Category: Covid-19 Vaccine

Dr. Dorry Segev, doctor at Johns Hopkins Medical CenterThe world quickly got less safe for immunosuppressed people.

Segev isstudying the effectiveness of a third dose, hoping "there's something we will ultimately be able to do for transplant patients."

He hopes to soon launch a formal interventional trial, providing a third shotin a clinical setting, where he can ensure safety and track participants' response.

A handful of patients already have started getting extra shots simply showing up at vaccination centers and not admitting that they've already been vaccinated. It would be far safer, Segev said, for them to get that third dose through a clinical trial.He is now looking for volunteers at transplantvaccine.org.

"It's really important for this to be out there so people know this is happening," he said.

Segev hoped that although transplant patients didn't develop antibodies, they might still have some protection against COVID-19.

Unfortunately, his and other hospitals are starting to admit transplant patients who contracted COVID-19 after being fully vaccinated. "That's almost unheard of in the general population," he said. "We're seeing this at a much higher rate in transplantation."

Segev, who recentlyexamined 30 patientswho'd had a third shot, said there were no safety issues except in one person who had a low-grade rejection event a week after the final dose. But that problem might have started before the shot. "Wedon't see a strong signal for it now," he said about possible rejection.

Dr. Dorry Segev will look at whether transplant patients who failed to develop a response after two doses of mRNA vaccines made by Pfizer-BioNTech and Moderna will fare any better after a booster shot.David Zalubowski, AP

Segev also will look at whether transplant patients who failed to develop a response after two doses of mRNA vaccines made by Pfizer-BioNTech and Moderna will fare any better after a booster. (His earlier research suggested that thesingle J&J vaccine was even less protective for transplant patients than the two-shot vaccines.)

Data can't come in fast enough for people who are worried vaccines may not keep them safe, Montgomery said.

"This is the No.1problem in our field right now," he said.

Luckily, most other immunocompromised people will get better protection than transplant patients, experts say.

Vaccines appear to be just as safe for them,and most seem to get at least some protection.

The problem is, it's impossible at this point to know how safe someone is. For the general population, which is more than 90% protected by the vaccines, there's no need to worry, experts said.

For people who are immunocompromised, there's no good way to tell if they're protected. Antibody tests, which look for some types of protective antibodies, may not tell the whole story and are only a snapshot in time, said Dr. Gil Melmed, who directsinflammatory bowel disease clinical research atCedars-Sinai Medical Center in Los Angeles. The CDC hasdiscouraged people from using the tests.

In everyone, antibodies are likely to decline over time, and it's not clear what level is protective.

Vaccines also generate T cells,often called the soldiers ofthe immune system, whichseem to provide longer-termprotection, but there are no commercially available tests to look for them.

To ensure they are safe, people who are immunocompromised should "build a wall of protection" around themselves, by getting vaccinated and making sure everyone around them also is vaccinated said Dr. Rajesh Gandhi, an infectious disease specialist at Massachusetts General Hospital.

Researchers believe people develop long-protecting T cells in response to vaccination, though they're hard to test for.Getty Images

"I don't think we're quite ready to throw caution to the wind," added Dr. Joshua Katz, a neurologist at the TuftsUniversity School of Medicine, also in Boston. He recommends his patients continue to take precautions like masking, and ensuring that people around them are vaccinated.

Dr. SamirParekh, a multiple myeloma specialist atThe Tisch Cancer Institute at Mount Sinai in New York, says immunocompromised patients should talk with their doctor about using accurateantibody testing to identify if they're at particular risk. "We are recommending testing for our myeloma patients who have immune suppression from their cancer as well as chemotherapy treatments," he said.

For patients with irritable bowel syndrome, vaccines appear to be safe and to provide about 80% protection, which is lower than fortotally healthy peoplebut still good, Melmed said.

Heruns a registry tracking 1,800 inflammatory bowel disease patients to understand how they react to vaccination. He said it's too soon to know if IBD patients are getting more "breakthrough infections" after vaccination than the general population, but he hasn't seen worse outcomes among his registry members.

Melmed hopes the registry will help teach researchers vaccine protection wanes over time, and whether it fades faster in people, like his IBD patients, who are immunocompromised.

Multiple sclerosis patients have been on a "roller coaster ride" for the past year, Katz said, with worries and fears about COVID-19. It turns out they are not an increased risk for catching COVID-19, he said, and vaccination poses no extra risk for someone with the disease.

The National Multiple Sclerosis Society encourages everyone with MS to get vaccinated againstCOVID-19.

Stay safe and informed with updates on the spread of the coronavirus

Whether vaccination is effective in MS patientsseems to depend on which treatmentthey are on out of the 16-17 available, Katz said. Most people on the drug Mavenclad(cladribine), for instance, were well protected by COVID-19 vaccines, while only about 20% ofthose on Gilenya(fingolimod) andOcrevus(ocrelizumab) made antibodies, he said.

Yet in a study of Ocrevus, even those who didn't make antibodies still made extra white blood cells after vaccination, suggesting they got some protection, he said.

For cancer patients, the amount of protection varies by cancer type and where they are in their treatment.

About 98% of people with solid tumors developed protective antibodies after vaccination, according to one study published this monthin the journal Cancer Cell.By comparison, only 85% of blood cancer patients and about 70% of those on strong immune system therapies developed antibodies.

If cancer patients do catchCOVID-19, they should consider getting monoclonal antibodies, said Dr. CraigBunnell, chief medical officer and a breast cancer specialist at the Dana-Farber Cancer Institute in Boston.HANDOUT

People should get vaccinated before starting chemotherapy if possible, saidDr. JohnZaia, who directs theCenter for Gene Therapy atCity of Hope, which runs cancer centers in California. If that's not possible, they should delay vaccination until theend of their chemotherapy treatments to get the best response to the shots, he said.

Zaia is leading research into a COVID-19 vaccine developed at City of Hope specifically for cancer patients, using a platform designed for bone marrow transplant patients who lose protection from all vaccines during their transplant. Zaia said he has tested the vaccine so far in 60 healthy people and will next compare its effectiveness against the Pfizer-BioNTech vaccine.

If cancer patients do catchCOVID-19, they should consider getting monoclonal antibodies, drugs that help reduce the chances of a severe case of the disease, said Dr. CraigBunnell, chief medical officer and a breast cancer specialist at the Dana-Farber Cancer Institute in Boston.

The same drugs may prove effective at preventing infection in people, like cancer patients, who can't get protection from vaccines, he added. Studies to confirm this are underway.

Unfortunately, Nadeem-Baker belongs to thegroup with the least protection from vaccines and the highest risk for catching COVID-19.

