Inside Medicine. What Are You Seeing? [COVID-19 medical news]

My daughter just asked me which one to get, Pfizer or Moderna. She has type 1 diabetes and neuro issues that make her vulnerable to vaccines in some ways- but COVID would be worse! She had Pfizer for first two and for the booster. I thought maybe Moderna would be better this time.

Any info on ingredients or amount of mRNA ins both of these bivalent vaccines? Does Moderna still have more? Do they both have the same proportion focused on original COVID and Omicron variant?

So Modernaā€™s is 25 microgramsm mRNA for original and 25 micrograms mRNA for Omicron.
Pfizer is 15 and 15 micrograms respectively.
So same as other boosters.

Since H and I had Covid in late June, weā€™re probably going to get ours sometime in October or November if we donā€™t get reinfected between now and then. Late October or early November should be the best we can get for the holidays and our relatively recent infection should be providing some protection keeping any reinfection from becoming bad. Thatā€™s my hope anyway.

Until then weā€™re going to keep watch, because weā€™re off the mainland for a good part of Feb/March (4-6 weeks, not sure exactly yet), so might put it off even more to try to cover that time period well. If Covid continues to die down a bit, it could be worth waiting until Dec or Jan for us.

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My feelings exactly. I managed to get an appointment for this morning. The pharmacist said they are now booked out for two weeks.

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  • Tel Aviv University scientists have isolated two antibodies that neutralize all known strains of COVID-19 ā€“ including Omicron ā€“ with up to 95% efficiency.
  • The researchers: Targeted treatment with antibodies and their delivery to the body in high concentrations may serve as an effective substitute for vaccines, especially for at-risk populations such as those with weakened immune systems. By using antibody treatment, it is possible that the need to provide repeated booster shots to the entire population every time a new variant emerges will be eliminated.
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That news is potentially awesome - thanks for posting it!

That references this paper:
https://www.nature.com/articles/s42003-022-03739-5

Includes this image of antibody binding to various variants and mutations:

Has anyone seen evidence of other health things improving after Covid? Pains Iā€™ve had in my neck from either lymph nodes or thyroid (probably lymph) and intense pain that comes on and off with my trigeminal nerve in my ear, face, and upper jaw have gone now. I still have a baseline level of pain with the trigeminal, but loud noise and vibrations or cold temps used to make it really bad. They donā€™t anymore. I mowed a whole field for hours with no extra pain at all. It was terrific.

The only different thing in my life was fighting off a mild case of Covid (post vaxxes and boosters) which made all of those areas ache terribly, but no other major symptoms, so it really seems like things are connected. Iā€™m not sure if fighting off the infection helped ā€œsomethingā€ or if it deadened nerves. Either way, Iā€™m thankful. Iā€™d have tried to catch Covid earlier (post vaxxes, etc) if I had known this was a potential side effect.

I hope it lasts and isnā€™t temporary. Iā€™ve had the pains for 7-8 years now and itā€™s only been 2 months that theyā€™ve been gone at the bad level. I donā€™t know that Iā€™ll mentally be able to take it if they return.

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I had been having increasing allergic reactions for years, and in the months before covid I often had welts and occasions of more generalized hives. Since having my first and only, and very mild, covid infection in January 2022, my allergies have virtually disappeared. I used to take an antihistamine every day and since then, I have taken them just a few times. I also never use Flonase anymore. After I got through spring allergy season, I wondered how ragweed season would go. And now that weā€™re here, some of family members have complained, but I havenā€™t felt anything all. Itā€™s weird.

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My PT, her son and her coworker have long covid. They had been perfectly healthy but now all have loss of stamina, can barely jog and only for very short distances, have shortness of breath, a lot of muscle pain, mystery bruises appearing from no known cause. The PT and her S have had they symptoms when they got covid before vaxes were available in early 2020. Theyā€™ve had to take anti-viral. Lattes so they can function with less pain.

The coworker had 3 bouts of covid in a few months in 2022. She is certified in Pilates and used to jog long distances for fun. Now sheā€™s always exhausted and short of breath.

That is concerning. Although it could be three different kinds of Omicron, the different kinds of Omicron are related enough that there should be some immune protection from one kind to another. And if she was vaccinated before, that is even more concerning that she got it three times and got long COVID.

One of my daughters never had covid prior to vaccination despite living on a college campus for the pandemic (excluding spring 2020) and being in the house when my husband had Delta. She was got her first vaccine in August 2021 and second vaccine in September. Then she got one omicron infection in January and another one in May. The first one was like a day of having a bad cold with congestion that lingered for awhile after that. She said the second infection was milder. So I think the immunity is working but not as much we would have liked in her case.

My husband was also vaccinated and had two infections in a very short time but in his case one was Delta and the next likely Omicron. The second one was also mild but very different because he had a day of weird fatigue and palpitations, nothing like a typical virus. Two vaccinations and two infections in four months. He did not get it from my daughter in January when I did, nor did he get it in other exposures since, so I think his immunity finally built up.

