General COVID-19 Vaccine Discussion

[Flashback]

I can give several examples in the family and friends family where members have had three vaccines and very much within a two month window of the last one and they have developed Covid. I’ve had four and latest flu.

Yes, my sister is triple jabbed but on the weekend tested positive for COVID for the 2nd time this year. She's in the vulnerable group.

 

[Pushka]

What did you have for your booster. I was going to try and search in a thread somewhere but it's easier to ask you

I've had AZ AZ and Pfizer and due for fourth booster in 2 weeks so not sure what to have. @drron - any comments?

I had Moderna. Likely it doesn't matter whether pfizer or Moderna, the booster which is half. But of all the three, Moderna certainly led to a more painful arm to the extent I couldn't lift it past shoulder level for a few days. But didn't get any other reaction. All gone within a week. If it's the same for you I'd check you aren't planning to do anything strenuous with your arms for a couple of days.

 

[bcworld]

2 weeks ago i attended the office on same day as a positive, I was only person in our hot desk area who did not subsequently get covid despite having my booster just under 4 months ago, which according to you should mean i have basically no protection left.

What is the sample size? Statistically, even with NSW's low 3rd dose rate, 60% of adults are boosted. Are you saying (that you know) no one else in the hot desk area had received a 3rd dose?

 

[lovetravellingoz]

show that those unvaccinated but having had covid are very little different in risk to triple vaccinated. And indeed if they have had just 1 dose of vaccine plus natural infection have a lower risk than triple vaxxed and any extra doses have no extra effect.

Yes but "but having having had covid" is really the key point.

For those of us who have not had it (or at least think we have not), surely the best course of action is to have had three doses so that when we do eventually catch Covid we are less likely to have a severe negative outcome.

And if it was a choice to deliberately catch Covid I would much rather do so after my third dose.

How Long Does a COVID Booster Shot Last?

Effectiveness wanes over time, but protection against critical illness can persist longer

www.aarp.org

B cells and T cells: It’s not all about the antibodies​

Neutralizing antibodies, though commonly discussed, is only one key component in this defense. These germ-attacking proteins spike after vaccination or infection (both trigger their production) and circulate in the blood, keeping an eye out for the virus. If they recognize an invader, they’ll attempt to bind to the virus, interfering with its ability to infect the cells. However, omicron has complicated their efforts: According to the National Institutes of Health, antibodies generated by the COVID-19 vaccines “don’t recognize their targets as well in heavily mutated variants like omicron,” which helps to explain why we’ve seen so many breakthrough infections since the variant rose to dominance. ​

​

What’s more, research suggests these neutralizing antibodies lose steam over time, and their levels drop off after several months.​

​

That’s where the next line of defense comes in: specifically, B cells, which make the antibodies, and T cells, which patrol and destroy the cells infected with the virus.​

​

“You can imagine that the B cells are soldiers that shoot out bullets, and the bullets are the antibodies. So once the attacker is gone, the soldiers stop shooting. It would be a waste of ammunition to keep on making antibodies for a virus that is no longer there,” Sette explains. If the virus comes back, “they are ready to go in a matter of days to mount a full-blown immune response again,” Sette says.​

​

A new preprint study, first reported on by The New York Times, found that a third dose of an mRNA vaccine (Pfizer or Moderna) increases the power of these B cells, allowing them to “produce antibodies capable of clearing even diversified variants such as omicron” within a few days of recognizing an invader, the report’s authors note. This can help explain why a booster shot of an mRNA vaccine that was not “specifically designed to protect against variants is effective against variant-induced serious disease,” they write. The research, however, has not yet been peer reviewed.​

​

“The B cells have this amazing capacity of continuing to evolve,” Sette explains, adding that even in the absence of an ongoing infection, “you have this continued maturation of the antibody response.”​

​

What’s more, research from Sette and others shows that the majority of T cells — these are the cells that help to control and terminate an infection — generated after vaccination continue to recognize coronavirus variants, including omicron. “These cells won’t stop you from getting infected, but in many cases, they are likely to keep you from getting very ill,” Shane Crotty, a professor at La Jolla Institute for Immunology and a coauthor of the study published in Cell, said in a statement. (The data from the study stemmed from fully vaccinated, but not yet boosted, adults. The researchers are currently studying T cell responses in boosted individuals.)​

​

It’s not clear how long these responses last, but B and T cell responses tend to persist for some time, experts say. According to Sette, T cells lasted more than a decade after infection with the SARS virus that was behind the 2003 outbreak in Asia.​

 

[Lynda2475]

Are you saying (that you know) no one else in the hot desk area had received a 3rd dose?