The CDC's decision last month to lift the mask recommendation for those who had been vaccinated made her life worse. Even the unvaccinated took off their masks.

"Dropping the mask mandate heightened my sense of fear," said Nadeem-Baker, a former corporate communications executive-turnedblood cancer patient advocate.She's particularly anxious about the variants, which seem to spread more quickly.

"I want to go back to living normally, just like everyone else," she said."I feel like I'm outside of life looking in."

Her college-student son moved out to protect her. Her husband strips just inside the front door, putting all his clothes into a garbage bag to be washed. Her sister, who was widowed last year, is going into quarantine soon to pay her first visit. "I have not been able to hug her," she said.

The only things she feels comfortable doing, with her doctor's blessing,are taking nature walks or rides with her dog, and diningin the backyard with vaccinated friends.

Nadeem-Baker wishes strangers would be more understanding of those like her, who have to keep wearing a mask. "We're doingthe best we can," she said. "I'm tired of explaining it."

She would consider joining a clinical trial to find out whether a third shot would be helpful for people like her.

"I hope something like that can help," she said. "I just want something that works."

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

Do you know an immunocompromised individual concerned about COVID-19 vaccine effectiveness? Share this story.

Published10:27 am UTC Jun. 27, 2021Updated10:30 am UTC Jun. 27, 2021

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It isnt over for us: For those with weakened immune systems, COVID-19 vaccines dont mean the end of the pandemic - USA TODAY

Governor Tom Wolf today announced that 75 percent of Pennsylvanians aged 18 and older have now received at least one COVID-19 vaccination.

Together, Pennsylvanians have hit a significant milestone in our fight against COVID-19, said Gov. Wolf. Now, three out of four Pennsylvania adults have done their part in keeping themselves and their loved ones safe by getting at least one COVID-19 vaccination. We should be proud of how far we have come, as data shows us that with increased vaccination rates, we see a decline in COVID-19 cases. We have watched our percent positivity rate decline week after week as evident in our current positivity rate of 1.2 percent as opposed to 1.4 percent last week.

Pennsylvania has surpassed the aggressive goal set forth by President Joe Biden of 70 percent of adults receiving at least one dose of the COVID-19 vaccine by July 4 and ranks 8th in the nation for first dose vaccinations. Additionally, 59.5 percent of Pennsylvanians aged 18 and older are fully vaccinated.

As we celebrate this milestone, we must continue to inform all eligible Pennsylvanians about the effectiveness of the available vaccines and the importance of getting their second dose. They remain our best defense against this deadly virus and the potential threat of the delta variant. We each have the tools needed to make our communities safer, healthier places, by getting vaccinated, continuing to wear masks as needed and staying home if we are sick. It is our collective responsibility to remain resilient and do our part for our fellow Pennsylvanians.

All Pennsylvanians age 12 and older are eligible to schedule a COVID-19 vaccine. UseVaccine Finderto find a COVID-19 vaccine provider near you.

For more information and data on the Wolf Administrations vaccine efforts, click here.

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Gov. Wolf: 75 Percent of Pennsylvanians Have Received First COVID-19 Vaccination - pa.gov

A sign urges people to get tested for a COVID-19 variant in Blackburn, England. The U.K. is experiencing a surge in the delta variant, which was first identified in India. Oli Scarff/AFP via Getty Images hide caption

A sign urges people to get tested for a COVID-19 variant in Blackburn, England. The U.K. is experiencing a surge in the delta variant, which was first identified in India.

Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.

I've been vaccinated. Do I need to worry about variants?

That depends on a few things including your personal risk tolerance.

But first off, know that your vaccine is quite valuable. The COVID-19 vaccines are expected to be protective against the new virus variants, according to the World Health Organization.

Exactly how much the various vaccines protect against the delta variant the newest form of the virus that the Centers for Disease Control and Prevention has dubbed a "variant of concern" is still somewhat of a guessing game. But if you're fully vaccinated (two weeks after your second dose) the odds are highly favorable that you won't get a breakthrough COVID-19 infection, and even better that if you are one of the unfortunate few, you won't get a severe case.

"At least for those vaccines approved in Europe and North America, in the case of the variants, these seem to be effective in preventing severe disease, hospitalization and death," says Dr. Jerome Kim, director general of the International Vaccine Institute.

The alpha variant, first identified in the U.K., is around 50% more transmissible than the original form of the virus. The Pfizer vaccine was found to be 90% effective against the most severe forms of infection (i.e., those resulting in hospitalization or death) caused by this variant. That study also showed high protection against the beta variant, first spotted in South Africa.

A study from Public Health England, an agency of the Department of Health and Social Care in the U.K., found that AstraZeneca also showed a high level of effectiveness against alpha, with an 86% reduction of hospitalizations. The study has not yet been published.

The delta variant is expected to overtake the alpha variant as the main form of the virus in the United States. More than 20% of new cases in the U.S. are already due to the delta variant.

Since the delta variant is even more transmissible about 60% higher than alpha that's what people in the U.S. will be at highest risk of soon. It's part of the reason the CDC upgraded delta from a variant of interest to a variant of concern.

Experts are also concerned because therapies such as monoclonal antibodies and convalescent serum don't seem to work as well against this variant, says Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine.

As for the vaccines, one study of the delta variant in Scotland from the University of Edinburgh found that while the variant was associated with a doubling in the risk of hospitalization in those infected in the region, the Pfizer and AstraZeneca vaccines offered a 79% and 60% protection, respectively, against infection two weeks after the second dose. And a study from Public Health England showed that two doses of the Pfizer vaccine were 88% effective against symptomatic disease from the delta variant.

As for other vaccines, David Montefiori, director of the Laboratory for AIDS Vaccine Research and Development at Duke University Medical Center, is optimistic. Based on research he has conducted that has not yet been published, including the Moderna vaccine, he says that "delta does not look like it will be much of a threat to vaccines."

And Weatherhead has this to say about Johnson & Johnson's effectiveness for the delta variant: "We just don't have the data, but that doesn't mean it's not efficacious. We know it works against [other variants]. We're going to have breakthrough infections, but the vaccines really prevent severe disease and death."

Just keep in mind that vaccines aren't effective the second you get them, she adds.

"The problem is you're really not protected until you've gotten both doses of the vaccines and you've waited two weeks afterward," she says. "So you're still vulnerable in between. That's why it's so important to get vaccinated now, before [delta] becomes the dominant variant circulating."

Think about the vaccine as a really good raincoat, suggests Dr. Leana Wen, an emergency physician and public health professor at George Washington University. "If it's drizzling out, you're not going to get wet, and even if it's raining hard, you probably won't get wet. But if there's a hurricane or a thunderstorm, there's a chance you'll get wet."

