By Karen Kier, Pharmacist on behalf of the ONU HealthWise team

We learn early in school to find credible sources when writing a paper. Many may remember encyclopedias or going to the library to read a book to take notes.  We have become a society of instant gratification with Google or asking Siri or Alexa for an answer.  

Each week, I research the published, peer-reviewed literature to find the most reliable evidence about health and medicine. Recently, I was told there is no need to read published newsletters or newspapers because they can just get their answers from Google.  When you search Google for Google search algorithms and misinformation, amazingly you will find some pretty sound criticism of the accuracy of the results.  Is this our most credible source of information?

What do you do with too many choices for a decision? Do you keep searching for other sources?  Do you ask friends for their advice?  Do you ask some experts?  Do you put off the decision until more information is available?  We handle complex decisions very differently.  

Right now, we have some tough decisions about COVID-19 vaccines.  The original vaccines focusing on SARS-CoV-2 spike proteins before mutations were highly effective in preventing disease, hospitalization and death.  Those original vaccines still have the ability to reduce hospitalization and death even though the major variants are Omicron BA.4 and BA.5.  

Many in the United States are still eligible to receive the current COVID-19 booster vaccine.  Data suggests only 33.2% have received a booster.  The US has sufficient supplies of Pfizer, Moderna, and Novavax vaccines to supply shots to those eligible.  

More studies are being released including a JAMA Network Open study from August 10, 2022 reporting benefit of mix and matching COVID-19 vaccines.  The study evaluated the combination of the J & J viral vector COVID-19 vaccine with the Pfizer mRNA COVID-19 vaccine against the Omicron variant.  The study reported an enhanced antibody response to the Omicron variant with the combination. This study joins other evidence demonstrating some benefits of mix and matching COVID-19 vaccines.  

The Novavax vaccine would provide a different mechanism than the mRNA vaccines. However, the Novavax vaccine is not currently authorized for booster doses after a series of either Moderna or Pfizer.  On August 15, 2022, Novavax asked the FDA to authorize a booster dose of Novavax based on a Phase 3 study, which reported benefit of a Novavax booster given six months after a two-dose primary series.  

Immunologists have provided evidence for waiting at least four months between COVID-19 booster doses to allow the immune system to have the best response for antibody production.  This is an important factor in the timing of COVID-19 vaccines no matter the mechanism by which they work.   

Companies are working on bivalent vaccines to combat the Omicron mutations of SARS-CoV-2.  Bivalent vaccines contain two distinct parts including the sequence for the spike protein in the original COVID-19 vaccines, as well as the spike protein for the Omicron sequence.  

The United Kingdom approved the use of a bivalent vaccine with the original spike protein sequence and the Omicron BA.1 sequence. The difficulty with this vaccine is the predominant Omicron variants in the United States and BA.4 and BA.5 in Europe. The UK vaccine has shown some ability to provide additional protection against Omicron infections.

The United States is waiting for data on a bivalent vaccine with the original spike protein sequence and a second sequence covering BA.4 and BA.5. The hope is for this data and vaccine authorization to be available in early to mid-September.  Pfizer has a bivalent vaccine with the original spike protein and the BA.5 subvariant for those 12 years of age and up.  Moderna is about 3-4 weeks behind Pfizer with a bivalent vaccine for those 18 years of age and up.  

A common question right now is should I get the booster shot or wait for the bivalent vaccine to be authorized. There are several choices.

So, should you wait for the bivalent vaccine for a few weeks to months or if eligible, should you get a COVID-19 booster now?  It is a good question because if you get a COVID-19 booster now, then you would need to wait four months before getting the bivalent vaccine.  Experts provide some guidance for answering this question.  If you are at high risk of a serious infection, then consider getting a booster now and not wait.  If the infection rate in your community is rising, then consider getting a booster now.  Otherwise, there could be a benefit in waiting for the bivalent vaccine.  One more consideration to think about is that the new bivalent vaccines may only be authorized as a booster and not as a primary series.  

In addition, we do know the immune system is stimulated by any vaccine including the influenza (flu) vaccine.  We are coming into flu season and vaccines are available in the next few weeks.  ONU HealthWise will have flu vaccines starting September 1, 2022.   

ONU HealthWise is offering COVID-19 including boosters, as well as flu shots Monday through Friday from 10 AM to 5 PM. Call the pharmacy for an appointment for other time slots. to get more information. 

ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com