Nope did not say that at all, I know at least 2 (my bosses) have had a 3rd dose, just simply pointing out the situation is not completely hopeless as some are implying.

Also noting that everyone who caught covid in office that week most were only mildly unwell for 2-3 days the rest would not have known they has covid at all except they were asked to test. Our workplace does not allow anyone on site who has not had at least 2 doses (people with medical exemptions have to continue to WFH).

So whilst some here see no benefit in boosting I will happily do so again when 4th doses are made available to under 65s.

 

[drron]

Yes but "but having having had covid" is really the key point.

For those of us who have not had it (or at least think we have not), surely the best course of action is to have had three doses so that when we do eventually catch Covid we are less likely to have a severe negative outcome.

And if it was a choice to deliberately catch Covid I would much rather do so after my third dose.

How Long Does a COVID Booster Shot Last?

Effectiveness wanes over time, but protection against critical illness can persist longer

www.aarp.org

B cells and T cells: It’s not all about the antibodies​

Neutralizing antibodies, though commonly discussed, is only one key component in this defense. These germ-attacking proteins spike after vaccination or infection (both trigger their production) and circulate in the blood, keeping an eye out for the virus. If they recognize an invader, they’ll attempt to bind to the virus, interfering with its ability to infect the cells. However, omicron has complicated their efforts: According to the National Institutes of Health, antibodies generated by the COVID-19 vaccines “don’t recognize their targets as well in heavily mutated variants like omicron,” which helps to explain why we’ve seen so many breakthrough infections since the variant rose to dominance. ​

​

What’s more, research suggests these neutralizing antibodies lose steam over time, and their levels drop off after several months.​

​

That’s where the next line of defense comes in: specifically, B cells, which make the antibodies, and T cells, which patrol and destroy the cells infected with the virus.​

​

“You can imagine that the B cells are soldiers that shoot out bullets, and the bullets are the antibodies. So once the attacker is gone, the soldiers stop shooting. It would be a waste of ammunition to keep on making antibodies for a virus that is no longer there,” Sette explains. If the virus comes back, “they are ready to go in a matter of days to mount a full-blown immune response again,” Sette says.​

​

A new preprint study, first reported on by The New York Times, found that a third dose of an mRNA vaccine (Pfizer or Moderna) increases the power of these B cells, allowing them to “produce antibodies capable of clearing even diversified variants such as omicron” within a few days of recognizing an invader, the report’s authors note. This can help explain why a booster shot of an mRNA vaccine that was not “specifically designed to protect against variants is effective against variant-induced serious disease,” they write. The research, however, has not yet been peer reviewed.​

​

“The B cells have this amazing capacity of continuing to evolve,” Sette explains, adding that even in the absence of an ongoing infection, “you have this continued maturation of the antibody response.”​

​

What’s more, research from Sette and others shows that the majority of T cells — these are the cells that help to control and terminate an infection — generated after vaccination continue to recognize coronavirus variants, including omicron. “These cells won’t stop you from getting infected, but in many cases, they are likely to keep you from getting very ill,” Shane Crotty, a professor at La Jolla Institute for Immunology and a coauthor of the study published in Cell, said in a statement. (The data from the study stemmed from fully vaccinated, but not yet boosted, adults. The researchers are currently studying T cell responses in boosted individuals.)​

​

It’s not clear how long these responses last, but B and T cell responses tend to persist for some time, experts say. According to Sette, T cells lasted more than a decade after infection with the SARS virus that was behind the 2003 outbreak in Asia.​

Yes but mix and match studies show that for those who have had 2 mRNA shots have a better response especially with cellular immunity.
Similiar work in the UK shows the same results for AZ as a booster.

Also shown is that some people who have had a recent common cold which can be due to a coronavirus have cross immunity to covid based on their cellular immunity.

 

[drron]

An interesting study comparing Pfizer and Moderna and antibody levels after 2 shots. Similiar maximum levels but the drop in antibody levels was more marked in those reciving Pfizer than those who got the Moderna shots. With Pfizer the decline began as early as 21 days after the shot. As well with Pfizer levels were significantly lower in people >50 but not seen with Moderna.

At 6 months those who had Pfizer had significantly less antibodies than those who had severe Covid 6 months earlier whilst with Moderna they were comparable.

