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Booster vaccinations?

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johnnychips

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I haven’t heard much about this recently. Assuming people have had their two standard vaccinations, are there any plans for boosters for certain categories or age groups? And will it have to be the same type of vaccine? I have heard some evidence that ‘mixing’ the vaccination type can actually lead to higher immunity.
 
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Smidster

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I haven’t heard much about this recently. Assuming people have had their two standard vaccinations, are there any plans for boosters for certain categories or age groups? And will it have to be the same type of vaccine? I have heard some evidence that ‘mixing’ the vaccination type can actually lead to higher immunity.
Yes, the plan is to start boosters in September -

https://www.gov.uk/government/news/jcvi-issues-interim-advice-on-covid-19-booster-vaccination

And then in all liklihood at least one more next year + regularly after that like the Flu.

Joy!
 

Bayum

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Majority are expected to be vaccinated with Pfizer due to its increased efficacy against the delta variant. Likely to be separate injections at separate times. Hopefully, both will be taken out of GPs hands so they can focus on everything else they need to.
 

Busaholic

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As it is being proposed that the flu vaccine should be administered at the same time as the covid vaccine for those eligible, the former would have to be available much earlier than it normally is if the programme were to start in early September.
 

johnnychips

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I was listening to Radio 5 live on the wireless in the car today, so I can’t quote it, but some professor whom the BBC seem to respect was saying the boosters may be unnecessary.
 

ashworth

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Majority are expected to be vaccinated with Pfizer due to its increased efficacy against the delta variant. Likely to be separate injections at separate times. Hopefully, both will be taken out of GPs hands so they can focus on everything else they need to.
There was an interesting report in the Telegraph last weekend suggesting that the AstraZeneca vaccine was actually much longer lasting than the Pfizer. I can’t remember all the details and the Pfizer may well have increased efficacy against the Delta variant. However, it was suggesting that boosters were perhaps not so necessary for those having received the AstraZeneca vaccine. It is suggested that the AstraZeneca could have a much stronger T cell response.
 
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Bayum

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There was an interesting report in the Telegraph last weekend suggesting that the AstraZeneca vaccine was actually much longer lasting than the Pfizer. I can’t remember all the details and the Pfizer may well have increased efficacy against the Delta variant. However, it was suggesting that boosters were perhaps not so necessary for those having received the AstraZeneca vaccine.
They’ll have to fight me. I’ll inject myself if I need to!
 

yorkie

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Long term, boosters are almost certainly not necessary.

However in the short to medium term, they might be given out because of any of the following:
  • people vaccinated with a short dose interval might benefit from a booster for longer efficacy
  • mixing & matching vaccine types is likely to boost efficacy (e.g. an initial mRNA vaccination may benefit from viral vector and vice-versa)
  • updated versions of the vaccines are in development, which may provide increase efficacy
  • if the virus continues to evolve and adapt sufficiently to warrant it
Even so, it is unlikely to be warranted for most people, just older people and those deemed particularly vulnerable

Majority are expected to be vaccinated with Pfizer due to its increased efficacy against the delta variant.
Even if originally vaccinated with Pfizer? I very much doubt that.

I also do not think you can conclusively say Pfizer has increased efficacy against Delta; any additional efficacy compared to viral vector vaccines may simply be because the latter take longer for the immunity to build up, so it will take longer to get the data. Too early to say in my opinion.

Likely to be separate injections at separate times.
Do you have a source for this?

I was listening to Radio 5 live on the wireless in the car today, so I can’t quote it, but some professor whom the BBC seem to respect was saying the boosters may be unnecessary.
A virologist, whose podcasts I listen to, has been saying this for months.
 

Bayum

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There was an interesting report in the Telegraph last weekend suggesting that the AstraZeneca vaccine was actually much longer lasting than the Pfizer. I can’t remember all the details and the Pfizer may well have increased efficacy against the Delta variant. However, it was suggesting that boosters were perhaps not so necessary for those having received the AstraZeneca vaccine.
Interestingly, today the government have placed a multi-million £ order for Pfizer BioNTech vaccines as a booster for 2022. Guardian reporting that Moderna or Pfizer most likely candidates for Autumn 2021.

