Second Bivalent Booster?

[donheff]

That is an interesting paper EastWest Gal. It confirms the reports that the bivalent vaccine provides pretty dramatic protection from hospitalization or death. For me, that degree of protection makes it a no brainer absent evidence of substantial harm.

 

[anethum]

On this CDC.gov page they outline what it means to stay up to date with your vaccines. They don't address AT ALL what, if anything, a person who has received their bivalent booster should do after X amount of time. As far as I can tell, those of us in this group are the ONLY group who are no longer receiving ANY information from the CDC.

I suppose it could be fair to say, 'If they aren't telling you what to do, that means you don't need to do anything,' but that isn't typically how information is communicated in a situation like this. Usually, when it comes to healthcare, it's better to over communicate rather than communicate through inference.

Frankly, assuming your information is correct, I would be satisfied with the CDC copying/pasting your first sentence and adding it to their site. Just looking for some communication from them to address the group I'm in.

Because bivalent boosters have only been available since early September, 2022, I'm guessing there is no data available yet for the CDC to draw any conclusions or make any recommendations about a 2nd bivalent booster. Perhaps there are studies being done right now.

I think you are being too quick to criticize the CDC about this. Once 6 months have passed since the introduction of bivalent boosters, maybe we will all know more.

 

[intent]

Because bivalent boosters have only been available since early September, 2022, I'm guessing there is no data available yet for the CDC to draw any conclusions or make any recommendations about a 2nd bivalent booster. Perhaps there are studies being done right now.

I think you are being too quick to criticize the CDC about this. Once 6 months have passed since the introduction of bivalent boosters, maybe we will all know more.

Understood, and maybe I am being too quick to criticize. Then again, I'd be satisfied if, assuming your guess is correct, they simply added verbiage to that page along the lines of, 'The CDC is actively researching the effects of the bivalent booster. Currently there isn't adequate data to draw any conclusions as to when/if additional bivalent boosters might be recommended. As soon as more information is available, recommendations for potential ongoing booster vaccinations required to stay up to date will be posted here.'

It just doesn't seem to me like too much to ask for them to address this topic in some form.

 

[Teacher Terry]

For me it’s also now a quality of life issue since I am friends with an avid hiker that can barely walk to his car after getting the vaccine. He is experiencing blood clots, etc. His doctor told him not to get anymore.

A woman in my building lost all her hair after the third dose and despite different treatments her hair is not coming back. Now the link to strokes is concerning since both my parents had them. So I went from being gung ho to no way I am done.

 

[Gumby]

Without evidence of causation, I don't believe you can draw a conclusion about Covid vaccines from your friends' current condition. "Post hoc ergo propter hoc" is considered a logical fallacy for good reason.

 

[dixonge]

Without evidence of causation, I don't believe you can draw a conclusion about Covid vaccines from your friends' current condition. "Post hoc ergo propter hoc" is considered a logical fallacy for good reason.

Nor can you draw a conclusion about them based on observational cohort studies, like the one cited by 'EastWest Gal.' Only a Randomized Controlled Trial can filter out statistical and demographic biases like the 'healthy user bias.'

https://inumero.substack.com/p/healthy-user-bias-is-obvious-in-booster

 

[RetMD21]

We want them I have not heard anything from the CDC about when/if a second bivalent booster will be recommended.

Probably it will be recommended if and when there is evidence to suggest a benefit. There isn't

 

[RetMD21]

They don't address AT ALL what, if anything, a person who has received their bivalent booster should do after X amount of time. As far as I can tell, those of us in this group are the ONLY group who are no longer receiving ANY information from the CDC.

Maybe they should add something to the website saying that if you've had your bivalent booster you are done for now. It is possible, maybe likely, that the effectiveness of the bivalent booster will wane after 6 months but it hasn't been available that long.

Can you complain if CDC waits to see what happens after 6 months and looks for evidence of benefit?

 

[ls99]

Maybe they should add something to the website saying that if you've had your bivalent booster you are done for now. It is possible, maybe likely, that the effectiveness of the bivalent booster will wane after 6 months but it hasn't been available that long.

Can you complain if CDC waits to see what happens after 6 months and looks for evidence of benefit?

Seems like CDC is conducting an experiment using the public.

 

[intent]

Maybe they should add something to the website saying that if you've had your bivalent booster you are done for now. It is possible, maybe likely, that the effectiveness of the bivalent booster will wane after 6 months but it hasn't been available that long.

