Covid vaccines and boosters

 To accommodate patients who have gone back to work we will be extending our Tuesday hours.

Appointments will be available from 11 am to 7 pm on Tuesdays.

UPDATE ON BOOSTERS

So this week as promised more information came out on the Covid vaccines and booster shots. Of note, the consensus is that Moderna is the most effective and long lasting of the 3 vaccines.

A nationwide study of more than 3,600 adults found the Moderna vaccine does a better job at preventing COVID-19 hospitalizations than the two other vaccines being used in the United States, the Centers for Disease Control and Protection said last Friday.

Vaccine effectiveness against COVID-19 hospitalization during March 11–August 15, 2021, was higher for the Moderna vaccine (93%) than the Pfizer-BioNTech vaccine (88%) and the Janssen vaccine (71%) the CDC’s weekly MMWR said.

The study also broke down effectiveness for longer periods. Moderna came out on top again.

After 120 days, the Modern vaccine provided 92% effectiveness against hospitalization, whereas the Pfizer vaccine’s effectiveness dropped to 77%, the CDC said. There was no similar calculation for the Johnson & Johnson vaccine.

Other studies have shown all three U.S. vaccines provide a high rate of protection against coronavirus.

No surprise, J and J came out today with the idea that people who got their shot should get a booster and this increases immunity to 94% or more. Which is great but why call it a booster? It is basically a second shot and lucky for those who took it, they still will only have to get 2 instead of 3 shots and still be ahead of the game.

When given two months after the first dose, a booster shot increased antibody levels by four to six times compared with one shot alone. When given six months after the first dose, a booster shot increased antibody levels 12-fold. (This information is taken from Medscape).

The booster recommendations for now are for seniors and immunocompromised but only 6 months after the second shot. This really only applies to Pfizer because that is the group that the study on boosters pertains to.

Plus as mentioned above it is Pfizer that starts to lose its potency at this point. The studies on the other two vaccines are yet to come out.

We have Moderna in the office and I am happy to give it to anyone who desperately feels they must have a booster NOW but my suggestion is to wait and be patient. The jury is not out yet and if you got your initial Covid vaccination you are still protected.

How about you get your flu shot while you are waiting?(Smile)

Remember we now have late appointments on Tuesdays and I will be working in Laurel on October 9^th which is a Saturday.

New office hours, rapid Covid tests, Boosters, Flu shots, Covid shots and other info

 To accommodate patients who have gone back to work we will be extending our Tuesday hours.

Appointments will be available from 11 am to 7 pm on Tuesdays.

I will also work on October 9th which is a Saturday in Laurel until 1pm (last appointment 12 noon).

We have the rapid covid test for those who need it for air travel.

We are vaccinating all those who are interested, with the new flu vaccine. That includes the regular and the one for seniors.

Also those who need the yellow fever vaccine for international travel can call the office.

Covid vaccines are still available in the office: Moderna and Johnson and Johnson/ Janssen.

Unless you are a cancer patient or otherwise immunocompromised you do NOT need a booster yet.

Remember the sooner you get a booster the sooner you will need the next one!

Spending a lot of time worrying about it and indulging in panic mongering is not necessarily productive. Try to focus on the big picture.

For me right now, one of the major dilemmas is whether I would want to give a young child a mRNA vaccine. I prefer the idea of the tried and true vector technology for the young ones simply because of unknown long term effects of the mRNA. Maybe there are none but still.... this is my personal opinion at this point.

Its hard to drown out the noise of big Pharma and give a balanced look at this issue.

When you get a call from the office suggesting you follow up on labs there is usually a reason. I know these days patients access their labs on line and then look on the internet to see what they mean. Sometimes you can reassure yourself that you are fine.

However, I would like to think that there is added benefit to discussing your labs with me and I can give you the benefit of my over 30 years experience. Perhaps we want to recheck a borderline Blood pressure, we may want to nip something in the bud or determine how we can improve things for the future. Maybe there is new information that is pertinent or new concerns about the medication you are on. Maybe identify future potential problems etc, etc

If coming into the office is a problem, this type of visit can often be done in a telemed visit.

As always I am available for questions and to disseminate information.

Speaking of which, I was in the Munich airport in Germany last weekend and while I was killing time I wandered over to the makeup counter. The topic of covid vaccinations came up and the lady attending me happened to be Russian. She had had the Pfizer vaccine but was very concerned about her 26 year old daughter who had had Lyme disease pericarditis last year. 40 minutes later she had scribbled down notes and asked all her questions, I felt like I was giving a lecture but it occurred to me how badly people need good information. I did manage to impress on her that if her daughter did catch Covid she would likely end up in the ICU.

Something that had not been made clear to her, she was just focusing on the vaccine side effects.

Do you sometimes feel like the wheels are coming off the rails? I hope to write some more about this next time :).

Meanwhile stay well.

FLU SHOTS AVAILABLE IN THE OFFICE!!!, Do you need a booster shot? Maybe not so fast!

 I hope you were able to enjoy your summer with the appropriate restrictions.

First and foremost we have flu shots in the office!!! Call for an appointment.

