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There is some useful new info here from epidemiologist Katelyn
Jetelina on COVID and flu vaccines and diagnostics.--Manny<br>
<br>
<pre class="moz-signature" cols="72">"...it has been said that democracy is the worst form of Government
except for all those other forms that have been tried from time to time..."
Winston S Churchill, November 11, 1947</pre>
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-------- Forwarded Message --------
<table class="moz-email-headers-table" cellspacing="0"
cellpadding="0" border="0">
<tbody>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Subject:
</th>
<td>Top 6 questions answered about fall vaccines</td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Date:
</th>
<td>Tue, 27 Aug 2024 13:47:01 +0000</td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">From:
</th>
<td>Your Local Epidemiologist <a
class="moz-txt-link-rfc2396E"
href="mailto:yourlocalepidemiologist@substack.com"
moz-do-not-send="true"><yourlocalepidemiologist@substack.com></a></td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Reply-To:
</th>
<td>Your Local Epidemiologist
<a class="moz-txt-link-rfc2396E"
href="mailto:reply+2g7bko&a13t&&c2e79ca2bd82ec4774fe5b7f3b224a18dd3230b8ec2665c1d15f2f24cab5e01e@mg1.substack.com"
moz-do-not-send="true"><reply+2g7bko&a13t&&c2e79ca2bd82ec4774fe5b7f3b224a18dd3230b8ec2665c1d15f2f24cab5e01e@mg1.substack.com></a></td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">To: </th>
<td><a class="moz-txt-link-abbreviated"
href="mailto:manny@ratafias.com"
moz-do-not-send="true">manny@ratafias.com</a></td>
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<title>Top 6 questions answered about fall vaccines</title>
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class="preview">Waiting, co-administration, kids, Novavax, and
free at-home antigen tests</div>
<div
style="display:none;font-size:1px;color:#333333;line-height:1px;max-height:0px;max-width:0px;opacity:0;overflow:hidden;"
class="preview">͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
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͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
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͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ </div>
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<p style="color: rgb(54, 55, 55); font-size:
16px; line-height: 26px; margin: 0 0 20px 0;
margin-bottom: 0; margin-top: 0;"><em><span>Si
quiere leer la versión en español, pulse </span><a
href="https://substack.com/redirect/7e9325ea-ba74-422f-a330-28a74d5bc5f2?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
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<h1 class="post-title published"
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Symbol'; font-size: 32px; font-weight: 900;
line-height: 36px; margin: 0;"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=148147800&utm_source=post-email-title&utm_campaign=email-post-title&isFreemail=true&r=a13t&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjE0ODE0NzgwMCwiaWF0IjoxNzI0NzY2NDUwLCJleHAiOjE3MjczNTg0NTAsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.-g7VNLfu83a9b5qIZpwpXyFjGZ67bTtfzl2vCnF0aY8"
style="color: rgb(54, 55, 55);
text-decoration: none;" moz-do-not-send="true">Top
6 questions answered about fall vaccines</a></h1>
<h3 class="subtitle" style="-moz-appearance:
optimizelegibility; -moz-osx-font-smoothing:
antialiased; -webkit-appearance:
optimizelegibility; -webkit-font-smoothing:
antialiased; appearance: optimizelegibility;
color: #777777; font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
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Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 18px; font-weight: normal;
line-height: 24px; margin: 4px 0 0; margin-top:
12px;">Waiting, co-administration, kids,
Novavax, and free at-home antigen tests</h3>
<table role="presentation" class="post-meta"
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margin: 1em 0;" width="100%" cellspacing="0"
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500; letter-spacing:
.2px; line-height:
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href="https://substack.com/@yourlocalepidemiologist"
class="pencraft
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moz-do-not-send="true">Katelyn
Jetelina</a></div>
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style="color: rgb(119,
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11px; font-weight: 500;
letter-spacing: .2px;
line-height: 20px;
list-style: none;
margin: 0;
text-decoration: unset;
text-transform:
uppercase;"><time
datetime="2024-08-27T13:47:12.629Z">Aug
27</time></div>
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<div dir="auto" class="post typography"
style="font-size: 16px; line-height: 26px; padding:
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<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;
