Should we (we= people or maybe old people) get Covid vaccine boosters?
September 4, 2021 9:53 AM Subscribe
So many opinions on this one. What are yours?
Israel says, "Yes! if you're older get a booster." Biden said "Sure!" CDC says, "Whoa! not so fast!"
Studies are showing waning of immunity six months after initial vaccinations. BUT here's a sweet article from NPR telling us that immunity probably lasts a LONG time. Well, that's the theory.
And then there's this other thing where it seems that, if you get too much vaccine you may develop EVIL antibodies that, should you get infected, will make it WORSE! Example given is Dengue Fever vaccine.
THEN there's the argument that we should wait for variant-specific boosters.
QUESTION: if a person 70-plus could get a booster now, should they? Adding up the pros and cons as I've set them out above (and any others!)?
Israel says, "Yes! if you're older get a booster." Biden said "Sure!" CDC says, "Whoa! not so fast!"
Studies are showing waning of immunity six months after initial vaccinations. BUT here's a sweet article from NPR telling us that immunity probably lasts a LONG time. Well, that's the theory.
And then there's this other thing where it seems that, if you get too much vaccine you may develop EVIL antibodies that, should you get infected, will make it WORSE! Example given is Dengue Fever vaccine.
THEN there's the argument that we should wait for variant-specific boosters.
QUESTION: if a person 70-plus could get a booster now, should they? Adding up the pros and cons as I've set them out above (and any others!)?
When you are vaccinated, your body will build up a store of antibodies. The vaccine will also produce long lasting t-cells.
Over time, if you do not come into contact with covid, the number of antibodies will decline. The t-cells are likely to last 10 years+
If and when you do eventually come into contact with covid, if you still have enough antibodies, they will fight it off immediately, you will have no symptoms. If you don't have enough antibodies, the t-cells will be triggered, and those will generate new antibodies to fight off the infection BUT this process can take 2-3 days during which you may be quite unwell with flu like symptoms and you may also pass the infection on to others. It is also possible to have a mild infection where you feel fine but are still infectious to others.
So having a third vaccine has little effect on you personally avoiding serious illness/hospitalisation but it does significantly reduce the chance of passing the virus on to others who may not have had the vaccine at all.
There is an argument that we should be focussing on getting at least a first vaccine to everyone before rolling out a third vaccine shot, but we don't live in a perfect world where everyone is willing or able to be vaccinated. If offered one I would take it.
There is evidence that having a mix of different covid vaccines is more effective than just having one type. I would not make any assumptions that Dengue Fever vaccines have anything in common with covid vaccines - it's a completely different illness.
A good channel to learn about this is Dr John Campbell on YouTube.
posted by Lanark at 10:29 AM on September 4, 2021 [14 favorites]
Over time, if you do not come into contact with covid, the number of antibodies will decline. The t-cells are likely to last 10 years+
If and when you do eventually come into contact with covid, if you still have enough antibodies, they will fight it off immediately, you will have no symptoms. If you don't have enough antibodies, the t-cells will be triggered, and those will generate new antibodies to fight off the infection BUT this process can take 2-3 days during which you may be quite unwell with flu like symptoms and you may also pass the infection on to others. It is also possible to have a mild infection where you feel fine but are still infectious to others.
So having a third vaccine has little effect on you personally avoiding serious illness/hospitalisation but it does significantly reduce the chance of passing the virus on to others who may not have had the vaccine at all.
There is an argument that we should be focussing on getting at least a first vaccine to everyone before rolling out a third vaccine shot, but we don't live in a perfect world where everyone is willing or able to be vaccinated. If offered one I would take it.
There is evidence that having a mix of different covid vaccines is more effective than just having one type. I would not make any assumptions that Dengue Fever vaccines have anything in common with covid vaccines - it's a completely different illness.
