COVID-19 vaccines: medical concerns and recommendations

[RoyGBiv]

Should a 70 year-old with comorbidities (including a predisposition to pneumonia) get a booster now - 6 months after Pfizer dose #2 - or wait until October? Local grocery store pharmacy is offering boosters to anyone with a CDC card...

Israeli data shows pfizer efficacy drops pretty quickly after 4 months, although the confidence intervals are too big to know for sure about hospitalization rates.



...but getting a booster now would mean waning protection in January/February when we had a big spike last year. Then again, we're having an equally big spike now...

I got an email from Tom Thumb pharmacy today offering a booster. I clicked on the link and their website said that boosters were not yet recommended by CDC. LOL. Damn webmasters need to get their poop in one sack.

I got my 2nd vax in late Feb. The chatter I'm reading/hearing is that the CDC will recommend boosters at 8 months, which would be mid-late October for me. Other than being mid 50's with high cholesterol since I was a teen, I'm fairly healthy.

The chart you posted here gives me confidence to wait. I'm honestly not too worried about symptomatic covid, but very worried about getting it bad enough to need a hospital bed that may/not be available. I don't see that a booster today will give me any greater protection against severe outcomes over the next month or so. I'd rather wait for October and be in a stronger antibody position come January, as you noted.

Not a Dr. Just my opinion.

YMMV, of course.

[YVK]

I'd rather wait for October and be in a stronger antibody position come January, as you noted.

I am leaning towards sitting it out for a bit to see if they will roll out a delta specific booster. This is a personal opinion, not a professional advice.

[Clusterfrack]

OUTSTANDING article!

Israeli data: How can efficacy vs. severe disease be strong when 60% of hospitalized are vaccinated?
https://www.covid-datascience.com/po...are-vaccinated
A surge involving the rapidly-transmitting Delta variant in heavily vaccinated countries has led to much hand-wringing that the vaccines are not effective against Delta, or vaccine efficacy wanes after 4-6 months. This has fueled anti-vaccine sentiment suggesting the vaccines are not working, and causing much stress in vaccinated people that they are not as protected as they thought they would be.


TLDR:
...there is very strong evidence that the vaccines have high efficacy protecting against severe disease, even for Delta

...the current Israeli data provide strong evidence that the Pfizer vaccine is still strongly protecting vs. severe disease, even for the Delta variant, when analyzed properly to stratify by age.

...as long as there is a major age disparity in vaccination rates, with older individuals being more highly vaccinated, then the fact that older people have an inherently higher risk of hospitalization when infected with a respiratory virus means that it is always important to stratify results by age; if not the overall efficacy will be biased downwards and a poor representation of how well the vaccine is working in preventing serious disease (the same holds for efficacy vs. death).

[0ddl0t]

I had hoped to wait for a delta booster, but Pfizer appears to be doubling down on a 3rd alpha dose booster so I wouldn't expect a delta booster in the next few months.

Israel's health minister reportedly recently stated a 3rd dose of pfizer halved the hospitalization rate for those over 60, but I haven't seen the data directly. ~80% of Israeli adults are vaccinated, but their hospitals have still been getting hit hard by Delta (~60% of patients being vaccinated).

[Clusterfrack]

I had hoped to wait for a delta booster, but Pfizer appears to be doubling down on a 3rd alpha dose booster so I wouldn't expect a delta booster in the next few months.

Israel's health minister reportedly recently stated a 3rd dose of pfizer halved the hospitalization rate for those over 60, but I haven't seen the data directly. ~80% of Israeli adults are vaccinated, but their hospitals have still been getting hit hard by Delta (~60% of patients being vaccinated).

Yes, and the article I linked above explains how this can be the case even if the vaccine is highly effective: older folks (especially with medical issues) are more likely to require hospitalization. That explains the hospitalization pattern given the relative rarity breakthrough cases of Delta in vaccinated individuals.

Under 60? Healthy? Vaccinated? --> not at high risk

[Borderland]

My wife and I had our 2nd Phizer vax in early Apr. We're both in our 70's so for sure a booster in Oct.

Another thing we do is socialize outside and mask up indoors. We don't have a lot of contact with the general public outside of shopping for food and talking to neighbors.

[0ddl0t]

I was typing when you posted your article. The problem with age stratefication analysis is that age is very very highly correlated with length of time since 2nd dose. It is hard to say with certainty what is going on since so few young were vaccinated in December & January so (from a booster standpoint) we can only really compare those of the same age & health who have gotten the booster against those who haven't. Unfortunately that is also currently a tiny number so week to week the data swings wildly.

Under 60? Healthy? Vaccinated? --> not at high risk

I agree. I'm <40 with 15% body fat, a resting pulse rate in the 40s, and a 4-month old vaccine. I'm not in a huge hurry for my booster.

On the other hand, my 70 year old mother is an obese stroke survivor with pulmonary fibrosis & poorly controlled hypertension going on 6+ months since dose 2 of pfizer. We are very seriously considering getting her a booster now because even with all 3 doses of the pneumococcal vaccine, she still ends up in the hospital with life-threatening pneumonia every year or two in pre covid times.

And even if with her original pfizer vaccination she'd normally be considered a less severe case of hospitalized covid, would that still be the case in a hospital operating over capacity (there are currently 3 open ICU beds in the county)?

There might be more of a moral dilemma if people who wanted the vaccine couldn't get one, but we live in a country that is literally throwing away tens of thousands of expiring vaccine doses (Alabama recently threw away 65,000)

[pangloss]

On the other hand, my 70 year old mother is an obese stroke survivor with pulmonary fibrosis & poorly controlled hypertension going on 6+ months since dose 2 of pfizer. We are very seriously considering getting her a booster now because even with all 3 doses of the pneumococcal vaccine, she still ends up in the hospital with life-threatening pneumonia every year or two in pre covid times.

And even if with her original pfizer vaccination she'd normally be considered a less severe case of hospitalized covid, would that still be the case in a hospital operating over capacity (there are currently 3 open ICU beds in the county)?

There might be more of a moral dilemma if people who wanted the vaccine couldn't get one, but we live in a country that is literally throwing away tens of thousands of expiring vaccine doses (Alabama recently threw away 65,000)

Given those comorbidities, I'd be very aggressive about seeking a third dose for her. Pulmonary fibrosis is what ends up killing a lot of COVID patients. They clear the infection, but their lungs are shot. (Some clinician please correct me, if I'm mistaken.) If this issue is one that your mom is already dealing with, she can't stand to lose as much lung function as an otherwise healthy person.

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[YVK]

I had hoped to wait for a delta booster, but Pfizer appears to be doubling down on a 3rd alpha dose booster so I wouldn't expect a delta booster in the next few months.

I doubt one thing affects another. I think they'll end up pushing for both.

[M2CattleCo]

Well I read this whole thread.

I’ve been pretty undecided on whether or not to get a shot because it’s so hard to sift through everything and filter out the bs and keep the good info. And I’m no kinda medical expert.

I think there are more legit professionals on this forum than probably any other place on the internet and I trust you guys.

Whatever is going around South Texas right now is tough. I know a LOT of people sick with it right now, tough guys, and it’s not looking good for some. I have had six acquaintances die over the past two weeks. Aged 35-44. Most all in good shape. Working men.

I’m going to get a Moderna shot tomorrow. We’ll see what happens.