margin-top: 0;"><span>We received many follow-up
questions after the </span><a
href="https://substack.com/redirect/ae180301-2c6a-4c53-991b-afa35a873090?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">last YLE email </a><span>about
options for fall vaccines. Here are the
answers to your top questions! </span></p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">The
bottom line is: Get your fall vaccines—it will
cut your risk of diseases by half. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Let’s
dig in. </p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>1. How long after a
Covid-19 infection/vaccination should I wait?</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">We have
frustratingly scarce scientific guidance on
timing. What we do have tells us this:</p>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Minimum
wait: 2-3 months</strong></em><span>. A
Covid-19 vaccine doesn’t add much benefit
within </span><a
href="https://substack.com/redirect/ecb06c63-2864-4ffd-814f-6e6c49ac1145?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">2</a><span>-</span><a
href="https://substack.com/redirect/88705b92-fae7-4fb7-a3d9-07d19660cd3d?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">3 months</a><span> of
infection. We don’t </span><em>have </em><span>to
wait 2-3 months after infection—we won’t
“exhaust” or “overwhelm” our immune
system. But waiting will reinforce our B
cells (our antibody factory that stores
some long-term memory). </span></p>
</li>
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Maximum
wait: 8-12 months. </strong></em><span>The
longer we wait, the more we get out of the
vaccine. </span><a
href="https://substack.com/redirect/d05be848-75ba-4f4f-943c-a424cb8c7c08?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">One study found</a><span>
that waiting 8 months increased
neutralizing antibodies 11 times more than
waiting 3 months after infection, which
would increase the likelihood of
preventing infection. Another </span><a
href="https://substack.com/redirect/72c1a245-68f4-4950-b624-16b5b88caee3?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">study</a><span> found
that a 12-month interval improved vaccine
effectiveness against hospitalization.
But, of course, waiting is a gamble,
especially for high-risk people.</span></p>
</li>
</ul>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Try not
to overthink it. 4-6 months is usually the sweet
spot. Your healthcare provider is an excellent
resource for discussing timing! </p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>2. What if I was </strong><em><strong>not</strong></em><strong>
recently infected? And why are vaccines
becoming available </strong><em><strong>after
</strong></em><strong>the Covid-19 summer
peaked? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">The U.S.
government is trying to force our seasonal flu
model to fit Covid-19, but it’s not working
well. Covid-19 is clearly not a once-a-year
thing—it’s now settled in two waves per year.
These vaccines were initially planned in
anticipation of the winter wave, but the FDA
pushed the release up because we’ve had such a
big summer wave. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>This
makes it very hard to decide </span><em>when</em><span>
to get the Covid-19 vaccine if you have </span><em><strong>not
recently had an infection or vaccination</strong></em><span>:
Get it now or wait until late fall. I’ve
struggled with the decision but decided to
wait until Halloween. It will still take some
time for vaccines to make it to doctors’
offices, and then a vaccine will still take
two weeks to work. By then, we will
(hopefully) be well on our way down the
current wave. Since I’m not high-risk, I might
as well wait to catch the next wave, which
will coincide with fun holiday activities I
don’t want to miss. </span></p>
<blockquote style="border-left: 4px solid #538cfa;
margin: 20px 0; padding: 0;">
<p style="color: rgb(54, 55, 55); font-size:
16px; line-height: 26px; margin: 0 0 20px 0;
margin-left: 20px;"><span>(Dr. Jen Dowd—one of
my favorite scientific communicators— just
wrote a great post for those seeking more
advice on timing. </span><a
href="https://substack.com/redirect/46abf278-1f2d-4616-bce5-787a7603b39a?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">Check it out here.</a><span>)</span></p>
</blockquote>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>Regardless,
if the U.S. wants Covid-19 vaccines to have a
dramatic population-level effect—like how flu
vaccines reduce the impact of flu yearly on
hospitals and individual disruptions—we need
to have vaccines </span><em>before</em><span> a
wave. Implementation would be challenging but
not impossible. </span></p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>3. Can I get the
flu and Covid-19 vaccine at the same visit?</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Yes!
