Booster Now or Later

[Davidcara]

I’m in California. Four covid vaccines zero antibodies. I’m debating, booster on Monday ( I am eligible) or wait until later summer when we are suppose to have omicron specific booster? Thoughtful opinions are welcomed.

[HopeME]

Tough question. I’m in the same boat, albeit I had a good response to my vaccines. I’m 6-months out from my fourth vaccination and I was just wondering about the question you raise. Get a fifth vaccination now and then my sixth in the late fall when the most up to date vaccine mixture is available or gut it out and wait until the fall for a fifth shot. I’ll be asking this question to my CLL NP next month when I have my periodic appointment. The biggest risk seems to be if you get too many of these shots too close together it may be counterproductive to your ability to fight Covid infections. The obvious question is what does your doctor recommend?

Best

Mark

[Davidcara in reply to HopeME]

If I had good response with previous vaccines, I may wait it out. But no response, don’t know if it would be a waste to get it now. I don’t know, maybe wait it out?

[Justasheet1 in reply to Davidcara]

Dave,

Omicron specific but expecting a better response? I’m not sure what to say.

I’ve had no response to the vaccines due to the ibrutinib that I take. But Evusheld has given me courage and so has the Paxlovid availability.

Jeff

[Davidcara in reply to Justasheet1]

Thanks for the reply Jeff. Yeah, I feel like I will get not response now. Maybe I’ll wait?

[Panz]

I have had six Covid injections plus I had Covid and didn’t know it . I was in the LLS study. I made no antibodies until after the fifth full strength shot. I will be tested in July to see if I made more following the sixth full strength shot. Because I have antibodies from a direct infection and some from the vaccine I think I shall be waiting until Fall.

My first two shots were Moderna, the 3rd and 4th were Pfizer and the 5th and 6th were full strength Moderna.

I am now waiting for the middle of July and I will be getting a Pneumonia 20. My last Prevenar23 was last July and I had to wait a year in between.

Panz 🙂☘️🙏💕

[rafew]

This may be the news you’re waiting for. pfizer.com/news/press-relea...

[HopeME in reply to rafew]

Very encouraging. Lots of focus this week as the trial data moves through the approval process. Interestingly, there was no estimated availability date. Hopefully, it is soon 🤞.

Best,

Mark

[Rpshe1]

My Onc recommended Evusheld. Referral has been sent, just waiting for them to call & schedule.

[LeoPa]

I wonder whether the omicron vaccines will be any good. Given BA 4 and BA 5 is quite successful in evading the antibodies created in reaction to ba1 and ba2. I wonder whether the omicron vaccines will be created specifically against ba4 and BA 5. I had only three vaccines till now but I think I will go and get the omicron specific version no matter what, but not another one of the original vaccines.

[Pin57]

My opinion is … go get the 5th now.

Caveat- With your docs backing.

Reasoning:

1. You could be like Panz and score big antibodies. His story is great!

2. Your likely more vulnerable now as-is w/no antibodies. Covid is raging in Calf, so why not try and better your antibodies situation “now” versus waiting? It could be a life or death decision. That’s why if it were me…I’d get it n then no regrets later.

3. The new vaccines (sometime in the fall?)… maybe 6 months out?

They’ll be there for shot 6 for you.

4. We are all unique … it’s anyones guess on your shot 5 effectiveness.

In this forum, there’s been both success stories with initial and/or booster shots as well as unsuccessful stories (unfortunately). Everyone’s case/situation is unique.

I’ve had 5 shots, no covid (yet)… knock on wood… n biggest success for me was starting over with the initial covid shots. Because of that success, I am an advocate on getting all boosters along the way while monitoring spike antibodies (I’m in LLS Study).

That’s just one opinion. Good luck!

[dmmck]

I would go for Evusheld. I had very little response to the Covid vaccine. I got Evusheld. My husband got Covid but I didn’t.

[Ernest2]

Hi David,

I've got a similar conundrum.

the 4th BioNtech made me ill with Nausea for 6 weeks (an underlying health problem I'm working on)

Go for a 5th or wait for the new one?

Guess I'll have to get myself some Ondansetron . . .

Best wishes,

Ernest

[rafew]

I’ve had 5 shots (all Moderna) with negative results on spike protein tests following the vaccines. However today I am getting the Evushield shot, which is supposed to be effective against Omicrom (FDA and AstraZeneca reports).

[DanBro1]

I was in the same boat..... 4 Moderna vaccinations resulting in zero antibodies. My next shots were Evusheld. Feel very safe, now. Will have an antibody test in August.

[Edalv]

It’s a very personal decision. When was your last booster..? And have you always received the same vaccine..? I am asking these questions because we know the antibodies decline over time. I have been taking my booster no more than 6 months apart. And on my last shot I switched from Pfizer to Moderna to mix things up a little. I have read that mixing vaccines produces a stronger response. I definitely had a reaction after the last shot, but I didn’t check my blood for antibodies… Since I got my last shot in May, I feel comfortable waiting until the fall for the omicron specific vaccine… I hope this helps 🙏

[Davidcara in reply to Edalv]

Got three Pfizer’s and Moderna about 5 months ago. So not sure what to do. I think I might hold off.

