There is a lot of discussion now about whether all adults should get a booster for COVID, even if they are at a low risk for complications. If you have risk factors such as increased age or certain medical conditions that put you at a higher risk for complications from COVID-19, or you are in a job that puts you at higher risk of contacting people with COVID-19, you should definitely get the booster. However, there are many young and healthy people who are wondering if they should get the booster shot. While I can’t answer that question for everyone individually, here are some my thoughts about this:
The bottom line is that if you are 18 years or older and want to get a booster, you should be able to get one. We will have both Pfizer and Moderna vaccines in the office, so call for an appointment.
The Omicron variant
Just a quick word about the recent news this weekend regarding the discovery of the Omicron variant, initially seen in South Africa but now being found in many other countries around the world. Although many people are worried about this variant because it has so many mutations on the spike protein, we don’t know yet at this point if it is much more transmissible or possibly more deadly than the current Delta variant. More information will continue to be coming out within the next week or two. Remember that even if we do see more people that are hospitalized with a new variant, it does not mean that it is more deadly – it could just be more transmissible. If the old virus causes 10% of people to be hospitalized and it infects 1000 people, we will see 100 people in the hospital. However, if the new variant also causes 10% of people to be hospitalized but it is much more transmissible, it could infect 10,000 people, and we would therefore see 1000 people in the hospital. People should not panic at this point, but I would continue to wear masks indoors if you are going to be in close proximity with many other people. While that is true that the face masks we wear do not provide 100% protection against transmitting or becoming infected with coronavirus, it is certainly better than not wearing a mask. Furthermore, wearing a mask is respectful to the people around you, as they may be at higher risk for complications from the infection, and wearing a mask decreases the risk of you transmitting anything to them. Stay tuned, as more information about the Omnicron variant should be discovered in the next few weeks.
COVID Vaccine Booster Information
Right now we do NOT have any COVID-19 vaccines in the office. Vaccine storage requirements recently changed, and we are in the process of getting re-certified. The earliest we will get any is November 1, but it is not guaranteed. Please do not call the office to schedule any boosters until after that date. If you get the booster at a local pharmacy, please let us know so we can document it. With the CDC coming out with their guidelines last week, here is what I am recommending regarding COVID-19 vaccine boosters:
Finally, there has been some information about a new pill from Merck that has been shown to be helpful in treating COVID-19, but it is currently not approved. When more information is available, we will contact you again.
Flu season is coming soon, and we are making preparations to vaccinate our patients. We had a light flu season last year because we were wearing masks all the time, but this year, with no mask mandates and everything being open, we will probably have many more cases of the flu. We feel the optimal time to get vaccinated in San Diego is late October or November because flu season here peaks around January, and by vaccinating at that time, you will have the most antibodies to protect you around the peak of flu season. However, if you are traveling out of town before November, you can certainly get your vaccine sooner. The CDC usually recommends getting the flu vaccine right now, as early as it's available, but that's because they are more concerned about developing "herd immunity" in a community -- if more people are vaccinated early on, there is less chance that influenza hits that community hard later on.
Once again, we will be carrying TWO different flu vaccines. We have the usual 4-strain (quadrivalent) flu vaccine that everyone is eligible to receive. We also have a HIGH DOSE 4-strain vaccine called Flublok. This vaccine has three times the amount of antigen for 4 different strains, and studies show that it gives 30% better protection than the usual 4-strain flu vaccine when tested in patients ages 50 and above. There is also a "senior” flu shot called Fluzone High-Dose which also protects against 4 strains of influenza. Given a choice between the two of them, I would choose Flublok because it is not grown in eggs, which prevents possible mutations that can occur in egg-grown vaccines. However, the difference is not huge, so if you can’t get Flublok, the Fluzone High-Dose is certainly a good substitute. Therefore, we are recommending the Flublok vaccine in all patients ages 50 and above. If you get your flu shot elsewhere, please let us know so we can document it, as we do try to monitor how many people get their flu shots annually. And if you are going to get a COVID-19 vaccine booster, know that it is OK to receive a COVID-19 vaccine together with a flu shot.
Most insurances, including Medicare, do cover all flu shots, but if it is not covered, Flublok costs around $80. If you happen to be in the Ximed building Tuesday, Wednesdays or Fridays, you can just stop by the office to get the vaccine. If you want to come in on Mondays or Thursdays, please call us first. If you have questions, please contact our office by phone at 858-452-7040 or through your web portal (accessed through www.sun-md.com).
