U.S. plans to begin administering Covid-19 booster shots in September(reuters.com)
reuters.com
U.S. plans to begin administering Covid-19 booster shots in September
https://www.reuters.com/world/us/us-advise-covid-19-booster-shots-8-months-after-vaccination-nyt-2021-08-17/
41 comments
>I’d rather have robust variety of antibodies provided by prior infection than get a leaky vaccine every 8 months. Sucks that I’m going to lose my job for that decision but having a IaaS (Immunity as a Service) subscription from Pharma sounds worse than getting longcovid again.
Er, what? It sounds like you're saying that you'd rather get COVID-resistance from a bout with COVID rather than from a vaccine, but then you suggest that you've already had COVID and that you'd prefer to experience COVID complications again.
The suspicious doubletalk aside, aren't the double-vaxxed currently doomed to risk a (mild, potentially infectious) Delta experience anyway? How's the resistance gained thereby stack up?
Why's this an issue, anyway? Are you having to pay for your shots, or something? Or is this a "principled" stance?
edit: probable answers to the personal questions I have of the parent can be found in this thread of theirs a few days ago. If the events of the past year and a half weren't enough to make any readers worried about trust in social institutions, reading this will: https://news.ycombinator.com/item?id=27986681
Er, what? It sounds like you're saying that you'd rather get COVID-resistance from a bout with COVID rather than from a vaccine, but then you suggest that you've already had COVID and that you'd prefer to experience COVID complications again.
The suspicious doubletalk aside, aren't the double-vaxxed currently doomed to risk a (mild, potentially infectious) Delta experience anyway? How's the resistance gained thereby stack up?
Why's this an issue, anyway? Are you having to pay for your shots, or something? Or is this a "principled" stance?
edit: probable answers to the personal questions I have of the parent can be found in this thread of theirs a few days ago. If the events of the past year and a half weren't enough to make any readers worried about trust in social institutions, reading this will: https://news.ycombinator.com/item?id=27986681
He's saying he'd rather depend on his natural immunity than be mandatorily jabbed over and over again.
What natural immunity? He implies that he's already got two vaccine shots, and would rather lose his job than get a third...
Will his vaccine-induced resistance to the virus result in a more robust protection, after the immune system successfully fights off the Delta infection he'll surely eventually get? Or will the immunity fade, leaving him at an unvaccinated-like risk some time in the future? Given the chance of the latter, and given that he's likely already gotten two, I just don't understand the logic -- unless one's willing to venture into slightly paranoid territory, as I note above.
Will his vaccine-induced resistance to the virus result in a more robust protection, after the immune system successfully fights off the Delta infection he'll surely eventually get? Or will the immunity fade, leaving him at an unvaccinated-like risk some time in the future? Given the chance of the latter, and given that he's likely already gotten two, I just don't understand the logic -- unless one's willing to venture into slightly paranoid territory, as I note above.
I didn't get any shots. I had longcovid from Mar 2020 - Jun 2021.
I think having the shot will ruin my robust immunity. If you train your immune system to create very specific antibodies to one part of the virus, that is already being evaded by breakthrough infections btw - you will be more susceptible to variants. Anyone who had covid and takes this vaccine is ruining their existing immunity IMO - but people can do what they want, just don't force it on me.
I think having the shot will ruin my robust immunity. If you train your immune system to create very specific antibodies to one part of the virus, that is already being evaded by breakthrough infections btw - you will be more susceptible to variants. Anyone who had covid and takes this vaccine is ruining their existing immunity IMO - but people can do what they want, just don't force it on me.
