and I will be getting the booster when available.

This is a valuable post, thanks. I say that having read every word of the three main threads we’ve had on this shit, starting Jan 22 or so 2020…

[DrkBlue]

Please read this carefully and with the proper jaundiced eye, but is officially published tomorrow by the CDC.
VE is vaccine effectiveness.

Adjusted VE during this Delta predominant period was 66% (95% CI = 26%–84%) compared with 91% (95% CI = 81%–96%) during the months preceding Delta predominance.



Effectiveness of COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Frontline Workers Before and During B.1.617.2 (Delta) Variant Predominance — Eight U.S. Locations, December 2020–August 2021
https://www.cdc.gov/mmwr/volumes/70/...cid=mm7034e4_w

[Nephrology]

Just happened across this thread.

I got Moderna vaccination in February and March. Wife brought home COVID August 4. I stayed home and took care of her. Tested negative three (3) times during the two weeks she was home coughing, hacking, shortness of breath, etc.

She returned to work and so did I. Tuesday last week around 1530 i started sneezing and just had an overall feeling of not feeling well. Got tested…it was positive. Tuesday thru Thursday I had what I want to call was a type of summer cold symptoms (headache, congestion, sore throat, and low grade fever). Friday came and I started feeling better…no more fever, slight congestion, minor sore throat. Saturday no more symptoms. I go back to work Monday.

I watched my wife struggle to breathe walking to the bathroom, take a shower, and even eat. We almost went to the hospital a few times. She weathered the virus but it was a lonnnngggg two weeks. I will take a 3-day head cold over two weeks of hell any day. Glad I got the vaccine…and I will be getting the booster when available.

thanks for sharing, glad your wife came out OK. That's hard to watch.

Vaccines work.

[OneZero]

It's all still a mystery. My wife is an NP and was vaccinated three months ago. She got covid two weeks ago.

Since January I have encountered cancer, chemo, covid with a WBC of 1 at time, tonsillitis, and Delta Variant. If I were to trust the science I would be dead. Going into the diagnosis I was in top two percent of my health in my age group. No history of sickness and no history of cancer in my family. There can be many variables and many different saviors for all I suppose. I chose my faith and refused to quit.