Long term, boosters are almost certainly not necessary.

However in the short to medium term, they might be given out because of any of the following:
  • people vaccinated with a short dose interval might benefit from a booster for longer efficacy
  • mixing & matching vaccine types is likely to boost efficacy (e.g. an initial mRNA vaccination may benefit from viral vector and vice-versa)
  • updated versions of the vaccines are in development, which may provide increase efficacy
  • if the virus continues to evolve and adapt sufficiently to warrant it
Even so, it is unlikely to be warranted for most people, just older people and those deemed particularly vulnerable


Even if originally vaccinated with Pfizer? I very much doubt that.

I also do not think you can conclusively say Pfizer has increased efficacy against Delta; any additional efficacy compared to viral vector vaccines may simply be because the latter take longer for the immunity to build up, so it will take longer to get the data. Too early to say in my opinion.


Do you have a source for this?


A virologist, whose podcasts I listen to, has been saying this for months.
From: https://www.gov.uk/government/publi...022-letter#influenza-and-covid-19-vaccination [Accessed 22:14, 11/8/21]

Influenza and COVID-19 vaccination​

Booster vaccines for COVID-19 are currently under consideration, with trials underway to ascertain whether co-administration of COVID-19 and influenza vaccines will be permissible, subject to the advice of JCVI. Early evidence on the concomitant administration of COVID-19 and influenza vaccines used in the UK, supports the delivery of both vaccines at the same time where appropriate.

Planning for influenza vaccination should continue as usual for this autumn, with further advice issued should co-administration with COVID-19 vaccination be recommended so that where appropriate both vaccines could be given at the same time.
I’m involved with some of the pharmacy sites liaising with NHS and St John Ambulance and the hopeful move is to vaccinate with flu boosters ASAP so the COVID-19 boosters can be delivered earlier in Autumn. Until JCVI sign off on concomitant administration they’re being very wary and only advocating in certain instances at the time being.
 

yorkie

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None of this really demonstrates they are necessary, but we won't know for certain until it is too late, so it makes sense to get the order in.

Most of the well respected experts seem to think they are not likely to be necessary though.
 

Bayum

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None of this really demonstrates they are necessary, but we won't know for certain until it is too late, so it makes sense to get the order in.

Most of the well respected experts seem to think they are not likely to be necessary though.
Clearly I wasn’t answering that. You asked me for a source for separate jabs and I’ve given it. I haven’t, however, seen any sources for your comments that boosters aren’t necessary.

It makes sense for GPs to be able to coadminister influenza and COVID-19 vaccines for those that are housebound or in residential homes due to the need to protect these vulnerable groups due to the dramatic spread of both diseases that we have seen in the past. Hopefully, results of trials will be released in the next few weeks and we can get both vaccines into the top risk groups in the next 8-12 weeks.
 

eastdyke

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Interestingly, today the government have placed a multi-million £ order for Pfizer BioNTech vaccines as a booster for 2022. Guardian reporting that Moderna or Pfizer most likely candidates for Autumn 2021.


From: https://www.gov.uk/government/publi...022-letter#influenza-and-covid-19-vaccination [Accessed 22:14, 11/8/21]
mmmm ...
Spending best part of £1bn in some sort of vaccine rush for 2022. From that link, the EU has ordered 900 million doses with an option for 900 million more. If the option is taken up that is 4 doses for every EU citizen. Where are they going to err.. stick it all?

A link for the some current thinking as to the necessity of any boosters at all can be found on the BBC (would have preferred a learned journal) and comes from Professor Sir Andrew Pollard (leads the clinical trials of Oxford's coronavirus vaccine in the UK, South Africa and Brazil).