> Anyone who had covid and takes this vaccine is ruining their existing immunity IMO
"Ruining" may be too strong a word but something like this has already been observed with the second Pfizer dose: https://www.biorxiv.org/content/10.1101/2021.03.22.436441v1
"Ruining" may be too strong a word but something like this has already been observed with the second Pfizer dose: https://www.biorxiv.org/content/10.1101/2021.03.22.436441v1
I note that the parent doesn't attempt to provide a summary. I'm no immunologist but it seems to me that this study examines a third-order consequence (levels of IFN-gamma in whole blood samples) to infer a second-level consequence (levels of CD4 helper and CD8 cytotoxic T-cells, which are secreting the IFN-gamma), which is presumed to be indicative of a root-level occurance ("a detrimental effect in the overall magnitude of the spike-specific humoral response in COVID-19 recovered individuals"). It's not clear to me how the second order consequence clearly implies the root-level occurance.
This [0] is the paper in the fifth citation from the parent's article. It seems to come to similiar conclusions, but, like the parent's article, doesn't assess any real world data, just lab conditions and inferences.
I urge everyone reading this to remind themselves of the specific language used in these articles -- they don't actually know whether these correlates they're observing are affecting immunity, just one component of what we consider to be a single aspect of an appropriate immune response in a blood sample.
Does my linked article, above and in a different thread, also measure blood sample conditions? Absolutely. But the article I linked directly analyses (spike protein) antibody levels -- an appropriate immune response in a blood sample -- while the articles here examine inferred T cell presence. One is a direct measure of something straightforward, and the other an inferential examination of something complex.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885942.1/
This [0] is the paper in the fifth citation from the parent's article. It seems to come to similiar conclusions, but, like the parent's article, doesn't assess any real world data, just lab conditions and inferences.
I urge everyone reading this to remind themselves of the specific language used in these articles -- they don't actually know whether these correlates they're observing are affecting immunity, just one component of what we consider to be a single aspect of an appropriate immune response in a blood sample.
Does my linked article, above and in a different thread, also measure blood sample conditions? Absolutely. But the article I linked directly analyses (spike protein) antibody levels -- an appropriate immune response in a blood sample -- while the articles here examine inferred T cell presence. One is a direct measure of something straightforward, and the other an inferential examination of something complex.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885942.1/
In reality we have no "real world data" and know very little about what the effects will be of piling Covid vaccinations on top of immunity from a prior infection, because it was never studied before pushing the shots to everyone including the Covid-recovered (who were explicitly excluded from the trials). Obviously spike protein antibodies are not the be-all and end-all of immunity to SARS-CoV-2, or we would not be observing relatively robust immunity even among recovered individuals who've had their antibody levels wane.
>the Covid-recovered (who were explicitly excluded from the trials)
Excluding these people from the initial trials makes perfect sense to me. The various understood complications of COVID, like blood clots or minor strokes, could have been mistaken for consequences of vaccination.
Why do you suppose that there aren't any papers being generated on the topic of the recovered-from-COVID who get vaccines?
>Obviously spike protein antibodies are not the be-all and end-all of immunity to SARS-CoV-2, or we would not be observing relatively robust immunity even among recovered individuals who've had their antibody levels wane
No, but serum antibody levels against the methods viruses use to hijack our cells is a long, storied, well-understood and widely-accepted means of assessing overall systemic immune response to whatever the antibodies are against, in a way that third-order inferences about T cells aren't.
Excluding these people from the initial trials makes perfect sense to me. The various understood complications of COVID, like blood clots or minor strokes, could have been mistaken for consequences of vaccination.
Why do you suppose that there aren't any papers being generated on the topic of the recovered-from-COVID who get vaccines?
>Obviously spike protein antibodies are not the be-all and end-all of immunity to SARS-CoV-2, or we would not be observing relatively robust immunity even among recovered individuals who've had their antibody levels wane
No, but serum antibody levels against the methods viruses use to hijack our cells is a long, storied, well-understood and widely-accepted means of assessing overall systemic immune response to whatever the antibodies are against, in a way that third-order inferences about T cells aren't.
I appreciate your judicious use of "I think" and "IMO". I don't think that you have much justification to think that way about your natural immunity.
For whatever it's worth, this preprint [0] suggests that your immunity, caused by a COVID infection, and my immunity, caused by two doses of the Pfizer vaccine, are similar, and have similar durations of functional protection. Note that, for both our cases, durable protection against Alpha and Delta was found after one year (but, interestingly, not against the dying variants Beta and Gamma).
