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.

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.

FDA Removes N95 Respirators from Shortage List

I think it’s ironic that about the same time a PLOs One study and news articles came out announcing a new method using 8-inch rubber bands for improving the fit of the surgical mask to approximate that of the N95 respirator, the FDA removed the N95 respirator from the medical device shortage list. This is relevant to help protect people from infection with Covid-19 because even vaccinated older people are getting hospitalized with the Omicron variant of the virus.

I’m not saying that the new rubber band method to tighten the fit of the surgical mask is not an improvement. It might come in handy when there is another shortage of N95 respirators.

The method mainly targets health care professionals. It would be difficult to persuade everyone in the community to adopt the technique. It’s tough enough to get people to wear masks even in crowded buildings in high transmission areas.

This is despite the CDC study showing that the elderly population continue to be at high risk for hospitalization from Covid-19 despite being vaccinated with the initial series and one or more boosters.

I think it’s hard to achieve a good fit even with the N95 respirators. The free ones distributed by the Federal government early this year were not widely available and fit poorly because the straps were elastic (similar to rubber bands, only flimsier) and loosened quickly, even after using only 2 or 3 times. At least the ones I got did. Prior to retiring, I was never able to pass a Fit test at the hospital using that type of mask.

I think my surgical masks fit better than the N95 respirators, especially after using the knot and tuck method to get a tighter seal.

Now the newer rubber band method to get a better seal uses two large 8-inch rubber bands to make the mid-face portion of the mask fit closer to your face. It looks a little easier to do than the earlier 3 rubber band technique developed a couple of years ago. That one was even tested at the University of Iowa Hospitals and Clinics by emergency room health care professionals, resulting in a small published study (the “double eights mask brace”).

All of the rubber band mask braces techniques were a response to the shortage of N95 respirators. What’s interesting to me is that, as the authors of the PLOs One study point out, there is a fair amount of variability in how well the N95 mask fits. Differences in the shape of a person’s face can account for some of this.

And there’s no shortage of N95 respirators—for now, at least according to the FDA.

If a non-health care professional wanted to use a rubber band brace, it would take some practice to get a good seal. There’s a bit of a learning curve even for a pro.

I think it would be difficult to persuade the average person to get the rubber bands and the surgical mask out of a pocket or a purse and fiddle around to achieve a good fit if you’re just going to run into Wal Mart—where I could not find that the big 8-inch rubber bands are even in stock. They’re pretty much a “3-day shipping” kind of item and could cost as much as $20 a bag.

Covid-19 Vaccine Immune Response to Omicron Wanes According to NIH

According to the National Institute of Health (NIH) the current Covid-19 vaccine booster elicits a robust immune response, it wanes quickly against the Omicron variant.

Novavax Covid-19 Vaccine Gets CDC Green Light

The Novavax Covid-19 vaccine was approved by the CDC a few days ago. University of Iowa Health Care was one of the sites in the multi-site Phase 3 trial.

The vaccine is not based on mRNA technology; it uses a more traditional method similar to the flu vaccine, which is familiar to more people.

FDA Advisory Committee Approves Adding Omicron component to the Next Covid-19 Vaccine

On June 28, 2022 the FDA Vaccine and Related Biological Products Advisory Committee came to a majority “yes” vote to the question:

“Does the committee recommend inclusion of a SARS-CoV-2 Omicron component for COVID-19 booster vaccines in the United States?”

The meeting was recorded and is available for review.

FDA Advisory Committee Green Lights Novavax Covid-19 Vaccine

The FDA Advisory Committee endorsed the Novavax Covid-19 Vaccine at their meeting June 7, 2022. It awaits the FDA Director’s decision and, if endorsed by the director, would next go to the CDC Advisory Committee for their evaluation, which looks like it might be scheduled later this month.

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