Health Secretary Sajid Javid says he has already put plans in place to give the most vulnerable groups a third or booster Covid jab early next month.
But the head of the Oxford Vaccine Group said doses needed to "go where they can have the greatest impact" - to protect unvaccinated people abroad.
The UK itself currently had no reason to panic, Prof Sir Andrew Pollard said.
Mr Javid said he would wait for final advice from the Joint Committee on Vaccination and Immunisation (JCVI).
"My plan is to offer the flu vaccine, especially to over-50s, at the same time," he said.
A bigger flu season than normal is expected, with scientists warning respiratory viruses will make a comeback this year after disappearing last year during lockdown.
NHS bosses had previously said they needed lots of warning of a Covid booster programme in order to plan the logistics of vaccinating millions of people against both viruses.
However, Prof Pollard, who led the team that created the Oxford-AstraZeneca vaccine, said decisions on whether to give boosters "should be scientifically driven".
"The time we would need to boost is if we see evidence that there was an increase in hospitalisation - or the next stage after that, which would be people dying - amongst those who are vaccinated," he said.
"And that is not something we are seeing at the moment."

When it comes to me deciding what I should do will I listen to the government or to the evidence?

Controversial bit:
It could easily be interpreted by some that the current UK government is a facilitator of a literal protection racket. Who needs the mob?

[edited only to remove a duplicated link]
 
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Bayum

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mmmm ...
Spending best part of £1bn in some sort of vaccine rush for 2022. From that link, the EU has ordered 900 million doses with an option for 900 million more. If the option is taken up that is 4 doses for every EU citizen. Where are they going to err.. stick it all?

A link for the some current thinking as to the necessity of any boosters at all can be found on the BBC (would have preferred a learned journal) and comes from Professor Sir Andrew Pollard (leads the clinical trials of Oxford's coronavirus vaccine in the UK, South Africa and Brazil).



When it comes to me deciding what I should do will I listen to the government or to the evidence?

Controversial bit:
It could easily be interpretted by some that the current UK government is a facilitator of a literal protection racket. Who needs the mob?
So what would you have the country do? Wait until we start to see deaths rising in the vulnerable groups again?
 

Dent

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Controversial bit:
It could easily be interpreted by some that the current UK government is a facilitator of a literal protection racket. Who needs the mob?
How? I don't see anything the government is doing is anything like a protection racket, much less a "literal" one.
 

eastdyke

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So what would you have the country do? Wait until we start to see deaths rising in the vulnerable groups again?
Simple, give our surplus vaccines to countries that don't have our (apparent) resources.

How? I don't see anything the government is doing is anything like a protection racket, much less a "literal" one.
We are in some sort of race with the EU (and probably some other countries as well) for vaccines that may not be required and for which there is currently no scientific trials data or even empirical evidence base. The price has gone up (it always does doesn't it). The only certainty here is that Pfizer, or more accurately the investors in Pfizer, will benefit greatly.
[As already said any available vaccines should go to the people of countries that don't have access to our resources]
 
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yorkie

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Clearly I wasn’t answering that. You asked me for a source for separate jabs and I’ve given it.
I thought you were saying the booster would be given as two doses, which confused me:
Majority are expected to be vaccinated with Pfizer due to its increased efficacy against the delta variant. Likely to be separate injections at separate times. Hopefully, both will be taken out of GPs hands so they can focus on everything else they need to.
However I now realise you actually meant the Influezna and Sars-CoV-2 vaccines will be administered separately


I haven’t, however, seen any sources for your comments that boosters aren’t necessary.
You saw the thread where I provided a source already but maybe you didn't read the post in question; here is a link directly to the post:


An immunologist who works in vaccine development on Twitter (known as Chise) says boosters are likely to only be needed for people who are immunocompromised or older people:

The only individuals that are needing a booster this year are those who are considered high-risk such as those who are immunocompromised or older. Not everyone needs them.

The booster is applying to nAbs which older and immunocompromised individuals need to fight off initial infection as they cannot fall back on their immune systems as much as we can.

There is a thread here:

I think longer term this really isn't going to be necessary though as immunocompromised people don't get vaccinated against other HCoVs such as OC43, so this really is probably only a short and perhaps medium term thing. But it's too early to say and a lot more research is needed.