In that case, people who really don't want to get wet might want an additional layer of protection. Other people may not mind getting damp.

Both of those are reasonable conclusions, Wen says. If the delta or "delta plus," an even newer mutation just discovered in India turns out to be a thunderstorm in your area, some vaccinated people may want to rely on the same precautions we've adopted throughout the pandemic: masking up, physical distancing when you're with unvaccinated people and getting tested when traveling upon arrival and departure to make sure you aren't carrying any variants into or out of your destination.

Just like stormy weather, outbreaks of COVID-19 due to the delta variant will likely be localized. But unlike a weather forecast, it's easy to predict where they'll happen: wherever there are high rates of unvaccinated people, Dr. Anthony Fauci of the National Institutes of Health has said.

Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She's written about COVID-19 for many publications, including Medscape, Kaiser Health News, Science News for Students and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.

Pranav Baskar is a freelance journalist who regularly answers coronavirus FAQs for NPR.

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Will My COVID-19 Vaccine Protect Me From Variants? : Goats and Soda - NPR

As the pandemic eases globally thanks to nearly 3 billion COVID-19 doses administered worldwide so far, Turkey has managed to get a top spot among the countries inoculating their citizens against the disease.

According to information gathered from Oxford Universitys Ourworldindata.org website, the country with the most vaccines administered is China with over 1.12 billion jabs, followed by the United States with over 320 million, India with over 300 million, Brazil with nearly 93 million, the United Kingdom with 75.5 million, Germany with 70.5 million, France with nearly 49 million, Italy with 48.3 million and Turkey with over 46 million doses.

Meanwhile, Turkey rolled out a new stage in its coronavirus vaccination drive Friday, with people over the age of 18 now able to get their jabs. They will be the last group to be vaccinated as the Health Ministry tries to convince those who were in previously eligible groups but who have shunned doses to reconsider.

With appointments open, youth rushed to the online appointment app and filled hospitals and clinics on Friday morning for their shots. It was a much-anticipated stage in the pandemic for youngsters, who were repeatedly warned to adhere to coronavirus measures as a group, thought to be least affected by the virus but more prone to easily infecting others. Their inclusion will boost vaccination numbers, which reached more than 46 million on Friday, with 14.7 million people now being fully vaccinated.

Everyone should get vaccinated. We have to trust the science of medicine and we need to protect ourselves, 19-year-old Ece elikkol said as she arrived at the Ankara City Hospital in the capital for vaccination.

Asl Cansu Bora, 21, said she was afraid of the potential side effects of vaccines but decided to have it as a citizen with awareness of the need for vaccination to overcome the pandemic.

Dr. Selmani Doan, the deputy chief physician of Dr. Sadi Konuk Training and Research Hospital in Istanbul, said they were seeing an increasing demand for vaccination. He told Anadolu Agency (AA) that more young people are expected next week as this weekends university admission exams may disrupt registrations.

Doan said they also sent crews to shopping malls and outdoor venues to set up vaccination booths to increase the drive. The Health Ministry has a vaccination schedule and it is very busy now. We have to prioritize vaccination to return to normal life, to return to the days when we did not have to wear masks, Doan said.

Yaman Erdoan, a 19-year-old university student, said he applied for vaccination because he wanted his school to be fully reopened for in-person education without the risk of infections.

Health Minister Fahrettin Koca on Friday shared the vaccination rates for provinces and named Edirne in the northwest as the province with the highest rate of inoculation at more than 68%. Edirne is followed by Amasya, Eskiehir and anakkale where the rate for each is around 67%.

Under a campaign entitled We Roll Up Our Sleeves, the Health Ministry seeks to convince vaccine skeptics to get their jabs, as they are now the last group not getting inoculated. The ministry set up vaccine persuasion crews all across the country. Crews visit skeptics at home and explain the benefits of vaccination. If they are convinced, citizens are delivered jabs on site or directed to the nearest hospital.

Ultimately, those below the age of 18 will be the only group exempted from vaccination, though a final decision on the issue has not been made yet.

Professor Serap imek Yavuz, a member of the Health Ministrys Coronavirus Scientific Advisory Board, told Demirren News Agency (DHA) on Friday that children may be administered a lower dose of vaccines. She said they are monitoring the results of vaccinations among children and young adults in other countries and may consider giving a low, single dose to children, and if two doses are needed, may prolong the period between two doses.

After combating vaccine hesitancy and delays in vaccine imports, Turkey went on to break daily vaccination records, surpassing 1 million per day this month. The numbers are a result of the Health Ministrys inclusion of new groups in the campaign, almost on a daily basis. Though the campaign began with a focus on age, with the oldest citizens vaccinated first, it expanded into occupational groups regardless of age this summer, from teachers to factory workers. Venues were also diversified and the public can now have their jabs in factories, in the fields and orchards where they work, or as in some cities, at malls or tents set up at busy squares.

The drive also gained momentum with the arrival of more shipments of vaccines from Pfizer-BioNTech and Chinas Sinovac. Russias Sputnik V vaccine is also expected to be available soon.

In the meantime, a locally made inactive vaccine launched its Phase 3 trials this week.

The inactive coronavirus vaccine began Phase 3 trials recently at a ceremony attended by Turkish President Recep Tayyip Erdoan. The first volunteers were injected with the jab, which was named Turkovac by Erdoan.

The vaccine is being developed in cooperation with Erciyes University and the Health Institutes of Turkey. It was tentatively named Erucov-Vac, after the name of the university. It is expected to be the first locally-made vaccine to be available in the country if it receives approval from the Health Ministry after safety tests. Earlier, authorities announced that it may be available before the end of 2021.

Speaking during a videocall to officials, including Health Minister Fahrettin Koca, at the ceremony held at the vaccine application center at Ankara City Hospital, Erdoan said the locally made vaccine was critical to save Turkey from the threat of a pandemic. This is the last stage to have our own vaccine. I hope the vaccine will start mass production and have widespread use soon. I call upon our citizens to get vaccinated as soon as possible to protect themselves and their loved ones from this (pandemic), Erdoan said.

Amid a nationwide fall in COVID-19 cases, Turkey is set to end all restrictions, which include nighttime curfews and a full lockdown on Sundays, as of July 1.

On June 1, the country eased some measures following a 17-day strict lockdown.

Since December 2019, the pandemic has claimed over 3.9 million lives in 192 countries and regions, with more than 180.1 million cases reported worldwide, according to Johns Hopkins University.

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Turkey 9th globally in number of COVID-19 vaccines administered | Daily Sabah - Daily Sabah

A teenager enters a pop-up COVID-19 vaccine site this month in the Jackson Heights neighborhood of Queens in New York City. Scott Heins/Getty Images hide caption

A teenager enters a pop-up COVID-19 vaccine site this month in the Jackson Heights neighborhood of Queens in New York City.