Levels were significantly lower after the J&J vaccine but had hardly changed at 5 months. But there were only 6 patients who received J&J.

https://dgalerts.docguide.com/ncov-home/article/trajectory-of-igg-to-sars-cov-2-after-vaccination-with-bnt162b2-or-mrna-1273-in-comparison-with-natural-infection

 

[woodyren]

So far I have had 2 x AZ and 1 X Moderna as a booster. After our upcoming trip to Singapore I will be eligible for my next shot (over 65). It's difficult to get data on which MRNA vaccine to have as the next booster although at present it probably makes little difference.

Of course there will be a lot more helpful links on here (thanks drron and others) that will assist in making my choice when the time arrises.

 

[Chalkie]

Yes but mix and match studies show that for those who have had 2 mRNA shots have a better response especially with cellular immunity.
Similiar work in the UK shows the same results for AZ as a booster.

Also shown is that some people who have had a recent common cold which can be due to a coronavirus have cross immunity to covid based on their cellular immunity.

I was looking to see whether there'd been any further heterologous vaccination studies and I found this one:

26 January 2022 - US Study (published in the New England Journal of Medicine)

"For all combinations, antibody neutralizing titers against a SARS-CoV-2 D614G pseudovirus increased by a factor of 4 to 73, and binding titers increased by a factor of 5 to 55. Homologous boosters increased neutralizing antibody titers by a factor of 4 to 20, whereas heterologous boosters increased titers by a factor of 6 to 73. Spike-specific T-cell responses increased in all but the homologous Ad26.COV2.S [Johnson & Johnson]-boosted subgroup. CD8+ T-cell levels were more durable in the Ad26.COV2.S-primed recipients, and heterologous boosting with the Ad26.COV2.S vaccine substantially increased spike-specific CD8+ T cells in the mRNA vaccine recipients." (my emphases)​

This reinforces what was reported in the previous heterologous studies (see this post: Chalkie's post with links to study publications about effectiveness of mixed (heterologous) vaccination).

If I am required to have a second booster (4th dose, after 1 x AZ, 1 x Moderna and 1 x Moderna booster), which I don't think will come until the next Canadian winter, I'll be considering Johnson & Johnson or Novovax if they are available to me. While there's only been one limited study using Novovax in heterologous vaccination regimens (ComCov2 is the only one I've found so far (and it raised a question about the ability of adenoviral-vectored and mRNA vaccines to prime T cells for subsequent stimulation by protein antigens), but Novovax is in two current heterologous studies, so more may come on that matter). It seems clear to me from all of the heterologous studies that combining vaccines with different mechanisms of action is the most efficacious approach, particularly if one (as I am) is more concerned about B and T cell protection (and not surface antibodies, which fade relatively quickly regardless of the specific type of vaccine). ComCov2's findings were that prime AZ+Novovax boost, prime AZ+Pfizer boost and prime AZ+Moderna boost had the strongest cellular immunity outcomes, exceeding those of AZ+AZ, Pfizer+Pfizer, Moderna+Moderna and Pfizer+Moderna.

 

[Chalkie]

So far I have had 2 x AZ and 1 X Moderna as a booster. After our upcoming trip to Singapore I will be eligible for my next shot (over 65). It's difficult to get data on which MRNA vaccine to have as the next booster although at present it probably makes little difference.

Of course there will be a lot more helpful links on here (thanks drron and others) that will assist in making my choice when the time arrises.

There's not really any useful controlled study data on 4th shot/second boosters yet (I don't regard the Israeli 4th shot study as particularly illuminating, and it's irrelevant so far as heterologous regimens are concerned in any event). You've had the "best" prime and booster combination (see the studies referenced in my post above). ComCov2 *might* (and this is a very qualified might because this wasn't specifically studied) suggest that after 2xAZ and 1 mRNA booster Novovax could be efficacious (if available as a booster), on the basis that AZ prime + Novovax booster produced the most significant cellular immune responses. But the AZ prime + Moderna booster + Novovax 2nd booster combination hasn't been specifically studied (yet), and there's a finding in the ComCov2 study about mRNA prime + Novovax booster that might contradict this.

