The skeptical cardiologist has been pondering the possibility of getting a fourth jab.
I received my first booster shot in August of 2021. The second booster of COVID-19 vaccine for those who are severely immunocompromised and fully vaxxed was recommended a while back.
While I am not moderately to severely immunocompromised I’m probably mildly immunocompromised like all my fellow Americans who are fortunate enough to have aged sufficiently to exceed age 65 years.
I’ve got reasons to be believe I’m going to get more exposure to coronavirus than typical because I’m going to be making inpatient rounds on cardiology patients starting in mid-April at SAINT LOUIS UNIVERSITY Hospital. In addition, the former eternal fiancee’ will return from a business trip to Kentucky where gathering and eating indoors will have been the norm.
There is not a unanimity of the experts whose opinion I respect on whether oldish people like me should get a 4th jab.
As a result I have been searching feverishly, far and wide for information, commentary, and/or studies that can help me make a better decision and I have made, canceled and rescheduled an appointment for the Moderna booster 3 times.
Last week we heard that the Biden administration was planning on recommending a second COVID-19 booster for all individuals over age 50 years.
Eric Topol (the legendary cardiologist of social media) has tweeted out his explanation for why this decision was made.ThreadReader_0_erictopol_1507900089611681794
This graph is from a preprint report on the Israeli program of providing a 4th jab to health care workers over age 60 years.
It shows that beginning at 12 days after the 4th jab there was a dramatic reduction in high risk individuals over age 60.
The study also showed a 78% reduction in mortality for 4 versus 3 jabs.
Several colleagues who are similarly oldish and contemplating jab#4 sent me this Wall Street Journal article from yesterday which argues against a 4th jab or even a booster:
The New York State Health Department’s large database shows the effectiveness of full vaccination (that is, at least two mRNA doses) remained above 90% against hospitalization, including during the recent Omicron surge. A study from Sweden found the same. Studies from Qatar and California showed no decline in protection against severe disease with Omicron.
Their recommendations are:
If you’ve had two doses of vaccine, you have a lot of protection against severe Covid. Likewise if you’ve been infected with the virus, including with Omicron. If you’re over 65 or otherwise at high risk of severe disease, it’s reasonable to get a third dose. A fourth dose is already authorized for the immunocompromised. For everyone else, the data haven’t shown meaningful benefit of three doses, never mind four.
The authors are experts are not charlatans:
Dr. Krause is a consultant to the World Health Organization and was deputy director of FDA’s Office of Vaccines Research and Review, 2011-21. Dr. Borio is a senior fellow for global health at the Council on Foreign Relations and was director for medical and biodefense preparedness policy at the National Security Council, 2017-19.
So what should the skeptical cardiologist and his fellow oldish triply vaccinated readers, friends and patients do? What are you going to do?
Keep in mind that anecdotes about how you know a guy who had a stroke after getting a jab are not helpful. Likewise anecdotes about how mild COVID-19 was for you and your wife are not helpful. We need RCT data with detailed breakdowns of side effects and COVID-19 illness by # of doses, age, gender and co-morbidities.
Right now I have an appointment at 9 AM at CVS for the vaccine but between now and then I’m going to keep on researching the question and feel free to reschedule my date with jab#4 if I change my mind.
I will keep you posted on the outcome.