Yeah, it’s exhausting being in this airplane they’re building while we’re flying in it. And moreso for those doing the building, I’m sure. The vast majority really are trying to do the best advising they can with what data they have at the time.
Those experts being truly transparent admit they don’t know. The optimal vaccination schedule could be about anything. 3 shots and done (optimal spacing TBD). 2 shots, a 6 month booster, then annual boosters. Etc. Etc. Pretty much any combination imaginable. And optimal schedule might be quite different during this acute phase of the pandemic vs at a time community spread is much lower. But the recurring theme is they do make a difference.
The first series makes the largest difference. But in recognition of the number of people not opting in, does boosting everyone else help the overall trajectory of the pandemic? That’s what they keep weighing in on, but there are so many factors to consider, it’s hard to have a solid handle to what degree. One of the experts is going to be right, but not sure if it’s because they’re really the smartest or just because someone will have the lucky guess!
Those they’re recommending to get a booster, they feel like it can make a significant difference on some level (individual outcomes, community outcomes, protection of essential services, etc.). The ones that are optional are the ones they are struggling to quantify how much difference it will make. (The recurring frustration in all the booster meetings is “but what we really need are more first shots!”). Real uncertainty towards boosters on overall rate of community transmission.
But, from strictly a risk assessment, getting a booster has extraordinarily slim odds of any kind of long term negative health outcome. A case of Covid has a higher one. There is the short term cost of a day or two of not feeling great, but for significantly higher protection. Even if a booster only helps for 6 months, that would cover through a potential winter surge.
No one knows if one is coming or not. One camp says this Delta wave should be the last major wave (assuming no new power variant). Another camp thinks another winter surge is pretty much inevitable (“look at the UK”). A third camp is vocally uncertain “this virus has surprised us at nearly every turn” (and I am believing them the most at this point!).
So. I don’t know that my concerns are so much with “a” single booster vs getting covid. Cumulatively the risks increase the number of times you get a booster - so not knowing the number of boosters one will need over a lifetime is enough to say, ok, you go first and I’ll watch. Is it still true that the side effects long or short term for the booster are fewer than a case of covid after vaccination? The risk/benefit begins to change.
For me, it probably means I will somewhat reluctantly schedule myself for the booster sometime this month. But if someone tells me in 6 months that I’m going to need another dose, I’ll probably drop deeper into the wait and see what happens crowd.
I’m probably also jumping in to vaccinate my 6th grader when that happens, but holding off on the 8 year olds, unless my pediatrician has changed her stance on under 10s, which she didn’t think was necessary pre-delta variant.
I’m getting a booster next month, mainly because of my job and a WDW trip coming up. DS13’s are vaccinated and we are getting DS9 vaccinated when it is available. But I have to agree, if they say to booster a second time, I may wait on that. Eventually, if they say annually like the flu shot, I would probably be ok with that, but I would like more information and see what happens before constantly getting boosters. Especially at every 6 months.
Fauci gives trick-or-treating a green light. (Which was pretty much my personal assessment as well, but makes me feel even better about it.) We haven’t told the DS11s yet. Told them we’d make a decision on 10/15. They will be so excited!
Circling back to those in Camp #2, I listened to Osterholm’s latest podcase today to get more specifics on his thinking. So…if any of you think I’m a “Debbie Downer”, stay away from Osterholm. He definitely knows his stuff, but talk about Dr. Gloom! I kind of want to stick him in a ring with Mr. Sunshine (@Jeff_AZ ) and see who’s left standing.
And he had this episode titled “A Surge in Optimism”. I’m glad I wasn’t listening to him closely during the run-up of this surge if this was his idea of optimism. He also has this annoying habit of saying things along the lines of “So, this RSV surge? Theory X is wrong about the cause because of these reasons. Theory Y is wrong because of these reasons. There is obviously a reason why it’s happening, but I’m really not convinced we know what it is.” So, yeah, now I remember why I stopped following him so closely.
Anyway, I thought his take on boosters was helpful from a short-term decision-making perspective. Not surprisingly, he’s not convinced what the long term booster schedule will be , but whatever it is, he recommends following it. He said something along the lines of “as far as safety goes, the jury is in for this vaccine: the benefits far outweigh the risk”. And that aligns with EVERY reputable expert that I follow across all those camps that I mentioned previously. Not a single one is saying “Hey, if you feel like your exposure isn’t high, you should probably hold off and see what the cumulative impacts of the boosters is.”
