[Duma]

What's the difference between 3rd dose and booster? My email talks about needing a referral letter for 3rd dose for people with severely weakened immune system. Doesn't mention boosters.

[mrjonathanr]

A 3rd dose is part of the primary series to create an effective immune response for the more vulnerable, that much is clear. I don’t know if it is a higher dose than a booster, or just a difference of terminology signifying it is part of the primary series of vaccination (as opposed to a stimulus to a successful but waning response).

I would be curious to know too.

[slab_happy]

What's the difference between 3rd dose and booster? My email talks about needing a referral letter for 3rd dose for people with severely weakened immune system. Doesn't mention boosters.

Very little in terms of what's in the actual jab (though according to this, they're using half-doses of Moderna for boosters but full doses for third doses: https://www.crohnsandcolitis.org.uk/news/third-covid-19-vaccine , and some people have been having third doses of AZ).

People who are immunocompromised/immunosuppressed have a much lower response to the vaccines, so 3 doses in fairly close succession are needed to (hopefully) kickstart the immune reaction which other people get from 2.

So, different purpose and timing from a booster, which is designed to pick up that original immune response later once it's started to wane over time.

Of course Omicron might shake all that up; depending on how the data looks, we might end up with "normal" Covid vaccination becoming 3 doses.

But anyway, it's a meaningful distinction in terms of the purpose.

[dunnyg]

Can confirm boosters and 3rd dose are different, tried to book the wrong one and got told to re book for the other.
It was explained in laymen's terms to me that 3rd dose is another "full" dose and the other is a half dose.

[Duma]

Be interested in sdm's email then, cause mine def implies you need a referral for a third dose, but doesn't mention boosters. (And I don't have such a letter...)

[Will Hunt]

Under 40s can now book boosters on the NHS website.

[steveyo]

Will, are you sure? Can you add the link?

I tried to get a booster tonight at the walk in, wife had hers booked (over 40), they initially said yes to me (37) but then changed their mind.

[spidermonkey09]

Won't work for me. This might be because I'm lucky enough to be under 30 still?

[JK]

You can, I just booked mine after seeing Will's post

[Will Hunt]

At time of writing they've updated the validation so that when you enter your date of birth while booking it still let's you proceed if over 30. No idea for under 30s. They haven't updated the accompanying text on the booking home page yet.

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/

[slab_happy]

Are all boosters Pfizer? For somebody who has had two doses of Pfizer is there any sense in seeking out a Moderna booster to improve protection?

I haven't been invited yet but see that there is a walk-in doing Pfizer boosters in Bradford today.

If I'm reading https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02717-3/fulltext correctly (someone check in case I'm not), people who've had two Pfizers might get an even higher antibody response with Moderna rather than a third Pfizer, though you may also get whapped harder with side-effects.

However, three doses of any mRNA vax performs very strongly, so personally I wouldn't delay getting boosted in order to get a particular one.

Though (just replying to myself for reasons of pedantry) that study data was with a full dose of Moderna, and I see they're using half-doses of Moderna as boosters, which you can do because the original dose is higher than with Pfizer so you can halve it and still get a decent respose.

So you wouldn't get the possible extra response if it's just a product of the higher dosage.

So yeah, I'd say go for whatever you can get soonest.

[Oldmanmatt]

We were Xmas shopping in Exeter yesterday.
There was an anti-vaccine/anti-mask protest.

All of 40/50 people. Noisy with whistles, but drowned by the crowds of hundreds (even thousands) of masked shoppers.
There was a lot of heckling from the shoppers, “Plague rats” prominent in the hubbub.

The queue for Churros had twice the number of people in it.

Churros, being a real thing, at least.

[slab_happy]

Looks like booking through the website officially opens to 30-39-year-olds tomorrow (Mon):

https://inews.co.uk/news/covid-19-booster-jabs-extended-over-30s-omicron-variant-1348237

So they've presumably changed the back-end settings already, just not the boilerplate text yet.