Update on COVID-19 Boosters
We finally have some guidelines on boosters, but things will continue to evolve. This is what we know right now:
COVID-19 Vaccine Boosters
Recently, there has been a lot of information in the news about COVID-19 boosters in people that have already been fully vaccinated. There is some evidence that vaccines may start to lose full effectiveness after a few months, but there is other evidence that protection may last for years. With the current outbreak of the Delta variant, a fair number of people who have been fully vaccinated are still contracting COVID-19, but it is important to note that these breakthrough infections are almost always mild and do not lead to severe disease or death. These are my thoughts on COVID-19 vaccine boosters:
Having said all this, is also true that there have been over a million doses of COVID-19 vaccines that have gone to waste in the US because they have expired or not enough people are choosing to get them. Our office is currently receiving only excess vaccine doses from health facilities that cannot use them, and we are not ordering them directly from the government. From my standpoint, instead of letting these doses go to waste when they expire, I would rather have someone receive them as a booster shot, even before we have definitive evidence that they are beneficial. I feel that as long as there is a chance that a booster shot will be beneficial, and any risks from the shot are negligible, it would be worth putting that vaccine in someone’s arms as opposed to in the trash can. To that end, we are now accumulating a list of people who are interested in receiving a booster shot. Because the data have not come back yet, we cannot say if it would be better to get the same manufacturer as your first vaccine or a different one. We will prioritize individuals over age 65 and those on immunosuppressive medications first, as these individuals are likely going to be the first that will receive approval for a booster shot if and when it is needed. If you are interested, please send us a message through the portal or email us at firstname.lastname@example.org and let us know your name, phone number, and which vaccines you are willing to come in for.
By now, most people who have wanted the COVID-19 vaccine have probably already received it. If you haven’t, or know someone who hasn’t, please read on. With the increasing number of infections in the US right now, it’s important to know the following information:
If you are interested in getting the vaccine, we now have them available to give at our office, so please call us to schedule an appointment.
For those of you who are still hesitant, here are my responses to several of the issues that people may be concerned about:
The vaccine approval process was conducted too quickly
It is true that most vaccines have taken much longer to receive authorization or approval. This is because when a vaccine company starts testing a vaccine, they start off with smaller trials, and only when they are shown to be successful, do they move on to larger and larger trials. Vaccine companies don’t want to spend a lot of money up front since they don’t know if their vaccine will be successful. After their final trials are successful, they then have to manufacture the vaccines, which also takes a lot of time. However, the Trump administration correctly offered to help fund several of the trials to allow them to be conducted much quicker (although Pfizer did not take any such money for their vaccine development), as well as guaranteeing to purchase millions of doses for all their vaccines. This allowed the companies to produce millions of doses even before they knew if their vaccine was going to be successful. If their vaccine was NOT successful, the government would have paid for those doses anyway, they just would not have been administered to people. What this allowed was the immediate distribution of millions of doses that were already manufactured, ready to be given as soon as the Emergency Authorization was received. So while it seems like the time line for the vaccine development and distribution was so short, this was NOT because scientific corners were cut, as all the proper steps were still followed, but instead, this occurred because we conducted and performed all of these steps at the same time, as opposed to waiting for each step to finish before moving on to the next step.
One other important reason why we were able to conduct these studies quickly was because of how prevalent COVID-19 was while the studies were going on in 2020. If you are testing a vaccine against Ebola, you give half the people the vaccine and half the people placebo, and then you have to wait for a while so that enough people get Ebola, and then you can compare the two groups to see if the vaccine group contracted the disease less often. For COVID-19, the disease was so prevalent last year, and we had many high risk groups such as nurses and doctors caring for sick COVID-19 patients in the hospital on a daily basis, that we didn’t have to wait very long before we could see the benefit of the vaccines.
The vaccine is experimental and we don’t know the long term side effects
While it is true that the Pfizer and Moderna vaccines are the first vaccines that utilize messenger RNA (or mRNA) to generate the immune response, that is really not a big deal. Scientists have been researching mRNA vaccines for HIV and Zika virus for years – COVID-19 is just the first mRNA vaccine that has received emergency approval. You should first realize that our genetic material is encoded by DNA in our cells, and in order to translate that DNA into proteins, we use mRNA that our body produces. Therefore, mRNA is not a new substance, and it’s certainly not something that we don’t know anything about. It’s something that is already in each and every one of us right now. The Johnson & Johnson vaccine is called a viral vector vaccine, and it is the same method that the current Ebola vaccine utilizes. This video does a good job explaining the various types of vaccines that are currently being evaluated as ways to deliver the COVID-19 vaccine.
With regards to side effects, it is important to know that other vaccines that we currently use (and that already have FDA approval) do not have any real long-term side effects. There are certainly short-term serious side effects that are possible with the COVID-19 vaccines. However, they are still very rare, so it is important to know about them, but they should be put into perspective.
The important thing to know after reading about these possible side effects is that the COVID-19 vaccines are the most studied vaccines in our history. We are constantly on the lookout for possible side effects, and all the data to this point shows that these vaccines are extremely safe. The major side effects occur in less than 10 cases per 1 million people, which is 0.00001%. Putting it another way, every year, more than 100 people out of 1 million in the US will die in a car accident, so your chance of dying in a car accident each year is significantly higher than a serious side effect from the COVID-19 vaccine, and yet people are willing to take that risk and drive every day. The benefits of being protected with the vaccine far outweigh the risks associated with any possible serious side effects.
So for those of you who have not yet been vaccinated, please reconsider and get vaccinated to protect yourself and those you love. Please call our office if you want to schedule a vaccination or would like to set up an appointment to discuss it further.