[Hac-announce] Fwd: Do I need a spring booster?

Manny Sholem Ratafia manny at ratafias.com
Tue Apr 25 10:16:26 EDT 2023


This just came in and I thought I'd share it. Epidemiologist Katelyn 
Jetelina does a good job helping you decide on whether to get a second 
COVID-19 updated (bivalent) booster vaccine now. The key factors are 
your age, any health conditions you may have, how long it has been since 
you got your first updated booster, and any upcoming social events you 
may have.

Manny

"Failure is unimportant. It takes courage to make a fool of yourself."
— Charlie Chaplin



-------- Forwarded Message --------
Subject: 	Do I need a spring booster?
Date: 	Tue, 25 Apr 2023 12:51:37 +0000
From: 	Katelyn Jetelina from Your Local Epidemiologist 
<yourlocalepidemiologist at substack.com>
Reply-To: 	Katelyn Jetelina from Your Local Epidemiologist 
<reply+1xnsiz&a13t&&749b32fdbbd697875c9311388b602b280560249650b1c0a60dae20f1ed64bf69 at mg1.substack.com> 

To: 	manny at ratafias.com



Do I need a spring booster?
The booster confusion in emails I have received over the past week is 
palpable. Should I get a spring booster? This is how I’m thinking about 
it. Hopefully it helps. Level of urgency The level of urgency for a 
spring booster should be dependent on two things: 
  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

	
	

	
Open in app 
<https://open.substack.com/pub/yourlocalepidemiologist/p/do-i-need-a-spring-booster?utm_source=email&redirect=app-store> 
or online 
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<https://substack.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.wciNS7XxplA0iUvG4dmQgJD9y1ocezfdZRgEH4d4MDA?> 


/Si quiere leer la versión en español, pulse aquí 
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------------------------------------------------------------------------


  Do I need a spring booster?
  <https://substack.com/app-link/post?publication_id=281219&post_id=117003563&utm_source=post-email-title&isFreemail=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjExNzAwMzU2MywiaWF0IjoxNjgyNDI3MTE2LCJleHAiOjE2ODUwMTkxMTYsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.5yhpE7yUk1DDFep6uMkFGHI0o-3RO1ioNcbudUhU-iQ>

Katelyn Jetelina 
<https://substack.com/redirect/87734c6d-0af0-42aa-8960-24582c61df24?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>

Apr 25

	
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The booster confusion in emails I have received over the past week is 
palpable. /Should I get a spring booster/?

This is how I’m thinking about it. Hopefully it helps.


        Level of urgency

The level of urgency for a spring booster should be dependent on two 
things:

/*1. Risk factors. */Ninety percent of people in the hospital “for” or 
“with” COVID-19 do /not/have a bivalent vaccine (i.e. fall booster). 
This group has the highest level of urgency.

If you had the fall booster, you’re in pretty good shape against acute 
severe disease. /Will this change with time?/We don’t know. The U.S. 
(and a handful of other countries) don’t want to risk finding out, so a 
spring booster is “permissible”.

People in the hospital today for COVID-19 are older adults and/or those 
with a comorbidity. (If you want to know why, read more here 
<https://substack.com/redirect/ca64fbd0-2719-4829-9953-a15cff69fe95?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>.) 
This means groups with the second highest level of urgency for a spring 
booster are those with a fall booster and:

  *

    Adults over 75 years;

  *

    Adults over the age of 65 years with a comorbidity; and,

  *

    Moderate or severely immunocompromised.

If you’re not in one of these groups, your level of urgency is 
/significantly /reduced. You could time a booster for maximum 
protection. If I were over 65 /without/a comorbidity, I would, 
especially since wastewater concentration is nosediving 
<https://substack.com/redirect/f5416f32-825a-41c6-a475-f183eb532681?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>. 
For example, four weeks before a really big event you don’t want to 
miss, like a wedding, get a booster. Or wait to get a booster on the 
chance that another variant of concern comes (and get it right before a 
wave).


	<https://substack.com/redirect/efafda3a-b7b5-4e28-8215-20f76ed119a7?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo> 	

/*2. Timing. */If you’re in one of the urgent groups, the next question 
is: /When was your last infection or vaccine? /

  *

    6+ months ago: Go get a spring booster today.

  *

    4-6 months: Schedule one, but you don’t need to rush to the pharmacy.

  *

    <4 months: Wait. But do not wait until past May/June, so that you
    enough runway time before the (anticipated) fall vaccine.


        Potential individual-level risks

People are wondering about risks of spring boosters. The risks are 
small, especially when we compare them to risks resulting from 
infection. Perhaps the following risks should really only be considered 
for those who are /not /in the high-urgency groups above.

  *

    /*Myocarditis*/. This is the biggest risk of COVID-19 vaccines but
    is really only a problem for adolescents. (Benefits still outweigh
    risks. There is also a risk of myocarditis from COVID-19 infection.)

  *

    /*Flu vaccine.*/There may be an increased risk of stroke
    <https://substack.com/redirect/0403416c-2a92-4463-9e23-c9ca42539adf?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>if
    you get flu and COVID-19 vaccines at the same time. This shouldn’t
    be a problem for your spring decision.

  *

    /*Side effects*/. Some people get their butt kicked from side
    effects immediately after the vaccine. Some just don’t have the
    ability to be out of commission for a few days.

  *

    /*Imprinting*/. We know imprinting is a thing with COVID-19. And, we
    /should /expect imprinting. (Read a deep dive here
    <https://substack.com/redirect/8b0eb562-eba0-4016-b502-a8258265fd02?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>.)
    The biggest influence of imprinting occurs after first exposure to
    the virus (through vaccine or infection). We still don’t have good
    evidence that imprinting is /harming /protection, though.

  *

    /*Unknown unknowns*/. We simply don’t know the risks of stimulating
    the immune system with 6 shots in 2 years, too. There are always
    unknown risks, albeit small.


        Bottom line

Anyone who hasn’t had a bivalent vaccine (i.e. fall Omicron booster) 
needs to get one. If you have your bivalent already, there is a spectrum 
of urgency. Try not to overthink it too much.

Love, YLE

------------------------------------------------------------------------

/“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, 
MPH PhD—an epidemiologist, data scientist, wife, and mom of two little 
girls. During the day she works at a nonpartisan health policy think 
tank and is a senior scientific consultant to a number of organizations, 
including the CDC. At night she writes this newsletter. Her main goal is 
to “translate” the ever-evolving public health science so that people 
will be well equipped to make evidence-based decisions. This newsletter 
is free thanks to the generous support of fellow YLE community members. 
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