A good channel to learn about this is Dr John Campbell on YouTube.
posted by Lanark at 10:29 AM on September 4, 2021 [14 favorites]
"There is an argument that we should be focussing on getting at least a first vaccine to everyone before rolling out a third vaccine shot, but we don't live in a perfect world where everyone is willing or able to be vaccinated"
Agreed. I kind of feel a bit like it's the ol' "clean plate club" argument from being a kid: just because I can't finish my dinner in the US doesn't mean I can ship the rest of it to the starving people of Africa, and whether or not I finish my dinner doesn't have any effect there at all. I don't have control over whether or not other countries get their shots. And when some idiots are refusing to get shots, well.... Meanwhile, we gotta worry about ourselves over here. Third shots sound like there'd be even LESS illness, which can only be to the good, right? If that lessens the numbers of infections and illness, then hell yeah!
I want boosters specifically because of Delta. I'm really concerned that I'm going to have to go out in the world again with my immunity lowering in a month in Deltaworld. Pre-Delta I would not have nearly been as worried about it. I listened to the "In The Bubble" episode on this and if a third shot boosts you as much as they said? HELL YES BRING IT ON.
What I REALLY want is Pfizer's specific Delta variant booster, but the way things are crawling at the speed of snail, that might not get approved for like years :P
Most of us probably won't be permitted to make that decision for ourselves though, sigh. We're going to have to go with whatever the CDC/FDA/whatever decide. But if you're over 70 and permitted? Heck yes, I'd get it. I hope my mom does.
I am concerned on the "too much" thing, it seems really out of the blue and weird to say though? I have found very little on this topic. Like barely saw anything about it yesterday level of not finding things, and I am constantly reading articles on this. So right now, I can't really factor it in.
posted by jenfullmoon at 10:37 AM on September 4, 2021 [2 favorites]
Agreed. I kind of feel a bit like it's the ol' "clean plate club" argument from being a kid: just because I can't finish my dinner in the US doesn't mean I can ship the rest of it to the starving people of Africa, and whether or not I finish my dinner doesn't have any effect there at all. I don't have control over whether or not other countries get their shots. And when some idiots are refusing to get shots, well.... Meanwhile, we gotta worry about ourselves over here. Third shots sound like there'd be even LESS illness, which can only be to the good, right? If that lessens the numbers of infections and illness, then hell yeah!
I want boosters specifically because of Delta. I'm really concerned that I'm going to have to go out in the world again with my immunity lowering in a month in Deltaworld. Pre-Delta I would not have nearly been as worried about it. I listened to the "In The Bubble" episode on this and if a third shot boosts you as much as they said? HELL YES BRING IT ON.
What I REALLY want is Pfizer's specific Delta variant booster, but the way things are crawling at the speed of snail, that might not get approved for like years :P
Most of us probably won't be permitted to make that decision for ourselves though, sigh. We're going to have to go with whatever the CDC/FDA/whatever decide. But if you're over 70 and permitted? Heck yes, I'd get it. I hope my mom does.
I am concerned on the "too much" thing, it seems really out of the blue and weird to say though? I have found very little on this topic. Like barely saw anything about it yesterday level of not finding things, and I am constantly reading articles on this. So right now, I can't really factor it in.
posted by jenfullmoon at 10:37 AM on September 4, 2021 [2 favorites]
You haven't mentioned when your hypothetical person got their first shots, and I think that matters.
It seems like a good time to link Zeynep Tufekci's article with the subtitle The Immune System is Not a Sea Wall With a Fixed Height. The NPR article is telling you that immunity to lethal levels of disease lasts a long time. But a disease can be non-lethal and still hurt you or the people around you.
posted by yarntheory at 10:38 AM on September 4, 2021 [1 favorite]
It seems like a good time to link Zeynep Tufekci's article with the subtitle The Immune System is Not a Sea Wall With a Fixed Height. The NPR article is telling you that immunity to lethal levels of disease lasts a long time. But a disease can be non-lethal and still hurt you or the people around you.
posted by yarntheory at 10:38 AM on September 4, 2021 [1 favorite]
I literally just today got a form email from NYC's health department about a booster (but they are only offering it to people who are "moderately to severely immunocompromised" right now). I think if we're at the point that some civic health offices are starting to promote the booster, my take is that if you qualify for it, you should get it.
