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New COVID Boosters

Many people have questions about the new COVID vaccine boosters.  Keep reading for answers to some of the most common ones here.

What’s new in this latest round of COVID vaccine boosters? 

The original COVID vaccines were effective at preventing infection and very successful in preventing complications from the Alpha and Delta strains.  But they are less effective against the Omicron variants which are more transmissible and immune-evading.

On September 1, 2022 the CDC approved new boosters from Pfizer (for ages 12 and up) and Moderna (for ages 18 and up).  These updated boosters add Omicron BA.4 and BA.5 to the original vaccine composition. 

Moderna COVID-19 vaccine, Bivalent is the name for Moderna’s new booster.  Pfizer’s new booster is called Pfizer-BioNTech COVID-19 vaccine, Bivalent.  Bivalent just means there are two strains in the vaccine (alpha and omicron).  I think we should call it COVID vaccine 2.0.

Is it better than the original?

As COVID has mutated into different strains and subvariants, it has gotten better at evading the vaccine.

For the original strain (Alpha) and the later strain (Delta), Pfizer and Moderna initial two-shot series were about 75% effective at preventing infection and 90-95% effective at preventing serious complications.  But the vaccines were less effective against Omicron – only 30-40% protection against infection and 70% protection against hospitalization.  A 3rd booster shot boosted effectiveness against infection to 75% and 88% for severe disease.

Unfortunately, it’s unclear exactly how much protection the new booster shots will provide, but models suggest 80% protection from infection and around 90% for prevention of complications. 

How could they approve the new booster without large clinical trials?

Believe it or not, this is something that has been done for decades with the flu shot.  The flu shot is reformulated every year based on an educated guess of what the circulating strains will be in the coming year.  They might take 1 or 2 strains out and put in different ones. 

Flu shots are made using eggs and take 9 months to produce.  Because large clinical trials require time (a minimum of 3-6 months, often longer), it’s not feasible to run clinical trials each year.  They have decades of data showing the vaccine is safe and effective (some years more than others), so they approve the latest formulation based on that history.  This has been a very effective strategy allowing the flu shot to adapt each year just in time for the next flu season.

They have adopted a similar process for the new COVID vaccine booster.  They have extensive safety and effectiveness data for the original COVID vaccines (over 600 million doses given in US).  Additionally, they have safety and immunogenicity data from a clinical study of a bivalent COVID-19 vaccine that contained mRNA from the Alpha strain and mRNA from the original Omicron strain (not BA.4 or BA.5 subvariants).

Should I get one?

Yes.  I plan to get mine and will give it to my 87-year-old mother.  I’ve encouraged my children (in their 20’s) to get it as well.

When should I get it?

Although you can get it as early as 2 months after your previous booster, I recommend waiting 4 months after your last booster.  That’s the point where the vaccine efficacy seems to drop. 

Another consideration is the current amount of COVID infections.  Currently cases are relatively low.  We are anticipating a surge in December/January, like what we’ve had for the past two years.  So, you might want to get the booster in October or November to have good immunity in December and January.

Does the new booster have side effects?

They are expected to be similar to the original vaccine – soreness in arm, body aches, fever, etc.

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Activities for a Stay at Home Order

Given the new lockdown orders in California, we need to get creative again to stay connected and engaged. Here are some of my favorites from a great article: 

Check out this article for more options.  Which are your favorite?

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Coronavirus Scams

The COVID-19 pandemic is now in its 6 month in the US, and there are still a lot of unanswered questions and fear. Unfortunately scam artists are praying on that fear and uncertainty. Wearing a mask and social distancing help protect you from COVID-19. But how do you protect yourself from COVID-19 scams? Learn what to look for and what common scams look like!

  1. COVID-19 Text Scams: Scammers use links in texts to put malicious code on your phone or link to a phony website that tries to get your personal information. NEVER click a link in a text about COVID. There are scams touting cures, warnings about the need for a test, or “special offers.” Some specific scams:
  • Claiming to be from the “FCC Financial Care Center” and offering $30,000 in COVID-19 relief.
  • Impersonating the U.S. Department of Health and Human Services. Recipients are told they must take a “mandatory online COVID-19 test”
  • “IRS COVID-19 News” includes a link and instructions for recipients “to register/update your information in order to receive the economic impact payment regardless of your status.” 

