Vaccine Booster Shots
This week we discuss the increasing amount of evidence that suggest that vaccine booster shots are in our future – already planned for those that are immunocompromised and did not develop a sufficiently robust immune response to the previous vaccine dose regimen. It is looking increasingly likely we will need booster doses – not an unusual development for vaccines
We discuss the looming FDA move on the current vaccines taking them from EUA status to full authorization, discuss the incredible pressure this latest wave of cases is having on our healthcare workers and talk about how to assess risk and the fact humans are very bad at this
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights or better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here. We’re helping employers figure out how to work their employee health benefits programs better, as well as operate through COVID. So Nick, another amazing week, it seems like they keep piling one on top of another. And we have another potentially major announcement in terms of the vaccine and a booster or a third shot, what’s going on?
Nick van Terheyden
Well, before I get to that, I just want to be clear, you’re talking that the weeks are amazing. And they’re piling on top of each other? Yes, absolutely. It’s always an amazing week. It really is. Yes, booster shots. Are we going to get a booster shot? We’ve been sort of I don’t want to say flip flopping. But there hasn’t been good solid evidence we’ve seen, you know, inconsistency in the messaging. Do the does the immunity persist? Is it like lifelong vaccine? Am I gonna have to get a booster, it’s looking like this evidence to suggest that some people are going to need it, we’ve already seen work on those that are immunocompromised. And in those particular instances, I think it’s individuals that their immune response didn’t quite work as well as fitter, healthier, and importantly, younger people. That’s the other thing, elderly people don’t have quite as robust an immune response. So we’re saying that they need boosters. This is not unusual. We see boosters, I think the MMR is an example is given as a three course vaccine. And it’s spread out over time. But what about the sort of average population? Well, it’s quite possible if you’re younger, you may not need it. All of this still is speculation. But I think, you know, the guidance that we’re starting to see in some of the data that’s emerging is suggesting that we are going to suggest boosters for the US population. And it’s going to be at the eighth month, eight month mark. So eight months after your last vaccine of your sequence vaccine, no commentary on the single vaccine, the j&j or Janssen vaccine, but I think we’ll see something about that. And what might be going on? Well, interestingly, because we had a protocol, and we stuck to that protocol, the body’s response, it had an immune response, and then you gave it a second booster, and it produced more immunity and, you know, a response that kills the virus. And then it seems to be on the wane. In the case of the UK, where they spread that out, not per the trial data, but to try and extend the availability, because they spread it out, they may have gotten a better, more extended version of this immune response. So they might not need it, or may not need it as frequently. Are you likely to have to have recurring boosters? We don’t think so. But we don’t know. But it’s probably in your future, those of you that are vaccinated, and that should be all of you just saying,
Fred Goldstein
yeah, that that exam from the UK that you raised, brings up an interesting side point, too, that they spread out the two shots in an effort to get one into more people. And so one of the concerns about this is we both in discussing is this issue of should we really be trying to focus on getting that first and second shot into as many people as possible, as well as looking to inoculate and help the rest of the world get access to this vaccine versus beginning to push through a third shout out to the US population? Obviously, that’s an interesting issue. It’s an important one we should be discussing. I think the President has made a comment that we have plenty and we’re going to continue to send others. But obviously, this is a pandemic that’s worldwide. And unless it’s addressed at that level, it’s going to continue on and on. Is that true?
Nick van Terheyden
I think that’s a an essential point to consider. This is not a US problem. UK problem or any other country, that is a worldwide problem. We need to have availability of this and distribution of that. And the question is, if you don’t get that out to the rest of the world, what are we going to do isolate them? I think that’s exactly right. So, you know, if if I had a choice, I would say give it to those that don’t have even their first opportunity, get it as widely as possible, and then start thinking about boosters, but I have no insight into the availability. So you have to take that into account. But I think essential point.
Fred Goldstein
Yeah. And obviously, both an issue here in the United States where we still have a large number of the population not vaccinated as well as around the world where many countries have very limited access to this. So the other area we’ve sort of been discussing, and one thing we probably should raise is It’s getting pretty close. We here to maybe one of the vaccines getting approved full approval.
Nick van Terheyden
Yeah. So I think the FDA is certainly assembled the documents, they’ve got a meeting. tentatively what I’ve heard is September for a full authorization, that’s one of the things that you hear from a resistance standpoint of individuals who say, I’m not willing to take it because it’s on a ua. It is notable that folks that say that, when they’re in the ICU suffering from COVID, are willing to take the emergency use authorized monoclonal antibodies, which, you know, have much less data available for them, but they’re willing to accept that, but they don’t accept the vaccine. I still struggle with that. That feels to me a little bit of a counterintuitive approach, and perhaps something about the risk assessment that we struggle with red.
Fred Goldstein
Yeah, absolutely. And before we get on to risk assessment, I just want to point out, I don’t think we can discuss anything this week without the continued increase in hospitalizations we’re seeing around the country and the incredible stress this virus is putting on those individuals working in the healthcare system
Nick van Terheyden
is off the job because they cannot cope. They’ve done this all once before. And they’re looking at people that have said more, I’m just not going to take the necessary steps to protect myself and the community that is working on my behalf.
Fred Goldstein
Yeah, sadly, it’s exactly what we’re seeing around the country and seen cases of that. And you know, getting to this idea of risk, when you add in the Delta variant, which we saw increased the likelihood of risk due to spread and contagiousness, etc. And then we added in vaccines, which we had hoped and which have shown to severely reduce that risk, it creates a whole issue of how you begin to identify how risky a situation is for you as an individual in your own personal life. So as you’re walking around, now, you have to begin to say, Well, at this event, will there be individuals who are vaccinated? What’s the likelihood of spread, what how big is the Delta variant in my community, and all of those are things that people are going to begin to have to factor in. And obviously, we haven’t been doing a good job at assessing risk.
Nick van Terheyden
Well, I think generally, human beings, individuals are not good at risk assessment, you know, perfect example, individuals that are frightened to fly flying is one of the safest forms of transportation, terrified to do that, but happy to jump into a car, which is a much riskier proposition, albeit they’re both relatively safe. But flying is much safer, but we don’t think about risk in those terms. And, you know, this is a very complex topics on its own. But now you’re layering in all of these changes, this delta variant has completely changed the risk assessment, you’ve got to take into account your local community, I think it’s a big struggle. And, you know, if I had one piece of incremental advice, it was to say, Don’t jump to conclusions, stop and think and try and access resources that you can say, have been thoughtful about it. I I’m, you know, be the first to admit when we’ve been wrong, or, you know, have views that are different. I think we’ve all got to accept different opinions. But we have to take account of the information and try and make really good informed decisions, not just about our risk, but the risk that we’re imposing on other people, particularly kids, although we’re going to see vaccinations for five and a half, hopefully, very soon, they’re still at risk because they can’t access the vaccines. And whilst they may not develop the disease at quite the same levels, they’re still at risk. We’re seeing people kids in ICU that are dying.
Fred Goldstein
Yeah, I think it’s a really great point for individuals to really look at the situation, look at what their situation is, what the situation is of the individuals they may be going to meet with, as well as who they may come in contact with later, so that they don’t bring this disease into a situation where individuals can potentially get it and suffer some of the catastrophic health effects we’re seeing.
With that, this is Fred Goldstein with the Campbell health. I’d like to thank you so much for joining us this week, you can get more information at accountable health LLC COMM
Nick van Terheyden
And this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