The Centers for Disease Control and Prevention says 323 cases of heart inflammation have been verified in people who received the Pfizer or Moderna COVID-19 vaccine.

The cases of myocarditis and pericarditis have been seen mostly in teens and young adults between 12 and 39 years old mostly after the second vaccine dose.

Most people who have experienced this side effect have recovered from symptoms and are doing well, according to data presented Wednesday at a public meeting of the CDC's vaccine advisory committee. Of the 323 cases, 295 were discharged from the hospital, nine remained hospitalized as of last week and 14 were not hospitalized at all. Outcome data was missing for five of the cases. No deaths have been associated with this side effect.

Symptoms include chest pain or pressure and difficulty breathing, says Dr. Kristen Sexson Tejtel, a cardiologist at Texas Children's Hospital who has treated people with the vaccine-related condition. For people experiencing symptoms, "the best thing to do is to talk to their physician or come to the emergency room for evaluation," Tejtel says, where blood tests and heart imaging results can confirm the diagnosis.

The CDC says there have been some cases of heart inflammation reported after the Johnson & Johnson vaccine to the Vaccine Adverse Events Reporting System, though not as many as with the Moderna and Pfizer vaccines.

The number of cases has not risen much from last week when CDC Director Rochelle Walensky told reporters at a White House briefing that the agency knew of "over 300" cases.

The CDC says the findings do not change the basic recommendation that all people 12 and older should receive either the Pfizer or Moderna vaccine. However, the CDC recommends that if a person develops myocarditis after the first dose, a second dose should be delayed until the condition has fully resolved and the heart has returned to a normal state.

"The facts are clear: this is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination," officials said in a statement. "Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment. In addition, we know that myocarditis and pericarditis are much more common if you get COVID-19, and the risks to the heart from COVID-19 infection can be more severe."

Health experts agree that the benefits of being protected from COVID-19 outweigh the risks of developing this temporary heart condition from a vaccine. "There's no zero risk proposition," says Dr. Brian Feingold, medical director of the heart transplant program at Children's Hospital of Pittsburgh. "If you're statistically going after what's safest, the data right now stacks up [to show] that vaccines are absolutely the safer route."

A representative from the Food and Drug Administration attending the meeting, Dr. Doran Fink, said the agency would add a warning to vaccine fact sheets reflecting the risk of this rare complication.

Naturally occurring heart inflammation is rare, but it does occur from time to time in teens and young adults. The rate seen after these vaccines is slightly higher than would be expected for these ages, prompting concern.

Teenagers get vaccination cards after receiving a first dose of the Pfizer COVID-19 vaccine last month at a mobile clinic at the Weingart East Los Angeles YMCA in Los Angeles. Patrick T. Fallon/AFP via Getty Images hide caption

Teenagers get vaccination cards after receiving a first dose of the Pfizer COVID-19 vaccine last month at a mobile clinic at the Weingart East Los Angeles YMCA in Los Angeles.

The group is also looking at the issue of booster doses. A report from the CDC presented to the expert panel says that the agency would recommend a booster dose only after seeing evidence that people who've gotten the vaccines have started getting infected in significant numbers. The agency would not rely solely on a decline in antibodies.

The Advisory Committee on Immunization Practices issues recommendations for the use and scheduling of all approved and authorized vaccines in the United States. It did not vote on any recommendations Wednesday regarding the use of the Pfizer or Moderna vaccines.

Pien Huang contributed to this report

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Heart Inflammation In Teens And Young Adults After COVID-19 Vaccine Is Rare, CDC Says - NPR

Wyatt Steach didnt have much to say as he pressed a bootheel into the rumbling varnish machine inside the cramped workshop of Flat Iron Boot & Shoe Repair and Rorys Saddlery in Molalla.

Steach, one of hundreds of thousands of Oregonians yet to get vaccinated against the coronavirus, said he was healthy, that the pandemic had been blown out of proportion and that getting a shot against the disease wouldnt change his life much.

I dont really see the use in it, the 17-year-old said, clamming up as sweat gathered on his forehead.

Todd Temples, left, and Wyatt Steach working on boots and other leather goods inside Rorys Saddlery in Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

Steach is far from an outlier in Molalla, where he lives in a ZIP code with the smallest percentage of people vaccinated against COVID-19 compared to any sizable ZIP code in the Portland metro area.

Only about 38% of the 97038 ZIP codes population of 15,000 has received a shot, state data show. And its areas like this that Oregon officials are trying to reach in their last marathon to vaccinate at least 70% of the population.

Though about 5% of the ZIP codes residents have contracted COVID-19, some believe COVID-19 wont affect them personally. Others recoil at the thought of putting something unfamiliar into their bodies. And others are tired of the social and government pressure to get vaccinated.

About 45 minutes drive south from Portland, past fields of hay bales, aging barns and neat stacks of wood behind lumber mill fences, Molalla and its surroundings are classic rural Oregon.

Inside The Spot Again in downtown Molalla. June 22, 2021 Beth Nakamura/Staff

A six-wheel pickup truck with U.S. and Dont Tread on Me flags rumbles down a residential street. Log trucks filled to capacity shake Main Street at least every 15 minutes. A worker at a drive-in burger joint wearing a tie-dye bandana and an American flag T-shirt delivers $6.75-burger baskets to the cars waiting outside in the heat.

Its not easy to understand why vaccination efforts havent made substantial inroads in this Clackamas County town. Those who are adamantly opposed to the vaccine generally dont want to talk about it with a reporter, saying theyre afraid of losing their jobs.

Molallas mayor declined an interview. Tootie Smith, the county chair who lives in the Molalla area and famously said in November she would celebrate Thanksgiving with family despite Gov. Kate Browns request to limit gatherings, was not available for an interview.

Downtown Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

But behind the reticence is what some locals say are deep-seated fault-lines.

There doesnt seem to be a middle ground, longtime Molalla barber Harold Hall said as he trimmed a longtime customers white hair. Either theyve taken it or theyre not going to take it.

Hall, 81, seemed to be among the few at the shop taking the subject seriously on a recent Tuesday.

A Hobart Oil Company calendar depicting a stagecoach in the western desert hung on a wall, and three baseball caps hung off a hat rack by the door. One of the hats, with the words Trump 2024 and The revenge tour emblazoned on the front, was hung there by someone after a Trump rally.

Inside Halls Barber Shop in downtown Molalla, Oregon. From left, Mike, a customer, gets his hair cut by Lenny Keller, 77, at the shop. At right, Harold Hall, 81, owner of the shop, cuts Ray Elliss hair. June 22, 2021 Beth Nakamura/Staff

Most of his customers have been vaccinated because, he said, the majority in here have been older gentlemen.

