I’m in basically the same boat as you, 30ish adult, Pfizer regime completed in April. I too have been lazy and uninterested in side effects (knocked out for a day after second dose). And I too am exceptionally interested in hearing discussion of “should I” as well as timing/choice thoughts. So—just throwing out my thoughts. (Caveats: I’m an econ/stat type, my last bio-ish class was in high school and I remember none of it).
Should we get boosters?
I think my basic answer is “yes”. The longer answer is:
if it will allow you to reduce other precautions: yes. Free, very low risk of complications and reduces risk of covid—allowing precautions to relax.
if you got covid, and have been vaxxed: don’t bother.
if you don’t/can’t risk compensate (have already relaxed all precautions, or will never), haven’t had covid: yes, but YMMV in terms of benefits.
I haven’t given any consideration to “lifetime mRNA vax limits” until your mention, I have no idea how plausible that is—but my current belief is “20% chance that’s a real issue down the line”.
So take everything below as being “conditional on getting a booster at all.”
Timing
I plan to try to get a booster in a few weeks. The holidays are subsequently anything in January/feb are likely to be high risk for everyone. It doesn’t seem unlikely to me that in terms of picomorts or QALY risk (etc) this winter—where we still face reasonable case counts, but effective treatment regimes are still being rolled out and assessed (for now) -- is probably the highest risk period (for covid-19) remaining. Waiting until after winter thus makes little sense to me. If it going to happen in the next 6 months, it should probably be in the next month.
Choice
I have a mild preference for a Moderna booster over a Pfizer booster. Moderna efficacy seems to have been consistently a smidge higher for everything—likely because its a larger dose (ETA: looks like booster dose is smaller so this factor may be ignorable). This + the benefits of some variation in vaccine regime makes it seem preferable. Two points on this however:
This is a small risk change—not worth it if it forces you to change plans or to do something “risky” without a booster. Given the choice I would choose Moderna—I’m not sure its worth much to search it out.
These benefits come with some risks. I’ve had two doses of Pfizer, and no reactions that warranted hospitalization or the like. No guarantees here—but switching it up does add some risk. (so does just another round of pfizer).
“Larger moderna dose” may be a negative if you are worried about some “lifetime limit on mRNA doses”.
ETA:
Wrapup
Would genuinely like to hear more debate on “should”, “timing”, and “choice”. “Should” seems likely it will be well covered by media shortly. But “timing” and “choice” are things I doubt I’ll see outside of this venue.
Does it really show that? Looks hoplessly confounded to me:
Among fully vaccinated persons, 93 of 122 (76%) Pfizer-BioNTech recipients and 0 of 50 (0%) Moderna recipients had been vaccinated ≥4 months before the outbreak (p<0.001). A larger proportion of Pfizer-BioNTech recipients had diabetes (p = 0.02) or hypertension (p<0.001) than Moderna or Janssen COVID-19 vaccine recipients, and a higher proportion of Pfizer-BioNTech and Janssen recipients had a history of smoking (p<0.001) than Moderna recipients
This sounds like serious confounding. In all likelihood, prison docs had X doses and triaged, and then repeated.
I will say though—I do still think Moderna primary was likely better, but I’ve (since writing) found out that the booster is half the dose of the primary dose—so I doubt Moderna’s increased efficacy translates to the booster.
On somewhat further investigation (really limited here—lets not lean too much on it) -- the Moderna boosters are half the dose of the Moderna primaries. If you believe, as I do, that the primary reason for increased Moderna efficacy in trials was due to dosing, then the reduced booster dose means that the reason I give above (higher efficacy) is no longer a relevant factor.
I do think @npostavs is right that this study is likely quite confounded. Though I do still believe Moderna primary doses had reasonably better efficacy against OG covid, and in all likelihood against delta and now omicron.
Adding in post: Omicron both increases short term value of booster and may increase risk of hitting any lifetime cap (its further evidence for more future variants that will warrant boosting)
I’m in basically the same boat as you, 30ish adult, Pfizer regime completed in April. I too have been lazy and uninterested in side effects (knocked out for a day after second dose). And I too am exceptionally interested in hearing discussion of “should I” as well as timing/choice thoughts. So—just throwing out my thoughts. (Caveats: I’m an econ/stat type, my last bio-ish class was in high school and I remember none of it).
Should we get boosters?
I think my basic answer is “yes”. The longer answer is:
if it will allow you to reduce other precautions: yes. Free, very low risk of complications and reduces risk of covid—allowing precautions to relax.
if you got covid, and have been vaxxed: don’t bother.
if you don’t/can’t risk compensate (have already relaxed all precautions, or will never), haven’t had covid: yes, but YMMV in terms of benefits.
I haven’t given any consideration to “lifetime mRNA vax limits” until your mention, I have no idea how plausible that is—but my current belief is “20% chance that’s a real issue down the line”.
So take everything below as being “conditional on getting a booster at all.”
Timing
I plan to try to get a booster in a few weeks. The holidays are subsequently anything in January/feb are likely to be high risk for everyone. It doesn’t seem unlikely to me that in terms of picomorts or QALY risk (etc) this winter—where we still face reasonable case counts, but effective treatment regimes are still being rolled out and assessed (for now) -- is probably the highest risk period (for covid-19) remaining. Waiting until after winter thus makes little sense to me. If it going to happen in the next 6 months, it should probably be in the next month.
Choice
I have a mild preference for a Moderna booster over a Pfizer booster. Moderna efficacy seems to have been consistently a smidge higher for everything—likely because its a larger dose (ETA: looks like booster dose is smaller so this factor may be ignorable). This + the benefits of some variation in vaccine regime makes it seem preferable. Two points on this however:
This is a small risk change—not worth it if it forces you to change plans or to do something “risky” without a booster. Given the choice I would choose Moderna—I’m not sure its worth much to search it out.
These benefits come with some risks. I’ve had two doses of Pfizer, and no reactions that warranted hospitalization or the like. No guarantees here—but switching it up does add some risk. (so does just another round of pfizer).
“Larger moderna dose” may be a negative if you are worried about some “lifetime limit on mRNA doses”.
ETA:
Wrapup
Would genuinely like to hear more debate on “should”, “timing”, and “choice”. “Should” seems likely it will be well covered by media shortly. But “timing” and “choice” are things I doubt I’ll see outside of this venue.
This prison study is weird but appears to show that Moderna is MUCH more effective than the other vaccines. Applying Robin Hanson’s heuristic that the non-headline numbers in a study are less biased than the headline numbers, we should maybe treat this as more credible than official estimates of relative efficacy.
Does it really show that? Looks hoplessly confounded to me:
This sounds like serious confounding. In all likelihood, prison docs had X doses and triaged, and then repeated.
I will say though—I do still think Moderna primary was likely better, but I’ve (since writing) found out that the booster is half the dose of the primary dose—so I doubt Moderna’s increased efficacy translates to the booster.
On somewhat further investigation (really limited here—lets not lean too much on it) -- the Moderna boosters are half the dose of the Moderna primaries. If you believe, as I do, that the primary reason for increased Moderna efficacy in trials was due to dosing, then the reduced booster dose means that the reason I give above (higher efficacy) is no longer a relevant factor.
I do think @npostavs is right that this study is likely quite confounded. Though I do still believe Moderna primary doses had reasonably better efficacy against OG covid, and in all likelihood against delta and now omicron.
Adding in post: Omicron both increases short term value of booster and may increase risk of hitting any lifetime cap (its further evidence for more future variants that will warrant boosting)
Why should we think a lifetime limit exists?
Based on this argument. It’s not especially strong but is enough to make me want to research further.