Covid vacs cut back for under 65s

[Julian]

If the body has reasonable immunity after having a jab, why are they giving out boosters? Presumably because they give even better protection.

My wife is under 65 but would like the booster. As so many over 65s will not bother to get the booster, could they not give it instead to younger people who would like it?

The evidence shows that the booster will not prevent you from catching the virus, nor stop you passing it on to anyone else. ...

Are you sure that's true John? I suppose that "preventing you from catching the virus" could be taken to mean 100% efficacy in which case yes, none of the vaccines are ever 100% effective at preventing infection, but I thought that at least in the first couple of months after a booster antibody levels went back to very high levels such that, even with some quite significant reduction in neutralising capability against newer strains than the booster was designed for, the level of cross neutralisation was still high enough when taken together with the temporary very high levels of antibodies to still give some protection against infection (50% or so efficacy or maybe slightly higher?).

Maybe the government thinking here, presumably informed by the epidemiologists they are consulting, is that even if the boosters only offer a 50% reduction in risk of infection for 2 or 3 months after administration that might still be useful in keeping case rates down and giving fewer opportunities for additional mutations to occur.

Also, you do go on to mention that the vaccines have a significantly more durable effect re preventing severe disease but for some people who only ever had their first booster that might have been coming up to 2 years ago now and my understanding is that while protection against severe disease is more durable it does still show at least some modest decline over time so maybe the government policy makers are exercising some caution there and, for the more vulnerable, wanting to ensure that protection against serious illness gets bumped up again where possible rather than staying on a course of even very gradual year-on-year decline.

Re the short-term boost in antibody levels, here's some recent Moderna results on its latest vaccine - an 8.7 fold increase in neutralising antibodies at least initially - https://www.cnbc.com/2023/09/06/moderna ... riant.html

Yes, it would be no surprise to see those antibody levels contract quite significantly after a few months but maybe the epidemiologists do think that even 2 or 3 months of attenuated transmission might have a significant impact on the size of the peak of the next wave, particularly among the elderly and vulnerable demographic, and that an extra boost over even still pretty decent existing protection against severe illness can't do any harm in terms of reducing the strain on the NHS over this next winter season (and with the possibility of the NHS still having to deal with strike action on top of everything else this next winter season must be looking pretty scary to government planners right now so I can understand an "every little helps" mentality right now).

- Julian

[Watis]

Is there an official view on whether someone should have - or would even need - this autumn's booster if they have just got over a recent bout of Covid, probably one of the new variants?

Wouldn't having had actual Covid give better immunity going forward than the vaccination?

Asking for a friend.

Watis

[redsturgeon]

The evidence shows that the booster will not prevent you from catching the virus, nor stop you passing it on to anyone else. ...

Are you sure that's true John? I suppose that "preventing you from catching the virus" could be taken to mean 100% efficacy in which case yes, none of the vaccines are ever 100% effective at preventing infection, but I thought that at least in the first couple of months after a booster antibody levels went back to very high levels such that, even with some quite significant reduction in neutralising capability against newer strains than the booster was designed for, the level of cross neutralisation was still high enough when taken together with the temporary very high levels of antibodies to still give some protection against infection (50% or so efficacy or maybe slightly higher?).

Maybe the government thinking here, presumably informed by the epidemiologists they are consulting, is that even if the boosters only offer a 50% reduction in risk of infection for 2 or 3 months after administration that might still be useful in keeping case rates down and giving fewer opportunities for additional mutations to occur.

Also, you do go on to mention that the vaccines have a significantly more durable effect re preventing severe disease but for some people who only ever had their first booster that might have been coming up to 2 years ago now and my understanding is that while protection against severe disease is more durable it does still show at least some modest decline over time so maybe the government policy makers are exercising some caution there and, for the more vulnerable, wanting to ensure that protection against serious illness gets bumped up again where possible rather than staying on a course of even very gradual year-on-year decline.

