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Your top 7 questions about fall vaccines answered

bY DR. KATELYN JETELINA (Reprinted with permission)

AUG 29, 2023

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Thank you for all of your questions! You’re keeping us busy here at YLE. Here are answers to the top 7 that I’ve received in my inbox.

When will we know about the COVID-19 vaccine?

The ACIP meeting is now scheduled for September 12. This will be a huge meeting, as we will find out:

• Who is eligible for a COVID-19 vaccine and why.
• Cost-effectiveness, given this vaccine is now privatized. In other words, we will get an answer to the question: Do the benefits of a vaccine outweigh the costs for all age groups?
• Updated myocarditis data for younger males (I hope).

I will be in attendance and provide cliff notes.

Then, vaccines should be available mid-to-late September.

 

Can I get the vaccines (flu, RSV, and/or COVID-19) at once?

There is no combined shot (some companies are working on it, but will not be available for years). This means that, if you’re eligible, you will need three shots to protect against the three viruses this fall.

You can get them all at once. But it may not be ideal. It just depends on your situation and your comfort with unknown risks:

• Benefits to getting all at once: Going to the doctor/pharmacy multiple times can be a pain for many people, including grandparents. Or some people may tend to forget to go. Getting all three at once may be the best option in this situation.
• Benefits to staggering: The optimal timing of vaccines is different for all three viruses. Also, we don’t know the safety risks of getting all three simultaneously. It hasn’t been studied. In other words, there are unknown risks. This is what we do know:
  • COVID-19 and flu vaccines are safe together
  • Older adult RSV and flu vaccines are safe together

Should I wait for the fall COVID-19 vaccine?

I’m telling my family and friends to wait (as opposed to getting last year’s vaccine formula). Of course, there is some risk to waiting, but there are two benefits, too:

1. While we are in a wave now, we expect a larger wave in winter. Getting it closer to this wave will better prevent infection;
2. Recent preprint shows that two shots of last year’s vaccine formula resulted in imprinting. This isn’t necessarily dangerous, but it means our antibody factory line (i.e. B-cells) wasn’t updated—it doesn’t broaden protection. Getting an updated vaccine formula will be more helpful against currently circulating variants.

Novavax vs. mRNA COVID-19 vaccine?

Both are great shots. And the data pool to draw on is so narrow I’m uncomfortable saying one is immunologically better than the other. But we’ve had some studies (here, here, here, and here), and they’ve shown many similarities and some subtle differences:

Similarities

• Both provide a solid first line of defense (i.e., neutralizing antibodies).
• Both strengthen a solid second line of defense (i.e., T-cells).

Differences

1. Negative: Novavax produced significantly lower levels of a specific antibody called IgG.
2. Positive: Novavax had a more durable response over time (waned less quickly).
3. Positive: Novavax has fewer side effects, like pain and muscle aches. For this reason alone, I will be getting Novavax this fall.

The new RSV vaccines aren’t covered by insurance?

Medicare Part D covers the RSV vaccine, but some private health insurance plans don’t. In other words, some older adults must pay ~$330 for their RSV vaccine. This is because of two factors:

1. The adult RSV vaccine is not yet included in the CDC’s annual vaccine schedule, which should be updated in 2024.
2. CDC’s official recommendation for RSV vaccines is that older adults “may” get the vaccine rather than “should.” Private companies use this language as justification not to cover expenses.

Aren’t there neurological side effects to the adult RSV vaccine?

Clinical trials found a possible safety signal. For more details, see this previous YLE post.

TLDR: Because the number of events was so small, it’s hard to know whether these are coincidental events or reflect a real safety issue. Future data will clarify this, but it will take time for real-world data to accumulate.

When will the maternal RSV vaccine be available?

It will still be a while. While the FDA has officially approved the vaccine, the CDC is not meeting until October 25-27 to determine policy.

Bottom line

A lot is going on this fall. Keep sending us your questions. I hope this helps!

Love, YLE

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“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife. During the day, she is a senior scientific consultant to several organizations. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:

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This is one of the largest illegal vape sales the County Health Department has come across in the history of the Adolescent Tobacco Use Prevention Act (ATUPA) program which occurred last week. This “bust” was done in combination with Greenburgh Drug and Alcohol Taskforce.  The Taskforce is made up of Police Agencies from Ardsley, Greenburgh, Dobbs Ferry, Hastings, Irvington, Tarrytown, Sleepy Hollow and North Castle. The County confiscated all of the product and have it secured and the operator was issued a ticket and has a hearing on the issue pending. Photo: WestchesterCounty Department of Communications

As part of County Executive George Latimer’s initiative aimed at cracking down on illegal vape sales, the Westchester County Department of Health has been conducting more frequent and enhanced compliance checks.

