Now that the FDA, and subsequently the CDC, have approved a fourth COVID vaccine, or a second booster, for ages fifty-plus and the immunocompromised, many around the country are trying to decide of the extra shot is necessary.
Wednesday, Dr. Gregory Poland of Mayo Clinic in Rochester, Minnesota, talked to WCCO’s Paul and Jordana Show to clear up questions and provide some of the latest data on how best to protect yourself from COVID and the new variants.
Poland is one of the nation’s leading experts on immunogenetics of vaccine response and has been a consultant for both the FDA and CDC during the pandemic.
Is the FDA requiring the second booster or is it optional?
“This is what is called a permissive recommendation. It's not an ‘ought to’ or ‘should’, it's a permissive. Now if you're immunocompromised and if you're elderly, and pick your number, for sure over 70-75 something like that, different story. Absolutely get that booster.”
If I’m under 50 and generally healthy, should I still consider a second booster?
“For the rest of us that are healthy here's the data. It's based on an Israeli study of a little over half a million people. When they got that second booster, the death rate decreased by 78%. What does that mean though? It means it went from .1 percent to .03 percent. The people who are in trouble are the people who haven't gotten a booster or who haven't gotten vaccinated.”
Why would the FDA make this permissive right now?
“It's because what the FDA wants to do is have this in place, so if the BA2 (variant) or God forbid the XE, XD or XF variants takeoff, other variants were watching, if those take off, they want to be prepared.
Remember that in the last week or two, the BA2 variant in the state of Minnesota has tripled. So it's about 30% of the new cases. When you get to the whole U.S. it's now about 55%. We were a month or so ago, down at one, three, four percent. In the northeast corridor of the U. S. It's over 70% of the new cases. And the reason for it is BA2 is about 50% more infectious and transmissible than Omicron was. And we look at the nasal viral loads, those viral loads with BA2 are two to ten times higher than Omicron was. No more increase in severity of disease but much more contagious. Which is why this is spreading so quickly, and it happened just as people took their masks off and pretended the pandemic was over.”
If there's no more increase in severity and Omicron did not create severe illness, is there a need for elevated concern?
“It's speculation at this point. We have generally followed the UK, Israel and Europe. In the UK, they have had about a 20% increase in hospitalizations and deaths. We are not seeing that so far. In fact, last week we had one of our first days in Minnesota where nobody died of COVID.
Now that hasn't been sustained. So we're making progress. It’s one of those things, if we could convince everybody, be sure you've got your two doses and your booster at a minimum, and wear your masks indoors, we would quickly get a handle on this thing. But, that's not what's happening, unfortunately. For the people who are otherwise healthy, have gotten three doses of vaccine, don't have significant underlying medical problems, this is meh. But for people who are unvaccinated or haven't gotten at least that one booster, this is potentially significant for them.”
If I had two shots of the Johnson & Johnson vaccine, should I get a third from J&J too?
“The best thing you can do, this is new data out, if you've gotten two doses of J&J get an MRNA vaccine (Pfizer or Moderna) if it's possible for you. Two doses of J&J is about 67% effective against hospitalization due to Omicron. If you get an MRNA you elevate that up to about 90%.”
If I’m fully vaccinated and boosted with either Pfizer or Moderna, is it a good idea to mix up which booster you get?
“The easy answer because we have data here, is that mixing it up, so called heterologous boosting, and actually gives you better immunity. So if you've got two doses of Moderna get a Pfizer. If you've got two doses of Pfizer, get a Moderna.”
If I’m vaccinated and boosted, could I still get one of the new variants of COVID?
“If you got to get either one of the MRNA vaccines, you could still get the new variant. But if you otherwise have a normal immune system you're as protected as you can be right now. The problem for all of us, whether it's illness-induced immunity or vaccine immunity, is it wanes with time. In this case the best immunity is even waning over the course of 90 days, or so.”
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