This is called co-administration, and it’s
recommended for convenience—you don’t have to
visit the pharmacy or doctor twice. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>Studies
have been </span><a
href="https://substack.com/redirect/8a035dbd-a105-4682-a02e-227988079aec?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">conducted </a><span>on
the safety and effectiveness of
co-administration with Covid-19 vaccines. In
one database, about 454,000 people got the flu
and Covid-19 vaccines. Both worked great. The
rate of side effects was the same or a little
higher among those who co-administered;
however, no specific safety concerns were
identified.</span></p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="1456" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/952f0753-0f85-43e9-8a46-19bbf0aa0e6f?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/c31f61b3-1211-4d35-9eb9-1baac129acb1_1456x502.jpeg","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":502,"width":1456,"resizeWidth":null,"bytes":null,"alt":null,"title":null,"type":null,"href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2912,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fc31f61b3-1211-4d35-9eb9-1baac129acb1_1456x502.jpeg"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="189.62912087912088"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;">(Source: CDC)</figcaption></figure>
</div>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">There is
no combined shot. (Some companies are working on
it. Maybe next year?)</p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>4. Is it worth it
for kids? What do other countries do? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">In the
U.S., everyone 6 months and older is eligible
for Covid-19, similar to other countries (like
Canada or Japan). Kids in the U.K. or Australia
qualify for the Covid-19 vaccine if they have a
pre-existing condition. (Note: Not all kids get
the flu vaccine in these countries either mainly
due to the cost—the government pays for the
vaccine, so they must consider this.) </p>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Death</strong></em><span>:
Covid-19 is about as deadly as the flu
among kids but far less risky than for
older adults (or those under 6 months
old). Covid-19 is more risky for those
under 6 months, which is why it’s
important to get the vaccine during
pregnancy. </span></p>
</li>
</ul>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="1176" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/e92c3793-bb81-451e-927c-99f6b66cae68?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/7076dca0-c41f-4b71-a216-2900619b8466_1176x934.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":934,"width":1176,"resizeWidth":null,"bytes":null,"alt":null,"title":null,"type":null,"href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2352,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7076dca0-c41f-4b71-a216-2900619b8466_1176x934.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="436.81972789115645"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
</figure>
</div>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Effectiveness</strong></em><span>:
They work for kids. Last season, the
pediatric vaccines provided ~60%
additional protection against going to
urgent care for Covid-19, compared to not
getting the vaccine. </span></p>
</li>
</ul>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="1350" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/b64322ee-f4b0-42ee-9d77-ab004873f1f8?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/9f35971c-9e62-411a-a127-a91db1070300_1350x632.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":632,"width":1350,"resizeWidth":null,"bytes":436385,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2700,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9f35971c-9e62-411a-a127-a91db1070300_1350x632.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="257.48148148148147"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;"><span>(Source: </span><a
href="https://substack.com/redirect/e3b94831-82e2-4ad5-b342-c56d84ca1f85?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="text-decoration: underline;"
moz-do-not-send="true">CDC</a><span>)</span></figcaption></figure>
</div>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Safety</strong></em><span>:
Unfortunately, the public hasn’t seen
myocarditis (i.e., inflammation of the
heart muscle) data for last season yet,
but there’s no reason to think it’s
changed—while there is a safety signal
among young men, the risk dropped
dramatically for boosters. </span><a
href="https://substack.com/redirect/0d95d599-a42b-4eb2-928d-071615a49649?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">An analysis last
year</a><span> showed that the benefits
still outweigh the risks. The most common
causes of myocarditis are viral </span><em>infections</em><span>,
where it’s typically </span><a
href="https://substack.com/redirect/b89cf965-865e-4bf4-9920-fe795091e1ca?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">much more severe</a><span>.