Be careful there, Harold, the man sitting in a waiting chair said to rounds of laughter. The man, who refused to give his name, had apparently been so sick with COVID-19 that he wasnt sure he would survive.

We were hoping hed pay for a couple of haircuts ahead of time, said Lenny Keller, a barber working at the only other chair in the shop.

Hall recently tried to convince a customer who was adamant she wouldnt get a shot. He reminded her that vaccines against chickenpox, polio and other diseases have saved countless lives.

Hall said he wishes he could have changed her mind but, he said, she was too entrenched in her opinion to budge.

Theres nothing thats going to shut this thing down except the vaccine, Hall said.

Inside Halls Barber Shop in downtown Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

And while the reasons for the division surrounding COVID-19 are vivid for some like Hall, others are less aware of the towns two sides.

Really? Mary Aubrey said from behind the bar at The Spot Again when told Molalla has among the lowest vaccination rates in Oregon. Thats weird.

Nearly everyone who comes into the saloon says theyve been vaccinated, Aubrey said. She rolled her eyes and laughed listing some of the conspiracy theories shes heard from those who havent gotten shots.

You know, all the classics, Aubrey said, including that the vaccine can cause infertility and that the shots are a vehicle for microchips. I just dont think the government is organized enough to do something like that.

Don Rollins, 73, left, and Wayne Doc Tyre, 83, inside The Spot Again in downtown Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

A small group of old friends sitting at a table for their weekly Tuesday morning drinks also struggled to understand.

Thats surprising, said Wayne Doc Tyre, 83, with a 63-year-old tattoo of a dagger and the blacked-out name of an ex-girlfriend on his left forearm. I have no idea why they dont.

Tyres friend, a 30-year-veteran of three Clackamas county lumber mills, nursed a Busch Light. Another, a retired truck driver wearing suspenders, a cowboy hat and a hearing aid, asked for another whisky.

All three men were vaccinated. So were most -- if not all -- of their friends and family. It seemed like a no-brainer, they said.

Its not a good choice, Tyre said of going without the shot. I would want to live instead of being on a ventilator or dying.

Inside The Spot Again in downtown Molalla. June 22, 2021 Beth Nakamura/Staff

But for some locals, its not about conspiracy theories, but a way of life and a way of thinking.

A lot of people are very logical and think critically about these things, Wyatts mother, Diana Steach, said in a phone interview.

An instructional assistant at the local high school, Steach declined to give her personal opinion on the vaccine, wary of influencing students. But, she said, given the information people in the community have, they would rather just wait and see.

Steach isnt the only one who wants to keep private health matters private.

Inside The Spot Again in downtown Molalla. June 22, 2021 Beth Nakamura/Staff

One of her friends, Ms. Marshall, appeared to resent the seemingly constant pressure to get vaccinated. She asked that her full name not be used because she feared being targeted for her opinions.

I just think people need to stay out of other peoples health business, said Marshall, who had breast cancer and is afraid that the COVID-19 vaccine could affect the medicine she takes to keep the cancer in remission.

And by people, Marshall meant the government, too.

I think their job is to protect our rights and let us make the best decisions for ourselves, Marshall said. I mean thats what America is about, is freedom.

Downtown Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

Another friend, Heather, said the pressure to get vaccinated triggers a fight or flight response because people feel forced to do something they legitimately fear could harm them.

Youre getting pressure from every direction, Heather said, including employers, the government and people around you who seem to think if you didnt do it, you dont care about people.

A Molalla resident in her late 30s, Heather made clear she is not an anti-vaxxer. All four of her children have received the standard course of shots for measles, mumps and rubella, she said. But with how little time the COVID-19 vaccine has been out there, its too early to be sure it is safe, she said.

At this point in the game, everyone should be making their own decisions about their lives, said Heather, asking that her full name not be used to protect her job.

More than 317 million doses of COVID-19 vaccines have been administered in the United States so far, under the most intense safety monitoring in U.S. history, according to the Centers for Disease Control and Prevention.

For every million COVID-19 doses given, about two to five people have a serious allergic reaction, the agency said. And 36 out of the 12 million people who got the Johnson & Johnson vaccine developed potentially life-threatening blood clots.

Rory Waddell, left, and Todd Temples take a break during the day outside Flat Iron Boot & Shoe Repair and Rorys Saddlery in Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

Back at Flat Iron Boot & Shoe Repair and Rorys Saddlery, two middle-aged men in jeans, denim shirts and black denim aprons caked with dried glue sat on either side of the shops open doors, one of them smoking a Camel cigarette.

Owner Rory Waddell, 59, said he only got a shot because of his wife. He said she works at a lumber mill and was worried about exposure to truckers who come from all around Oregon and out of state, as well as the many customers who see Waddell every day. She got vaccinated and told him she wouldnt let him come home unless he did, too.

One of his employees felt no such pressure. Todd Temples said he hadnt been sick with anything in seven years, which he thinks could be because he eats a lot of spicy food.

Inside Flat Iron Boot & Shoe Repair and Rorys Saddlery in Molalla, Oregon. June 22, 2021 Beth Nakamura/Staff

Temples, 47, was much more excited to talk about his work than the vaccine. Leather boots, saddles, holsters, bags, scabbards, saddle bags, reins, ranch ropes and billets line the walls on the way to Temples worktable, where he had strips of leather that hell craft into a holster.

He eagerly scrolled through photos on his iPad showing the many holsters he had repaired or made from scratch in 2021.

Eh, Temples said, shrugging his shoulders and spreading his arms in a dismissive gesture when asked about the vaccine.

Todd Temples hasnt been vaccinated for COVID-19 and isnt interested in getting the vaccination, he said. June 22, 2021 Beth Nakamura/Staff

Hes not the kind of person to do that, he said. Hes got a bad toothache now and wont take painkillers for it.

I dont trust anything thats manmade, Temples said. Its just too risky.

Yet he bristles at others reaction to his decision.

They cant really understand why, Temples said. Its my deal. Its not theirs.

Data journalist Mark Friesen contributed to this report.

-- Fedor Zarkhin

fzarkhin@oregonian.com|503-294-7674

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No middle ground: How the COVID-19 vaccine split one Oregon town - OregonLive

Midway through Americas first mass-immunization campaign against the coronavirus, experts are already girding themselves for the next. The speedy rollout of wildly effective shots in countries such as the United States, where more than half the population has received at least one dose of a COVID-19 vaccine, has shown remarkable progressfinally, slowly, steadily beating the coronavirus back. But as people inch toward something tantalizingly resembling pre-pandemic life, a cloud hangs over our transcendent summer of change: the specter of vaccine failure. We spent months building up shields against the virus, and we still dont know how long we can expect that protection to last.

