Category: COVID-19 vaccines

To Boost or Not to Boost?

To boost or not to boost? That is the question. I’m still thinking about whether or not it’s important for me to get the second booster for the COVID vaccine. What might help me decide is a little bit more information from University of Iowa Hospital epidemiologist Dr. Daniel Diekema, MD.

The Omicron subvariant, BA.2, is much more transmissible than most past variants. According to Dr. Diekema, it’s responsible for more than half of all Covid-19 cases in Iowa. On the one hand, it doesn’t cause more severe disease than the other variants, and it’s just as responsive to the current vaccines.

On the other hand, just because I’m older makes me more susceptible to severe disease and less responsive to vaccines. That’s according to studies done by Stanley Perlman. MD, PhD at the University of Iowa.

So even if the first booster dose is effective against severe COVID-19 disease, I may be better off getting the second booster sooner rather than later.

It’s also important to continue wearing a mask and practicing social distancing as well as good hand hygiene.

My Opinion So Far of the 2nd Covid-19 Booster

My title for this post indicates my opinion of the Covid-19 vaccine 2nd booster. I missed nearly all of the FDA Advisory Committee meeting last Wednesday but got the last hour of the discussion of the questions:

“Following the scheduled presentations and open public hearing, the VRBPAC will be asked to discuss and provide input on the following topics (no voting questions):


• What considerations should inform strain composition decisions to ensure that available COVID-19 vaccines continue to meet public health needs, e.g.:
-Role of VRBPAC and FDA in coordinating strain composition decisions
-Timelines needed to implement strain composition updates
-Harmonization of strain composition across available vaccines


• How often should the adequacy of strain composition for available vaccines be assessed?


• What conditions would indicate a need for updated COVID-19 vaccine strain composition, and what data would be needed to support a decision on a strain composition update?


• What considerations should guide the timing and populations for use of additional COVID-19 vaccine booster doses?”

I think the Stat News summary is helpful. There is a link to the recorded meeting. Sorry, it was over 8 hours long and I don’t think I can sit through that much technical difficulty—which was reportedly more of a problem than usual.

I’m a little disappointed that the duration of the protection from the 2nd booster might be only about 8 weeks, according to the Israeli presentation. Then what? FDA Director Peter Marks frankly calls the 2nd booster a “stopgap” measure. We need a new vaccine, not a series of boosters of the same old, same old.

Can the drug companies coordinate their efforts to come up with a new vaccine that will target the most prevalent variants of concern? Frankly, I doubt it, especially if they have to get going on the production in June and there doesn’t seem to be consensus on what variants would be important by the time the new vaccine would be needed, which is this fall. The virus mutates quickly and not in predictable ways.

I think we’re well past the idea of getting a vaccine that will lead to a sterilizing immunity, especially since it sounds like a product that stimulates nasal mucosa IgA antibodies would be necessary—if you can keep from sneezing the product back out on your sleeve. If the vaccines keep me out of the hospital, I guess I’d be happy with that. It looks like immunity will wane no matter what you do and there doesn’t seem to be a correlate of protection nor any guarantees on durability.

Counting hospitalizations for Covid as a way of tracking infections might be misleading since many hospitals are now not counting them if they’re not the primary reason for admission.

While I think getting the 2nd booster is fine as a stopgap measure for now, and I’ll likely get it, I’m hoping for a new vaccine in the coming months.

Reminder: FDA Advisory Committee Meeting Today on Covid-19 Vaccine Boosters

Just a reminder; today the FDA Advisory Committee will meet from 8:30 AM to 5:00 PM, ET today to discuss Covid-19 vaccine boosters. I’ll be unable to post a “play by play” as I have in the past because I have something else on my schedule.

Especially noteworthy is the Briefing Document in the meeting materials, entitled:

“Considerations for COVID-19 Vaccine Booster Doses and Process for COVID-19 Vaccine Strain Selection to Address Current and Emerging Variants.”

Section 7 starts on page 17, “Topics for VRBPAC Discussion.” The important issue is determining strain composition of Covid-19 vaccines and what goes into consideration for the optimal use of additional booster doses.

April 6, 2022 Update:

“Topics for VRBPAC Discussion


Following the scheduled presentations and open public hearing, the VRBPAC will be asked to discuss and provide input on the following topics (no voting questions):


• What considerations should inform strain composition decisions to ensure that available COVID-19 vaccines continue to meet public health needs, e.g.:
-Role of VRBPAC and FDA in coordinating strain composition decisions
-Timelines needed to implement strain composition updates
-Harmonization of strain composition across available vaccines


• How often should the adequacy of strain composition for available vaccines be assessed?


• What conditions would indicate a need for updated COVID-19 vaccine strain composition, and what data would be needed to support a decision on a strain composition update?


• What considerations should guide the timing and populations for use of additional COVID-19 vaccine booster doses?”

Quick Announcement on Covid-19 2nd Vaccine Booster

According to a University of Iowa Hospitals & Clinics announcement on The Loop, 2nd booster doses were available to employees, volunteers, and patients starting April 4, 2022.

Permissive Recommendation for Covid Vaccine 2nd Booster?