These checks over the last two months have resulted in more than 70 inspections of licensed facilities in the County.

Latimer said: “In our pursuit of protecting public health – particularly in the case of minors, our initiative against illegal vape sales is showing real results. Through intensified compliance checks and strong partnerships like the recent operation with Greenburgh Drug and Alcohol Taskforce, we’re combating this issue. Our actions, supported by dedicated teams, are showing results. While most comply, we’re taking a stand against illegal sales, confiscating banned products and upholding our commitment to a healthier Westchester County. We salute the County professionals who enforce these laws every day.”

Since the County began the enhanced enforcement, utilizing Department of Public Safety Park Rangers under the age of 21 and a larger group of trained staff (sanitarians), the County has seen greater results with enforcement of NYS Tobacco Regulations.

Although the majority of checks have resulted in facilities being in compliance, there have been multiple illegal sales of tobacco products to minors across the county.  In addition, the County Health Department has also seized hundreds of flavored vape tobacco products which are illegal to sell in New York State.

Facilities that are found to be in violation of New York State Public Health Law Article 13-F are issued an appearance ticket by the Department of Health where significant fines may be assessed in addition to potentially losing their license to sell tobacco products.

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CASES RISE 7  WEEKS SINCE JULY 8:    

JULY CASES: 1,064.  AUGUST NEW COVID CASES: 1,885. 

RISE AT 75 A DAY THAT WE KNOW OF.

WHITE PLAINS HOSPITAL AUGUST:  68% OF PATIENTS ADMITTED FOUND WITH COVID AFTER BEING ADMITTED IN AUGUST.

WPCNR CORONAVIRUS SURVEILLANCE. Statistics from New York State Covid Tracker. Observation & Analysis by John F. Bailey. August 28, 2028:

The number of  lab-confirmed persons with Covid in August in Westchester was  519  August  20 through Saturday August 26.

The number of walk-ins for a labtest as a result of antigen positive results OR checking symptoms testing positive according to the State in Westrchester County  last week was 519.

The 519 is the highest  week total of the month of August.

It is also the highest weekly Westchester number of cases since February 25 of this year when that week reported 542 cases.

That was when vacinations were having the  effect of slowing new case growth in Westchester from 6,573 cases in January. In the month of February, new Westchester covid cases slowed to  2,681 by the end of the week of February 25. With 542 for that week. In that third week of  February this year the county was running 77 new cases a day.

Last week  ended Saturday, the county 519 cases for 7 days  were 75 A DAY close to equal the spread rate of last August, 2022.

The  Westchester county growth matches the case rise of mid February.

The trendline of the two monites is exactly the opposite.

Last August in 2022, infections dropped sharply from 10,298 in July 2022 down to 6,325 at the end of August, new cases dropped 40%

This August 2023, new confirmed lab verified tests for the month  were 1,885 compared to July 1,064. – a 77% INCREASE in a month.

The 1,064 verified positives  infected 1,885 in August a spread rate  1.7, one infected person infecting  1.7 other persons or around 2 a person. At this rate, the positives we knew about spread the disease to 2 others in a   very fast 2 to 3 days…and that multiplied.

At this rate of almost two persons infected by every positive September may see  1,883 infectons.

It is sobering to look  at how the summer activities of July 4, great weather launched a summer wave now washing over us.

It increased new positives in July from 20 a day at the beginning of July to up to 50 a day by the first week of August.  By the end of August our relief at “the covid being over” was “living in a feel’s paradise.”

Now  we are seeing instant spread after a weekend with new cases  as high as 100 in a day.

On Friday, August 25, Westchester reported 103. The highest single day infections of the month.

People are coming down with covid fast fast fast.

From August 1 to August  27 the positives have soared Monday through Friday, directly as a result on the increased risk of infection. We are not masking, we are getting careless.

The schools open  across the county and there is high potential for infection from the three new varients.

Do not be lulled  about how mild covid is. You do not know how it will affect you.

If you test yourself with an antigen test and are positive—

You have about 5 days in which to go in to a medical provider, confirm you are positive and get yourself treated with paxlovid which I do not know whether it kills the covid infection or just abates the systems.

Paxlovid was the drug Donald Trump received to treat his positive covid case during his Presidency.