But the current thought of experts is along the lines that most people are able to produce their own T cell and antibody responses long after the initial antibody response has waned and for the vast majority of people a natural infection in a vaccinated individual will act as a booster, as is already the case with the four existing HCoVs.
 

Bayum

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I think longer term this really isn't going to be necessary though as immunocompromised people don't get vaccinated against other HCoVs such as OC43, so this really is probably only a short and perhaps medium term thing. But it's too early to say and a lot more research is needed.
OC43 causes pneumonia in~17% of people, if that. Covid-19 is a different kettle of fish completely. That’s why we’re vaccinating against this and haven’t needed to vaccinate against OC43 in the past.


You saw the thread where I provided a source already but maybe you didn't read the post in question; here is a link directly to the post:

They don’t provide any evidence to suggest that a booster shot is not necessary.
 

Bantamzen

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Interestingly, today the government have placed a multi-million £ order for Pfizer BioNTech vaccines as a booster for 2022. Guardian reporting that Moderna or Pfizer most likely candidates for Autumn 2021.


From: https://www.gov.uk/government/publi...022-letter#influenza-and-covid-19-vaccination [Accessed 22:14, 11/8/21]

I’m involved with some of the pharmacy sites liaising with NHS and St John Ambulance and the hopeful move is to vaccinate with flu boosters ASAP so the COVID-19 boosters can be delivered earlier in Autumn. Until JCVI sign off on concomitant administration they’re being very wary and only advocating in certain instances at the time being.
There should be no talk or procurement of boosters for all expect for those very most in need until vaccinations have be equalised across the world. Period.

Whether or not you would fall into this category would be for your doctors and consultants to decide, but a third jab in 2021 for most people is at best frivolous & at worst irresponsible when so many countries are struggling to even get their hands on first doses for hundreds of millions, maybe even billions of people. Only when the situation globally is more balanced should boosters be considered, and even then it should be based on sound scientific evidence that they would actually be effective, not just as a "just in case" to make a few people feel safer. Most people have immune systems that will respond & develop following infection and/or vaccination. There are going to be some massive pressures on the Treasury, and by proxy the NHS in the coming years. If we don't need to spend countless billions on boosters for all, then we should not.
 

big_rig

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As far as I can tell 'boosters' is just another completely meaningless and unscientific term which people have jumped on. See: 'circuit breaker lockdown' 'firebreak' etc etc
 

Bayum

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As far as I can tell 'boosters' is just another completely meaningless and unscientific term which people have jumped on. See: 'circuit breaker lockdown' 'firebreak' etc etc
What would you call it?
 

yorkie

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OC43 causes pneumonia in~17% of people, if that. Covid-19 is a different kettle of fish completely. That’s why we’re vaccinating against this and haven’t needed to vaccinate against OC43 in the past.
Do you have any evidence that the difference is the viruses itself and not out immunity to them?
They don’t provide any evidence to suggest that a booster shot is not necessary.
In healthy individuals?
 

Bayum

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Do you have any evidence that the difference is the viruses itself and not out immunity to them?
Y Alimi et al performed a systematic review and meta analysis of 28 studies looking at the aetiology of community acquired pneumonia (CAP) and the role that co-infection of bacterial and viruses. They found that only 29% (via Polymerase chain reaction) of CAP patients suffered from viral pneumonia with influenza being the most common virus at between 7 and 12% of patients within the studies. Coronaviruses only accounted for 4% of the CAP.


Lieberman et al (2010) studied a variety of pneumotic and non-pneumotic lower respiratory tract infection (NPLRTI) patients and found Coronavirus was only identified in 13.1% of cases of CAP and 10.4% of NPLRTI whilst influenza accounted for 8% and 31% of CAP and NLPRTI respectively.

Seema Jain summarises the US-based study EPIC (Etiology(sic) of Pneumonia In the Community) showing that in 81% of children where a pathogen was identified, coronaviruses accounted for 5%. In 38% of adults where a pathogen was detected, coronaviruses were detected in 2% of cases.

rticles/PMC7115731/#!po=0.847458

Won, Il Choi (2021) demonstrated that of 1689 patients, only 77 had HCOV43 infection.


