8 Potential Side Effects of the Flu Shot You Might Not Know About, According to Doctors
People Over 65 Or With Certain Medical Conditions Can Get Second COVID Shot After 6 Months, CDC Says
A Pfizer COVID-19 vaccine booster shot is administered in Freeport in 2021. Credit: Newsday/Steve Pfost
People over the age of 65 or with certain medical conditions can now get a second dose of the latest COVID-19 vaccine six months after their first shot, the Centers for Disease Control and Prevention announced this week.
The recommendation covers the 2024-25 COVID-19 vaccine that first became available at the end of August.
Experts have maintained that older people and those with compromised immune systems are more at risk of developing severe COVID-19 infections. The CDC said more than 81% of COVID-19 deaths occur in people over 65.
Dr. Justin Chan, director of Infection Prevention and Control at Bellevue Hospital Center, called it an "important recommendation that will help save lives."
"While getting vaccinated does not guarantee you won't get COVID-19 infection, it will significantly reduce your chance of having severe disease," Chan told Newsday in an email. "We also know that the immune protection from the COVID-19 vaccine diminishes over time, so getting an additional dose six months after the first dose will boost immunity in this vulnerable group, and provide longer lasting protection."
Some medical conditions that put a person at higher risk of getting a severe case of COVID-19 include cancer, lung disease, diabetes, asthma and illness affecting the heart and liver.
The CDC recommendations said people who are moderately or severely immunocompromised can get a third or even a fourth dose if that is what they and their health provider agree is needed.
Interest in getting the COVID-19 vaccine has waned over the years. Last year, according to national data, only about 14% of children and 22.5% of adults reported receiving the updated 2023-24 COVID-19 vaccine.
So far this year, 4.8% of children and 13.5% of adults 18 and older reported being vaccinated since Aug. 27, according to the CDC.
New York State Health Department data shows that on Long Island, 11.7% of people between the ages of 65 and 74 and 16.5% of people 75 and older reported receiving the updated COVID-19 vaccine.
In other age groups, the number who got the updated vaccine was less than 5%.
Some experts hope this summer's unusually active COVID-19 surge may convince more people to get vaccinated.
Dr. Geeta Sood, assistant professor in infectious diseases at Johns Hopkins University, said getting vaccinated can also reduce the chance of getting long COVID, a long-term condition that researchers are still trying to unravel.
"We are learning more about it, about the biology of what's happening and even learning a lot about how severe and how many complications you can get from a COVID infection, even if it's not an acute infection," Sood said.
Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.
People Who Had COVID-19 Develop Strong Immunity After A Single Vaccine Dose - So They Might Need Only One Shot
Both Pfizer's and Moderna's coronavirus vaccines require two shots: a prime dose, followed by a booster.
The initial shot should trigger the production of antibodies to the virus for the first time. By the time we get a booster, our bodies should mount an even stronger immune response. That explains why some people have reported more side effects after their second shot.
But for people who've already had COVID-19, the process seems to progress differently. An emerging body of research suggests that people who already got a coronavirus infection mount a stronger immune response to their first shot than those who never had the disease. That could mean that people with a history of infection don't need a second shot to sufficiently protect them from getting sick again.
A new study from UK researchers found that antibody levels were roughly the same among uninfected people who received the first dose of Pfizer's vaccine and people who'd had COVID-19 but weren't vaccinated yet. Then after people who'd COVID-19 got their first shot, their antibody levels were 140-fold higher than their peak antibody levels before the vaccine.
In other words, the prime dose acted more like a booster.
Another new study found that people who previously had COVID-19 mounted a stronger T-cell response to one shot of Pfizer's vaccine than vaccinated people who'd never gotten sick did. Like antibodies, T cells have powers of recollection that can help the immune system recognize and re-attack the coronavirus.
But the two studies examined only a small group of vaccinated healthcare workers - 123 in total. For this reason, many scientists are wary of prescribing anything other than the standard two-dose regimens.
"I'm a big proponent of the right dosing and right schedule, because that's how the studies were performed," Maria Elena Bottazzi, an immunologist at Baylor College of Medicine, told The New York Times.
People who had COVID-19 may develop 10 times as many antibodies after a single doseEven before the two new studies came out, preliminary research had started to show that two shots might not be necessary for people who'd already had COVID-19.
In one study, which is still awaiting peer review, researchers at the Icahn School of Medicine at Mount Sinai discovered that people who'd had COVID-19 developed at least 10 times as many antibodies after their first dose as the average uninfected person who received two doses of the Pfizer or Moderna vaccines.
Those with a history of infection also developed stronger side effects after their first injection - including fatigue, headache, chills, fever, and muscle and joint pain.
The researchers wrote that "changing the policy to give these individuals only one dose of vaccine" could "spare them from unnecessary pain and free up many urgently needed vaccine doses."
Another preliminary study supports those findings - it showed that healthcare workers who'd had COVID-19 had higher antibody levels after their first vaccine dose than vaccinated healthcare workers who had never been infected.
"It was a very large difference. It was something that we could easily see," Dr. Mohammad Sajadi, an associate professor at the Institute of Human Virology at the University of Maryland School of Medicine, told Insider.
Typically, Sajadi said, COVID-19 patients develop antibodies about two to three weeks after their initial infection. But it didn't take nearly as long for the people who'd already been sick to develop antibodies in response to a vaccine: These people showed high antibody levels a week after their first shot, peaking about 10 to 14 days after vaccination.
How long does a 'memory response' to COVID-19 last?Pfizer's and Moderna's trials suggested both vaccines are safe for people with a history of coronavirus infection. But there are some exceptions.
