11 Comments
Jan 12, 2023Liked by Jeremy Faust, MD

Thank you for this. I am in for five and hoping we get to one a year for those who need it or for all of us. Really hoping this virus stops throwing curve balls. We all need a break!

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Waiting to hear if seniors should receive another boost of the bivalent after 6 months…

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One more question...are we at a point where we can fear this virus less from an outcome perspective?

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I appreciate how you acknowledge the modest reduction in absolute numbers of 65+ hospitalizations. The rate is so much more favorable at 1:2200 instead of the much scarier 1:200 previously.

I am also a big fan of the relative risk reductions, as a 90% reduction in hospitalizations, and an 86% reduction in deaths in the Israeli study sounds convincing.... even as the absolute numbers are less impressive.

It seems like the emerging evidence has been disappointing for repeated boosters and better protection against long Covid. Seems like that is plateauing. Makes me more motivated to recommend Paxlovid/remdesivir which I believe was shown to reduce long Covid by 25% in older patients, and probably more like 40-50% I’m guessing in middle aged patients who are the most likely to develop long Covid. No data on this age group that I’m aware of.

Offit is still dug in against the data with his booster op-ed downers. Eric Topol’s recent post on Ground Truths addresses this problem directly towards the end.

And finally, I think 5 or so studies of neutralizing antibodies show superiority of the bivalent boosters over the original boosters, with neutralization titers against live virus being 2-8X higher. This includes against BA.1.5 and XBB. Real world outcomes and T cell immunity markers I’m not sure but would seemingly be better based on this data you presented here.

Not regretting my bivalent booster, for myself, family, and persuaded patients!

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