When he and other experts discuss their concerns about the vaccines, they typically comment on the latest safety data, conclude the safety issues are not significant, then move on to the 2 concerns that do give them pause:
The impact of boosters on first time shots in the US. There is plenty of supply, so that is not the concern. It’s whether recommending boosters is discouraging the unvaccinated from getting vaccinated. But, honestly, IMO the hospitalization/fatality numbers overwhelmingly speak for themselves, so if that won’t convince them of the vaccines effectiveness, I don’t think vaccine effectiveness is really what’s holding them back from being vaccinated.
The impact of US boosters on global vaccine uptake. This is where experts do differ more in their conclusions. Osterholm’s take is that the US has donated more doses than the rest of the world put together so is definitely doing its share, and part of the struggle isn’t supply, it’s distribution due to the “cold-chain” requirements and such, so yes, we need to continue our efforts globally, but that shouldn’t be impacting our promotion of boosters domestically, because this pandemic is far from over. (ouch)
I’m kinda chuckling about “the impact . . .” re boosters in your quote above.
While I’m totally sold on the booster, the impact of all the crap in my daily life has shoved boosters to a back shelf. November is looking much less busy.
I did miscount - thinking that 6 months from round 2 was end of September. Recent recount put 6 months at the end of August, instead.
Sigh. Best friend’s granddaughter turned 12 a week ago Saturday. Got her first vaccine on Monday. On Friday she came home from school and said 1/3 of her class was absent. Tested positive on Sunday.
Her family’s careful. (Dad’s a physician, a hospitalist whose work place is being overrun right now.) She feels not-too-bad but both she and her brother are out of school for ten days after she tests negative (gets longer if her brother shows up + too.) And, as many of you mentioned, the resources for staying home this year are NOTHING like last year - handed them a bunch of worksheets and said “good luck!”
Ugh. Totally get that. It’s just out of control in so many schools and so many people just shrugging.
All 3 of my boys have now received a “classroom exposure” letter but nothing reported as “close contacts.”
DS11.2 got his first on Friday. He said the only person absent doesn’t sit near him and is one of their best maskers “you never see her nose!” He also mentioned she was chosen as a soloist for their upcoming choir concert.
When we let them choose choir as their elective in the spring (vs band or art), we really thought we’d be in a better place by now with vaccinations being available. We briefly considered trying to get them moved to art, but the choir teacher was very much encouraging masking and attempting to maintain physical distancing, so we let them stay.
FWIW, I think all three camps have a point and could be right in different ways. While I think Delta will be the last major wave, I also believe there will be a significant winter wave, but it’s impact will be less than the others, perhaps far less. But there’s uncertainty there.
Which is why the third camp could be right as well - we just don’t know what could or will happen next. It’s up to experts and policymakers to be prepared for the unthinkable. But I personally don’t want to be overly burdened by so many contingencies that I can’t control and would rather be optimistic. Be prepared and pivot if things change. That’s my mental health coping strategy.
ETA: it’s also clear that Covid will be endemic and so ongoing boosters and “flu season” cycles are going to become the norm. But I can deal with that.
Osterholm was recapping how vaccine waning starts around 6 months, more pronounced at 7 months, then more significant at 8 months.
I think by making people eligible at 6 months, they are really hoping people will get it done by 7 months, so a cushion before the more serious 8 month mark. 8 months is kind of my hard deadline for my family members. (I hit 7 months yesterday and am impatiently waiting for the J&J recommendation.)
If vaccines were in short supply, they might have gone with 8 months, but since they’re not, I think they want people to get it on their agendas to make sure it’s done before the 8 month mark. And people with high risk factors and/or exposure (esp healthcare workers) should probably be rope dropping that 6 month mark.
Not from Osterholm, but someone else(?) I was reading this week. There are also a very small percentage of random people that, for no obvious reason, didn’t have the vaccines “take” the initial time around. Without widespread antibody testing, it’s hard to know how many people that is and what percentage of the hospitalized breakthrough cases it might account for. Widespread booster uptake is a more efficient means of covering those people than doing widespread antibody testing. (And based on the percentage of immunocompromised people responding to an additional shot, they feel like it will be an effective means of coverage).
DD18 texted me this morning early with complaints about her roommate’s insulin pump “going off” and waking her up. (Not an alarm and roommate is fine but doesn’t know why her pump is beeping.) Among her complaints was a “rash” on her lips that was really bothering her. Not normal c happed lips. Little painful bumps. She assured me she hasn’t been kissing anyone (a joke - she’s pretty shy!) so I started googling. What do you know, it could be a Covid symptom. So I picked her up and took her to be tested. We should know tomorrow morning. And I’m working from home for the rest of the day.
happed lips. Little painful bumps. She assured me she hasn’t been kissing anyone (a joke - she’s pretty shy!) so I started googling. What do you know, it could be a Covid symptom. So I picked her up and took her to be tested. We should know tomorrow morning. And I’m working from home for the rest of the day.
