Here’s a lively interview with one of the experts on the FDA advisory panel who voted against authorizing the combo (Wuhan classic and also Omicron) vaccine boosters for the fall, something the Biden admin has been pushing for to look like they’re doing something as Omnicron’s new variants run around the country reinfecting everyone since prior vaccination or infection aren’t particularly protective.
First 45 minutes or so
Here were his reservations - .
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PFE and MRNA showed 1.5-2x higher O1 antibody levels compared to boosting with a 4th shot of the old vaccines. This is about as much as MRNA was better than PFE in the original trials, and the difference in health outcomes has been quite small. As such, it wasn’t clear this new O1 based vaccine would matter for actual health, especially since O1 is gone and we’ve got O.BA4/5 mostly now.
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the new combo vaccine tech, ie having two strains (Wuhan+O) in the same vaccine, hadn’t been studied widely before and could potentially have rare safety issues the way we saw unexpected myocarditis from the mRNA vaccines. Hence he wanted to see a compelling risk/reward benefit to approve the new approach, and didn’t think they had the data to justify that based solely on antibody measures.
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the drug companies could have tested how their O1 vaccine worked in generating antibodies against the now dominant O.BA4/5 and see if the new vax resulted in higher levels than the existing-vax boosted control group. But they didn’t - the data was only the O.1 antibody levels that this vaccine was specifically targeted to create. This seemed suspicious to him (**).
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both the WHO and the FDA seemed to be subtlety pressuring them to approve this, even if the data wasn’t compelling
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there’s a small but possible risk that boosting against similar strains can confuse your immune system via a mechanism called Original Antigenic Sin such that when given a new vaccine similar to a prior one, your immune system doesn’t make a response to the new antigen but just makes a lot more of the old one. Basically it can’t learn the new one if it had exposure to the prior old one, but could if it hadn’t been exposed to both. He was theoretically concerned that we might see a nastier version of O come along, and if we did O boosters now when they might only help a little, the Extra Bad O boosters we would really need in that case might not work on everyone who got this round. Obviously that would be a poor risk/reward trade off.
So we got the political outcome without compelling data. Par for the course for most of our pandemic responses.
What should you do if offered yet another booster this fall? Maybe it’s not worth it for normal people. More recent studies have shown for example that those dying of covid now are largely the very old and those with compromised immune systems or multiple health issues. Certainly those groups should be considering additional boosters, prophylaxis with EvuSheld, prompt testing and treatment with Paxlovid if not counter indicated, etc.
** and suspicious to me also, since antibody titer studies are easy. perhaps they did do them and the new vax didn’t work or work well against the newer variants, and the drug companies decided reporting those results wouldn’t sell $billions in new vaccines to the credulous Feds and didn’t bother to say. You might recall Pfizer did this with their studies where they did booster efficacy and had compared if it helped or not depending on if you’d already gotten covid. Their data said the boost didn’t help if you’d already had it, but they only presented the data in aggregate for all people (with or without covid infection) in order to sell the boosters to more people and to sell the booster mandates more universally. Shady as expected.