The  highway to paxlovid has limited access, it can only be used  within 5 days when first symptoms first appeared.

That was this week in Covid.

It is up sharply.

Careless socializing, failure to mask well you never know when covid will drop in.

The new wave is building.  The three new variants are lurking and they are rapidly deploying.

They are looking for you to make a slip.

At White Plains Hospital Medical Center, since August 1, according to the New York Health Department through Friday, August 25, of 263 patients admitted to beds in the hospital, 181 of the were found after admissions to also have covid. That is 68% of admissions to beds.

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Rendering of Patient Care Tower at Westchester Medical Center

New Tower Would Allow Hospital to Convert to 100% Private Rooms

WHITE PLAINS, NY (August 2023) – The Westchester County’s Local Development Corporation (LDC) voted on August 23 final approval of $195 million in tax-exempt bond financing for the development of a new 162,626-square-foot Patient Care Tower on the campus of Westchester Medical Center in Valhalla.

“Today’s historic approval by the Local Development Corporation is yet another example of how we are working with our not-for-profit community in securing tax-exempt bond financing benefits that are provided at no cost or risk to the taxpayers of Westchester County. This magnificent new project will further enhance our County’s world-class healthcare sector while providing a boost to our region’s economy,” said Westchester County Executive George Latimer.

“The Local Development Corporation is very pleased to approve the bond financing for this very important healthcare development at the Westchester Medical Center campus. As a result, nearly 900 construction jobs and new full-time jobs will be created and the County will receive more than $3.5 million in total economic benefits,” said Local Development Corporation Chair Joan McDonald.

“The LDC has a clear vision for the future of Westchester County, and we’re happy that vision includes projects such as the Patient Care Tower,” said Michael D. Israel, President and Chief Executive Officer, Westchester Medical Center Health Network (WMCHealth). “The Patient Care Tower on the Westchester Medical Center campus will be the Hudson Valley’s hub of critical care medicine as it will bring together critical care and medical-surgical specialties in one location, enabling Westchester Medical Center to convert to all private inpatient rooms across the rest of the campus. Additionally, the Patient Care Tower will advance our academic mission by giving medical residents and students a state-of-the-art facility in which to train.”

According to a cost benefit analysis prepared for the LDC, the project would provide the County with total benefits of $3,531,780 over 30 years. The total benefits are comprised of $722,468 in sales tax revenue from construction; $2,528,062 of sales tax revenue from operations over 30 years, and $281,250 in fees to be collected by the LDC based on the bond proceeds. The project is also estimated to create more than 770 construction jobs and 127 new full-time jobs.

The $221.3 million Patient Care Tower project would feature a five-story, 128-bed structure with all of its inpatient rooms ICU-equipped and a patient-centric design with leading edge amenities that will create a soothing, healing environment. It will house vital services for WMCHealth patients and their families including trauma, neurosciences, cardiology and general surgery.

The Local Development Corporation assists Westchester not-for-profit organizations in securing tax-exempt bond financing benefits. These benefits are provided at no cost or risk to the taxpayers of Westchester County. Since its inception in 2012, LDC has assisted not-for-profit organizations in securing tax-exempt bond financing totaling over $500 million.

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BROWNOUTS POWER FAILURES AND GRID FAILURE IF NEW YORK LEGISLATORS DO NOT ACT NOW — BACK TO 2003 HOW DID YOU GET HOME  AUGUST 14, 2003, THE NIGHT WHEN  THE CITY BLACKED OUT

JOHN J. MURPHY  OF CLEAN ENERGY JOBS COALITION NEW YORK ON WHAT THE STATE

IS NOT DOING, WHAT IT NEEDS TO DO TO FILL THE 3,500 MEGAWATT GAP IN THE GRID LEFT BY CLOSING INDIAN POINT. NO ONE IN ALBANY IS TALKING ABOUT IT BUT WHITE PLAINS WEEK IS.

SUPERINTENDENT OF SCHOOLS DR. JOSEPH RICCA ON WHITE PLAINS SCHOOLS OPENING

GOVERNOR HOCHUL CALLS OUT THE PRESIDENT : LET THE MIGRANTS WORK 

SEND LAWYER MONEY OPEN FACILITIES NOW.  

PLUS NEW TCA INITIATIVE BY COUNTY

SENIOR NEEDS INITIATIVE

AND MORE

THE BIG MIKE: JOHN BAILEY AND THE NEWS

THIS WEEK EVERY WEEK ON WHITE PLAINS WEEK

FOR 22 YEARS