September 2, 2022 - Good Enough for Me

Good Enough for Me

September 2, 2022

Alabama’s daily reported case count rose another 6% during the last week - from 2,239 cases per day to 2,385 cases per day. According to the Washington Post, Alabama’s per capita rate of 49 cases per 100K population is currently higher than every state, except Kansas (80 per 100K) and West Virginia (50 per 100K). In the U.S. as a whole, there are 26 cases per 100K, which is the same rate as France. In Germany, the rate is 36 cases per 100K and in the U.K., it is only 6 cases per 100K (Note: actual cases are estimated to greatly exceed reported cases due to the prevalence of at-home testing).

Alabama is doing better relative to hospitalizations, according to the U.S. Dept. of Health & Human Services. Statewide hospitalizations for Covid-19 dropped 4% this week, from 724 patients to 683 patients. This makes Alabama’s per capita rate of 14 hospitalizations per 100K population higher than the national average of 11 patients per 100K.

The big news this week is that Federal approval was granted for bivalent boosters that target the BA.5 subvariant, by far the dominant variant in the United States today. The Pfizer booster was approved for use in people as young as 12, and the Moderna booster was approved for those 18 and older, subject to the caveat that persons who either have received a booster or have contracted Covid-19 within the last 2 months should wait until they are outside this 2-month window to get the booster.

Following the FDA and CDC approvals, both Pfizer and Moderna immediately began shipping the vaccines to pharmacies and doctors. Alabama is expected to make the new booster widely available beginning this weekend.

Last week, I reported some reasons why the decision to give the new booster fast-track approval before human trials are completed might be controversial. (https://frankmcphillips.substack.com/p/august-27-2022-to-wait-or-not-to). As it turned out, the decision was less controversial than I anticipated, receiving a 13-1 favorable vote from the CDC’s advisory committee. As a lay person, I’d like to share my reasons for getting the booster next week.

First of all, I’m convinced that safety is a nonissue with respect to the new booster. There is universal confidence in the booster’s safety due to good data from earlier studies involving 1,400 adults who received BA.1-targeted bivalent vaccines produced by Pfizer and Moderna. Although the new booster targets the BA.5 variant, rather than Ba.1, the differences between BA.1 and BA.5 boosters are considered minimal. Indeed, the side effects of the BA.1 were the same or lower than for either the original booster formula or the original series that most everyone received in early 2021.

In terms of the likely effectiveness of the new booster, again the data from BA.1 bivalent booster studies show the bivalent vaccine is 1.22 times better. There is also evidence that the BA.1 bivalent booster is effective for as long as 6 months, which is somewhat longer than the duration of the original series (around 3-4 months). Granted, we don’t yet have human data on the efficacy of the BA.5 bivalent vaccine, but the same can be said of tweaks to the flu vaccine that are made virtually every year. Given the fact that BA.5 is the dominant strain today, and we have suffered through two consecutive winter surges, I want to receive the best protection possible today, even if the marginal benefit in efficacy is not precisely known.

Finally, as lay people, I believe we must place our trust in the experts. Our very own Dr. Jeanne Marrazzo, director of the infectious-diseases division at UAB, supports the bivalent booster approach. So does Dr. Katelyn Jetelina, who writes as “Your Local Epidemiologist”. So do 13 of the 14 experts who comprise the CDC’s Advisory Committee. Frankly, that’s good enough for me and I hope you find that it’s good enough for you. The totals:

8/20 - 2,199

8/21 - not reporting

8/22 - 1,461

8/23 - 3,512

8/24 - 2,910

8/25 - 3,020

8/26 - not reporting

8/27 - not reporting

8/28 - not reporting

8/29 - not reporting

8/30 - not reporting

8/31 -12,210

9/1 - 2,485

9/2 - 1,995