To keep our bodies from slipping back toward our immunological square one, where the virus could pummel the population again, researchers are looking to vaccine boostersanother round of shots that will buoy our defenses. Around the world, scientists have already begun to dole out these jabs on an experimental basis, tinkering with their ingredients, packaging, and dosing in the hope that theyll be ready long before theyre needed.

When exactly that will be, however, is well, complicated. Nearly all the experts I spoke with for this story said that the need for boosters is looking more and more likely, but no one knows for sure when theyll arrive, what the best ones will look like, or how often theyll be needed, assuming theyre part of our future at all. What underlies this uncertainty isnt scientific ignorance: We know the signs that will portend an ebb in vaccine protection, and were actively looking for them. But their timing could still surprise us. The immunization process is much less akin to erecting an impenetrable fortress than it is to prepping forgetful students for an exam full of unpredictable questions. We can cram with flash cards for weeks, but to some degree we just have to cross our fingers and hope were still well studied when the pop quiz arrives.

Read: Expect the unexpected from the Delta variant

That same brand of bet-hedging is unfolding on a global scale. Around the world, researchers and vaccine manufacturers have been, for months, preparing for what seems to be an inevitable end to our immunological dtente with the virus. But these experts are also playing a very hard and very necessary waiting game. The only way well really know the best approach to boosters is to allow the vaccines to show their weak points, then patch them as soon as they arise.

There are at least two major ways that COVID-19 vaccines could falter. The first might best be described as a memory lapse, and its a bit of a flub on the human side: Left to its own devices, the immune system slowly loses its intellectual grasp on the pathogen, and is much less prepared the next time it sees it. The second is a mismatch between what immune cells studied and what ended up on the final exam: a mutation in the coronavirus that alters its appearance so significantly that it becomes unrecognizable, even if immune memory of the vaccine remains intact. Designing and deploying boosters requires keeping tabs on these two fast-changing variables at once.

Memory lapses can, in theory, be easier to detect and repair: Researchers take blood samples from vaccinated people and track the levels of different immune actors, such as antibodies and T cells. If those levels start to dip below a crucial protective threshold, its time to offer a booster. This approach works well in certain boosting regimens, such as the Hepatitis B vaccine for health-care workers, But sussing out this so-called correlate of protection typically takes gobs and gobs of data. For many vaccines, even ones that have been in use for decades, such as the mumps vaccine, those numbers still arent clear-cut. SARS-CoV-2s correlate remains elusive.

Read: Show your immune system some love

We do have, at least, hints about the longevity of vaccine protection. Antibodies that recognize SARS-CoV-2 are known to stick around in high numbers for at least six months after the first round of shots is administered. John Wherry, an immunologist at the University of Pennsylvania, told me that, based on the data hes seen, he suspects that antibody levels will hold their own for at least a couple of years after vaccination, though antibodies represent just a sliver of the complex immune response to the coronavirus. There have also been encouragingly few breakthroughs, or infections in people who have been fully vaccinated. An unexpected uptick in these cases would serve as a canary in the coal mine for public-health experts, an indication that protection was ebbing, Sallie Permar, the chair of pediatrics at Weill Cornell Medicine and NewYork-Presbyterian Komansky Childrens Hospital, told me. (The chickenpox vaccine, originally conceived of as a one-and-done shot, became a two-doser in the U.S. in the 2000s to stamp out breakthroughs, including some potentially linked to waning antibody levels, in the years after kids got their first jab.)

Virus mutations can be even tougher to pin down and predict than immunological memory lapses. No known variants have yet managed to fully flummox our current repertoire of vaccines, and none yet seems to be disproportionately causing breakthroughs. But certain versions of the virus do seem more resistant to vaccine-driven antibodies in the laba hint that the pathogen is becoming more and more unfamiliar to the immune cells that studied it. Some experts are worried that, if enough alterations occur, we may need another round of mass inoculations as early as this fall, possibly with an updated vaccine recipe that accommodates the viruss shape-shifting forma more labor-intensive approach than simply juicing people up with more of the OG inoculation.

In a way, our vaccines stellar track record is an ironic hindrance to the process of improving them. Without more long-term data on their shortcomings, epidemiologists and vaccinologists are effectively trying to predict the weather in a climate theyve only just discovered. No universal litmus test exists for making decisions about boostersno single definition for what would constitute a concerning rise in cases, no flare that goes off when our immune cells are hit with microbial amnesia, no spoilers that warn of the coronaviruss next metamorphosis. Instead, the experts are left to determine their own benchmarks for boosters, by evaluating the available information on antibody levels, breakthroughs, variant surveillance, and how different versions of the virus fare in labs and animal models, all while being mindful of the pandemics progress on scales both local and global.

All of this intel then gets fed into a risk-benefit analysis, to determine whether the need for boosters outweighs any possible costs, which can span the medical to the economic, says Grace Lee, a pediatrician at Stanford University and a member of the CDCs Advisory Committee on Immunization Practices. Thats all before public-health officials have to coordinate the logistics of getting another round of vaccines into peoplea campaign that will inevitably reawaken the issues about trust, equity, and access still stymieing our current rollout. And even after boosters debut, agencies like the CDC might tinker with the playbooks for years or decades to get the scheduling just right. (The CDC did not answer questions about the nature of future boosting efforts, noting only that the need for and timing of COVID-19 booster doses have not been established.)

Even amid all this uncertainty, the road to boosting wont be a fumble in the dark. In the past year and a half, millions of SARS-CoV-2 genomes have been sequenced, helping researchers monitor the viruss every genetic change; other scientists are monitoring the vaccinated, in the hope of catching or even predicting the inflection point, when our immune protection against the virus might start to drop. By the time our first round of shots starts to lose its oomph, contingency plans will have long ago been set in motion.

Some companies and researchers have already started experimentally doling out additional jabs. Johnson & Johnson representatives told me that their single-dose vaccine is being tested as a two-doser, while Moderna and Pfizer have confirmed that theyre checking whether third shots, some of which have been specially reformulated to fight worrisome variants, can better equip immune systems to tussle with new versions of the virus. The National Institutes of Health recently announced a clinical trial that will offer a Moderna booster to participants who were vaccinated three to five months prior. And researchers at Johns Hopkins are exploring whether certain immunocompromised peoplea group at higher risk of not responding to standard-issue vaccinesmight benefit from a third injection. These individuals and others with less exuberant immune systems, such as older people, might need boosters sooner than the rest of us, says Ali Ellebedy, an immunologist at Washington University in St. Louis.