Re the short-term boost in antibody levels, here's some recent Moderna results on its latest vaccine - an 8.7 fold increase in neutralising antibodies at least initially - https://www.cnbc.com/2023/09/06/moderna ... riant.html

Yes, it would be no surprise to see those antibody levels contract quite significantly after a few months but maybe the epidemiologists do think that even 2 or 3 months of attenuated transmission might have a significant impact on the size of the peak of the next wave, particularly among the elderly and vulnerable demographic, and that an extra boost over even still pretty decent existing protection against severe illness can't do any harm in terms of reducing the strain on the NHS over this next winter season (and with the possibility of the NHS still having to deal with strike action on top of everything else this next winter season must be looking pretty scary to government planners right now so I can understand an "every little helps" mentality right now).

- Julian

You seem to think I am against the government's vaccine programme when I actually support it.

Mea culpa, Perhaps my wording was not entirely correct and better would have been to talk about lack of significant evidence re. infection and transmission prevention rather than to suggest evidence against.

I have yet to see any evidence that shows significant prevention of infection or transmission of Omicron by the latest boosters. My understanding is that the manufacturers are claiming only lessening of serious outcomes via the vaccines. I am happy to change that view if evidence exists.

In the light of only mild symptoms for the vast majority of healthy under 65 year olds therefore it seems OK to me for the government to recommend vaccines be reserved for over 65s and those who are at extra risk.

As with all public health interventions the cost/risk/benefit equations need to be considered.

I don't dispute the vaccines work but suggest that the time for mass vaccinations of the whole populations is over and I even think with hindsight that the vaccination of younger adults and children may have been a mistake.

[Julian]

Are you sure that's true John? I suppose that "preventing you from catching the virus" could be taken to mean 100% efficacy in which case yes, none of the vaccines are ever 100% effective at preventing infection, but I thought that at least in the first couple of months after a booster antibody levels went back to very high levels such that, even with some quite significant reduction in neutralising capability against newer strains than the booster was designed for, the level of cross neutralisation was still high enough when taken together with the temporary very high levels of antibodies to still give some protection against infection (50% or so efficacy or maybe slightly higher?).

Maybe the government thinking here, presumably informed by the epidemiologists they are consulting, is that even if the boosters only offer a 50% reduction in risk of infection for 2 or 3 months after administration that might still be useful in keeping case rates down and giving fewer opportunities for additional mutations to occur.

Also, you do go on to mention that the vaccines have a significantly more durable effect re preventing severe disease but for some people who only ever had their first booster that might have been coming up to 2 years ago now and my understanding is that while protection against severe disease is more durable it does still show at least some modest decline over time so maybe the government policy makers are exercising some caution there and, for the more vulnerable, wanting to ensure that protection against serious illness gets bumped up again where possible rather than staying on a course of even very gradual year-on-year decline.

Re the short-term boost in antibody levels, here's some recent Moderna results on its latest vaccine - an 8.7 fold increase in neutralising antibodies at least initially - https://www.cnbc.com/2023/09/06/moderna ... riant.html

Yes, it would be no surprise to see those antibody levels contract quite significantly after a few months but maybe the epidemiologists do think that even 2 or 3 months of attenuated transmission might have a significant impact on the size of the peak of the next wave, particularly among the elderly and vulnerable demographic, and that an extra boost over even still pretty decent existing protection against severe illness can't do any harm in terms of reducing the strain on the NHS over this next winter season (and with the possibility of the NHS still having to deal with strike action on top of everything else this next winter season must be looking pretty scary to government planners right now so I can understand an "every little helps" mentality right now).

- Julian

You seem to think I am against the government's vaccine programme when I actually support it.

Mea culpa, Perhaps my wording was not entirely correct and better would have been to talk about lack of significant evidence re. infection and transmission prevention rather than to suggest evidence against.

I have yet to see any evidence that shows significant prevention of infection or transmission of Omicron by the latest boosters. My understanding is that the manufacturers are claiming only lessening of serious outcomes via the vaccines. I am happy to change that view if evidence exists.

