FDA Approves Booster Shot for People with Weakened Immune Systems

[REWahoo]

I really want that nasal vaccine!

Yes. That would be nothing to sneeze at!

 

[ivinsfan]

I really want that nasal vaccine!

Well there has been some evidence that the nasal flu vaccine isn't a good as the standard flu shot.

 

[Chuckanut]

The UK (or maybe just England) put off the 2nd shot for their AtraZeneca vaccine for up to 12 weeks. I wonder if they have some useful data on the differences in protection for those who waited different lengths of time?

 

[Sojourner]

Older friend wants booster but isn't eligible

A good friend of mine called me last night to tell me about how worried his is that he can't get a COVID booster shot. He's 63 and in pretty good health, although he does take meds for high blood pressure and is borderline diabetic. His dilemma is that he has to fly to Tennessee in early October (job requirement that he can't get out of, apparently) and will be there for 10 days. He's worried that he's flying right into the heart of the Delta surge there and will be very susceptible to a breakthrough infection. He's fully vax'd with Pfizer but has read all the studies showing a reduction in efficacy after six months, etc. He told me that he's so worried about this Tennessee trip that he's considering just getting the booster shot anyway by stating (falsely) that's he immunocompromised. But he's also worried about the repercussions of getting medical treatment for which he's not technically eligible. He even asked me "Is that illegal? Could I be arrested if certain people found out about it?"

I didn't know what to tell him, honestly. I feel badly for him, considering he's so close to the age threshold for which the FDA just approved boosters. And having to spend extended time in Tennessee right now seems like asking for trouble, to say the least. Only about 44% of adults are fully vaccinated there and their daily case rate is north of 100 (per 100K), compared to about 12 where he lives (San Jose, CA).

His question got me thinking, though, about the repercussions of lying to get the booster. I suspect the worst that would happen is his insurance would refuse to cover it, so he'd be out $100 or so in that case. I don't think that misrepresenting your health status in order to get a vaccine is a criminal act, but I honestly don't know. I was tempted to tell him that he should go ahead, simply for peace of mind and to be sure he has the best possible "vaccine armor" when he goes into dangerous, low-vax, high-infection-rate territory. But all I could offer was "Gee, that's a tough call. Not sure what I'd do in your shoes."

What would you do if you were in my friend's shoes?

 

[tmm99]

The UK (or maybe just England) put off the 2nd shot for their AtraZeneca vaccine for up to 12 weeks. I wonder if they have some useful data on the differences in protection for those who waited different lengths of time?

I don't know about AZ, but as for Pfizer in the UK, they were reporting more than double the antibody response with 12 weeks compared to the three-week interval.

This article says 3.5x antibody response...

https://www.birmingham.ac.uk/news/l...r-vaccination-interval-antibody-response.aspx

 

[iloveyoga]

A good friend of mine called me last night to tell me about how worried his is that he can't get a COVID booster shot. He's 63 and in pretty good health, although he does take meds for high blood pressure and is borderline diabetic. His dilemma is that he has to fly to Tennessee in early October (job requirement that he can't get out of, apparently) and will be there for 10 days. He's worried that he's flying right into the heart of the Delta surge there and will be very susceptible to a breakthrough infection. He's fully vax'd with Pfizer but has read all the studies showing a reduction in efficacy after six months, etc. He told me that he's so worried about this Tennessee trip that he's considering just getting the booster shot anyway by stating (falsely) that's he immunocompromised. But he's also worried about the repercussions of getting medical treatment for which he's not technically eligible. He even asked me "Is that illegal? Could I be arrested if certain people found out about it?"

I didn't know what to tell him, honestly. I feel badly for him, considering he's so close to the age threshold for which the FDA just approved boosters. And having to spend extended time in Tennessee right now seems like asking for trouble, to say the least. Only about 44% of adults are fully vaccinated there and their daily case rate is north of 100 (per 100K), compared to about 12 where he lives (San Jose, CA).

His question got me thinking, though, about the repercussions of lying to get the booster. I suspect the worst that would happen is his insurance would refuse to cover it, so he'd be out $100 or so in that case. I don't think that misrepresenting your health status in order to get a vaccine is a criminal act, but I honestly don't know. I was tempted to tell him that he should go ahead, simply for peace of mind and to be sure he has the best possible "vaccine armor" when he goes into dangerous, low-vax, high-infection-rate territory. But all I could offer was "Gee, that's a tough call. Not sure what I'd do in your shoes."

What would you do if you were in my friend's shoes?

My opinion, since he has had both shots, he needs to wear his mask all the time indoors, wash his hands, use hand sanitizer, and stay as far away as possible from people. It is our new way of life.