posted by EmpressCallipygos at 10:55 AM on September 4, 2021 [2 favorites]
posted by EmpressCallipygos at 10:55 AM on September 4, 2021 [2 favorites]
FYI, third vaccines for immunocompromised people are not technically considered boosters. They are additional shots.
posted by FencingGal at 11:17 AM on September 4, 2021 [12 favorites]
posted by FencingGal at 11:17 AM on September 4, 2021 [12 favorites]
^ +1 to FencingGal. Because of the need to roll out the vax as quickly as possible, the vaccine trials focused on generally healthy populations. It was suspected all along that the standard dose might not be quite as effective on immunocompromised folks. Had we had the luxury of more time before rollout, there likely would have been a standard protocol of 2x for genpop and 3x (additional dose) for specific vulnerable groups from the beginning, with continued studies on boosters etc. to follow.
posted by mochapickle at 11:33 AM on September 4, 2021 [2 favorites]
posted by mochapickle at 11:33 AM on September 4, 2021 [2 favorites]
IANAX (i am not an eXpert) but I wanted to record some definitions here, because I keep forgetting them.
The "vaccine helps the virus" syndrome associated with dengue fever is called antibody-dependent enhancement (ADE). I haven't seen any evidence that it's a concern with Covid vaccines or boosters. It's not a concern with any currently administered vaccines, because once it's detected those vaccines are discontinued.
The "your body remembers your first immune response the best" syndrome is called original antigenic sin (or immunological imprinting, or antigenic seniority). This is thought to be why people born in different eras seem to respond to influenza strains differently. I believe the impact is still being studied (and how even exposure to the common cold affects Covid response) but I can't find anything specifically related to Covid boosters.
posted by RobotVoodooPower at 11:48 AM on September 4, 2021 [1 favorite]
The "vaccine helps the virus" syndrome associated with dengue fever is called antibody-dependent enhancement (ADE). I haven't seen any evidence that it's a concern with Covid vaccines or boosters. It's not a concern with any currently administered vaccines, because once it's detected those vaccines are discontinued.
The "your body remembers your first immune response the best" syndrome is called original antigenic sin (or immunological imprinting, or antigenic seniority). This is thought to be why people born in different eras seem to respond to influenza strains differently. I believe the impact is still being studied (and how even exposure to the common cold affects Covid response) but I can't find anything specifically related to Covid boosters.
posted by RobotVoodooPower at 11:48 AM on September 4, 2021 [1 favorite]
Response by poster: EmpressCallipygos: seconding that the letter you got was not about boosters; it was about 3rd shots for people whose response to their 1st and 2nd shots is presumed to be less than optimal because of their compromised immune systems. Boosters are for people whose 1st and 2nd shots "worked" but now time has passed and perhaps their immunity has waned.
Speaking of which, answering somebody else's question about how much time has passed from the 1st and 2nd shots of the original poster (i.e. me): 7 months. Age: almost 71. Husband got immunized on the same day(s). Age: almost 76.
So yeah, that is my concern. Good point about how the original trials were mostly on not-so-old healthy individuals.
Am now "boosting" the idea of boosters. (I also thought the same thing about how eating my vegetables was not going to help children in India, except other people say it actually WILL (e.g. one of those department heads at W.H.O. who is incensed that Western nations are getting third shots ))
posted by DMelanogaster at 12:43 PM on September 4, 2021
Speaking of which, answering somebody else's question about how much time has passed from the 1st and 2nd shots of the original poster (i.e. me): 7 months. Age: almost 71. Husband got immunized on the same day(s). Age: almost 76.
So yeah, that is my concern. Good point about how the original trials were mostly on not-so-old healthy individuals.
Am now "boosting" the idea of boosters. (I also thought the same thing about how eating my vegetables was not going to help children in India, except other people say it actually WILL (e.g. one of those department heads at W.H.O. who is incensed that Western nations are getting third shots ))
posted by DMelanogaster at 12:43 PM on September 4, 2021
My immunocompromised husband just got his third shot, and I'll get a booster when I'm due in October or November. Both of us 70+. As has been said, there are plenty of shots in the world and me getting one would not take a first shot away from anyone, leaving aside the fact that all kinds of people are simply refusing to get vaccinated at all in the USA and pharmacists have to throw shots out.