2. Posing as a Contact Tracer: These are the most scary in my opinion. True Contact Tracers work for state health departments to try to track anyone who may have been exposed to COVID-19, and they are an important part of our road to recovery. It differs from state to state, but they may contact you by call, email, text or even visit your home. They may ask for your name and address, health information, and the names of places and people you have visited. They WILL NOT ask for:

  • Payment of any kind
  • Your Social Security number or financial information. 
  • Immigration status
  • you to click on a link or download anything. Real tracers will only send you texts or emails that say they’ll be calling you

3. Stimulus payment scams: These are less common now, but if there is a second round of stimulus payments, these scams will certainly return. Tips to avoid these scams:

  • Use only IRS.gov/coronavirus to submit information
  • The IRS won’t contact you by phone, email, text message, or social media with information about your stimulus payment
  • The IRS will not reach out to you to ask you for your Social Security number, bank account, or government benefits debit card account number.
  • You don’t have to pay to get your stimulus money.
  • The IRS won’t tell you to deposit your stimulus check then send them money back because they paid you more than they owed you. 

4. Robocall scams: phone scammers have seized the opportunity, using robocalls and call-back scams to offer free home testing kits, promote bogus cures, sell health insurance and promise financial relief. Some current Robocall scams include:

  • Purporting to be from WHO and asking for account information or money
  • Offer free virus test kits in an effort to collect consumers’ personal and health insurance information. One pernicious version of this scam targets higher risk individuals with diabetes, offering a free COVID-19 testing kit along with a free diabetic monitor. 
  • Marketing fake cures and asking for payment over the phone. If you get a call that says a product can prevent, treat, or cure COVID-19, stop. Think to yourself: if there’s actually been a medical breakthrough, am I really going to hear about it for the first time from an ad or sales pitch? The answer is clearly “no.”
  • COVID-19 themed work-from-home opportunities, debt consolidation offers, and student loan repayment plans. (For legitimate information about the coronavirus-related interest rate deferral on student loans, check FSA’s website.
  • Small businesses are also getting scam calls about virus-related funding or loans and online listing verification.

5. COVID mask exemption cards:  There are cards circulating online and on social media that say the holder has a disability that prevents them from wearing a mask, and that it’s illegal for any business to ask them to disclose their condition. Variations of the card include the seal of the U.S. Department of Justice (DOJ), one of the federal agencies responsible for enforcing the Americans with Disabilities Act (ADA). These cards aren’t issued or endorsed by DOJ, or any other federal agency.

6. Free COVID-19 money offers on WhatsApp and Facebook: Have you seen a message on WhatsApp or Facebook offering you free help during the pandemic? These messages all offer money to people who need it — through grants, coupons for food support, or other giveaways. But they’re all fake. The message may tell you to click a link to get your money. If you click, you might find a survey to take. Or they might ask you to enter your name, address, phone number, or other information. And they might ask you to forward the message to several friends to be eligible to collect. DON’T CLICK ON ANY LINKS in these messages.

7. Coronavirus Charity Scams: Opportunistic scammers are using fake appeals or sham charities to swindle donations from good-hearted people. Before you give, do some research. Search online for the charity’s name and the words “scam” or “fraud.” Review ratings of the charity by organizations like BBB Wise Giving Alliance, Charity Navigator, CharityWatch, or GuideStar. Here are some tips to make sure you’re not talking to a scammer:

  • Donate using a credit card. It’s the safest way to donate.
  • Double check the name of the organization. Many fake charities try to trick you by using names similar to those of well-known organizations, but with one word different or a misspelled.
  • Ask lots of questions. What’s the charity’s website, address, and mission? How much of my donation will go to the program I want to help? How many people does the charity help, and how? If you get vague answers, it’s probably a scam.
  • Don’t assume a donation request on social media is legitimate just because a friend liked it or shared it. Call your friends or contact them offline to ask them about the post they shared.

8. Scams targeting older Americans:

  • The US Securities and Exchange Commission posted a warning about fake stock offers pitching a nonexistent biotech company developing a vaccine for COVID-19.
  • The Social Security Administration posted an alert about a scam claiming that benefit payments may be suspended or decreased due to office closures related to the COVID-19 pandemic. Any call, text or letter offering to “maintain regular benefit payments” if you make a payment is FAKE.
  • Another scam offers investment gains while protecting against losses — a coronavirus twist on a classic phony investment offer.
  • Pandemic versions of the “grandparent scam,” where a scammer poses as a relative, often a grandchild, in a desperate situation and urgently in need of money. 

If you see a scam, report it to ftc.gov/complaint or fcc.gov/complaints.