I have a question about the permissive recommendation by the CDC for the 2nd Covid vaccine booster. Does that mean I should get the booster or that I can get it if I just want one?

There’s an important distinction between “should” and “can.” According to the AMA, the CDC gave permissive recommendation, which means that it’s not saying you should get it, but that you can if you so choose:

“The CDC’s action is commonly known as a “permissive recommendation,” meaning that certain people may get the second booster if they wish to get it, though the agency itself is not yet officially urging them to do so.”

There are a couple of recently updated tables on the CDC website in which the language is clearly permissive about the 2nd booster dose.  One is dated April 2, 2022, Stay Up to Date with Your Covid-19 Vaccines. The other is dated April 1, 2022, Covid-19 Vaccine Boosters.

Some of us may be finding it challenging to get the booster scheduled right now. I wonder if that means even those providing the booster might be wondering who should or should not get one.

Does vaccine supply have a bearing on the issue? Or is there significant uncertainty about the necessity for the 2nd booster?

I wonder if experts are waiting for further guidance from the scheduled FDA Advisory Committee meeting on April 6, 2022.

That’s this coming Wednesday. I’d like to listen to the meeting as I have in the past, but I have a schedule conflict that day. That’s not the only conflict I have.

No officials are clearly saying that I should not get the 2nd booster. On the other hand, neither are they clearly saying I should.

Maybe I’ll wait for an FDA update after the April 6 meeting. And I wonder if that will lead to a CDC Advisory Committee meeting.

Update April 5, 2022: Here’s a link to a new article on CDC Director Rochelle Walensky’s remarks intended to clarify the confusion about this issue of whether the 2nd booster is needed or not. It turns out it all depends (as it usually does). If I’ve been infected with Omicron in the last 2-4 months, then I might not need one, at least for now.

The catch is that my immunity is waning. I might still need the 2nd booster. I’m old enough that it might be a good idea to get it. On the other hand, I’m probably still going to need another jab come autumn. Dr. Walensky says this is “a personal judgment call.”

I’m still waiting for the FDA Advisory Committee’s conclusions on April 6, 2022.

AMA Update on Covid-19 2nd Vaccine Booster

The AMA published an update on the Covid-19 Vaccine 2nd booster and the YouTube presentation is only a couple of days old and pretty thorough. While the CDC indeed gave a permissive recommendation, it sounds like another jab would be recommended in the fall anyway, likely targeting variants. The FDA Advisory Committee still has a meeting scheduled for April 6, 2022. It sounds like Medicare and private insurance will cover the cost. The Federal funding outlook doesn’t sound as positive for the uninsured.

Second Covid Vaccine Booster Got Any Mojo?

Tomorrow’s April Fool’s Day and I thought I’d get this post up today so it wouldn’t get confused with a joke.

I’m genuinely a little confused about the FDA and CDC approval of the 2nd Covid vaccine booster. It’s almost like this vaccine is getting a mojo of some kind, at least with some experts.

Although I’m not keen on getting another jab, I’ll do it if there is reasonable evidence to support it. Not everyone on the FDA Advisory committee is for it. Dr. Paul Offit was quoted in a news story as saying, “We’re going to have to learn to live with mild disease at some point.” 

Dr. Offit is the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. I’ve heard him speak at FDA Advisory Committee meetings during public Zoom meetings on the subject and I respect his opinion. He doesn’t think frequent boosting is a reasonable thing to do. I’m inclined to agree with his opinion that most people won’t do it anyway. I’m sure he’ll have more to say at the April 6 FDA Covid Vaccine Advisory Committee meeting.

I was not surprised to learn that of the 90 million Americans who got their initial Covid vaccine series, only about half got the first booster. What kind of mojo is that?

Even the Pfizer drug company CEO, Albert Bourla, says frequent boosting is impractical.

There is some serious doubt in my mind about the booster mojo. Sena says that it would be helpful if more local infectious disease experts would express their own opinions about the direction this vaccination strategy is going. She has a point.

Does the Covid vaccine booster have any mojo? What do you think?

Featured image picture credit: pixydotorg.

FDA and CDC Endorse 2nd Vaccine Booster for Covid-19

On March 29, 2022, both the FDA and the CDC endorsed a 2nd Covid-19 booster vaccine dose. The FDA Advisory Committee on vaccines still has a meeting scheduled about vaccine boosters on April 6, 2022. Neither of the booster doses will be variant specific.

FDA Advisory Committee Meeting on Covid Vaccine Boosters Scheduled for April 6, 2022

The FDA Advisory Committee on Vaccines and Related Biological Products has scheduled a meeting on April 6, 2022 “to discuss considerations for use of COVID-19 vaccine booster doses and the process for COVID-19 vaccine strain selection to address current and emerging variants.” The meeting will run from 8:30 AM-5:00 PM ET.

FDA Postpones Meeting to Discuss Pfizer Covid-19 Vaccine for Children Less Than 5 years Old

The FDA announced today that the meeting to discuss Pfizer’s request for authorization of Pfizer-BioNTech COVID-19 Vaccine for children 6 months through 4 years of age, originally scheduled February 15, 2022, will be postponed. This will give Pfizer time to evaluate a third dose of the vaccine in this age group.