 

[Aerides]

.... He even asked me "Is that illegal? Could I be arrested if certain people found out about it?" <snip>
His question got me thinking, though, about the repercussions of lying to get the booster. I suspect the worst that would happen is his insurance would refuse to cover it, so he'd be out $100 or so in that case. I don't think that misrepresenting your health status in order to get a vaccine is a criminal act, but I honestly don't know. What would you do if you were in my friend's shoes?

In his shoes I might go get one. No, there's no criminal penalty. In the month of August the CDC already estimated about a million people snuck a booster. At most his insurance might blink, but i doubt it. And then still mask and keep a distance, booster or not.

And I'm less worried about these generalizations on location. It's not about the where, but the who. I can live here in all-time-high florida and feel quite safe. I don't spend any time up close and personal with strangers, nor indoors without a mask. So general geography, IMO, is far less of a risk factor than actual personal behavior.

But I'd also hope your friend is going up the chain of command. Forced travel for someone over 63 in this climate sounds insane to me.

 

[ivinsfan]

Isn't the vaccine itself actually free, no matter what? I dont think there a procedure in place to charge for it. The most you might pay is the fee to have it administered on site.


I for sure would want the info entered on my vaccine card, it would seem silly not to do that.

 

[Koolau]

Those that claim this is all settled science are deluding themselves.

True. Just about the time we say something is "settled science" something else (like a new variant or waning immunity) pops up. I've just about resigned myself to the fact that this will be with us for quite a while while we continue to "settle" the science. YMMV

 

[MrsHaloFIRE]

In his shoes I would also prob go get the booster. There's no appetite for punishing those willing to take covid vaccines be they 12 or 3. Availability is robust and they are going on the trash everyday. In my opinion.

 

[NomDeER]

What would you do if you were in my friend's shoes?

A friend recommended that I find a way to get a booster dishonestly even if I don't qualify. I don't know if it is illegal, but I am not willing to do that.

However, so far, I have been successful at dodging some higher risk situations I've confronted (work situations with upwards of 50 people in the same room, etc.). At least I am retiring before the holidays and before my risk and community COVID numbers may go up more. I am disappointed that I will be doing that at a time of increased risk, but at least I will be able to avoid a lot of riskier situations. If I thought that I could not avoid significant risk at work, like your friend, then I probably would go to my doctor and see what my risks are given the science, my age, and my health factors and see if the doctor thought I needed a booster and would authorize it. Your friend might be able to do that, and maybe the doctor would authorize him to get a shot because of his age and blood pressure and blood sugar. It stinks that his employer is making him fly to Tennessee.

In the meantime, he definitely should make sure that he can mitigate any risk by getting the most effective masks and doing other things while he's traveling like quick TSA, social distancing when he can, and not eating and drinking next to someone else who is eating and drinking. (Eating before his flight - not during - and getting takeout when he can in TN.)

 

[Sunset]

....

What would you do if you were in my friend's shoes?

In his shoes, I'd go get it and bring my card to get the 3rd one written on it.

He will be at work, and can't avoid people.
Since Covid is spreading so much there, whatever is making it spread, will expose him more to the chance.

I'm retired, I can pick when/where I go so I can limit my exposure and just mask up at those times. So I can wait for a while.

It's not a crime, and maybe would cost $50 if insurance didn't pay, but I bet they would pay, as a booster means the person won't be in hospital getting treatment which is 1000s times more expensive to the insurance company.

Similar to how my insurance company tells me to get the flu shot, and they pay for it. They probably wish all the customers got the flu shot, so less would end up in hospital sick.

 

[Alan]

I don't know about AZ, but as for Pfizer in the UK, they were reporting more than double the antibody response with 12 weeks compared to the three-week interval.

This article says 3.5x antibody response...

https://www.birmingham.ac.uk/news/l...r-vaccination-interval-antibody-response.aspx

Research also shows 12 weeks is better for AZ.

https://www.bmj.com/content/372/bmj.n326

The analyses suggest that it is the dosing interval and not the dosing level which has the greatest impact on the efficacy of the vaccine. This is in line with previous research supporting greater efficacy with longer intervals with other vaccines such as influenza and Ebola.

The study found vaccine efficacy reached 82.4% after a second dose in those with a dosing interval of 12 weeks or more (95% confidence interval 62.7% to 91.7%). If the two doses were given less than six weeks apart the efficacy was only 54.9% (CI 32.7% to 69.7%).

 

[bobbyr]

In his shoes, I'd go get it and bring my card to get the 3rd one written on it.

He will be at work, and can't avoid people.
Since Covid is spreading so much there, whatever is making it spread, will expose him more to the chance.

I'm retired, I can pick when/where I go so I can limit my exposure and just mask up at those times. So I can wait for a while.

