Covid-19 vaccines and vaccinations

Sasha said:
Do you have a link to the JCVI info?
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I can't remember which document it was now, but there's something on gov.uk (specifically about heath and care workers) that contains very similar wording:

www.gov.uk

Advice accepted on autumn 2025 COVID-19 vaccination programme

The government has accepted advice from the Joint Committee on Vaccination and Immunisation (JCVI) for the autumn 2025 COVID-19 vaccination programme.
www.gov.uk www.gov.uk

In the current era of high population immunity to COVID-19, additional COVID-19 doses provide very limited, if any, protection against infection and any subsequent onward transmission of infection.
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By the same token, it's not a given that vaccination would provide a net benefit to people who're at low risk of infection in the first place.

The vaccine programme is about trying to reduce the risk of severe illness, not stopping people getting infected. But if your exposure to the virus is much lower than normal because you're not socialising unprotected, it follows that your risk of severe illness is also lower than normal.

The risk weighting then starts to shift the other way. Some people do get side effects from Covid vaccines, possibly at a higher rate than has been realised, so is that a bigger risk than developing severe Covid symptoms?

Obviously I don't know, but that's the point I was making.

For people with ME/CFS who're not on immune suppression and don't have any of the conditions known to be associated with severe Covid, it's unclear whether the vaccine would help. The risk is not so much that they might end up with respiratory failure, but that the virus (like any other infection) has the potential to make their ME/CFS worse. If the vaccine could help them avoid infection it'd definitely be worth it, but often it doesn't.
 
Sasha said:
I wish we had some numbers on the various risks.
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Yeah, I know. It probably wouldn't be easy to look at the consequences of infection on people's ME/CFS without a formal study though.

A proportion of them will get a mild infection and shake it off much like a healthy person, which won't get recorded because there's no need to see a doctor. Some will get it without even realising, either because they've no symptoms at all or it's indistinguishable from a cold. They're also invisible.

The only data likely to be available is reports of people who've been hit really hard by it or needed months to recover their previous level of function. But it'll be a very skewed picture.

We're a weird anomaly when it comes to things like this ... probably not at any increased risk from Covid itself, but at very difficult-to-quantify risk from worsened ME/CFS.
 
Article (CBS news) about limited access to COVID vaccines in the USA.

CVS and Walgreens limit access to COVID vaccines as required by some state guidelines

Note that this is not just about age limits. My husband is 73. I thought there would be no restrictions for COVID vaccines for anyone over 65. But when I tried to make a vaccine appointment (includes entering a birth date) for him I got a message that a prescription would be required. Which means a doctor appointment (unless we can get it by phone?). Which means extra time, hassle, and cost.

I predict that even many seniors will have trouble with this restriction, to say nothing of all the folks under 65 who have other health conditions.

I'm hoping this situation will change, but things are not looking good.
 
Weirdly, this other news article has a map showing that Oregon (my state) is one of the states that should not require a prescription.

States where you can get a COVID vaccine at CVS following RFK Jr. changes

I'm confused. Maybe it's a CVS vs. Walgreens thing?

Maybe the Walgreens website is messed up? (it wouldn't be the first time)

I'm going to try again next week, after Labor Day (holiday on Monday).
 
As someone with long covid, it’s really difficult to understand what purpose the vaccine serves at this point for most people.

It’s terrible at preventing infection and transmission. It doesn’t seem to prevent long covid (it didn’t for me!) and it seems to mostly worsen long covid. Long vax, even if rare, is real. Finally, nearly everyone has some level pre-existing immunity these days, and severe acute illness is pretty rare outside of a few sensitive populations.

Even for those in sensitive groups, or those who just really don’t want to get Covid, Pemgarda is way more effective at preventing infection (and avoiding long vax risk). So, why would anyone need protection, but settle for the vaccine? It’s a weird middle ground.
 
re Pemgarda Wikipedia says

Pemivibart, sold under the brand name Pemgarda, is a monoclonal antibody medication authorized for the pre-exposure prophylaxis (prevention) of COVID‑19. Pemivibart was developed by Invivyd.

The US Food and Drug Administration (FDA) issued an emergency use authorization for pemivibart in March 2024.

See https://en.wikipedia.org/wiki/Pemivibart
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Added - struggled getting rid of the original formatting which did not copy well, hopefully this is now readable.
 
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Peter T said:
Pemgarda is not currently available outside the USA (for the UK see this March 2025 Parliamentary question and answer )
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The question there was, 'To ask the Secretary of State for Health and Social Care, whether he has had discussions with NICE on the potential use of PEMGARDA to protect clinically vulnerable people against covid-19 in emergency situations.'

I wonder what 'emergency situations' were being referred to? The answer includes, 'Pemivibart, sold under the brand name Pemgarda, for use in the prophylaxis of COVID-19', so it appears to be intended for protection, and it's hard to see how that would be regarded as an emergency situation. Being a mab, I'd have thought it would be pretty heavy-duty and not risk-free itself.
 
Sasha said:
The question there was, 'To ask the Secretary of State for Health and Social Care, whether he has had discussions with NICE on the potential use of PEMGARDA to protect clinically vulnerable people against covid-19 in emergency situations.'

