Category: Covid-19

Reminder: FDA Advisory Committee to Meet in May 2024 to Discuss Updating Covid-19 Vaccine:

Just a reminder: the FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet on May 16, 2024 to make recommendations on Covid-19 strain selections for the fall vaccine of 2024-2025.

Svengoolie Triggers Memory Lane Trip to the Drive Ins

Both Sena and I stayed up to see the cheesy 1972 horror flick The Gargoyles last Saturday night. No kidding, Sena stayed up for the whole thing! The show runs from 7-9:30 PM but the actual movie is only a little over an hour long. It’s about a clan of gargoyles that every 500 years hatch from eggs and wage war on humans to take over the planet. They never get the job done, probably because humans have all the guns and all the gargoyles have are claws and flimsy wings which you don’t see used until the very last scene. Like all of the Svengoolie movies, all of the jokes are so bad they’re good.

You can ask a fair question, which would be what else is on in addition to the movie? There’s a lot of commercials, of course, as well as the corny jokes and skits. But the other features last Saturday were excerpts from the Flashback Weekend Chicago Horror Con, in August 2023. I think it’s an annual historical horror convention that takes place in Rosemont, Illinois.

One of the attractions was a panel presentation about the history of the 90th anniversary of the drive-in theater hosted by Svengoolie and Joe Bob Briggs. It was arguably better than the feature flick. I have heard the history elsewhere about how the drive-in theatre began (I think it was on the travel or history channel).

The most interesting part of the history is how the Covid-19 pandemic influenced the recent history of the drive-in theaters. The point was that, when the pandemic hit the country, all indoor theaters closed, leaving the drive-ins the only place to watch movies for several weeks. They did pretty good business.

Moreover, horror movies and drive-ins go together like cheese and crackers (see what I did there, cheese as in cheesy movies?). OK, fine.

Anyway, horror films were mainly linked to low budget projects that big stars and big directors avoided like the plague. Mainly, those movies were played at the drive-ins—which is how they got a tarnished reputation. That led to cherished stories by older people who used to sneak their friends into the drive-ins by stowing them in the trunks of their cars. That probably did happen, even in the old Mason City Drive-In Theater in Iowa where Sena and I grew up. It was demolished in 1997.

As far as The Gargoyle movie goes, the one thing I couldn’t find out was exactly why Bernie Casey, who played the head gargoyle, didn’t voice his own lines. The web references I found just mentioned briefly that it was because his natural speaking voice didn’t fit the character. They were dubbed in by Vic Perrin who did the voice-over for the introduction to The Outer Limits.

Maybe the funniest scene was when the head gargoyle placated and playfully slapped the fanny of the female head breeder gargoyle after she noticed he was flirting with the human woman he kidnapped. The breeder was obviously really jealous. Maybe this means that the battle between gargoyles and humans will always come to a stalemate because we’re too much alike.

FDA Advisory Committee to Meet in May 2024 to Discuss Updating Covid-19 Vaccine

The FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet on May 16, 2024 to make recommendations on Covid-19 strain selections for the fall vaccine of 2024-2025.

Well, The Times They Are A’Changing at the CDC

We just found out that the CDC is, in fact, changing their recommendations on isolation precautions and other guidance for respiratory illness. It turns out the 5 day isolation rule for a positive Covid 19 test is going away. The Respiratory Virus Guidance page has changed as of today.

Sena found out about it from an article in the Wall Street Journal. The rules for health care personnel are not the same as they are for the public. I guess the times theye are a’changing.

CDC ACIP Meeting on Covid 19 Vaccine Additional Dose

The CDC ACIP meeting on February 28, 2024 on the proposal of a Spring booster of the Covid 19 vaccine was interesting and confusing. Initially right after the morning presentations, we were a little confused about whether the committee was targeting only those who got the vaccine booster last fall or everybody. That didn’t make much sense given the concern about low overall uptake of the vaccine.

The presenters also mentioned that getting the Spring Covid booster would be part of a shared clinical decision-making discussion with your doctor, similar to that recommended for the RSV vaccine. That was bewildering because we think that’s part of the reason some people might skip the RSV vaccine, given the news reports last year pointing out you had to have a prescription from a medical provider in some states to get it.

I was pretty interested in learning more about T-cell immunity given the concern about waning which of immunity from vaccines over a few months, which I think was based on neutralizing antibodies from B cells. I thought the CDC web site link to an article about the T-cell immune response suggested that cell mediated immune responses might mean that our immunity might not be waning that quickly. However, one of the presentations, “Evidence to Recommendation” showed a slide indicating that your T-cell immunity gets weaker with age (ref. de Candia P, Prattichizzo F, Garavelli S, Matarese G. T Cells: Warriors of SARS-CoV-2 Infection. Trends Immunol. 2021 Jan;42(1):18-30. doi: 10.1016/j.it.2020.11.002. Epub 2020 Nov 13. PMID: 33277181; PMCID: PMC7664351.)

