Two Vaccine Jabs in One Arm or One in Each Arm?

There were headlines about whether it’s better to get the flu shot and the Covid-19 updated booster in one arm or one in each.

It doesn’t matter. Sena got both in one arm. Mine were split. I think it depended on the preference of the person giving the shots.

The main thing is that you consider getting them, at least. That part is up to you.

HHS Campaign for Updated Covid-19 Updated Vaccine Booster

See the HHS Campaign for the Covid-19 updated vaccine booster for older adults-a high risk group. We’re scheduled for both the flu shot and the updated booster.

How to Get the Updated Covid-19 Vaccine Booster at University of Iowa Hospitals & Clinics

Here’s an updated link to how to get the updated Covid-19 vaccine booster (often called the Omicron bivalent booster). It’s sometimes faster to get this booster at local pharmacies, although there’s less urgency now.

I Say Omicron and You Say Ahmicron

Well, we tried the Miracle Whip salad dressing on egg salad sandwiches the other day. I thought they tasted better than the tuna fish sandwiches we had before.

But maybe it was the mustard in the egg salad. Anyway, Sena says we’ll be going back to Mayonnaise after the Miracle Whip is gone.

The difference between Mayo and Miracle Whip may be debatable. But the difference between the updated Covid-19 vaccine Omicron bivalent booster and the previous Covid-19 vaccines is more important than just the difference between the two pronunciations of Omicron. I say OH-muh-kraan, you say AH-muh-kraan. You say tuh-May-toh, I say to-MAH-toh, etc.

Some clinicians are worried about the risk for substituting the wrong vaccine for the new bivalent booster. That’s more than just fussiness; administration errors have already occurred with previous formulations of the vaccines and their boosters. These are nontrivial, reportable mistakes.

Some say the different colors of the vial caps should be enough to prevent mistakes. The CDC advisory committee members disagreed.

It doesn’t seem to be enough to simply read the vial labels. Busy workers in pharmacies and primary care clinics have grabbled the wrong ones and injected them.

One person at the CDC ACIP meeting on September 1, 2022 said, “Structural problems required structural solutions,” referring to the vials which have similar packaging, an opinion shared by others. The Interim Clinical Considerations for COVID-19 Vaccines: Bivalent Boosters slide set makes the distinctions pretty clear.

I hope the pharmacies and other clinics get the pictures. Just because we’re all a little nervous about making mistakes doesn’t mean we have to call the whole thing off.

What is the Answer to Automated Answering Machine Recordings?

I’ve been calling local pharmacies in an effort to schedule getting the updated Covid-19 vaccine updated bivalent booster and the flu shot as well. I imagine I’m not the only one encountering the frustrating automated answering machines.

It’s confusing to find out that if I answer the question about how many Covid-19 vaccine shots I’ve gotten (which is 4, including the two initial doses and two boosters), the machine politely sort of congratulates me (“you’re good to go!) and then hangs up. That contrasts with the web-based organization message in large font against a bright red background which assures me that I can schedule a time to get both vaccines—if I set up an on-line account (which always makes me suspicious). It turns out that the old “continue as a guest” alternative puts my personal information at risk. I’m unable to get a live person on the line.

I found a few tactics on the web for bypassing these recordings, but I’m pretty sure they don’t work. Some of them have been around for over 15 years, like pressing zero once or even repeatedly. That can result in the recording automatically hanging up on you.

There are other suggestions for pressing various special characters on your smartphone, which some people swear by.

Speaking of swearing, I even found one suggestion for swearing repeatedly into the phone to get past the automated answering machine. I’m pretty sure that doesn’t work.

I think I’ll just sit tight and wait a while. There’s no rush. But I wish there were some polite and effective way to get a live person on the line when you get the automated answering machine from hell:

Drugs-R-Us Pharmacy: Hello, what would you like to do today? You can say, “vaccine,” “alien abductions,” or “triple fat burger with soggy fries and a cola.”

Customer: Vaccine.

Drugs-R-Us: Thank you! Would you like to do: schedule a new, review a scheduled time, cancel an appointment, or talk about the weather?

Customer: Schedule a new.

Drugs-R-Us: What vaccine would you like to schedule?

Customer: Updated Covid-19 booster.

Drugs-R-Us: Got it! And would you like any other vaccines?

Customer: Flu shot.

Drugs-R-Us: I see; I’ll make a note of that. You can ask the pharmacist at your visit for another vaccine, which would be administered as an intra-ocular injection in the eye of your choice. Now, a booster. I’ll need some more information, including your birthdate, phone number, number of previous vaccinations, distinguishing marks, social security number, all bank account numbers, record of previous arrests, and the name of your first-born child, if any. First, how many vaccines have you received?