Can you complain if CDC waits to see what happens after 6 months and looks for evidence of benefit?

I definitely am not complaining that they are awaiting evidence. My only complaint is that they aren't communicating anything about their process/plans to those of us in the group who have received our bivalent booster. They aren't even communicating that they don't yet know what the plan is.

They simply aren't directing communication to this group AT ALL.

 

[Teacher Terry]

Without evidence of causation, I don't believe you can draw a conclusion about Covid vaccines from your friends' current condition. "Post hoc ergo propter hoc" is considered a logical fallacy for good reason.

Luckily I am free to make my own decisions and have decided to error on the side of caution. I would never attempt to influence others as we probably won’t know the side effects versus benefits of the vaccines for at least a decade. There’s always a risk versus benefit ratio for any medication or medical treatment.

 

[Gearhead Jim]

For me it’s also now a quality of life issue since I am friends with an avid hiker that can barely walk to his car after getting the vaccine. He is experiencing blood clots, etc. His doctor told him not to get anymore.

A woman in my building lost all her hair after the third dose and despite different treatments her hair is not coming back. Now the link to strokes is concerning since both my parents had them. So I went from being gung ho to no way I am done.

A few people will have problems like that even without getting the vaccine.
A few people may actually develop problems like that because of the vaccine.
More people will have problems like that because they got covid.

The vaccines do not provide perfect protection, and they have some rare potentially dangerous side effects. But the evidence so far indicates that I'm more likely to be alive a year from now if I get my next booster than if I don't.

 

[RetMD21]

I definitely am not complaining that they are awaiting evidence. My only complaint is that they aren't communicating anything about their process/plans to those of us in the group who have received our bivalent booster. They aren't even communicating that they don't yet know what the plan is.

They simply aren't directing communication to this group AT ALL.

So should they remind you that you are up to date? Is that what you are asking?

 

[Aerides]

I mean I guess unless they put "no more for right now, check back in a few months we'll see", and just tweet that out every week, would you all be happy?

The last update on bivalents was the guidance from December.

https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html

If you have the full series, you're good. Until/unless that changes, I'm good with that. As noted above, when this last one came out they said "new, annual" a bunch, so that's my conclusion until things change.

A new raging variant would change things, of course. But if things stay steady, then I'll get another next fall, or if/when "they" say differently.

 

[intent]

So should they remind you that you are up to date? Is that what you are asking?

Yes, and some communication as to what to expect going forward. And no weekly tweets needed, just a sentence or two on the page to which I provided a link earlier. Something that lets us know they are aware that 16% or so of the population (or however many have received the bivalent shot now) - which also happens to be the most attentive group and the group that is most likely to follow CDC guidance - might have legitimate questions as to what they should do/expect next.

 

[Gearhead Jim]

^^^^^

As previously posted, the current (non)-information from the CDC can leave people wondering if the CDC is even studying the questions at all:

Effectiveness of bivalent boosters vs legacy boosters vs no booster?
Effectiveness and durability of bivalent boosters against symptomatic disease?
Effectiveness and durability of bivalent boosters against severe disease?

The virus is constantly changing, but it should still be possible to gather data from the time of bivalent introduction up until now.

 

[RetMD21]

Yes, and some communication as to what to expect going forward. And no weekly tweets needed, just a sentence or two on the page to which I provided a link earlier. Something that lets us know they are aware that 16% or so of the population (or however many have received the bivalent shot now) - which also happens to be the most attentive group and the group that is most likely to follow CDC guidance - might have legitimate questions as to what they should do/expect next.

Data is collected on vaccination status of patients with severe disease and death from Covid. Presumably that and other factors would be taken into consideration for any future recommendation.

I think the recommendation of what to do next is pretty clear for those who have had all the shots including the bivalent.

Are you under the impression that the CDC knows what will happen next?

 

[intent]

Data is collected on vaccination status of patients with severe disease and death from Covid. Presumably that and other factors would be taken into consideration for any future recommendation.

I think the recommendation of what to do next is pretty clear for those who have had all the shots including the bivalent.

Are you under the impression that the CDC knows what will happen next?

I think it's pretty clear that the CDC thinks I, having received the bivalent booster in early September, need do nothing at the moment with respect to seeking additional vaccination. Ok, fine.

But, on their "Stay Up to Date" page they state:

COVID-19 vaccine recommendations are based on three things:

1. Your age
2. The vaccine you first received, and
3. The length of time since your last dose

To EVERY group other than those who have received the bivalent booster they communicate about item #3. For us, and us alone, who according to their site represent 50.6 million people, there is no communication whatsoever as to item #3.