I hope that you'll be willing to get the vaccine. I've experienced long term medical complications from something unrelated to COVID, and I can't imagine why anyone would want to risk something like long COVID, especially someone who's already had it.
[0] NB that I've linked to the second version uploaded https://www.medrxiv.org/content/10.1101/2021.08.12.21261951v...
For whatever it's worth, this preprint [0] suggests that your immunity, caused by a COVID infection, and my immunity, caused by two doses of the Pfizer vaccine, are similar, and have similar durations of functional protection. Note that, for both our cases, durable protection against Alpha and Delta was found after one year (but, interestingly, not against the dying variants Beta and Gamma).
I hope that you'll be willing to get the vaccine. I've experienced long term medical complications from something unrelated to COVID, and I can't imagine why anyone would want to risk something like long COVID, especially someone who's already had it.
[0] NB that I've linked to the second version uploaded https://www.medrxiv.org/content/10.1101/2021.08.12.21261951v...
That's a really good question I'd like the answer to. I was reading that natural infection tends to create a stronger response against the nucleocapsid for t-cells.
https://www.medrxiv.org/content/10.1101/2021.04.19.21255739v...
Is this an either or thing? Will your immune system develop proper full immunity after getting vaccine + delta ?
https://www.medrxiv.org/content/10.1101/2021.04.19.21255739v...
Is this an either or thing? Will your immune system develop proper full immunity after getting vaccine + delta ?
Who said you are going to lose your job? You seem to accept that as a fact, but I’m not sure where you are getting confirmation of this.
Are you just assuming that all employers will require you to get a booster shot in the future, even though as of now most employers do not require you to get even a single COVID shot?
Are you just assuming that all employers will require you to get a booster shot in the future, even though as of now most employers do not require you to get even a single COVID shot?
My employer has a mandate so it looks like I'm going to be fired in October. I didn't take the vaccine and won't be taking it.
I really cannot overstate how stupid it would be to lose your job over this. What, exactly, do you think the vaccine is going to do to you?
People are already losing their jobs over these vaccines.
????????
This was probably the hold-up for FDA approval. They needed to see if a third dose would be recommended. But if two doses weren't enough to stop the delta variant, how can they be sure that three are?
As I understand it(which could be completely wrong, so take with a grain of salt), there is no actual 'stopping' variants. The idea is to keep tricking your body with mock spike proteins, so that your body builds defenses against it. And data shows the more shots you get, the more your body builds resistance. So when the real thing arrives, it doesn't affect the host as much, if at all.
Is the booster customized for Delta? The article doesn't say.
No. Pfizer indicated it could develop and begin mass-producing a variant-specific booster within 100 days, if a third dose of the original vaccine is ineffective. [0] But the plan is to use the existing stock.
I'd feel a lot safer if Pfizer started developing a polyvalent booster with mRNA for all significant variants.
0. http://ctmirror.org/2021/08/13/pfizer-ceo-to-public-just-tru...
I'd feel a lot safer if Pfizer started developing a polyvalent booster with mRNA for all significant variants.
0. http://ctmirror.org/2021/08/13/pfizer-ceo-to-public-just-tru...
The boosters in question are not at this time. Same as other shot.
It's confusing because Pfizer was touting they could modify boosters for variants months ago.
It's confusing because Pfizer was touting they could modify boosters for variants months ago.
This binary thinking is wrong. Nobody thinks three shots will "stop" the delta variant. They think it'll lower the number of severe cases and deaths.
Okay, so if the binary thinking is wrong, why stop at three? Why stop at all? Does the science say we just blast our bodies with as much mRNA as we can get away with?
Elementary economic thinking answers this question.
Benefits asymptote, so you'll stop at the point where the marginal benefit of an additional shot is less than the marginal financial cost, marginal opportunity cost and marginal cost of side effects all combined.
