The thing that interest me most is the durability of memory based immunity. It’s addressed very briefly in that paper:
“Predicting vaccine efficacy against severe SARS-CoV-2 infection and death is significantly more challenging, and binding and neutralizing antibodies alone may not reflect measures of protection against these more important outcomes. 12”
The drug companies want symptomatic disease to be the end point, because that will mean yearly boosters to top up antibody levels, and thus much more profit. The bigger question is how durable are memory cells that are still very protective against severe disease. It can be done in a lab setting, but there’s no clinical test available that will measure that yet. I feel pretty safe as a healthy 58 year old with 2 doses of mRNA, but I’m still getting boosted in 2 weeks. It’ll be interesting to see how this eventually shakes out.
This is speculative, but could it be helpful to get J&J to induce a cellular immune response that may be more durable over time and more adaptable to variants, while getting boosted with an mRNA vaccine when case counts are high or increasing (or predicted to be so, such as during winter family gathering season)? Perhaps it could also help if the vaccines could be made for the current variants. Hmmm, like seasonal flu vaccines?
If your immuno-compromised the CDC says you can now get a fourth shot. Yup…4th… “Details: People over 18 who are “moderately to severely immunocompromised” and have received three doses of an mRNA vaccine may get a fourth shot (of either the Pfizer, Moderna, or Johnson & Johnson vaccines) at least six months after getting their third Pfizer or Moderna dose, per the CDC.” Do I hear a 5th??? CDC says some immunocompromised people can get fourth COVID shot
The 4th shot makes sense since people who are immunocompromised got their third shots so early . Others claimed to be immunocompromised and I wonder if, this time, there will have to be proof of immunocompromise or if the date of third booster will be used to determine eligibility.
There will come a point where the “juice is not worth the squeeze.” It’s interesting that we have everything from “don’t put anything into me” to “pump everything into me (justified or not)” in the US.
Why do you think the fourth shot means the third shot didn’t work? The response of anyone who is immunocompromised may be less than those with healthy immune systems, of course. A six month interval between third and fourth shots makes sense. There are no studies yet showing whether the rest of us will need a shot every 6 months, or, as Moderna apparently just announced, annually.
I am part of a Johns Hopkins study still going, testing antibody levels for those who are immunocompromised, before the third shot, two weeks after, one month after, three months after, six months after. Studies like this will help provide more info on the need for shots in the future.
If the shot protects the individual for 6 months, then it actually “works.” Sure, it would be better if one shot provided lifetime immunity, but it doesn’t. So we act accordingly.
ps My friend with rheumatoid arthritis is doing the JH study. Her antibodies were 250 before the third shot and two weeks later were greater than 2500, a measure of effectiveness. The shot worked for her apparently, at least in the short term
More like saying since my yogurt and coffee for breakfast didn’t work I’m going to have yogurt and coffee for lunch and since that didn’t work I’ll have yogurt and coffee for dinner…until it WORKS.
We might need ongoing jabs of some kind. We just don’t know. But I think it is reasonable to question the wisdom of jabbing the same thing over and over at what appears to be becoming increasingly smaller intervals.
In fact, it’s rarely the case. Measles is one example, but I’m not sure there’s a single respiratory pathogen where we get sterilizing immunity from either natural infection or vaccination.
The real question in my mind continues to be what’s the endpoint? Is it preventing severe disease or any disease?
Before vaccines, the messaging was prevention of severe disease and that even a 50% effective vaccine would be a good thing. But the mRNA vaccines worked so well (at least initially and against non-Delta variants) that people started getting the impression that they worked against any disease (which they did initially and against non-Delta variants). Then the Delta variant came…
It’s hard to say if they aren’t as effective against Delta or not because of the time lapse between dosing and exposure to the new variant. What it certainly showed us is that 2 doses are still good against severe disease for most, even against Delta, and that bulletproof immunity is transient. I for one am exceedingly grateful for the two doses in my arm. I think most of us out here would say the same.
I completely understand we are in uncharted waters. It is a ‘learn as we go’ adventure. I also accept that there are questions to which the answer is ‘we just don’t know’. We know seem to know that if we’d extended the time between jab 1 and jab 2 of the Pfizer version we’d have had a better antibody response.
But it concerns me that there continue to be questions which can’t/shouldn’t be asked because they land you in a ‘anti-vax/consipracy/political bucket’ which has negative social consequences.
The process at this point seems like a case of ‘they jumped on their horses and rode of wildly in all directions’. Maybe it’s time to hit pause on the increasing number of doses/combinations/boosters.
I also find it sadly funny that one will be chastised for ‘doing their own research’ yet this is EXACTLY what we are being asked to do with this mix and match plan.
I mean no offense by saying this, but anyone who says that just isn’t up to speed with what has actually happened, at least with the science. The messaging on the other hand has been scattered.