I wonder what 'emergency situations' were being referred to? The answer includes, 'Pemivibart, sold under the brand name Pemgarda, for use in the prophylaxis of COVID-19', so it appears to be intended for protection, and it's hard to see how that would be regarded as an emergency situation. Being a mab, I'd have thought it would be pretty heavy-duty and not risk-free itself.
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Pemgarda seems to have been developed initially for use with the immunocompromised where the ordinary Covid vaccine is not appropriate, hence the phrase ‘clinically vulnerable, though I am not sure what is intended by ‘emergency situations’. Could it it just relate to the pandemic situation, or a personal emergency such as increased risk of exposure with something like a hospital admission?
 
Peter T said:
Pemgarda seems to have been developed initially for use with the immunocompromised where the ordinary Covid vaccine is not appropriate, hence the phrase ‘clinically vulnerable, though I am not sure what is intended by ‘emergency situations’. Could it it just relate to the pandemic situation, or a personal emergency such as increased risk of exposure with something like a hospital admission?
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Anybody's guess, but it seems peculiar, and an 'emergency situation' sounds more like one in which someone has caught Covid and needs urgent treatment.
 
People in Vermont near the Québec border can get Covid shots but not flu shots from my understanding. I'm sure many people who live in border towns in the US will cross over to get their shots or while traveling up here.
 
I contracted Covid in 2023 and got the Covid vaccine the next morning without realizing I had Covid because I didn't have symptoms yet. It was awful but I eventually got back to my original baseline six months later.

So now I'm back to masking and getting both Covid and Flu shots as soon as they become available.
 
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Peter T said:
Pemgarda seems to have been developed initially for use with the immunocompromised where the ordinary Covid vaccine is not appropriate, hence the phrase ‘clinically vulnerable, though I am not sure what is intended by ‘emergency situations’. Could it it just relate to the pandemic situation, or a personal emergency such as increased risk of exposure with something like a hospital admission?
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The EUA is for use as a vaccine alternative in a narrow set of health conditions. Essentially, those who are unlikely to make their own antibodies or those for whom response to an antigen may be dangerous.

It’s also being used off label for long covid. Anecdotally, for those with LC without ME/CFS, it seems to be an outright cure for perhaps 1/3, provide substantial improvement for another 1/3, and have no effect for the remaining 1/3. In my case, it improved my long covid symptoms by about 75% for the first 8 weeks. The effect seems to be waning a bit, so perhaps 50% at this point. I’m scheduled for a second infusion in a few weeks.

In terms of safety, it’s about as safe as it get for this sort of thing. It avoids all that comes with exposure to spike antigen, and is essentially inert unless it’s binding to spike protein. The only noted side effects in trials was 1/200 anaphylaxis, but they modified the rate of infusion in clinical use and there have been zero cases of anaphylaxis in clinical use.

Cost and availability are currently issues, but those problems should get solved soon. They are beginning a 12 week expedited phase 2/3 of an updated version. The new version is a lower dose with a higher affinity and longer half life, that is given as an IM injection instead of an infusion. Once approved, it should be much less expensive and will not require an infusion. In the interim, it’s very much obtainable if one is in the US and willing to track down a doctor who is willing to prescribe it. I don’t qualify under the EUA and it wasn’t terrible difficult to get.

Once the new IM version is approved, I suspect we will see an outright ban on the existing vaccine. The new IM mAb would be dosed twice per year as a replacement for the vaccine. Steve Cohen (hedge fund) and a few private equity firms just bought about 1/3 of the company betting on this outcome.
 
What I've read about Pemgarda and other similar drugs is that they are not a replacement for vaccination. They do seem to be helpful for immunocompromised folks.

I found several links from 2024 saying that monoclonal antibodies are not a substitute for vaccines. Some patients are advised to get both (vaccine and Pemgarda).

But in case those links seem old, I also found this interesting article dated today. The coverage seems to be written from the point of view of whether to invest in the company which makes Pemgarda and talks about a new drug that's coming. By the way, it was a bit shocking to see a company applauding placebo controlled trials for COVID vaccines!
["... bioethicists pointed out the pitfalls of giving people a placebo when an effective intervention is available." No kidding.]

But there's a section near the end which says:
Immunocompromised people don’t get as much active immunity from vaccines because their immune systems are weaker to begin with, but “it’s not a black-and-white issue,” says Johns Hopkins immunologist Arturo Casadevall.

“My advice to the person at high risk is to get vaccinated,” he adds. “I don’t see this as either-or.”

Should monoclonals like Pemgarda and VYD2311 be used as a replacement for COVID-19 vaccines? The answer from infectious disease specialists, so far, is a resounding no.

“There is a role for monoclonals. I’ll leave it at that,” Sullivan says. “Honestly, I do not see monoclonal antibodies replacing vaccines.”

Greene agrees. “I don’t think it’s a great plan to try and introduce this type of passive protection into a normally immune-responsive population,” he says. “I don’t think that would fly.”
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To give another data point, let's look at one of the risks of Pemgarda vs. COVID-19 vaccines. The patient fact sheet for Pemgarda shows a higher rate of anaphylaxis (" 0.6% (4/623) of participants in a clinical trial") than for COVID-19 vaccines ("approximately 5 cases per one million vaccine doses administered" - from the CDC website).
 
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