That's definitely not the case before two and may not be the case before three based on data we've seen. It might be the case before four.
And this doesn't factor in declining immunity over time. It might make sense to keep taking shots every half a year forever, until COVID mutates into something less deadly perhaps.
Benefits asymptote, so you'll stop at the point where the marginal benefit of an additional shot is less than the marginal financial cost, marginal opportunity cost and marginal cost of side effects all combined.
That's definitely not the case before two and may not be the case before three based on data we've seen. It might be the case before four.
And this doesn't factor in declining immunity over time. It might make sense to keep taking shots every half a year forever, until COVID mutates into something less deadly perhaps.
This is basically what is done with the flu shot although it's a very different mechanism in the actual vaccine.
> until COVID mutates into something less deadly perhaps.
How do we know that that hasn't already happened? If we don't know, when will we know?
How do we know that that hasn't already happened? If we don't know, when will we know?
We will know when CFR/IFR goes down among unvaxxed people who haven't had COVID before.
[deleted]
Assuming you are asking earnestly, because of diminishing returns. Pfizer has been found to be 90 something percent effective at 2 months. They've noticed it seems to lose about 3% effectiveness per month, leaving you at 70-something percent after 8 months. That's with the data we have today, it could be much higher or lower as more data is collected.
To preemptively answer your question - yes, I could see needing to get a booster every 8 months for the foreseeable future.
To preemptively answer your question - yes, I could see needing to get a booster every 8 months for the foreseeable future.
"Assuming you are asking earnestly, because of diminishing returns."
The economics of this are showing increasing returns to the worldwide medical cartels, so this looks like it will continue indefinitely. With broad immunity to product safety laws, why not lay in another billion or two as profit? The C-level company staff will gleefully take home fat bonus checks.
The economics of this are showing increasing returns to the worldwide medical cartels, so this looks like it will continue indefinitely. With broad immunity to product safety laws, why not lay in another billion or two as profit? The C-level company staff will gleefully take home fat bonus checks.
They can't. No clinical trials. It's a hail mary.
I feel like "hail mary" would imply some sort of negative consequences for failure in this case. But short of the third shot just dropping dead everyone who takes it (unlikely), it will be easy enough with our media ecosystem to suppress adverse events and handwave away any problems with efficacy.
I mean, we're already seeing numerous countries experience higher cases and hospitalizations with 50%+ vax rates than they ever did before the vaccine rollouts but hardly anyone is asking "hey, what's going on here?"
I mean, we're already seeing numerous countries experience higher cases and hospitalizations with 50%+ vax rates than they ever did before the vaccine rollouts but hardly anyone is asking "hey, what's going on here?"
>I mean, we're already seeing numerous countries experience higher cases and hospitalizations with 50%+ vax rates than they ever did before the vaccine rollouts but hardly anyone is asking "hey, what's going on here?"
There's no reason to ask because we actually do know what's going on here. The r0 of OG COVID is ~3, higher than the flu. The r0 of Delta COVID is between 5 and 9, and the CDC currently estimates it at 8.5. Worse, Delta generates more, and more serious, hospitalizations (among the unvaccinated). [0]
Which countries are experiencing hospitalization rates higher than pre-vaccine times? More importantly, do those trends disappear if you look at areas within those countries that are highly- or poorly-vaccinated?
[0] https://health-desk.org/articles/how-contagious-is-the-delta...
There's no reason to ask because we actually do know what's going on here. The r0 of OG COVID is ~3, higher than the flu. The r0 of Delta COVID is between 5 and 9, and the CDC currently estimates it at 8.5. Worse, Delta generates more, and more serious, hospitalizations (among the unvaccinated). [0]
Which countries are experiencing hospitalization rates higher than pre-vaccine times? More importantly, do those trends disappear if you look at areas within those countries that are highly- or poorly-vaccinated?
[0] https://health-desk.org/articles/how-contagious-is-the-delta...
Meanwhile the rest of the world outside the US and EU are still starving for any vaccines at all.