</span></p>
</li>
</ul>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Missed
school days</strong></em><span>: I’m
frustrated that we don’t have robust data
for other outcomes, such as reduced sick
days. Since vaccination prevents ~20% of
infections in the first few months, we can
assume vaccines reduce sick days “a bit.”
But other than that, we don’t know, which
is unhelpful for parental decision-making.
</span></p>
</li>
</ul>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>5. Are you sure
that Novavax isn’t better than mRNA vaccines?
</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>Both
are good shots. I’m uncomfortable saying one
is immunologically better than the other.
We’ve had some head-to-head studies (</span><a
href="https://substack.com/redirect/dcaafe96-f8ea-4188-a364-c4f1a337bbaf?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">here</a><span>,
</span><a
href="https://substack.com/redirect/3f6fb20f-7830-4ded-a42e-466ada6532e1?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">here</a><span>,
</span><a
href="https://substack.com/redirect/927fcb03-c4d9-4d69-b1a7-fe0d4805f3f8?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">here</a><span>,
and </span><a
href="https://substack.com/redirect/e0ad99d5-5149-4f74-aa09-e416a32f5b7e?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">here</a><span>)
showing lots of similarities and some subtle
differences:</span></p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><em><strong>Similarities</strong></em></p>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;">Both provide a solid
first line of defense (i.e., neutralizing
antibodies), which helps prevent infection
in the first months (but is not perfect.) </p>
</li>
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;">Both strengthen a
solid second line of defense (i.e., T
cells), which helps prevent severe disease.
</p>
</li>
</ul>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><em><strong>Differences</strong></em></p>
<ol style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Negative</strong></em><span>:
Novavax produced lower levels of a
specific antibody called IgG. This </span><em>may</em><span>
contribute to </span><a
href="https://substack.com/redirect/ae6c035c-109a-432a-9716-4b61ad0d0dd1?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
text-decoration: none;"
moz-do-not-send="true">more infections</a><span>
after Novavax than mRNA vaccines. </span></p>
</li>
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Positive</strong></em><span>:
Novavax had a more durable response over
time (waned less quickly).</span></p>
</li>
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Positive</strong></em><span>:
Novavax has fewer side effects, like pain
and muscle aches. For this reason alone, I
will be getting Novavax this fall.</span></p>
</li>
</ol>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="574" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/9558fc9a-b25d-4cc4-9544-921864dc558f?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/d599e1ef-e53a-476c-bc4c-79b553c23ab6_1038x950.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":950,"width":1038,"resizeWidth":574,"bytes":313917,"alt":"","title":null,"type":"image/png","href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" title="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_1148,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd599e1ef-e53a-476c-bc4c-79b553c23ab6_1038x950.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="503.37186897880537"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;"><span>Side effects from varying
combinations of COVID-19 vaccines. Figure
from the Lancet, with YLE annotations.
Original source </span><a
href="https://substack.com/redirect/e0ad99d5-5149-4f74-aa09-e416a32f5b7e?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="text-decoration: underline;"
moz-do-not-send="true">here</a><span>.</span></figcaption></figure>
</div>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>6. Free antigen
tests will be available again this season. </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>The
U.S. government </span><a
href="https://substack.com/redirect/665b9e82-456b-4f42-96a4-0381cf9e3a4e?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">plans</a><span>
to give each household four free at-home
Covid-19 tests again this season. This should
open in late September. I will be sure to
update you when you can order your tests. </span></p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>There
are </span><a
href="https://substack.com/redirect/85d6452b-a572-46dc-a08d-820b04531ade?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">flu/Covid-19
combined at-home antigen tests now</a><span>.
There isn’t one for RSV yet. </span></p>
<div style="font-size: 16px; line-height: 26px;">
<hr style="background: #e6e6e6; border: none;
height: 1px; margin: 32px 0; padding: 0;"></div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>Bottom line</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Fall is
almost here! Make a plan to get your vaccines.
The best vaccine is the one you get. Our
priority is preventing severe disease among
high-risk individuals, but staying up to date
has secondary benefits for everyone! </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Love,
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