ETA: This is not to say he wonā€™t get it again, but I think heā€™s protected from serious outcomes.

I know my son and plenty of others have had long Covid. Fortunately for my son, two doses of Moderna over a year after getting Covid got rid of his chest pains and fatigue.

Iā€™m in no way saying Covid is always good - I lost my uncle to it and H/I lost a friend roughly our age, plus medical lad has told us of multiple others heā€™s encountered - but I wonder if weā€™re (universal we) focusing so much on those who have bad issues and missing that there might be some facet of good for some of us, and if so, how/why?

Does the immune reaction help other things for some of us? Or does it deaden some other things, and if the latter is that good or bad? Am I odd (@MACmiracle too)? Or are there others?

This is the Inside Medicine thread. I was hoping it could be rationally discussed without any repercussions from the bad side.

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Yes, she was fully vaxed and boosted before she got her 3 bouts of Covid. Covid is still circulating and can create long Covid that results in great pain and misery.

My PT and her S have had their shots and boosters. The S got Covid after the booster because they had a 3500 student assembly right after school started, no masks required. He started taking the antiviral nasal spray his mom bought from Israel, and his parents took their nasal sprays. Neither parent got it and it helped him recover and it didnā€™t worsen his long Covid (nor improve the long Covid).

I donā€™t expect ā€œimmunityā€ from vaccines. I hope for vaccines to prevent serious illness or death.

Regarding nasal sprays, I use Xclear but read that ordinary saline can help. I donā€™t use it often: only after possible exposure. I mainly rely on vax and masks.

I believe people underestimate the frequency and severity of long Covid and how it could affect their lives or the lives of loved ones. .

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I still use a saline spray or rinse almost always after being inside with people, as well as gargle. If I have any real concerns about exposure, I will rinse a few times a day for a few days. I saw studies that were encouraging about the impact of them on serious outcomes. And I wear masks. Sadly, I still avoid most indoor gatherings and restaurants, but there are people in my life Iā€™m concerned about protecting, besides not wanting to get sick myself.

I have two friends who are about 60 and overweight. The wife has some kind of autoimmune condition. They were never vaccinated and never had covid. She called me a couple weeks ago when the husband came down with symptoms, I said rinse your nasal passages and gargle with a mouthwash that says ā€œkills 99% of germsā€
a few times a day until your doctor appointment. The wife slept next to her husband and got covid, too, but it was like a cold, while his was more like a flu-like virus. The husband didnā€™t start Paxlovid until almost a week after symptoms started but his symptoms did not progress before starting it, thankfully. The wife started Paxlovid after only a few days of symptoms, said it felt like an enema (whatever that means), but the improvement was dramatic after that.

I was relieved because I had worried about them getting sick for a long time. Who knows why they had a mild course given their age, vaccination status, and comorbidities. Weā€™ll never really know, but donā€™t think the gargle and nasal rinsing couldnā€™t hurt if done with common sense while waiting to get Paxlovid.

It does seem like she is an outlier, though. I do not know any people who got COVID-19 (at least in a way that got noticed) more than once after vaccination*, and the long COVID instances I have heard about came before vaccines were available, although a few who got COVID-19 after vaccination had what may be called ā€œmedium COVIDā€, where they needed some weeks after clearing the virus to completely recover from symptoms (as opposed to months or not recovering at all from symptoms).

*I know far more people who got COVID-19 once after vaccination during the Omicron-dominant time than those who got COVID-19 before vaccines were available ā€“ although that probably has a lot to do with people being much more careful to avoid the virus before vaccines were available.

Post #5617 links to a research letter finding that long COVID was much less common in post-vaccination cases than in pre-vaccination cases (of course, vaccination also reduces the risk of getting COVID-19 in the first place). However, higher age, allergies, and comorbidities increased the risk, while being male reduced the risk. The letter does not mention whether the general severity of long COVID varied among the different groups (vaccinated or not, gender, age, etc.).

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The researchers noted that reporting about the virus usually highlights a single dominant strain, which leads to under-reporting virus genetic variation and can have serious consequences in public-health planning and response.

ā€œOur work brings attention to the complexity of infectious diseases that is often over-simplified when considering only the most abundant virus in an infection, and we demonstrate the importance of examining the variations that are historically considered noise,ā€ said Ernest (Ricky) Chan, director of the bioinformatics core with the Cleveland Institute for Computational Biology at the Case Western Reserve School of Medicine. "We see that genetic variants observed in low frequency in SARS-CoV-2 infections can be early indicators of new strains responsible for later transmission surges."

Emphasis added by me. Perhaps this will give us the additional information necessary to formulate vaccines that target new variants before they become big wavesā€¦. similar to flu vaccines?