But America pays more so they get doubled-up, even though their real problem is all the unvaccinated.
But America pays more so they get doubled-up, even though their real problem is all the unvaccinated.
Whether the real problem is the unvaccinated or need for boosters, the solution for non-antivax people at risk is the same: vaccines get administered to Americans.
> Global health leaders including Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, have pleaded with developed countries not to administer boosters given that most of the world’s population hasn’t received even a single dose. [1]
> U.S regulators authorized a third dose of COVID-19 vaccines by Pfizer Inc (PFE.N)-BioNTech and Moderna Inc (MRNA.O) on Friday for people with compromised immune systems who are likely to have weaker protection from the two-dose regimens. [2]
> "It will be a patient's attestation, and there will be no requirement for proof or prescription or a recommendation from an individual's healthcare provider," CDC official Dr. Amanda Cohn said [2]
Clearly we are facing a supply shortage and distribution problem with the vaccines - and citizens of wealthier & more developed countries will fare better given the dynamics playing out. Perhaps that's just the status quo, not sure why I'm even surprised at this point.
For the poor and rural populations in less developing countries, we really need to be pursuing early treatment using combinations of existing and widely available medicines, which have been shown to be very effective at preventing hospitalization and death [3][4] - it's what many front line doctors are already doing anyway, just without the same level of press coverage that vaccines are getting.
[1] https://www.sciencemag.org/news/2021/08/grim-warning-israel-...
[2] https://www.reuters.com/world/middle-east/us-fda-authorizes-...
[3] Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltex...
[4] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...
> U.S regulators authorized a third dose of COVID-19 vaccines by Pfizer Inc (PFE.N)-BioNTech and Moderna Inc (MRNA.O) on Friday for people with compromised immune systems who are likely to have weaker protection from the two-dose regimens. [2]
> "It will be a patient's attestation, and there will be no requirement for proof or prescription or a recommendation from an individual's healthcare provider," CDC official Dr. Amanda Cohn said [2]
Clearly we are facing a supply shortage and distribution problem with the vaccines - and citizens of wealthier & more developed countries will fare better given the dynamics playing out. Perhaps that's just the status quo, not sure why I'm even surprised at this point.
For the poor and rural populations in less developing countries, we really need to be pursuing early treatment using combinations of existing and widely available medicines, which have been shown to be very effective at preventing hospitalization and death [3][4] - it's what many front line doctors are already doing anyway, just without the same level of press coverage that vaccines are getting.
[1] https://www.sciencemag.org/news/2021/08/grim-warning-israel-...
[2] https://www.reuters.com/world/middle-east/us-fda-authorizes-...
[3] Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltex...
[4] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a...
Vaccine exports are underway and on track. However the vaccines require refrigeration which can be logistically challenging in underdeveloped countries.
https://www.wsj.com/articles/u-s-says-it-has-shared-110-mill...
Those poor countries tend to have fewer people at risk due to having younger populations and lower incidences of co-morbid conditions like obesity and diabetes. A recent meta analysis calculated an infection fatality rate of 0.05% in Africa.
https://onlinelibrary.wiley.com/doi/10.1111/eci.13554
https://www.wsj.com/articles/u-s-says-it-has-shared-110-mill...
Those poor countries tend to have fewer people at risk due to having younger populations and lower incidences of co-morbid conditions like obesity and diabetes. A recent meta analysis calculated an infection fatality rate of 0.05% in Africa.
https://onlinelibrary.wiley.com/doi/10.1111/eci.13554
Early on in the pandemic it looked like things might unfold differently. You can read about why that didn't happen here:
https://newrepublic.com/article/162000/bill-gates-impeded-gl...
https://newrepublic.com/article/162000/bill-gates-impeded-gl...
All we need to do is quarantine the developed world for just a little longer..
I’d rather have robust variety of antibodies provided by prior infection than get a leaky vaccine every 8 months. Sucks that I’m going to lose my job for that decision but having a IaaS (Immunity as a Service) subscription from Pharma sounds worse than getting longcovid again.