If I was choosing my 4th shot after your current combination (and neither Novovax nor another adenovirus vaccine were available as a booster), I'd be inclined towards Pfizer on the basis that the heterologous study combinations clearly suggest that switching things up produces better cellular immunity repsonses. But I wouldn't mind if all I could get was Moderna - the AZ+Moderna combination is a goody! And whatever the Australian authorities offer will be safe and effective, so if the Australian recommendation is for you to have a 4th shot in your circumstances, whatever is offered will be fine, IMO.

 

[drron]

As to a 4th shot in Australia the approved boosters are Pfizer,Moderna and Novavax, However Novavax is for use if a person can't use an mRNA vaccine or refuses an mRNA vaccine. Know what I will do.

You are spot on @Chalkie about the 4th shot. the Europeans regulation officials don't think the current studies are enough to recommend a 4th shot in most people. just >80 or immunocompromised.

https://dgalerts.docguide.com/ncov-home/article/ecdc-and-ema-issue-advice-on-fourth-doses-of-mrna-covid-19-vaccines-1

The NIH is running a trial now but only using mRNA vaccines though some new vaccines. Short sighted I believe.

https://dgalerts.docguide.com/ncov-home/article/nih-begins-clinical-trial-evaluating-second-covid-19-booster-shots-in-adults

 

[Chalkie]

As to a 4th shot in Australia the approved boosters are Pfizer,Moderna and Novavax, However Novavax is for use if a person can't use an mRNA vaccine or refuses an mRNA vaccine. Know what I will do.

Canada's done the same with Novovax. You might know what I will do too!

 

[JohnM]

Well, I'm triple vaxxed (AZ, AZ, Pfizer), it's been >4 months since the booster and I'm >65.

But, fortuitously, I've just caught Covid. It's like a mild cold or hay fever. No need to even take a Panadol.

Why fortuitous? A few reasons:

First, given a cold or flu has never, ever knocked me about in the slightest and I have no co-morbidities, I reckoned that I'm at vanishingly low risk of serious symptoms. I'd rather get the disease to give my immunity the broadest spectrum. I was always hoping to catch it - at a convenient time.

Second, my elder son got married last Thursday, so we got a very big weekend of festivities in the Margaret River region done and dusted without anyone having to pull out of anything.

Third, I'm heading to Qld/NT/SA 9 May-5 June.

PERfect timing, I'd say - and I'll dispense with thoughts of a fourth vaccination.

Happy days!

 

[Pushka]

Well, I'm triple vaxxed (AZ, AZ, Pfizer), it's been >4 months since the booster and I'm >65.

But, fortuitously, I've just caught Covid. It's like a mild cold or hay fever. No need to even take a Panadol.

Why fortuitous? A few reasons:

First, given a cold or flu has never, ever knocked me about in the slightest and I have no co-morbidities, I reckoned that I'm at vanishingly low risk of serious symptoms. I'd rather get the disease to give my immunity the broadest spectrum. I was always hoping to catch it - at a convenient time.

Second, my elder son got married last Thursday, so we got a very big weekend of festivities in the Margaret River region done and dusted without anyone having to pull out of anything.

Third, I'm heading to Qld/NT/SA 9 May-5 June.

PERfect timing, I'd say - and I'll dispense with thoughts of a fourth vaccination.

Happy days!

You are my role model. With Easter done and a major trip to hair dresser tomorrow pre trip and a trip to UK in four weeks, had the second booster, I’d love to follow your path by the end of this week.

 

[Must...Fly!]

You are my role model. With Easter done and a major trip to hair dresser tomorrow pre trip and a trip to UK in four weeks, had the second booster, I’d love to follow your path by the end of this week.

It goes to show how wrong our settings are at the moment that this is the attitude most people have.

 

[Flashback]

You are my role model. With Easter done and a major trip to hair dresser tomorrow pre trip and a trip to UK in four weeks, had the second booster, I’d love to follow your path by the end of this week.

Head to PER then, most of my family have had it in the last few weeks.

 

[Pushka]

Head to PER then, most of my family have had it in the last few weeks.

Pretty much the same in SA. We just haven't been to places with kids or mixed families. Not because of avoidance but just because. However no masks now here in SA and up until first week of May will be the test. Just don't want to get it when in UK as I've got fun stuff to do.

 

[Oneworldplus2]

Better of getting covid now than later. I mean, your going to get it one way or another.

 

[tgh]

your going to get it one way or another

I have no idea if I have had "it"…...nor does a significant portion of the population.
IF I "knew", I could make a more informed judgment about future boosters and travel arrangements

 

[Oneworldplus2]

Where do you draw the line on the number of boosters you will take?