Once again, people are making noise about the “Twindemic” of the flu and Covid just as they were last year. I don’t subscribe to scare tactics. The reason you should get a flu shot every year is because you don’t want to get the flu!

Amazingly, we are still discussing Covid because people still refuse to follow basic public health guidelines including getting vaccinated.

And so we are now in the 4^th phase of Covid infections.

But let’s talk about booster shots: Is it politics, profit or really about protection?

Stay abreast of the information and make up your own mind.

I get a lot of questions about Covid vaccine booster shots. I hope this answers some of them.

Many healthcare practitioners and pharmacies have already been giving people third doses of vaccines, even if they are not among the immunocompromised — the group for which the shots are currently approved.

If you go to your local CVS they are happy to give you one. Even if they know nothing about you or your health conditions.

Just because you can get one doesn’t mean that you necessarily need to get it. At least not at this time.

FYI, the whole booster thing was a Pfizer idea and the notion of boosters was ‘rushed to market’ i.e the court of public opinion way before the jury is out.

We know that the Pfizer people said that their vaccine starts to wane and that people need boosters at 8 months. Hmm! 8 months, very specific! What about all the others?

Meanwhile we practitioners were advised that boosters should not start until September 23 2021 but only to those who are immunocompromised.

It seems that it is the usual theory that if some is good, more is better. Or is it just that some people had such a hard time getting the first one, getting one easy feels like winning a prize?

But let’s look at the opposite view. Just because immunity wanes around the 8^th month doesn’t mean that by the 9^th month you have no protection at all!

Yes, people who have been vaccinated are still getting Covid infections. And I told you very early in the year that just because you are vaccinated doesn’t mean that you cannot contract Covid or transmit it to others but the third dose will still not change that.

What does that mean?

Let’s look at the flu vaccine. Everyone who get’s the flu shot every year knows that it doesn’t guarantee they will not get the flu. But if they get the flu of a different strain they will still be protected to some extent and they will not get as sick.

Similarly with Covid, the people that got vaccinated are NOT dying, This is the main take home message: If you get vaccinated you will not die! 

Does that mean exactly 8 months after your last shot you will die from Covid if you get it? Probably not!

One of the downsides of getting boosters too early is that now you will end up getting more shots per year than you really need with a shorter interval to the next shot.

But if you have it in your mind that you need booster shots every 6 months that is certainly your prerogative I just don’t recommend it.

For people who got the J and J they haven’t even had to take two shots yet, does that mean they are ahead or behind?

For people that got the mRNA vaccines they already got two shots and then they now get another one every 6 months? Do you get the same type or will mixing and matching give you stronger protection?

So what happened to all the concerns and reservations about taking the shots in the first place? All that has now gone out the window and now its "give me more and more".

Yes, I will be giving booster shots in my office because it has been recommended, but I will not be giving them to anyone who is not at least 8 months out from their last shot. Why?because I don’t think that it is necessarily in a person’s best interest, unless certain circumstances show it to be appropriate (like travel to a country without healthcare).

That’s my view on the booster shots.

There is no harm in boosting immunity, we do it every year with the flu shot and I think that is reasonable but if someone said you should get a flu shot every 4 months ‘just in case’ it would sound excessive. In fact why not get two at the same time so you can be bulletproof? Common sense says maybe not, right?

As it is, we do not know what the long term consequences of the mRNA vaccines are and we will NOT know until we get to the long term! They started being given in January, this is not long term.

This is one of the reasons that I think the vector vaccines have an advantage as far as immunizing children but that is a whole different subject.

A study out of England showed that AstraZeneca maintained its immunity longer than the Pfizer vaccine even though the original efficacy number for Pfizer was in the 90’s and AstraZeneca was in the 80’s. AZ is a vector borne vaccine like the J and J and they work in a manner that we have been very familiar with over many decades. (Hence less hesitancy with young children).

A study from the UK showed that Moderna vaccine creates twice as much antibody as Pfizer. We don’t know if that necessarily relates to stronger immunity but maybe that's why Pfizer brought up the whole booster issue.

Finally, this is from a Medscape article today on boosters:

(FYI The ACIP is the committee that makes the rules on immunization schedules, they and some of the FDA people are ticked off that the politicians announced the need for boosters before the scientific groups had had a chance to study the data Pfizer brought forward to support boosters).

“In Monday's ACIP meeting, Demetre Daskalakis, MD, who leads vaccine equity efforts at the CDC, cautioned that physicians who give extra doses of the vaccine before the FDA and CDC have signed off may be in violation of practitioner agreements with the federal government and might not be covered by the federal PREP Act. The PREP Act provides immunity from lawsuits for people who administer COVID-19 vaccines and compensates patients in the event of injury.

The ACIP signaled that it is considering recommending boosters for a much narrower slice of the American population than the Biden administration has suggested.

They said that so far, the data only point to the need for boosters for seniors, who are the patients most likely to experience breakthrough infections that require hospitalization, and healthcare workers, who are needed now more than ever and cannot work if they're sick.”

Sorry the email is so long but it only touches on the tip of the iceberg.

Knowledge is healthy but fake news is dangerous to your health.