The Centers for Disease Control and Prevention recommends that people with an active infection wait until their symptoms have resolved and the standard 10-day isolation period has passed before getting vaccinated. That includes people who've already received their first dose.
"The recommendations for receiving any dose of the vaccine are not to get it if you're frankly ill at the time," Dr. Sandra Sulsky, an epidemiologist and principal at Ramboll, a global health-sciences consulting firm, previously told Insider.
But scientists still aren't sure when vaccines are actually necessary for previously infected people. Coronavirus antibodies could last anywhere from several months to several years - but even then, antibody levels don't always translate to immunity.
All the participants in Sajadi's study, for instance, tested positive for coronavirus antibodies in July and August. By the time they got their shot, he said, some of them had "very, very low levels" of antibodies, but they still seemed to respond strongly to the vaccine.
"What that shows you is that individuals who had a prior COVID infection have what we call a recall response or a memory response," Sajadi said. "For most infections, the second time you see that microorganism, you should get a faster response."
He cautioned, however, that the findings apply only to people with a "run-of-the-mill COVID infection" - people who developed antibodies and have recovered from their illness.
An interim solution to limited dosesSajadi said that giving just one dose to people who've already had COVID-19 could help address vaccine shortages. So far, just 47 million Americans vaccinated, with the majority of adults still waiting.
"In times of vaccine shortage, where every vaccine dose counts, we think the data shows if you had previous COVID infection, you may only need one dose for the booster," Sajadi said. That "may even be the ideal scenario" for previously infected people, he added.
The CDC has said vaccination sites can delay administering a second dose for up to six weeks - instead of the recommended three to four weeks - in "exceptional circumstances."
It is not yet known how antibody levels among people who've had COVID-19 will change in response to to Johnson & Johnson's shot. That vaccine expected to get authorized for emergency use in the US within days.
"There's no reason to think it would act differently," Sajadi said. "But you just never know until you test."
This story has been updated with new information. It was originally published on February 2, 2021.
Cancer Patients 'lack Same Protection' After First Jab
Cancer patients are much less protected against Covid-19 than other people after one dose of the Pfizer vaccine, the first real-world study in this area suggests.
With a 12-week wait for the second dose this could leave them vulnerable, says the King's College London and Francis Crick Institute research team.
An early second dose appeared to boost cancer patients' protection.
Cancer charities are calling for the vaccine strategy to be reviewed.
But Cancer Research UK said the small study had not yet been reviewed by other scientists and people undergoing cancer treatment should continue to follow the advice of their doctors.
The government said it was focused on "saving lives" and the antibody response "was only part of the protection provided by the vaccine".
"The independent Joint Committee on Vaccination and Immunisation (JCVI), which advises government on vaccine use and prioritisation, regularly reviews data and evidence on vaccine efficacy and effectiveness," it said.
About 1.2 million people at very high risk of being seriously ill with Covid-19 were prioritised for a first vaccine dose in the first phase of the UK rollout, which includes people with specific cancers.
The UK government decided to extend the gap between first and second jabs from three to 12 weeks in late December to give more people some protection as soon as possible.
Dr Sheeba Irshad, oncologist and senior study author from King's College London, said the findings were "really worrying" and recommended an urgent review of the timing of doses for people in clinically extremely vulnerable groups.
"Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination," she said.
The study, not yet published or peer-reviewed, recruited 205 people, including 151 with solid cancers, such as lung, breast and bowel, or blood cancers.
The researchers tested volunteers for antibodies and T-cells in their blood, which signals that the immune system can protect against illness from the virus in the future.
Three weeks after one dose of the Pfizer jab, an antibody response was found in:
Following a second dose three weeks after the first, which some cancer patients received, there was a sharp rise in their antibody response against the coronavirus, to 95%.
But among those who had to wait longer for their second dose, there was no real improvement in protection.
Five weeks after the first dose, an antibody response was detected in:
WATCH: Pfizer v Oxford v Moderna – three Covid-19 vaccines compared
In trials of the Pfizer vaccine, two doses were given three weeks apart and although a longer gap between doses works for healthy individuals, the researchers say cancer patients do not respond in the same way.
"One size does not fit all," said Dr Irshad.
"Cancer treatments have profound effects on the immune system and cancer patients' immune mechanisms are inferior.
"We need to be concerned about other vaccines for this population too - they do need a second dose quickly."
Dr Irshad also said leaving people unprotected for many weeks could give new variants the space to emerge and allow the virus to spread among family members caring for patients.
There are around 370,000 new cases of cancer in the UK every year, with up to three million people living with the disease.
People with compromised immune systems were not included in clinical trials of the vaccine, although previous studies suggested vaccines may not work as well in this specific group.
'Follow doctors' advice'
Cancer Research UK said the small study was "interesting" but there could still be limitations with the results.
Martin Ledwick, the charity's head information nurse, said: "We know that this information could be worrying, but anyone undergoing cancer treatment should continue to follow the advice of their doctors, and we encourage all who can to take up the vaccine."
Breast Cancer Now has called on the UK's vaccine committee, the JCVI, to "urgently review the evidence presented in this study and consider adapting its strategy" to give people with cancer both doses within three weeks.
Blood Cancer UK echoed this call, saying more research was needed urgently so that people don't "face a future of shielding indefinitely, not knowing whether they are protected". They added that blood cancer patients should still definitely have the vaccine.
Prof Stephen Evans, professor of pharmaco-epidemiology, from London School of Hygiene & Tropical Medicine, said: "These data will undoubtedly need to be examined by JCVI, but the evidence that harm has been caused to patients with cancer by delaying a second dose has not yet been demonstrated conclusively.
"Full follow-up of those who get vaccinated with a delayed second dose will be very important."
The study will continue to follow cancer patients after their vaccinations for up to six months.
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