February 29, 2024
Leap day
Many of you have heard the new CDC recommendation that came out yesterday after the CDC’s ACIP meeting. ACIP (Advisory Committee on Immunization Practices) is an external scientific committee that meets to discuss all vaccines. They focused on data that shows a few pertinent things.
This winter, 20,000 people a week have been hospitalized with COVID, and up to 2000 a week have died from COVID.
16% of hospitalized patients are immunocompromised, a higher percent than the general population of 3-4%.
About 2/3rds of hospitalized patients between October and January were 65 and older. Those over 75 were more than half.
The majority of hospitalized patients were unvaccinated or had not received the most up-to-date vaccine.
In October and November, adults who received a fall dose accounted for 4 percent of Covid-related hospitalizations. Those who got a booster in the fall of 2022, but not the updated vaccine this fall, accounted for 25 percent.
The new XBB fall vaccine is about 40-50% effective against symptomatic infection or hospitalizations.
That may not seem like much but: At this point after 4 years, nearly 100% of people have been infected and/or vaccinated, which means the fall vaccine gave extra protection to the new variant.
Only about 5% of adults in the US are up to date on their vaccines. Vaccine confidence has declined. (Or vaccine fatigue is part of it.)
The updated vaccine is safe. A new study from Denmark looked for adverse events after vaccination with the XBB.1.5 vaccine given last fall to more than 1 million adults aged 65 years and older. No increased risk of 28 adverse events was observed following vaccination with.
ACIP ended their meeting with the statement that “Those over 65 should get a second updated COVID vaccine this spring.” Older adults and those with weakened immune systems would benefit the most. They don’t feel it’s cost effective in adults 18-64 years old if they are healthy and at low risk.
It makes sense to consider getting a booster, especially if you are older than 75, or immunocompromised. Or if you didn’t get the fall vaccine. You might consider waiting if you’re healthy or if you’ve had a recent infection. That will boost your immunity. (I know so many people who’ve had infections these past few months. Most have done well, with vaccines and Paxlovid as needed. If you are one of them, no need to run to the pharmacy, probably OK to wait for the fall.)
If you do get the booster, consider getting it in a different arm this time. (If you can remember!) It might work better.
Katelyn Jetelina of Your Local Epidemiologist fame has a great analysis of the meeting and recommendations on a booster.
Hang in there. Spring is on its way.
Stay sensible.
And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available. Thanks for reading.
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https://www.nytimes.com/2024/02/28/health/covid-boosters-spring-older.html?unlocked_article_code=1.ZU0._Vvq.iiV1JunGdETl&smid=url-share
https://www.medpagetoday.com/infectiousdisease/covid19vaccine/108943
https://jamanetwork.com/journals/jama/fullarticle/2815787
https://www.nytimes.com/2024/02/06/health/vaccines-arms-immunity.html?unlocked_article_code=1.ZU0.jVdy.a8yI0zsjn3Zc&smid=url-share