Customer: Four.

Drugs-R-Us: You rock! You have all the vaccines you need and that means it’s Beer O’clock for you, dude. Is there anything else?

Customer: But I want the updated Covid-19 booster! Can’t you understand that it’s new and your company says it’s available now?

Drugs-R-Us: Good-bye (click).

Maybe I’ll have better luck next week.

Is Treatment with Antibodies a Substitute for Vaccination for Covid-19?

I read the news article about scientists publishing a study which shows it’s possible to make antibodies that may neutralize most of the Covid-19 variants. I read this after failing to find any local facility in my area that has the updated bivalent Covid-19 vaccine booster available yet. Sena and I plan to get the booster, which would be our 5th shot.

I don’t have a clue how to evaluate the study itself, which was published in an Open Access journal, Communications Biology. I didn’t understand the peer reviewers’ comments and suggestions because I lack the scientific background to make sense of them.

I was under the impression that using antibodies for Covid-19 has to be prompted by getting infected first. In fact, the lead author of the study actually points out in the news article in published in the Jerusalem Post,

“In our view, targeted treatment with antibodies and their delivery to the body in high concentrations can serve as an effective substitute for repeated boosters, especially for at-risk populations and those with weakened immune systems. COVID-19 infection can cause serious illness, and we know that providing antibodies in the first days following infection can stop the spread of the virus.

“It is, therefore, possible that by using effective antibody treatment, we will not have to provide booster doses to the entire population every time there is a new variant,” Freund concluded.

I understand that immunity wanes after vaccination and that’s frustrating because apparently you need another booster every few months.

But I’m not sure I see how the antibody treatment would be a replacement for vaccines, if that’s the implication.

The interventions sound complementary. Wouldn’t it be better to have vaccine-induced immunity and use the antibodies as a backup treatment when you get infected?

I got the impression from reading about monoclonal antibody treatments that they have to be administered by infusions in specialty clinics. And you have to catch it in the first few days. And the indication for it is getting infected with the virus—which I thought could be avoided in the first place by getting vaccinated.

The plan now seems to be to manufacture vaccines annually to target important variants of Covid-19, similar to what we’ve been doing for influenza. We’ve been getting flu shots every year for a long time. Maybe we won’t need to get boosters every few months.

It makes sense to use antibodies for immunocompromised persons, though, because they don’t respond as well to vaccines.

Why would we “substitute” monoclonal antibody infusions administered in clinics to treat infections for vaccines which can prevent severe disease and death?

I’m not knocking the study; I’m just a retired psychiatrist, not an infectious disease scientist. Am I missing something?

CDC Interim Clinical Considerations for Covid-19 Vaccine Bivalent Boosters

Taken from the CDC ACIP meeting on 9/01/2022, here is the link to the CDC Interim Clinical Considerations for the Covid-19 Vaccines: Bivalent Boosters.

University of Iowa Hospitals Information on Omicron-Specific Covid-19 Vaccine Booster

The University of Iowa Hospital & Clinics has information on the facts and expected availability of the new bivalent Omicron Covid-19 vaccine boosters.

CDC ACIP Meeting Today and Tomorrow: Covid-19 Vaccine Omicron Bivalent Booster Candidates

The CDC ACIP will meet today and tomorrow about the Covid-19 Vaccine Omicron Bivalent Booster candidates from Pfizer and Moderna. A vote is expected this afternoon.

Update: The committee voted by a majority to upvote the approval of the Pfizer and Moderna bivalent boosters this afternoon. There was one dissenting vote because there was no clinical data to present. There was a clinical study using the bivalent vaccine booster, but results would not have been available until November or December.

However, there was a complicated statistical predication model which showed that if the boosters were rolled out this month, many thousands of hospitalizations and deaths could be prevented as opposed to waiting a few more months. That got prioritized in order to approve the boosters now rather than wait for the clinical study results.

There was a lot of concern about the packaging of the boosters resembling other boosters which might lead to mistakes in administration. Pfizer has a booster vial that looks very similar to that of their bivalent Omicron booster, unless you closely read the tiny print on the vial which says it’s BA.4/BA.5.

The committee voted to cancel tomorrow’s meeting since they completed the goal today.

CDC ACIP Meeting for September 1-2 on Bivalent Omicron Covid-19 Vaccine Boosters

The CDC ACIP have an agenda posted indicating that the advisory committee will discuss Covid-19 Bivalent Omicron vaccine candidates on September 1-2, 2022. A vote is scheduled on September 1, 2022.

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