Read: COVID-19 vaccines are entering uncharted immune territory

Several boosting trials will take a mix-and-match approach, offering vaccines that differ in formulation from the first COVID-19 shot people tooka Moderna boost for people who initially got Pfizer, for instance. If so-called heterologous boosting is safe and effective, future rounds of shots will be much easier to give: People wont have to scour their neighborhood for a company-specific vaccination clinicor waste time struggling to remember which shot they got months or years ago. Hybrid inoculations could even improve on the original plan, potentially by marshaling different branches of the immune system, as they have with vaccines against HIV, Ebola, and tuberculosis. Delivered in succession, different types of COVID-19 shots could, in theory, build a punchier and more cohesive response because of their diverse packagingand perhaps provide more comprehensive protection when it comes to variants, Srilatha Edupuganti, an infectious-disease physician and vaccinologist at the Emory Vaccine Center, one of the sites for the NIH trial, told me.

New vaccine recipes, which havent yet been cleared, could also play a role in future vaccination efforts. Some researchers are looking outside the spike protein, to see whether they can build shots that contain more instructive bits of SARS-CoV-2 anatomy. A few are experimenting with delivering vaccines as oral drops or nasal sprays that might coax out an airway-specific immune response, to head off the coronavirus at its natural point of entry. This whole rigmarole will get easier if we eventually find SARS-CoV-2s elusive correlate of protection, which will probably involve a specific kind of antibody: Instead of running long, expensive clinical trials to determine a vaccines efficacy, scientists can just check whether it marshals an immune response strong enough to match or exceed the threshold. Its what we dream about, Permar told me. Vaccines would be so much easier to develop and test. Theres even talk of developing universal vaccines that could accommodate a wide range of potential variants, perhaps cutting down on the amount of mutant-specific tinkering well need to do in the future, and the number of shots well need to give.

Boosting in perpetuity isnt an ideal option, if we can avoid it. For some shots, the severity of side effects can ratchet up with each additional dose. (Some evidence exists that the mix-and-match approach might come with nastier side effects as well.) Vaccinating too often is also possible: At a certain point, cells will stop learning efficiently from the material vaccines provide, and essentially burn out from information overload, Wherry told me. Perhaps the heaviest immunization schedule well end up with is one thats already familiar: annual shots, like those we develop for the flu, each reformulated to tackle a slightly different set of strains. But many experts think thats not terribly likely. Flu viruses mutate faster than coronaviruses do, and hop between animals and humans much more frequently, giving them more opportunity to mutate.

The world is better served when were judicious with vaccines, after all, and inoculate as needed, no more, no less. A lot would feel wrong about lining people up for a second or third helping of a COVID-19 vaccine while billions around the world have yet to receive their first dose, Krutika Kuppalli, an infectious-disease physician at the Medical University of South Carolina, told me. Every unprotected person represents another potential depot for the virus to establish itself and mutate, and jump ahead of our vaccines once again. Getting more first shots into arms means slowing the viruss spread, and limiting its costume changes. It means, perhaps, delaying our need for boosters a little while longer.

Here is the original post:

COVID-19 Vaccine Booster Shots Are Probably Inevitable - The Atlantic

With the vaccine behind me, I feel hopeful for the future for the first time in over a year.

Having an autoimmune disease is tough physically, mentally, and emotionally. Having an autoimmune disease during a pandemic? That is a completely new experience that I wasnt prepared for.

I have ulcerative colitis (UC), a type of inflammatory bowel disease (IBD), and have been fighting a flare-up off and on throughout all of 2020. I like to say that I was quarantining before quarantining was cool.

I finally felt a glimmer of hope mixed with a twinge of uncertainty when the Centers for Disease Control and Prevention (CDC) announced that a COVID-19 vaccine was finally available.

Was it going to work? Was it going to make my disease worse? So many questions were living rent-free in my brain.

I did so much research about the effects of the vaccine on people with IBD and initially found very little. I want to share my experience in the hope that it will help you make an educated decision on COVID-19 vaccination for yourself.

Im not going to lie: I was hesitant about getting the vaccine at first. Like many people, I truly didnt know if I even wanted or should get the vaccine.

For a while, I was in the camp of absolutely not. My body had started heading into remission and was sensitive beyond belief. The last thing I needed was a foreign substance in my body.

However, I continued seeing more positive research coming out about trial participants with autoimmune diseases, as well as medical leaders encouraging people with IBD to get the vaccine.

Additionally, I did not want to suffer the effects of COVID-19 on top of my existing symptoms.

Ultimately, I chose to get vaccinated.

I did not make this decision lightly. People with an autoimmune disease, myself included, are at greater risk of having severe complications from COVID-19 and I did not want to risk it. On top of that, the chronic stress and fear of getting COVID-19 that I have felt for over a year now have wreaked havoc on my gut and my overall well-being.

On the other hand, the side effects of the vaccine on autoimmune patients are very minimal and provide me with peace of mind in knowing that I am protected.

I weighed all the pros and cons and decided that the reward outweighed the risk.

I was a ball of nerves driving up to the vaccination site on my appointment day, not knowing what to expect. However, the overall experience was a positive one.

I waited in line for no more than 10 minutes, and the injection was completely painless. I then waited in the car for 15 minutes in case of an allergic reaction and drove home.

In the hours after the first dose, I actually felt better than I have felt since the start of my flare-up. Coincidentally, my symptoms were less severe, and I had more energy than normal. (I am not sure yet if the vaccine caused the improvement of my symptoms, but I look forward to reading studies on the vaccine and IBD to see if this is related.)

I heard from friends that the second dose was far worse than the first, so I braced myself. My first dose went exceedingly well, but I feared this would be the moment I would feel the negative effects. I even prepped all my food for the next few days in case I didnt feel well enough to cook.

The overall experience again was very positive, and the actual injection was not painful. Later that evening, I felt run down and a little tired, so I drank a lot of water and went to bed early.

Fearing the worst, I woke up in the morning and did a quick mental scan of my body. But I felt normal.

I cautiously waited the rest of the day for the symptoms to set in and they never did. I feel extremely lucky to not have experienced more intense symptoms, especially when I already had symptoms from my UC flare-up.

With the vaccine behind me, I feel hopeful for the future for the first time in over a year. I feel like a huge weight has been lifted and that I can rest easy knowing that I am protected from this awful virus.

My vaccinated future feels bright. You will find me at a bar laughing with friends, playing beach volleyball, and singing my heart out at a country concert. These are all things that seemed so basic and normal in 2019, and yet these are the moments that I will cherish in 2021.

Every person is unique and, therefore, will have their own individual experience with the vaccine.