[Edalv in reply to Davidcara]

It’s hard to tell when the new vaccines will be available.., it might still be a while. You probably have some protection left, but it’s hard to tell the levels after 5 months from your last shot…

[wizzard166]

Hey David

I might give it a try now. I know how frustrating it was with no antibody production after three shots for me. My Primary even suggested maybe not trying anymore. My CLL Specialist on a visit a month or so later, said definitely try again. So I had the fourth shot in April. This time a whopping body response with flu like symptoms and even 103 fever on one night. Then the symptoms receded and finally went away, although the red rash on the arm lasted a good bit longer. Then I was tested and boom, I now had antibodies. Since then I was exposed at Mass Covid Production Events twice. Once a party in our own house with Karaoke done, and on June 7th a month after that first event at my Daughter's Wedding in Jerusalem. I was one of the few people at each event that didnt get sick and test positive.

Don't give up hope, maybe in your case it will be the fifth one.

Carl

[Davidcara in reply to wizzard166]

I looked at your profile, are you on treatment?

[wizzard166 in reply to Davidcara]

Hey David

Still on W&W since April 2018. A big part of me hopes I live a number of years I would have anyway, and never go on treatment, but if I reach a goal I have that won't happen. In March I was still on the field when the 3rd Quarter ended. I was playing with pain, but wouldn't let them take me out. Now I've started the 4th Q and my intent is to finish the game. If by some chance it goes into Overtime, I intend to stay in despite the pain and injuries. So if I make it to the two minute warning, and then to the end of the 4th, I can't imagine I'll be without treatment.

Treatment sounds nice, with the chance to have numbers go back to near normal. The think is there are always some side effects and some of them can be deadly. So my thinking is why not avoid any risk of a bad side effect, if I can go the route to the same end point without starting treatment. Maybe I'm not understanding things that would make me say I hope to start treatment soon. The other part of this is the cost. On Medicare the Novel Targeted Theraputic meds will cost about $14,000 per year.

Carl

[Kingfish6]

I'm in CA with what I assume is the same situation. Assume you have gotten antibody tests (Spike, nucleocapsid, & ace-backing). I have had 3 Moderna, 1 Pfizer -- little response. Doc admits I'm basically unprotected & said.5th shot won't do anything. Trying to get authorized for Evusheld -- no word yet. With us immune compromise, VAX's ineffective, might be better to get 6 month antibodies 2x/year rather than VAX though with antibody, followed in a bit with a VAX, might help. My philosophy has been, in the event I test positive for Covid, I'm off to the the ER (hate to abuse the ER, but tough) to force treatment issue. I already had. severe Covid pneumonia in. Jan '21. Ecusheld, Paxlovid, sotro....., are all in short supple as the gov't has no Covid budget (only bought 1.7M doses of Evusheld) thanks to 1 side of Congress, & we may push the fall season with a shorts of VAX's. early '22, gov't did order 600k dishes of "new" Lilly antibody.

[Davidcara in reply to Kingfish6]

Thanks Kingfish6. I had Evusheld March 3, so pretty sure those antibodies are dying off. I feel there is no go answer, hope for more Evusheld, maybe wait off on booster

[SofiaDeo in reply to Kingfish6]

Unless you have had T-cell testing, I wouldn't say you are "basically unprotected." Not producing antibodies, yes. We do get some T-cell protection, if those are functional/we are able to make them:

pennmedicine.org/news/news-...

frontiersin.org/articles/10...

At least 1 source thinks the importance of T cell immunity may be underestimated:

nature.com/articles/s41590-...

[Davidcara in reply to SofiaDeo]

My oncologist, and a leading CLL expert who sometimes posts on this forum has said…many with CLL, have both poor T Cell and antibody vaccine response. I have only had TCell testing through LLS, so don’t know my results. But I am not optimistic for a robust TCell response. Anyways that’s my take for my situation

[Davidcara]

Thank you for the replies everyone. Today I heard Pfizer and Moderna stated the following: if approved by FDA, they expect to have their new booster rollout in the United States, during the month of October. Partly because of this, I got my fifth covid vaccine today. So I am at three Pfizer followed by two 1/2 dose Moderna’s.

Also if anyone is interested and does not already know… The FDA has extended the Evusheld expiration date by six months for unopened vials.

[skipro]

Hi

have you had prior treatment with Rituximab or Obituzimab? The combo of CLL plus one of these 2 CLL drugs makes for poor antibody response to vaccines.

which vaccine did you have. I had no response after 4 jabs with Pfizer and moderate response after jab #5 with a FULL dose of Moderna. Not sure if it was the Moderna or if the Rituximab response had worn off by the time I got Moderna.

mike

[E-Lynn]

B-cells or T-cells -- which will help more with COVID? No one knows, but lots of research taking place. UCSF does a great "town hall" live every other Friday, with a focus on current look at COVID (especially in the SF Bay Area). coronavirus.ucsf.edu/town-h... Great infectious disease researchers there, so lots to be learned. What I'm hearing is November for the more focused omicron lineage vax. But clearly you have to mask up for now and make sure everyone you hang out with is doing the same. Some places, like the UK, and a number of US states are in crazy denial, and the numbers are going up, and now that includes deaths and ICU visits. Will more Evusheld help? Who knows, but most likely cannot hurt.? Just be aware of timing between that and vax when it is available. And anyone who hasn't had their 2nd boost is playing with fire. And anyone not masking indoors, or eating in restaurants with strangers? Best of luck with that.