Nicole writes:
Hi Dr. Griffin,
I am so grateful for you, your team, and this informative podcast!
I was hoping you could review any data informing risk/benefit ratio of the updated 2024-2025 COVID booster for healthy children who have already received the primary series as well as last year’s (2023-2024) updated booster vaccine, AND had prior remote natural infection (in some cases more than once). Can you review data supporting the US universal recommendation that children with such a history should receive (ie are expected to meaningfully benefit from) the updated 2024-2025 booster (and the implication that they will benefit from annual boosters, even considering they are likely to experience natural infection in any given year).
When Dr. Offit spoke on the topic of boosters for healthy children previously on TWIV (I believe it was last year) he speculated that there was probably little benefit of the 2023-2024 updated booster for healthy children who had already received the primary series (which he emphasized was most important) especially since most of those children had natural infection at some point, and he also cautioned that that vaccines are not entirely without risk. (If I misinterpreted Dr. Offit’s prior statements on TWIV please omit mention of him in this question, but that is my recollection). I was hoping we would have updated data this year to better inform risk/benefit calculation of annual boosters in healthy children).
Thank you!
Nicole
Sue writes:
Dear Dr. Griffin,
On the TWiV podcast 1152 from 9/28/24 you mentioned that your family was on team Novavax for vaccination this year.
Was that primarily because of the apparent lower risk of reactogenicity compared to mRNA vaccines or in addition because you and perhaps some of your colleagues feel there is more durability having it following prior mRNA vaccines?
I know you mentioned that all the vaccines impact the JN1 lineage.
However, since Novavax only targets JN.1 which is one step up in ancestry in comparison to the mRNAs which target KP2 and we are in the KP variant era for now (admittedly KP3.1.1 is circulating) could that lessen Novavax efficacy?
Certainly recombinant XEC may emerge as a new problem altogether. So I understand that there are alot of unknowns here.
Finally, do you think that the mRNA vaccines and/or Novavax can be associated with the development of type 1 diabetes? I know autoimmune arthritis can occur after the mRNA vaccines.
Thanks so much to you and Dr. Racaniello for your weekly, always illuminating clinical updates. I am a loyal listener.
Sue
Margie writes:
Hello!
I asked my doctor for a prescription for Paxlovid to take on an upcoming European cruise. I am 74, take no medications, and have no health issues. She ordered the low dose (150-100) Paxlovid instead of the standard dose (300-100), by mistake I assume, which I discovered after I got home from CVS. When I called her office, she said that the lower dose should work fine. Is that an acceptable solution?
The doctor sent in a new prescription as I requested, but I assume it will be a hassle with the pharmacy and health insurance, and I expect to have to pay again, maybe a higher price. Should I stick with the low dose this time? Would you expect it to work just as well as the higher standard dose?
Thank you. I am a loyal listener to your weekly podcast updates.
Margie
Bruce writes:
Dr. Griffin,
Last week you referred to an editorial suggesting use of gowns and gloves by healthcare workers attending to Covid 19 pts may be out of step with current knowledge concerning transmission of Covid 19. I raised this question with my daughter who is a pediatric nurse. Her immediately response was:
What about when the Covid 19 pt coughs on me? Would this cover my clothes and face with infectious particles if I am not wearing a gown, gloves, and face mask which could lead to me being infected?
Seems like a reasonable question. What do you think a scientific response might be?
Thank you,
Bruce
Ruth writes:
I wonder if it is really a surprise that any type of SARS-2 vaccine would fail to induce long-lasting antigen-specific B cell response. One of the characteristics of coronaviruses is their ability to produce reinfection, suggesting that they can evade long-lasting immune responses.
In addition to comparison with protein antigen-based vaccines, it would be interesting to see if durable B cell response results from infection.
Ruth Greenblatt, MD
Emeritus Professor of Clinical Pharmacy, Infectious Disease Medicine, Epidemiology and Biostatistics
University of California, San Francisco