In the light of only mild symptoms for the vast majority of healthy under 65 year olds therefore it seems OK to me for the government to recommend vaccines be reserved for over 65s and those who are at extra risk.

As with all public health interventions the cost/risk/benefit equations need to be considered.

I don't dispute the vaccines work but suggest that the time for mass vaccinations of the whole populations is over and I even think with hindsight that the vaccination of younger adults and children may have been a mistake.

We seem to have had a misunderstanding. Apologies if something in my phraseology made you think I was casting you as someone against the government's vaccine policy. I've read a lot of your posts since the pandemic and my impression is and always has been the exact opposite re your views, i.e. that they are broadly in line with mine.

I specifically asked about your doesn't-prevent-infection comment because I know that you used to (still do?) run a testing company so had been following things quite closely at some point hence I thought it entirely possible that your comment was because you had kept more up to date with the data than I have and if so then my impression based on previous data that the vaccines can somewhat reduce the chances of infection, at least for a few weeks or months after vaccination, might no longer be accurate.

The more likely reason why I thought you might have made that doesn't-protect comment was for much the same reason as I might on occasion make it, namely that sometimes I get so infuriated by the mantra many anti-vaxxers spout that the "vaccines don't work" because they "don't prevent infection", while completely ignoring the huge benefit of significant and relatively long-lasting protection against serious illness, that sometimes I think "fine, I can't be bothered to argue the nuances of protection against infection, I'll just totally concede that point so that I can move on to making the point about protection against severe illness".

On the assumption that the reason for your statement was that second reason, while I understood your reasoning (there's only so much banging your head against anti-vaxxer brick walls that you can do without it hurting), I felt that in this particular instance you might have ceded that particular piece of the battleground (doesn't stop infection) a little too easily within the context of this particular why-the-next-round-of-boosters? discussion so I thought it might be useful to maybe retake a bit of that battleground and fill in a bit of potential extra justification related to there maybe being an added benefit from even a short lived 50%-ish reduction in infection rates amongst the boosted population.

I typed everything after my initial "Are you sure" question thinking that what I was typing was additional support for your position. I did not for one second intend it to be taken as me in some way thinking you were against the booster program; sorry again that it appears to have come across in the wrong way.

- Julian

[redsturgeon]

No apology needed Julian. I think that our views pretty much align on the whole issue and it may indeed have been me getting the wrong end of the stick.

John

[elkay]

Surely, if vaccination reduces symptoms, it therefore reduces the potential for spread of the diseease through those symptons? E.g. less coughing, lower viral spread when breathing out?

Incidentally, in my daughters' workplace there are about 15-20 employees. 10 tested positive over the last 2 weeks of August - and that didn't include my daughter and her boss who were unwell with covid-like symptoms, but tested negative.

[dealtn]

Incidentally, in my daughters' workplace there are about 15-20 employees. 10 tested positive over the last 2 weeks of August - and that didn't include my daughter and her boss who were unwell with covid-like symptoms, but tested negative.

Interesting. How are they "testing"? In my world that is almost entirely no longer possible.

[mc2fool]

Incidentally, in my daughters' workplace there are about 15-20 employees. 10 tested positive over the last 2 weeks of August - and that didn't include my daughter and her boss who were unwell with covid-like symptoms, but tested negative.

Interesting. How are they "testing"? In my world that is almost entirely no longer possible.

Uh? Boots, and I expect other pharmacies, are still selling lateral flow test kits.

https://www.boots.com/health-pharmacy/covid-19-information-products-and-testing/covid-test-kits

[dealtn]

Interesting. How are they "testing"? In my world that is almost entirely no longer possible.

Uh? Boots, and I expect other pharmacies, are still selling lateral flow test kits.

https://www.boots.com/health-pharmacy/covid-19-information-products-and-testing/covid-test-kits

Thank you. Neither my or my wife's workplace (or indeed industry) receives kits, not encourages (let alone insists on) testing now. Good to know that for those that are concerned about their situation that option remains available.

Interesting that for someone though their sickness rate is more than 50% AND that they are testing (and presumably paying for that). Is that usual? As I say its not something I recognise among my (or wife's) peer group.