However, I hope my story and experience will help you to weigh your options regarding your health and the vaccine.

Holly Fowler is a Certified Health Coach and personal trainer in Los Angeles. She loves hiking, spending time at the beach, trying the latest gluten-free hot spot in town, and working out as much as her ulcerative colitis allows. When she isnt seeking out gluten-free vegan dessert, you can find her working behind the scenes of her website and Instagram, or curled up on the couch bingeing the latest true-crime documentary on Netflix.

Link:

My Experience with the COVID-19 Vaccine and IBD - Healthline

The states COVID-19 vaccination incentive campaign today announced the five winners of its second week of prize giveaways.

The five new winners include Sarah Delgadillo of Oahu, who won 100,000 HawaiianMiles from Hawaiian Airlines; Gary Oliveira of Maui, who won 100,000 Marriott Bonvoy Points; Jon Bynes of Oahu, who won two round-trip tickets on Alaska Airlines; Brent Muraoka of Oahu, who won a round-trip ticket on Southwest Airlines; and Alan Matsui of Oahu, who also won a round-trip ticket on Southwest Airlines.

The campaign, which was launched June 4, offers Hawaii residents ages 18 and up who get at least one COVID-19 vaccine by June 30 a chance to register to win a smorgasbord of prizes, including the round-trip tickets, a trip to Las Vegas for two, a two-night stay at the Kahala Hotel & Resort, along with gift cards, Zippys for a year, and other winnings.

Accuity LLP, an independent accounting firm, is providing official contest verification services to ensure winners are selected fairly and according to the official contest rules.

The first two winners of HawaiianMiles and Alaska Airlines round-trip tickets were announced last week. Another set of winners will be announced next Wednesday.

Nearly 20 businesses have donated prizes to the campaign, and more than 80 businesses are offering discounts and deals throughout the month of June for vaccinated individuals.

The #HIGotVaccinated campaign is supported by Adventist Health Castle, ConnectWorks, H&B Marketing, Hawaii Pacific Health, Humana, Kaiser Permanente Hawaii, Maui Health, MDX Hawaii, The Queens Health Systems, and Hawaiis business community.

As of today, more than 1.6 million doses had been administered in the state; 57.2% of Hawaiis population of about 1.4 million have completed vaccinations, while 62% have received at least one dose.

The COVID-19 vaccine is free at hundreds of sites across the state, including local pharmacies, hospitals, and pop-up clinics, including one this Saturday at Honolulu Zoo and the Honolulu Stadium Swap Meet.

To register for the #higotvaccinated incentives campaign, visit higotvaccinated.com. To find a place to get a COVID-19 vaccine, visit hawaiicovid19.com/vaccine-info.

More:

5 winners announced in Hawaiis COVID-19 vaccination incentive campaign - Honolulu Star-Advertiser

The first thing you need to know about COVID-19 booster shots is that nothing about them has been set in stone.

There is no guarantee we will need them one day. There is no guarantee we wont.

To make matters murkier, its also unclear just what a booster shot would have to accomplish, should it become necessary.

If scientists discover that immunity to the coronavirus starts to wane months or years after vaccination, a booster could be deployed to extend that immunity.

If a new variant emerges that is impervious to the immunity offered by our current vaccines, a booster would be required to broaden our protection to include this new foe.

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Unfortunately, scientists are already seeing evidence that the immunity provided by our initial vaccines will not last forever.

In a study published Wednesday in the journal ACS Nano, scientists found that people lost an average of 90% of the antibodies they developed within 85 days of receiving a second dose of vaccine. A similar drop was seen in those who had been infected with the virus.

It happened to everybody, regardless of circumstances, and it suggests that at some point antibodies will drop to a level where there is not a sufficient amount to be protective, said Dr. Otto Yang, an infectious disease specialist at ULCA who led the work. Thats why a booster would be needed.

But before you freak out that your vaccination will become moot three months after you got it, keep in mind that scientists dont know if the attrition of antibodies will continue at the same rate, or what levels of antibodies are needed to provide protection from the virus.

The vaccines generated a vast excess of antibodies compared to whats needed, Yang said. Even 10% of the original antibody level is probably a lot.

He also cited other studies that have shown vaccines are still offering excellent protection six months after a person was inoculated.

To find out more about the state of COVID-19 boosters and how scientists will determine when and if they are needed, I spoke with Dr. Kawsar Talaat, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health.

Do you think were going to need booster shots?

We dont have the data yet of how long immunity will last, because the vaccines are so new. But they are really good vaccines and induce a really good immune response, and an even better memory response.

Whats a memory response?

Some vaccines induce both an immediate immune response and a memory response. When the cells that fight the infection are generated, some become short-lived cells called effector cells that make antibodies, and some become memory cells.

Memory cells live a long time and protect you even after those effector cells are gone. If the virus enters the body, they say, I know what this is, and spin off and divide to make new effector cells to fight the infection.

What about needing a booster thats targeted to a variant?

What weve seen so far is that two doses of vaccine work very well against the [current] variants. Eventually we could have a variant that the vaccines dont protect against, and then wed want to make a vaccine for that variant that would be a booster.

But instead of focusing on giving fully vaccinated people additional doses, we should use our vaccines to vaccinate more people and prevent the development of variants.

Why do some vaccines require periodic boosters and others just need one or none?

Different vaccines act differently. Some do a better job of creating a memory response than others.

Also, the longevity of the immune response to vaccines varies. Ninety percent of us are protected essentially our whole lives from measles after getting that vaccine. The second dose is not to boost the immune response but instead to capture half of the people who didnt respond to the first vaccine.

On the opposite end, the flu vaccine does not induce a good memory response, so the immune response to the flu vaccine is short-lived. Even if the strains didnt change every year you would need another shot.

How will scientists determine if we do need booster shots for COVID-19?

Were going to be looking at the antibody response and memory response of people who participated in the vaccine trials. I volunteered for one of the studies and I go back periodically and they take my blood and measure my antibody response. Theyll keep following me for two years and collecting that data.

What about breakthrough cases?

We know breakthrough cases do happen, so well also be monitoring them to understand who gets them and what variants they have. If we see an uptick of breakthrough cases in populations that are fully vaccinated, that would be cause for concern because either immunity has waned or there is a variant that has escaped.

If we dont even know whether COVID-19 boosters will be needed, why is there so much discussion about them?

I dont know!

Some of it is that we have to think about variants and plan ahead for that. And there is some question about whether immunocompromised people or the elderly will need boosters because their immune system is waning.

But mostly, I think there is a lot of concern, but there is no data that says we need to be concerned.

This interview has been edited for length and clarity.

Read more here:

Everything to know about COVID-19 vaccine booster shots - Los Angeles Times