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All About Coronavirus Testing

There is a lot of confusion about Coronavirus testing – should I get tested? When? How often? Which test? What do the results mean?

One reason for so many questions is that we still don’t know very much about COVID-19, although we’re learning new information every day. So I’ve tried to explain testing and what it does (AND DOESN’T) tell us.

TYPE OF TEST:

Virus Test – The test for active Coronavirus infection is done by PCR (polymerase chain reaction) which picks up even very tiny amounts of viral RNA. This is usually done by deep nasal swab. Yes, this can be uncomfortable, but that’s where the virus lives in large amounts, so it is the best place to sample. Throat swabs are less sensitive so you might get a negative result but still be infected.
       Rapid test – Results within 15-30 minutes. This requires an expensive machine to run, so it’s often only available in ER or hospitals.

       Standard test – Is done by most labs, turnaround is usually 2-5 days

Antibody test – this test tells is if we’ve been infected in the past. These antibodies develop about 4 weeks after the acute infection. This test requires a routine blood draw and turnaround time is about 1-2 days.

HOW GOOD IS THE TEST:
We’ve heard a lot about various tests with some being better than others. The FDA has given Emergency Use Authorization to a number of tests and click here for a good explanation of their findings. All of the tests they’ve “approved” are performing reasonably well, so I’ve personally decided not to get lost in this discussion (sensitivity, specificity, positive predictive value, negative predictive value, etc).

WHAT DO THE RESULTS MEAN :
For this discussion, I’m assuming the test is accurate. But remember that no test is always 100% accurate.

Virus test (nasal swab):
     A positive test means there is virus RNA in your body – you are actively infected, even if you don’t have symptoms. You are infectious to other people and should self quarantine. There is a caveat here – people who get infected with COVID-19 can remain positive on this test for up to 12 weeks. Since we do not believe people are infectious this long, it may be that the test is picking up dead virus. But this remains an area of significant uncertainty.

     A negative test means there is no virus RNA present – you are not actively infected. You are not infectious

Antibody test (blood test):
     A positive test means you’ve been infected with Coronavirus at some point in the past. This is very helpful to Public Health professionals to know what percentage of the population has been infected and how close we are to “herd immunity”. It is less helpful for a specific individual and questions remain:
  –  it doesn’t tell us when you were infected.We do not know how long these antibody tests remain positive – a few months, a few years or forever?

  –  We do not know if these antibodies protect us from getting infected again. With some viruses (e.g. cold viruses), antibodies protect us for a short while, but we can get infected again and again. With some viruses (e.g. chicken pox, measles) antibodies protect us and we only get infected once in a lifetime. And with other viruses (e.g. herpes, HIV), having antibodies doesn’t help at all – we remain chronically infected.

   A negative test means you’ve not been infected with Coronavirus in the past. One caveat: If you’re recently infected with Coronavirus, the antibody test will not become positive for about 4 weeks.

WHEN TO TEST:
With symptoms – Always test if you have symptoms suggestive of Coronavirus.
After an exposure – Not everyone gets infected even if exposed. But when (and if) to test is an area of debate . The incubation period of Coronavirus is 2-14 days. If you test negative on day 2, unfortunately you can still turn positive on day 3, 4, 5 up to day 14. So regardless of the results, you should self isolate for 14 days. One recommendation is to test on day 14 – if negative you can safely return to life.
Before visiting a high risk person – Ideally get a rapid viral test right before you’re planned visit. A negative result means you can visit Grandma without concern you’ll spread it to her. This is limited by the availability of the rapid test (see “where to get tested” below). If you are planning on visiting Grandma for a week, however, you’ll need to test every day which is often not feasible.

WHERE TO GET TESTED (San Diego County):
  –  I offer standard virus and antibody testing in my office. I do not have rapid virus testing.

  –  County testing sites can be found here. These sites are free and some require an appointment.

  –  Scripps is only testing patients with symptoms. If you are a Scripps patient, Call the Scripps Nurse line (888-261-8431) to get scheduled. They offer standard virus testing, they are not doing rapid virus testing.

  –  Many CVS locations offer standard virus testing with 2-4 day turnaround. Cost is usually covered by insurance. Register in advance at CVS.com.

  –  CovidClinic.org In downtown San Diego offers rapid virus testing and antibody testing for about $150

  –  QuestDirect allows people to request an antibody test and pay for it online ($130). An appointment is then made for a blood draw at a Quest lab.

  –  At Home testing – this is a rapidly expanding area with many unknowns currently. I will provide more information in the next newsletter.