[redsturgeon]

PCR tests are still available and necessary for travel to certain destinations.

[servodude]

PCR tests are still available and necessary for travel to certain destinations.

Do you know if there is somewhere we can look to check the requirements?

I mean like a global portal for travel - or is it on a case by case (country by country) hunt on the internet basis

It occurs to me that I've got tickets booked for a late year trip and I'm well out of touch on what might be required re transfers/stop-overs etc as it's just "not a thing" in these parts
(and I was going to watch the "last night of the proms" before the rugby )

[servodude]

Uh? Boots, and I expect other pharmacies, are still selling lateral flow test kits.

https://www.boots.com/health-pharmacy/covid-19-information-products-and-testing/covid-test-kits

Thank you. Neither my or my wife's workplace (or indeed industry) receives kits, not encourages (let alone insists on) testing now. Good to know that for those that are concerned about their situation that option remains available.

Interesting that for someone though their sickness rate is more than 50% AND that they are testing (and presumably paying for that). Is that usual? As I say its not something I recognise among my (or wife's) peer group.

My better half works in a school and they have cupboards full of "stock" nearing expiry that they can't give away because no-one cares!

Makes a change from my first bout all that time ago where I realised I should go home instead of look to source a test kit.... because I'd driven round a round about a few times (the glass in the throat and what I thought were hallucinations probably should have been enough warning given I'd not really been "mixing")

[Hallucigenia]

Interesting that for someone though their sickness rate is more than 50% AND that they are testing (and presumably paying for that). Is that usual? As I say its not something I recognise among my (or wife's) peer group.

I'd assume it's "reactive" testing - feeling sick and then testing, to see how careful they should be around other people - rather than routine testing proactively to catch it before symptoms appear.

I think I've had Covid-19 four times now. The first time was before tests became available, but my first test on all the others was negative despite being supposedly "in the window" for a lateral flow to work. In fact the only time I've tested positive was when I ignored the instructions and tested my throat as well as nose - the omicrons of last summer seemed to be particularly "throaty". But other people around me were getting it much worse and clearly could only have been Covid.

[redsturgeon]

PCR tests are still available and necessary for travel to certain destinations.

Do you know if there is somewhere we can look to check the requirements?

I mean like a global portal for travel - or is it on a case by case (country by country) hunt on the internet basis

It occurs to me that I've got tickets booked for a late year trip and I'm well out of touch on what might be required re transfers/stop-overs etc as it's just "not a thing" in these parts
(and I was going to watch the "last night of the proms" before the rugby )

I only know because Mrs RS told me someone needed one for travel to an African country last week(can't remember which one) and China was needing them in the last few months but the situation changes day by day so really checking individual countries is the best way.

John

[dealtn]

Interesting that for someone though their sickness rate is more than 50% AND that they are testing (and presumably paying for that). Is that usual? As I say its not something I recognise among my (or wife's) peer group.

I'd assume it's "reactive" testing - feeling sick and then testing, to see how careful they should be around other people - rather than routine testing proactively to catch it before symptoms appear.

I think I've had Covid-19 four times now. The first time was before tests became available, but my first test on all the others was negative despite being supposedly "in the window" for a lateral flow to work. In fact the only time I've tested positive was when I ignored the instructions and tested my throat as well as nose - the omicrons of last summer seemed to be particularly "throaty". But other people around me were getting it much worse and clearly could only have been Covid.

I assume so too, just surprised, especially as it appears you now have to pay, that a business would have as many as half of staff willing to pay and actually doing as you describe. I can guarantee it wouldn't happen in my business.

[Hallucigenia]

I assume so too, just surprised, especially as it appears you now have to pay, that a business would have as many as half of staff willing to pay and actually doing as you describe. I can guarantee it wouldn't happen in my business.

