By Tony Shields, M.D., Ph.D. / Detroit
Another Covid-19 vaccine injection! Actually, it’s just what I wanted. The FDA and then the CDC approved the updated vaccines two days ago (September 1), and I was excited to find a place to get the injection today.
So far, I have been spared a Covid-19 infection. Unfortunately, many family members, friends, patients, and colleagues have recently had Covid-19, presumably from one of the new BA.4 or BA.5 omicron subvariants. Almost all have had previous Covid-19 vaccinations, and some have had previous infections.
I have already had four previous vaccinations, including the J & J vaccine for the original study in November 2020, which I wrote about in The Insider. Additionally, I received two Moderna injections in October 2021, and a Pfizer booster in March 2022. While I know that these injections decrease the risk of infection and severe disease, the antibody levels decrease within months, and they have limited efficacy against the omicron variants. Hence, my desire was to get one of the updated Moderna (SPIKEVAX) or Pfizer (COMIRNATY) bivalent vaccines.
The updated vaccines are based on the technology using mRNA, which has already been shown to be successful, although not providing the long-lasting Covid-19 protection we wished. One advantage of this new vaccine development method is that it is easy to switch the mRNA sequence to provide protection for new variants.
That said, the efficacy of the updated vaccines is still under study. The companies have shown in limited trials in patients using both new vaccines that they are safe. They have also demonstrated that patients receiving these new vaccines produce improved antibody responses against the omicron variants. It will take more months to prove that these vaccines effectively prevent infections and decrease symptoms in those infected.
At this point, many of us don’t feel that we have time to wait for those results and the risk of another injection is minimal. This is the approach already used to produce and distribute influenza vaccines. Scientists produce new flu vaccines each year based on the strains found around the world at that time. The new influenza shots undergo limited testing to demonstrate safety, and efficacy results are collected over the flu season. We can’t wait for complete data on the influenza vaccines each year, and we must act with limited data on the updated Covid-19 vaccines.
I have been watching with great interest to find out when the updated Covid-19 vaccines would be approved and distributed. Since their approval two days ago, I have been searching the web and drug stores online to find out when and where to get them. I was pleasantly surprised that they were available in some limited places today (September 3). I immediately signed up and was pleased to get a slot seven miles from my home this afternoon.
The websites for the pharmacy chains are variable in their ease of use. For example, the CVS website just said that I could get a booster and did not specify whether it was the updated vaccine. I had to call and verify that I would be getting the new vaccine.
Actually, the FDA removed authorization to use the old versions of the vaccines as boosters when they approved the new ones. One of our friends signed up and was told by the pharmacy that they still had the old vaccine version and that no one had the latest version. It turns out that they were speaking with uninformed pharmacists and were able to get the new version. A family member in Seattle was pleased to sign up to get the vaccine today, but then realized that the scheduled pharmacy was a 1.5-hour drive away. Over the next few days, the updated vaccines should become more available, but finding one near you may still take some work.
We don’t know of any apparent differences between the updated Pfizer and Moderna vaccines, so take what you can get. The FDA and CDC state that you should not get an updated booster within two months of a previous booster. It may be better to wait three to four months. The previous booster may limit the efficacy of the updated shot. There is no clear guidance for people who have had recent infections, but I think that these timing guidelines make sense in that situation too.
I would encourage everyone to think about getting the updated vaccines. After a few hours, my arm hurts a little, but hopefully, I will have very mild side effects with this injection as I did with the previous ones. While it is no guarantee that you will not get a Covid-19 infection after getting the updated vaccine, I would take every option to decrease your risk of infection and severe disease.
Tony is an oncologist with an M.D. from Harvard and a Ph.D. in biology from M.I.T, where he studied viruses that cause cancer. He is currently a professor of oncology at Wayne State University, where he works on the development of new imaging methods and therapeutics. He is also a practicing medical oncologist at the Barbara Ann Karmanos Cancer Institute in Detroit, where he is Associate Center Director for Clinical Sciences. Since 1996, he has participated in more than 500 cancer research and drug trials as the principal investigator or participated as a co-investigator.