I'll get my flu shot next week, too. I'm pretty confident that any possible weirdness from too many vaccines is up there with the side effects of too many X-rays, which is to say, I'm 70 and honestly I'd rather risk side effects from a well-supported booster shot than play routlette. I might end up with Long Covid like my cousin or even just a bad breakthrough infection if I don't get a booster.
My husband always refused to get a flu shot until he ended up in the hospital with pneumonia from his last go-round with the disease.
Meanwhile, a guy around my age pulled his mask down at the meat counter today to shout his order at the butcher, and I think that's a bigger risk to me than a booster might be.
posted by Peach at 1:15 PM on September 4, 2021 [4 favorites]
I'll get my flu shot next week, too. I'm pretty confident that any possible weirdness from too many vaccines is up there with the side effects of too many X-rays, which is to say, I'm 70 and honestly I'd rather risk side effects from a well-supported booster shot than play routlette. I might end up with Long Covid like my cousin or even just a bad breakthrough infection if I don't get a booster.
My husband always refused to get a flu shot until he ended up in the hospital with pneumonia from his last go-round with the disease.
Meanwhile, a guy around my age pulled his mask down at the meat counter today to shout his order at the butcher, and I think that's a bigger risk to me than a booster might be.
posted by Peach at 1:15 PM on September 4, 2021 [4 favorites]
Anecdotally, I know a number of people who got vaccinated early (Dec/Jan) who have nevertheless gotten covid in the last several weeks. Almost all asymptomatic or mild. One was sick enough to be hospitalized.
Likely the perfect storm between pandemic fatigue, waning immunity, and delta variant escaping the vaccine. But it's enough to make me think that general boosters can't come soon enough. It is absolutely appropriate and possible to want to save oneself as well as the rest of the world. This isn't a zero-sum game.
posted by basalganglia at 1:16 PM on September 4, 2021 [7 favorites]
Likely the perfect storm between pandemic fatigue, waning immunity, and delta variant escaping the vaccine. But it's enough to make me think that general boosters can't come soon enough. It is absolutely appropriate and possible to want to save oneself as well as the rest of the world. This isn't a zero-sum game.
posted by basalganglia at 1:16 PM on September 4, 2021 [7 favorites]
I made a commitment from the start to just follow the CDC's guidance and not spend too much time second-guessing them. (Sort of like how I put my money in mutual funds with a target retirement date and I let the experts at Vanguard decide how to invest it ... because what do I know about investing? It has worked well for me so far, knock on wood). I'm definitely going to get the booster.
posted by SageTrail at 2:33 PM on September 4, 2021 [3 favorites]
posted by SageTrail at 2:33 PM on September 4, 2021 [3 favorites]
I've had a tab with this article open on my phone for over a week now:
ADE Is Still Not a Problem With COVID Vaccines -- [Derek Lowe says] paper "not aligned with reality"
So that's encouraging, anyway.
posted by metonym at 3:04 PM on September 4, 2021 [3 favorites]
ADE Is Still Not a Problem With COVID Vaccines -- [Derek Lowe says] paper "not aligned with reality"
So that's encouraging, anyway.
posted by metonym at 3:04 PM on September 4, 2021 [3 favorites]
Zeynep Tufeki is a social scientist and is not an epidemiologist. Her guidance is not necessarily grounded in epidemiological expertise. We really just need to listen to what the CDC, epidemiologists, and biological scientists say and do that. We need to listen to actual experts in the field, not to social scientists like Tufeki or to economists like Emily Oster. People who are not experts in epidemiology should not be claiming expertise on COVID-19, nor should they be giving advice.