Whilst they don’t discuss whether this is due to immunity or not, Chan, Tsung Yen (2020) state that OC43 pneumonia is rare in children with cancer, suggesting that even in these extremely vulnerable groups, infection was rare and unlikely to lead to pneumonia.

Patric D. (2003) cite an outbreak of HCOV43 in an aged-care facility where deaths were restricted to just 6 of 95 residents that tested positive for the infection.

So looking at just those three studies (albeit dated and not taking into account pneumonia infection with COVID-19) coronaviruses accounted for a low proportion of pneumonia samples detected and whi
 

DelayRepay

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As it is being proposed that the flu vaccine should be administered at the same time as the covid vaccine for those eligible, the former would have to be available much earlier than it normally is if the programme were to start in early September.

I'm not sure I'd want both at the same time. I felt awful for a couple of days after my first Covid jab and I wasn't alone. I've never bothered with a flu jab but most people I know who have report feeling like they've got flu for a couple of days after.

So if you have both together, are you likely to have a couple of really unpleasant days dealing with two lots of side effects?

An academic question for me, really, as I'm not in the age group that will be offered a Covid booster, unless they extend them to younger people for some reason.
 

Bayum

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I'm not sure I'd want both at the same time. I felt awful for a couple of days after my first Covid jab and I wasn't alone. I've never bothered with a flu jab but most people I know who have report feeling like they've got flu for a couple of days after.

So if you have both together, are you likely to have a couple of really unpleasant days dealing with two lots of side effects?

An academic question for me, really, as I'm not in the age group that will be offered a Covid booster, unless they extend them to younger people for some reason.
This would be my worry! My second COVID-19 vax in May floored me for five days. I’m usually absolutely fine with the flu vax but I’d not want to risk it really!

In healthy individuals?
The podcast you quoted they give no data for, no studies or anything to back up their statements that, in their opinion as far as I’m concerned, boosters are/aren’t needed.
 

johncrossley

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I notice some countries are allowing quarantine free entry only if the vaccine was administered less than a year ago. So, unless this changes, many people will want another dose or doses to enable foreign travel next summer.
 

DelayRepay

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I notice some countries are allowing quarantine free entry only if the vaccine was administered less than a year ago. So, unless this changes, many people will want another dose or doses to enable foreign travel next summer.

True, but it would not surprise me if, in the fullness of time, Covid vaccines become a paid for service if they're just needed for travel reasons. So those deemed at higher risk will still get any necessary boosters on the NHS, but anyone who's low risk but needs a jab simply to travel will have to pay for it privately. I wouldn't object to this; the NHS is not there to facilitate foreign holidays.

But I don't think anything like that will be introduced in the short term while the focus is still on maximising vaccine take up.
 

Dent

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True, but it would not surprise me if, in the fullness of time, Covid vaccines become a paid for service if they're just needed for travel reasons. So those deemed at higher risk will still get any necessary boosters on the NHS, but anyone who's low risk but needs a jab simply to travel will have to pay for it privately.
The NHS provides other travel vaccinations free.
 

DelayRepay

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The NHS provides other travel vaccinations free.
Only some of them.


Which travel vaccines are free?​

The following travel vaccines are available free on the NHS if your GP practice is signed up to provide vaccination (immunisation) services.

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?​

You'll have to pay for travel vaccinations against:

Yellow fever vaccines are only available from designated centres.

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.
 

johncrossley

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True, but it would not surprise me if, in the fullness of time, Covid vaccines become a paid for service if they're just needed for travel reasons. So those deemed at higher risk will still get any necessary boosters on the NHS, but anyone who's low risk but needs a jab simply to travel will have to pay for it privately. I wouldn't object to this; the NHS is not there to facilitate foreign holidays.

But I don't think anything like that will be introduced in the short term while the focus is still on maximising vaccine take up.

I have no objection to paying a reasonable amount for another vaccine dose. However, the fact that this rule exists suggests that there's a possibility that the vaccine's effectiveness might wear off after a year and therefore people need to be vaccinated every year.
 
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