It's not a crime, and maybe would cost $50 if insurance didn't pay, but I bet they would pay, as a booster means the person won't be in hospital getting treatment which is 1000s times more expensive to the insurance company.

Similar to how my insurance company tells me to get the flu shot, and they pay for it. They probably wish all the customers got the flu shot, so less would end up in hospital sick.

I'm in complete agreement. I would get it as well.

I am 63 and avoiding inside socializing. I have a HS reunion coming up this weekend and it makes me a bit nervous even though all activities are going to be outside. I am debating on attending. (have not had booster, approaching 6th month since vac 2)

 

[Scuba]

So I believe I found the article regarding antibodies that has been mentioned:
https://jamanetwork.com/journals/jama/fullarticle/2783797

Here's my understanding of the article, FWIW.

They measured antibodies 6-10 weeks after the second vaccine dose.

They found antibody titers were higher for those vaccinated with Moderna vs Pfizer.

The mean titer was 3836 u/ml for Moderna, vs 1444 U/ml for Pfizer.

The study did include those who had already had COVID prior to vaccination. Their titers were higher than those who didn't previously have COVID.

For those previously uninfected, the mean titer was 2881 u/ml for Moderna, vs 1108 u/ml for Pfizer.

For those previously infected, the mean titer was 10,708 u/ml for Moderna, vs 8174 u/ml for Pfizer.

So, we know that Moderna creates more antibodies. What we don't know is how does a certain antibody level correlate with risk for infection...apparently you can't assume a low antibody number means you are at high risk, because other parts of the immune system (T-cells) play a role in fighting off infection.

See this article: https://www.npr.org/sections/health...as-a-reliable-indicator-of-vaccine-protection

In fact, it's pretty clear that antibodies alone don't explain why some people are protected, and other parts of the immune system also play important roles in fighting off the coronavirus, including T-cells.

"Two percent of the individuals who were vaccinated had very, very low levels. Levels of antibodies that were below that lower limit of detection," says Christopher Houchens, a biomedical researcher at the Biomedical Advanced Research and Development Authority, another author of the study. "However, about 50% of those individuals in that 2% of the population were still protected and did not come down with symptomatic COVID-19 disease."

So, if you get yourself tested for antibodies, and they are low, you might actually still be protected by your vaccine, apparently because your T-cells may be very active against the virus still. I think I'm correct in understanding this, but not 100% sure...so someone I'm sure will chime in if I've misunderstood this.

Thanks for this information. Is there any data on antibodies measured for those who previously had COVID and are not vaccinated? It would be interesting to see how that compares with antibodies for people who’ve never had COVID but are vaccinated.

 

[Scuba]

A good friend of mine called me last night to tell me about how worried his is that he can't get a COVID booster shot. He's 63 and in pretty good health, although he does take meds for high blood pressure and is borderline diabetic. His dilemma is that he has to fly to Tennessee in early October (job requirement that he can't get out of, apparently) and will be there for 10 days. He's worried that he's flying right into the heart of the Delta surge there and will be very susceptible to a breakthrough infection. He's fully vax'd with Pfizer but has read all the studies showing a reduction in efficacy after six months, etc. He told me that he's so worried about this Tennessee trip that he's considering just getting the booster shot anyway by stating (falsely) that's he immunocompromised. But he's also worried about the repercussions of getting medical treatment for which he's not technically eligible. He even asked me "Is that illegal? Could I be arrested if certain people found out about it?"



I didn't know what to tell him, honestly. I feel badly for him, considering he's so close to the age threshold for which the FDA just approved boosters. And having to spend extended time in Tennessee right now seems like asking for trouble, to say the least. Only about 44% of adults are fully vaccinated there and their daily case rate is north of 100 (per 100K), compared to about 12 where he lives (San Jose, CA).



His question got me thinking, though, about the repercussions of lying to get the booster. I suspect the worst that would happen is his insurance would refuse to cover it, so he'd be out $100 or so in that case. I don't think that misrepresenting your health status in order to get a vaccine is a criminal act, but I honestly don't know. I was tempted to tell him that he should go ahead, simply for peace of mind and to be sure he has the best possible "vaccine armor" when he goes into dangerous, low-vax, high-infection-rate territory. But all I could offer was "Gee, that's a tough call. Not sure what I'd do in your shoes."



What would you do if you were in my friend's shoes?

We are vaccinated with J&J, no booster. Went to GA and SC last month for 10 days. No issues. We did not worry and we are fine. But it sounds like your friend is very worried so I think he needs to decide what scares him most - prematurely taking the booster and perhaps having unintended consequences which aren’t yet known (anything from getting in trouble for lying to negatively impacting his immunity by taking the booster too soon), or going on the trip and taking the risk of getting COVID. A third option is telling his employer he is not comfortable going. I would be surprised if his employer tried to force him.

