dreamshark (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
dreamshark) wrote2022-04-04 07:50 pm
dreamshark) wrote2022-04-04 07:50 pm
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Waiting on the latest booster... but maybe not for long
Fact: There is some evidence for the efficacy of a 2nd COVID booster, but the data is sparse. Mostly two preprint studies from Israel, one of which suggests that 4th shots in the midst of a massive Omicron spike significantly reduces mortality/hospitalizations in the elderly. The other one showed minimal efficacy for middle-aged health care workers (average age 50), arguably because they were young and healthy enough to have reached peak vaccination-fueled immunity already and had little to gain from another boost. But in neither case was there any sign of harm. There is, as far as I know, no data to show that another booster does anything to reduce transmission of the current viral variants - we're just talking about preventing catastrophic outcomes for the people that are infected. So whether or not to get that 2nd booster right now is a matter of personal risk management, not public health.
One interpretation of all this is "Get the booster if you are eligible. It might help and it almost certainly won't hurt. And it's free, so why not?" Okay, that makes sense. Richard is going with that philosophy, and just got his 2nd booster today.
My viewpoint is slightly different. It seems pretty clear that the effect of an mRNA booster shot is a large but transitory surge in coronavirus antibodies. Originally everybody hoped that the first booster shot would result in greatly improved long term immunity. That was revised downward to 8 months, then 6 months, and now the advice is to get another booster after 4 months. Immunity doesn't drop suddenly like falling off a cliff - it drifts downhill. If the current thinking is that the booster has pretty much worn out by 4 months, that suggests that it gives you at most 2 or 3 months of robust additional immunity.
It seems to me that the time to get a booster that will only protect you for 2 or 3 months is at the BEGINNING of a COVID surge, not at the end. So my plan is to wait until the roller coaster starts up the next hill for that booster, not to waste my two months of turbo-charged immunity in a flat period.
Of course, the next surge may well be in the offing. Minnesota releases its weekly infection numbers on Monday. Last Monday, the decline had essentially plateaued. Today the new numbers came out, and it's up 9%. Still under 10 cases/100K, but moving the wrong direction. The wastewater surveys the last couple of weeks have also reported increases. So I'm biding my time, but watchful.
One interpretation of all this is "Get the booster if you are eligible. It might help and it almost certainly won't hurt. And it's free, so why not?" Okay, that makes sense. Richard is going with that philosophy, and just got his 2nd booster today.
My viewpoint is slightly different. It seems pretty clear that the effect of an mRNA booster shot is a large but transitory surge in coronavirus antibodies. Originally everybody hoped that the first booster shot would result in greatly improved long term immunity. That was revised downward to 8 months, then 6 months, and now the advice is to get another booster after 4 months. Immunity doesn't drop suddenly like falling off a cliff - it drifts downhill. If the current thinking is that the booster has pretty much worn out by 4 months, that suggests that it gives you at most 2 or 3 months of robust additional immunity.
It seems to me that the time to get a booster that will only protect you for 2 or 3 months is at the BEGINNING of a COVID surge, not at the end. So my plan is to wait until the roller coaster starts up the next hill for that booster, not to waste my two months of turbo-charged immunity in a flat period.
Of course, the next surge may well be in the offing. Minnesota releases its weekly infection numbers on Monday. Last Monday, the decline had essentially plateaued. Today the new numbers came out, and it's up 9%. Still under 10 cases/100K, but moving the wrong direction. The wastewater surveys the last couple of weeks have also reported increases. So I'm biding my time, but watchful.