​COVID and Measles update

COVID shots for 65+
As many of you have heard, last month the CDC announced that all patients 65 years and over should get another COVID vaccine if it has been over 4 months since their last one. This vaccine is the exact same one that was introduced last September, and this recommendation was made because in patients over 65, antibodies formed to the COVID vaccines are not as robust and do not last as long. At this point, COVID levels in the community are not as high as they were over the winter, and the numbers of people being hospitalized or dying are definitely much lower. However, people are still getting infected, and the vast majority of people who are hospitalized are those over 65. We are also worried about long COVID, with more than 15% of people reporting they have long COVID symptoms. The best way to prevent long COVID of course, is not to get it. One of the concerns I initially had with getting another COVID vaccine was that in the beginning, there were some studies that suggested that too many COVID vaccines may blunt the desired protective effect of subsequent vaccines. However, it seems that it is not the case, as people do still mount a good response. There is even a case of a 62-year-old man in Germany who got over 200 COVID vaccines in a little over two years! He agreed to be studied, and his immune system was still functioning normally. While we would never recommend this, at least it is reassuring that in this particular case, there was no sign of a blunted response to multiple vaccines. We also know that the current vaccine is about 40-50% effective at preventing infection (although much higher at preventing severe infection). This supports the phenomenon that we’ve all seen where people who have been properly vaccinated still end up getting COVID. While we would love this to be higher, a 50% reduced risk with the vaccine is better than a 0% reduced risk for not getting the vaccine.
 
So who should get this vaccine now? We do anticipate a new COVID vaccine this fall, which will be newly formulated to best match what the current circulating strains are at that time. As long as you have not had a COVID vaccine or actually had COVID in the last four months and you are 65 years or older, you are eligible. These are the people I feel should get another vaccine now:

• If you have lung disease such as asthma or COPD, diabetes, chronic kidney disease (stage 3 or higher), active cancer, or other diseases that decrease your immune system
• If you are taking medicines that suppress your immune system such as biologics, chemotherapy, or steroid medicine
• If you plan on upcoming travel where you are going to be exposed to a lot of people (such as a large conference or vacation on a cruise ship)
• Or simply if you want another COVID vaccine at this time

 
We currently only have the Pfizer vaccine, so if you specifically want the Moderna vaccine you can get it at a local pharmacy. However, there were some studies earlier on that showed that people that got the vaccines actually had a little better immune response.
 
Finally, a reminder that if you have cold or allergy symptoms, be sure to test for COVID. Even though we don’t have to isolate as long as we did in the past, it is important to know if you have COVID, and some people should still be treated with Paxlovid.
 
Measles
Measles had previously been thought to be eliminated in the US, but there has been a resurgence recently. The number of cases since the beginning of 2024 are now as high as the entire number of cases in all of 2023. The vast majority of these cases are from people who come back to the US after traveling internationally, although there is also risk in children because a higher percentage of children are not getting their measles vaccines. There has been a lot of confusion over the years about measles because there have been both inactivated vaccines, at least two different live attenuated vaccines, and also different dosing regimens. Therefore, depending on when you were born, you may not have been fully vaccinated and therefore may be at risk for getting measles. This is my recommendation:

• If you were born before 1957, you are assumed to be immune because the disease was so common and so contagious before vaccines were available. You do not need to check a blood test for antibodies.
• If you were born in or after 1957, and you have a record that you had two doses of the live measles vaccine (such as MMR), you are assumed to be immune. You do not need to check a blood test for antibodies.
• If you were born after 1957, you do NOT have a record of two doses of live measles vaccine, AND you plan on traveling internationally, you can get a booster shot of MMR without checking any blood tests. It will not hurt you to get another shot if in fact did have two doses of live measles vaccine in the past.  It is also possible to check for measles antibodies by a blood test to check for immunity. We do not carry the MMR vaccine, but you can get it at most local pharmacies. 

 
One last thing – you may have hear there was a cyberattack at Change Healthcare last month. It has not directly affected Scripps, but it did interfere with our ability to get results from Scripps Labs sent directly to our electronic medical record. If it makes no difference to you, having labs drawn at LabCorp or Quest will make it easier for the results to be sent directly to our EMR.  Hopefully this will be fixed soon.

​Thanks for reading!