 

[audreyh1]

Thanks for this information. Is there any data on antibodies measured for those who previously had COVID and are not vaccinated? It would be interesting to see how that compares with antibodies for people who’ve never had COVID but are vaccinated.

Yes, there are quite a few studies out there. The antibodies in someone who had COVID is highly variable probably depending on the exposure dose as well as the individual immune system.

 

[Scuba]

Yes, there are quite a few studies out there. The antibodies in someone who had COVID is highly variable probably depending on the exposure dose as well as the individual immune system.

I just googled this topic and study results are all over the map. One Israeli study concluded that natural immunity after having COVID provided a 27 times higher immune response vs never having COVID but being double vaccinated. The next study said natural immunity is not as good or as long-lasting. I guess this is a good example of evolving science.

 

[Sojourner]

A third option is telling his employer he is not comfortable going. I would be surprised if his employer tried to force him.

That's what I was thinking, too, so I asked him if he's really sure he can't get out of it. He said nope, no way. The project requires his particular expertise, apparently.

 

[Sojourner]

In his shoes I might go get one. No, there's no criminal penalty. In the month of August the CDC already estimated about a million people snuck a booster. At most his insurance might blink, but i doubt it. And then still mask and keep a distance, booster or not.

I'm starting to think this is the best thing for him to do. I'm going to call him tonight and suggest he go ahead and schedule a booster shot appointment. The downside risks seem trivial compared to how worried he is about the situation. He would gladly pay the $100 or so, if necessary, to cover the shot if his insurance balked.

And I'm less worried about these generalizations on location. It's not about the where, but the who. I can live here in all-time-high florida and feel quite safe. I don't spend any time up close and personal with strangers, nor indoors without a mask. So general geography, IMO, is far less of a risk factor than actual personal behavior.

That's true, although my friend is worried because he'll be spending many, many hours in small meeting rooms with people who are far less likely to be vax'd than he is comfortable with. All wearing masks, of course, but the anti-vaxxers have a way of wearing masks sort of carelessly, like chin diapers, and he is losing sleep over this possibility.

But I'd also hope your friend is going up the chain of command. Forced travel for someone over 63 in this climate sounds insane to me.

He did ask if the trip was necessary, and apparently it is. He has specialized expertise in this field for this particular client, and it's one of their biggest accounts (so he told me). Hearing all this made me feel really grateful to be FIREd!

 

[Koolau]

That's what I was thinking, too, so I asked him if he's really sure he can't get out of it. He said nope, no way. The project requires his particular expertise, apparently.

I thought the info Allan provided about "timing" of boosters was interesting. It related to a question I asked some time ago. I have come to learn that there does seem to be at least a range of 2nd shot or booster timing which provides the best overall immunity - I'm sure that varies on an individual basis.

BUT if one is facing a significant potential for exposure, would NOT a booster - whether perfectly timed or "too early" provide MORE immunity than no booster (until after the exposure?) YMMV

 

[Sojourner]

I thought the info Allan provided about "timing" of boosters was interesting. It related to a question I asked some time ago. I have come to learn that there does seem to be at least a range of 2nd shot or booster timing which provides the best overall immunity - I'm sure that varies on an individual basis.

BUT if one is facing a significant potential for exposure, would NOT a booster - whether perfectly timed or "too early" provide MORE immunity than no booster (until after the exposure?) YMMV

Yes, that is certainly my understanding, provided the booster happens at least 10 days (preferably 14 or more) before the anticipated exposure. So my friend needs to get his booster ASAP—today if possible—to be "extra" protected by early October.

 

[Koolau]

Yes, that is certainly my understanding, provided the booster happens at least 10 days (preferably 14 or more) before the anticipated exposure. So my friend needs to get his booster ASAP—today if possible—to be "extra" protected by early October.

That's seems totally appropriate. After all, there appears to be plenty of vaccine around. He would not be preventing anyone else from receiving a shot. Also, at some point, we'll ALL likely need yet another booster - or perhaps the next generation of vaccine (to include better protection from the current and emerging variants.) Best of luck to your friend!

 

[iloveyoga]

DH and I have both have had chances to get ours early. You would have to lie to the pharmacist; they directly ask if you are immunocompromised. So I'm sure it is not illegal, but we did not do it.

 

[Koolau]

DH and I have both have had chances to get ours early. You would have to lie to the pharmacist; they directly ask if you are immunocompromised. So I'm sure it is not illegal, but we did not do it.

Just got our flu shots and asked the pharmacy about the Covid booster. They confirmed that currently, immune compromised folks can receive the booster and the person I spoke with (shot giver) indicated it was self reported immune compromised. So true or not true, a person could (probably legally) get the booster. YMMV