I am not under the impression that the CDC knows what will happen next, no. Not knowing what will happen next is, IMO, not an excuse discontinue all communication on the subject.

Are you under the impression that it would be excessively difficult, complicated, or unwarranted for the CDC to add language to their site that says something like, 'As we approach the 6-month mark from when the bivalent booster was first made available, and because vaccinations to date have typically been performed at intervals of 6 months or less, we recognize that many who have received their bivalent booster are likely interested to know what they might need to do going forward to remain up to date on their Covid vaccinations. The CDC is actively studying this question and as of [enter date this was last updated] have not determined when, if at all, a second bivalent booster might be recommended. More information will be released as additional data is compiled and analyzed.'?

 

[Aerides]

I think it's pretty clear that the CDC thinks I, having received the bivalent booster in early September, need do nothing at the moment with respect to seeking additional vaccination. Ok, fine.
...

Are you under the impression that it would be excessively difficult, complicated, or unwarranted for the CDC to add language to their site

I don't think anyone thinks that would be difficult, but it does appear that many here, in this thread at least, are ok with the lapse in official updates since December. Perhaps that's due to vaccine weariness, perhaps not having immune conditions, acceptance of just getting once per year, or other individual factors. But continuing to argue with others here who don't feel the same sense urgency isn't helpful. Perhaps contact the CDC and ask them for a communications plan?

 

[intent]

I don't think anyone thinks that would be difficult, but it does appear that many here, in this thread at least, are ok with the lapse in official updates since December. Perhaps that's due to vaccine weariness, perhaps not having immune conditions, acceptance of just getting once per year, or other individual factors. But continuing to argue with others here who don't feel the same sense urgency isn't helpful. Perhaps contact the CDC and ask them for a communications plan?

RetMD21 asks me questions, and I answer them. I'm not trying to be argumentative, just trying to make my point clear to another member who is evidently having some difficulty understanding the point I'm attempting to make.

 

[Gumby]

I think everyone gets your point even though they might not share your sense of urgency. As for me, I figure that any new CDC recommendation will be well publicized. Then I'll act on it.

 

[Out of Steam]

I have had all COVID boosters as recommended, including a bivalent booster, but have seen nothing to suggest that I get a second. I'll see what the recommendations are in the fall, at the time I'm getting a flu shot.

While durability of immunity from mRNA vaccines is disappointing to me so far, protection from serious illness in people in reasonable health appears to be holding up.

 

[Calico]

I had the two original vaccinations; then two boosters; then the bivalent booster. I am as up-to-date as I can be.

I assume if/when the CDC has something to say about the need for/availability of further boosters, they will proclaim it loud and clear.

In the meantime, I don't lose any sleep over what they are not saying to me, and I live my life.

 

[RetMD21]

I have had all COVID boosters as recommended, including a bivalent booster, but have seen nothing to suggest that I get a second. I'll see what the recommendations are in the fall, at the time I'm getting a flu shot.

While durability of immunity from mRNA vaccines is disappointing to me so far, protection from serious illness in people in reasonable health appears to be holding up.

It would be great if the vaccines gave permanent total immunity but the reduction in serious illness and death is something

I think all any of us can do is wait and see what happens and what is recommended. A nasal booster is being used as one of the options in India but I don't know if they will be able to tell if it reduces infection and transmission more than the alternatives. It would be nice to know what to expect next but that isn't possible.

 

[JBTX]

I doubt the cdc is saying anything because they don’t know anything., in terms of what sort of boosters will be necessary.

From what I’ve read

- there is evidence that the booster had stronger antibody response than original shot vs omicron strains it was made against
- the evidence is mixed as to whether the above actually translated to a higher level of efficacy vs original boosters. There is some evidence that it doesn’t.
- as each variant comes around, the booster antibody response is comparatively less effective.
- the real value of the shots isn’t the antibody response but the longer term TCell and memory cell response that guards against severe Covid disease.
- I have not seen any definitive study of how long the TCell and memory protection lasts, nor have I seen anything to to indicate either way that boosters improve the TCell and memory cell response.

I’ve had the 2 original and 3 boosters including the most recent. I don’t have any plans or urges to get another any time soon, unless there becomes a compelling reason to do so. Logically I could see another booster next fall, a year after my last, but who knows.