It comes down to respect for your fellow workers - and the practical cost/benefit of trying to muddle through. How much does a test cost versus the cost of having someone off work for 2 weeks? Which is what happened to someone else who was at the same meal that I (probably) got it this summer. Even though I didn't test positive, as soon as I got a sore throat I started masking and only took the mask off during the day when I went outside to eat - two days later I was properly ill and not leaving my bed. I'd hope that by taking precautions as soon as I got the sore throat, I saved several people from getting it.

[Julian]

I assume so too, just surprised, especially as it appears you now have to pay, that a business would have as many as half of staff willing to pay and actually doing as you describe. I can guarantee it wouldn't happen in my business.

It comes down to respect for your fellow workers - and the practical cost/benefit of trying to muddle through. How much does a test cost versus the cost of having someone off work for 2 weeks? Which is what happened to someone else who was at the same meal that I (probably) got it this summer. Even though I didn't test positive, as soon as I got a sore throat I started masking and only took the mask off during the day when I went outside to eat - two days later I was properly ill and not leaving my bed. I'd hope that by taking precautions as soon as I got the sore throat, I saved several people from getting it.

And also not everyone has to pay for tests. I don't. I'm not special but my next I think 7 tests will be free, provided they are all taken before 3rd May next year(*). That's simply because I bought a couple of boxes of tests a year or so ago when people were still more inclined to use them and I still have unused tests left over. I wonder how many other people might also still have a few tests still kicking around at home. Some people I know went pretty crazy stocking up on tests in the final weeks when they were still free and I bought mine not long after they stopped being free so I can imagine that tests in the free 7-packs might still be inside their expiration dates.

I would still test, partly out of curiosity, if I came down with something that felt worse than a mild to moderate cold.

- Julian

(*) 3rd May 2024 is the expiry date on my tests (I just checked) although, like food with many months of shelf life, I'm sure the tests won't suddenly become invalid (or food toxic) on the expiration/best-before date. Presumably there is some decent margin taken into account so I would still use my tests for a few months after the expiration date.

[elkay]

Incidentally, in my daughters' workplace there are about 15-20 employees. 10 tested positive over the last 2 weeks of August - and that didn't include my daughter and her boss who were unwell with covid-like symptoms, but tested negative.

Interesting. How are they "testing"? In my world that is almost entirely no longer possible.

Her workplace had some stock of unexpired tests. However, my daughter didn't go into work, choosing to work from home, and her partner called to collect a box of tests that I had left over - we had several boxes when they started charging, and only use them when symptons indicate it is a possibility, and take into consideration who we would be encountering. My wife and I were regularly meeting with three very vulnerable relatives, and therefore asked our daughters not to visit us when they were unwell.

Incidentally, my other daughter was unwell, but also tested negative. As a school teacher, she couldn't avoid contact with her students, but did try to reduce any risk of exposure to them.

At the end of the day, it doesn't really matter as much now whether it is Covid, a heavy cold, or the flu - we will try and reduce risk of exposing those that are vulnerable to any bug that might affect the respiratory system. The testing of Covid is more for interest than any specific action, therefore we probably wouldn't pay for tests...

[Clariman]

I would happily have a covid vaccination but I'm not eligible. I'm not a long way from 65 and with mild asthma, high BMI (but not >40) and on some medication for blood pressure, I would like one, but don't qualify.

I remember the phone call I had with my GP at the beginning of Covid and it still scares me, "Mr Clariman, we've seen a lot of overweight men of your age seriously ill with this Covid, so you should exercise extreme caution."

I had it a few times and was not seriously ill but that may have been thanks to recent vaccinations.

Maybe I'm feeling sorry for myself. I had a virus last week, recovered from it, and went down with another virus 4 days later. Perhaps age is making me more vulnerable.

[Dod101]

Personally I am more concerned about a wasp bite. I was doing some weeding in my garden last Friday evening and I clearly disturbed a wasp or three. Got a sharp bite on my upper arm and it swelled, got hot and itched like nothing on earth. Saturday it was uncomfortable and on Sunday was worse so wasted hours trying to get hold of NHS24. Only now is it calming down but I feel nervous about resuming my weeding!

Dod