To boost or to not boost

Many have been asking about Covid vaccine booster shots. The data on these third shots for the mRNA vaccines is accumulating. The main thing is that the third or booster shot appears to be safe, but not completely without side effects. According to the CDC, the Moderna booster side effect profile is similar to that of the first two shots.

Headache (55%), fatigue (59%), muscle (49%) and joint (415) aches are very common after the Moderna booster.

35% developed chills and 11% developed nausea/vomiting. BTW, doctors group together nausea and vomiting as one thing. For instance, we would say something like this - "The patient developed nausea/vomiting 2 days ago..."

Lymph node swelling was the most common, localized side effect and seen in 20%.

As for a simple blood test to check for immunity, I am surprised we do not yet have one.

In August, a large study was posted as a preprint, which means it had not undergone peer review. A study's results typically are not considered trustworthy until it has gone through the peer review process. The study showed that antibody levels correlated well with protection against infection. This study gives me hope that we will soon have a lab test to determine who is protected and who is at-risk of infection. But as of now, we cannot recommend whether or not you get the booster based upon an antibody test.

If you antibody level against the spike protein is low, then you're likely at increased risk for Covid compared with those whose antibody levels are high. But we don't have good data for those with higher antibody levels to determine who is protected and who isn't in that group.

So, if you're ≥ 65 years-old or you just feel more comfortable, get the booster.

If you're under 65 and are not obese and not diabetic, then you can wait.

Friends asked me what I have done, I said "I hadn't thought about it myself. I knew I responded to the vaccine (I had bad chills after the second dose). So I figured I was good for a while. And I am not quite obese and I don't have diabetes or prediabetes." So, I just wasn't worried about it.

But for those concerned about infection and not concerned about the side effects, go ahead and get. I have a few employees without risk factors and both under 35 yo who got the booster. I asked why and they didn't have a good answer, I mean other than that they are in a Covid pt's room every single day.

I started thinking more about it and thought "Maybe an asymptomatic infection or minimally symptomatic infection after vaccination would give me the better protection than a booster." That's probably true. But that difference shouldn't be that great. So, I probably will get the booster soon, unless I get minimally symptomatic Covid before I get around to getting the booster.

As for vaccinating kids, I hope no one asks me that question again. Parents, who want to give their kid the vaccine even if they have already recovered from Covid, want my blessing. Parents, who don't want to give their kid the vaccine, want me to misrepresent the safety data.

It's simple. The vaccine appears to be very safe in kids, but the data are limited because only a few thousand kids got the vaccine in the clinical trial.

Simultaneously, if the kid doesn't have a pre-existing condition putting her/him at risk for severe disease, then she/he also likely won't benefit from the vaccine in any significant way. So, to give a child a vaccine, which has limited, but good safety data, without a clear benefit? That's up to you. The odds are with you. Making vaccination of kids mandatory? Well, that's just unfounded and unprecedented based upon the available data.

If we vaccinate kids, will they get boosters in 9 months or so?

I just heard from the lead author of the study I mentioned above. He said the study doesn't support using a commercial lab blood test or assay to determine who is at risk and who isn't. So, don't hold out for that.

Stephen