What should J&J’ers do now?

That’s definitely a question I’ve had for a long time.  I think as much as anything the much, much more rare status of J&J people has led us to be largely ignored (or at least belatedly paid attention to) in a lot of public health guidance, and to my display, led to far too little scientific discussion among all the science types I follow on twitter.

Finally, I found somebody on the case.  Stanford MD/PhD Michael Lin has been one of my best twitter finds of recent months and I love that in this great thread he actually gets nicely explicit on what all the latest findings on Omicron mean for J&J folks.  Whole thread is quite interesting, but here’s the key upshot:

JnJers who haven't gotten a RNA booster should be told to get one 2 months after their last J&J, and then another booster 6 months later. They can benefit from the wider B cell repertoire. If they are in a vulnerable population, they absolutely will need it.

— Michael Lin, PhD-MD 🧬 (@michaelzlin) December 14, 2021

Also, my physician said he’d consider letting me have another mRNA regardless of CDC guidelines once the science shows the benefit.  So, now that I’m writing this blog post I’ll at least know where to find this twitter thread to show him.  Hopefully by the point I should get that booster, though, there will be something more than a twitter thread to show him.

Also, next semester I’ll be interacting with probably a fair number of people whose primary dose was J&J (NCSU was really pushing it on students last April due to the ease of just 1 dose and the fact that many would leave at the end of Spring semester before a 2nd dose), so, I really want them as boosted as possible, too.  

Does the anti-booster crowd get an annual flu shot?

I was very pleased to see that the FDA actually acted fairly boldly in expediting approval for 16-17 year olds to get boosters without all the advisory committees, etc.  This is much-needed as it is entirely clear that a full vaccination for Covid is 3 shots with the third at least several months later (officially, 6 months, but I’ve read 5 months is probably optimal).  Personally, I’m very pleased my 15 year old will be able get his 3rd shot when he turns 16 in another month (and 7 months after his second shot).

What’s really frustrating, though, is the anti-booster crowd once again joining in against this (even with an Omicron wave bearing down on us):

Not everyone agrees young people need boosters. Paul A. Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, said on a media call Wednesday that he didn’t see a “compelling reason” to administer a booster to healthy young people. The two-dose regimen adequately protects those individuals from serious illness, he said.

Or, for example, this…

No booster for my 17-yr-old son for now. I trust his 2 shots (+ young age) to prevent serious COVID outcomes.

Caveat: I *would* boost him if he had comorbidity or immune deficiency.

New study from Germany: zero COVID deaths in healthy kids age 5-17.👇https://t.co/dLTiuZ8D1R

— Lucy McBride, MD (@drlucymcbride) December 10, 2021

It’s not just about serious Covid!  It’s about not getting sick and not spreading disease. You are far more likely to spread Covid if you get a symptomatic case of Covid, which you are far more likely to do if you are not boosted (or, as I know prefer to think about it, fully vaccinated with 3 shots).

I don’t know why it didn’t occur to me before, but, do these people get influenza vaccines?  According to their logic, they shouldn’t, as the risk of a serious case of influenza to an otherwise healthy adult is pretty close to zero.  But I bet virtually all the anti-booster crowd does get their influenza shot.  Why?  Because it sucks having a significant respiratory disease (even if you aren’t a “serious” case) and because it means you are less likely to spread the disease to others.

So, let’s get the third shot in everyone we can with Omicron and its significant vaccine escape bearing down on us.  (And, yes, of course, try and get first and second shots in everyone we can, but anybody who hasn’t by now is a tough nut to crack).