I’ve read other articles, one of them on the CDC website, which says you may have more durable immunity provided by T-cells, but if I read it carefully, the authors hedge and say that T-cell adaptive immunity may not be as strong when you’re older. (Moss, P. The T cell immune response against SARS-CoV-2. Nat Immunol 23, 186–193 (2022). https://doi.org/10.1038/s41590-021-01122-w).

Later in the afternoon, the committee voted that those who are 65 years old and older should get the spring dose. There was no further discussion of limiting it to only those who got the Covid vaccine in the fall of 2023. There was also no discussion of the shared clinical decision-making detail. The committee upvoted the resolution with a majority.

And yet, the voting question did say: ACIP recommends that persons greater than or equal to 65 years of age “should” (which was changed from “may”) receive an additional dose of 2023-2024 Formula COVID-19 vaccine. The “additional dose” means in addition to the vaccine (monovalent XBB.1.5) given last fall. That’s a relatively select group, when you take the subset of those who are 65 and older.

However, the slides in the “Evidence to Recommendation” had recommended there should be shared clinical decision-making, meaning that you should discuss getting the vaccine with your doctor. However, according to the STAT NEWS article summary of this meeting, substituting the word “should” for “may” would make the conversation with a doctor unnecessary.

Finally, there was no discussion at all of changing the 5-day isolation precaution for those testing positive for Covid-19. If the committee were planning to drop that, as many news agencies recently reported, I would think they’d have discussed it at length at the meeting.

The CDC Director will have to sign off on the additional Covid-19 shot before it’s official.

2/29/2024 Update: CDC Director endorsed the additional dose yesterday.

Thoughts on Upcoming CDC ACIP Meeting

Sena and I are talking about the upcoming CDC meeting on February 28th-29th next week. The agenda looks like they’ll be talking about an “additional dose” of the Covid-19 vaccine.

Given the extent of vaccine fatigue going on, I tried to find a layperson-friendly article on the web about vaccine immunity with details about how long it lasts.

There’s review article from 2022 that helps a little bit. The author says that boosting every few months may not be practical as a long-term strategy. It leads to vaccine fatigue in the population. We all know how low the Covid-19 vaccine uptake has been. The author says that boosters should be offered annually or even less often. There is more to immunity than neutralizing antibodies.

The suggestion of some experts is to offer Covid-19 boosters to whoever wants it. I feel like I’m getting mixed and circular messages when I read that my immunity is “waning,” and I need another one. We’ve gotten every Covid-19 shot since the vaccine campaign began. Experts even differ on whether to call Covid-19 a “seasonal” respiratory virus. That would suggest you could get one shot annually during the respiratory virus season-like the flu shot. Obviously, it’s not that simple if the CDC recommends another Covid-19 vaccine this spring.

And the CDC respiratory virus channel snapshot from February 16, 2024 is a little concerning. A couple of days ago there was a news report that schools in Forest City, Iowa would have to move to remote learning because of outbreaks of influenza, strep throat, and even stomach flu. According to the CDC, respiratory virus activity levels are high all over Iowa, which surprised me this late in the season.

CDC ACIP Meeting February 28-29, 2024 to Discuss Covid-19 and Other Vaccines

There are news stories about a pending CDC-ACIP meeting (February 28-29, 2024) which might include information about a CDC recommendation to possibly add a 3rd additional Covid-19 vaccine booster this spring.

The Covid-19 vaccine portion of the meeting is scheduled for February 28, 2024 at 8:30 AM EST. There will be a vote at 1:55 PM EST that day.

Interestingly, also on the agenda is a discussion about the RSV vaccine on February 29, 2024 at 8:30 AM EST. We wonder whether the committee will talk about the current requirement for a shared clinical-decision making discussion with a physician for getting the RSV vaccine.

New Large Covid-19 Vaccine Study Shows Association with Rare Side Effects Which Other Smaller Studies Have Found

I’ve seen a couple of news stories about the CDC supported large study across many countries which essentially shows that Covid-19 vaccines can be associated with rare side effects. The stories might tend to raise anxiety about the vaccines’ overall safety, which has been repeatedly proven in other studies.

The study is published in the journal Vaccine and the conclusions are consistent with smaller studies showing the Covid-19 vaccines safety although they do have rare side effects.

One of the news stories contacted an expert, Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center, who confirmed that.

Unfortunately, there are over 1200 comments (and counting) containing alarmist and misleading information about the vaccines.

CDC May Change the 5 Day Covid-19 Isolation Guidelines

I see many news headlines reporting that the CDC may be planning to drop the 5 day Covid-19 isolation guidelines. For now I’m taking that as a rumor until the CDC website says something official about it.

Word on the street is that we may know more in April.