CDC says to wait unless you're immuncompromised because of a transplant, cancer drugs, and other immunosuppressing situations/conditions, so we should wait. For what it's worth I really wanted to get the third shot as soon as possible as an immunocompromised person. I did wait until it was actually announced by the CDC, despite the fact that there was plentiful data from both Israel and France that suggested that people like me absolutely need a third shot. If people committed to listening to epidemiologists and actual experts on this, we would all be in a much better spot than we are today with covid. No one on a Metafilter thread has better advice on this than the CDC.
posted by twelve cent archie at 3:28 PM on September 4, 2021 [5 favorites]
CDC says to wait unless you're immuncompromised because of a transplant, cancer drugs, and other immunosuppressing situations/conditions, so we should wait. For what it's worth I really wanted to get the third shot as soon as possible as an immunocompromised person. I did wait until it was actually announced by the CDC, despite the fact that there was plentiful data from both Israel and France that suggested that people like me absolutely need a third shot. If people committed to listening to epidemiologists and actual experts on this, we would all be in a much better spot than we are today with covid. No one on a Metafilter thread has better advice on this than the CDC.
posted by twelve cent archie at 3:28 PM on September 4, 2021 [5 favorites]
Excellent Atlantic piece summarizing the current state of this discussion.
posted by Roach at 3:28 PM on September 4, 2021 [3 favorites]
Per Andy Slavitt's Twitter:
I talked to several scientists, including Dr. Fauci who will be on
@inthebubblepod
next week, who believe that with a booster shot, it is very likely that vaccinated people will no longer be able to be contagious.
posted by jenfullmoon at 11:08 PM on September 4, 2021 [1 favorite]
I talked to several scientists, including Dr. Fauci who will be on
@inthebubblepod
next week, who believe that with a booster shot, it is very likely that vaccinated people will no longer be able to be contagious.
posted by jenfullmoon at 11:08 PM on September 4, 2021 [1 favorite]
I believe that older people will have a good reason to get the booster once the relevant agencies decide it's safe and appropriate.
That said, as a younger person, I have decided not to get the booster while there is significant worldwide vaccine inequity, and as long as I feel personally safe and that I am not a significant danger to people around me. (And as long as it's not mandatory for something I suppose; I'm no saint.)
As for the argument that the booster I refuse will not go to someone outside my country who needs it urgently to save their life, that's only true on the small scale. Some amount of people will make decisions like mine. (A lot more will be too busy, or not want to risk needing to take time of work to recover, or not care, or whatever.) Based on all those individual decisions, my country will be using a certain, fairly predictable amount of vaccine per unit time. Planners can look at that and decide that they have excess to requirements, and decide to allocate the excess to COVAX, probably before those doses even go into the national stockpiles.
posted by joeyh at 6:52 PM on September 5, 2021 [1 favorite]
That said, as a younger person, I have decided not to get the booster while there is significant worldwide vaccine inequity, and as long as I feel personally safe and that I am not a significant danger to people around me. (And as long as it's not mandatory for something I suppose; I'm no saint.)
As for the argument that the booster I refuse will not go to someone outside my country who needs it urgently to save their life, that's only true on the small scale. Some amount of people will make decisions like mine. (A lot more will be too busy, or not want to risk needing to take time of work to recover, or not care, or whatever.) Based on all those individual decisions, my country will be using a certain, fairly predictable amount of vaccine per unit time. Planners can look at that and decide that they have excess to requirements, and decide to allocate the excess to COVAX, probably before those doses even go into the national stockpiles.
posted by joeyh at 6:52 PM on September 5, 2021 [1 favorite]
This thread is closed to new comments.
This is a bit of a cheeky answer, but the point is that you should wait and see what the authorities converge on. Because the whole problem with COVID-19 is that no-one really knows what they are doing and they are catching up as they go.
I don't know about you, but most of my +70 friends are being very careful and not participating in raves, church or soccer games. If you are doing the same thing, you will probably be safe.
There is a new thing, though, which is that because of corona, we have been less exposed to all the other vira and infections, and thus have developed less immunity. So the government is offering free vaccines against the flue and other common winter diseases.
posted by mumimor at 10:04 AM on September 4, 2021 [4 favorites]