[slab_happy]

Over-18s should be able to book via the website from Weds, and some places will be offering walk-in appointments to over-18s from Mon:

https://www.bbc.co.uk/news/uk-59631570

Though a friend reports that the website is currently crashing under load ...

[User deactivated.]

Daily deaths have been at about the same level since August so why all the recent fuss? I see there's another new variant (isn't there always?), but why are restrictions suddenly coming back now?

[Will Hunt]

Exponential growth mixed with small-%-of-a-big-number-is-still-a-big-number mixed with uncertainty about what exactly Omicron will do to the projections, I believe.

[slab_happy]

Exponential growth mixed with small-%-of-a-big-number-is-still-a-big-number mixed with uncertainty about what exactly Omicron will do to the projections, I believe.

Plus Omicron's immune escape capacity -- it's REALLY good at infecting vaccinated (or previously-infected) people.

Even if breakthrough infections are relatively milder (which is what we're crossing fingers for, based on the early reports from South Africa), it means vaccinated people don't serve as a "firewall" to stop it moving through the population.

And it makes Delta look slow-moving.

[slab_happy]

Find a walk-in site:

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/find-a-walk-in-coronavirus-covid-19-vaccination-site/

Currently says:

You can get a booster dose from a walk-in site if it's been 3 months (91 days) since your 2nd dose and you're either:

    aged 30 years old or over
    aged 16 years old or over with a health condition that puts you at high risk from COVID-19

Appointment booking through the website is now totally overwhelmed and they're advising "try again later today or tomorrow":

https://twitter.com/NHSuk/status/1470331876883804160

[Will Hunt]

Slabs, I don't doubt the thrust of what you're saying and I'm absolutely sure that you've done loads more reading about this (I know this because I have done almost precisely none), but I'm not sure that speaking in absolute terms is helpful.

Looking at this through the eyes of somebody who is weary of the whole thing by now and would quite like to crack on as normal:

Plus Omicron's immune escape capacity -- it's REALLY good at infecting vaccinated (or previously-infected) people.

Even if breakthrough infections are relatively milder (which is what we're crossing fingers for, based on the early reports from South Africa), it means vaccinated people don't serve as a "firewall" to stop it moving through the population.

It might seem like there's no point in getting a booster at all. Wouldn't it be truer to say the vaccine is not as good at preventing transmission of Omicron but it still has some effect and it's the best chance we've got of reducing R without having restrictions on social contact. Not to mention that, although there is some cause to be optimistic about the severity of illness from Omicron, there's still a chance that it'll fuck you or your gran up so best to give yourself the best protection available.


My take at the moment is that shit is likely to kick off, because of the reasons above, but nobody has any idea yet to what extent the shit might be kicked off. Thus the best thing to do is to get the best mitigation you can and keep an eye on things.

I don't know whether more social restrictions might be necessary before Christmas, but I'm absolutely certain that the government will find it almost impossible to enact and enforce them before Christmas is done - such is the mood in the public and their own party. People would need to see the bodies piling up outside morgues before they accepted a cancelled Christmas, by which point (of course) it's too late.

[User deactivated.]

Exponential growth mixed with small-%-of-a-big-number-is-still-a-big-number mixed with uncertainty about what exactly Omicron will do to the projections, I believe.

Plus Omicron's immune escape capacity -- it's REALLY good at infecting vaccinated (or previously-infected) people.

Even if breakthrough infections are relatively milder (which is what we're crossing fingers for, based on the early reports from South Africa), it means vaccinated people don't serve as a "firewall" to stop it moving through the population.

And it makes Delta look slow-moving.

Ok, I won't be rushing for a vaccination then (recent covid antibodies so other variants still in circulation aren't a concern). Seems the best precaution for me is to be diligent about hygiene and take a LFT before social interactions.

[slab_happy]

Slabs, I don't doubt the thrust of what you're saying and I'm absolutely sure that you've done loads more reading about this (I know this because I have done almost precisely none), but I'm not sure that speaking in absolute terms is helpful.

Looking at this through the eyes of somebody who is weary of the whole thing by now and would quite like to crack on as normal:

Plus Omicron's immune escape capacity -- it's REALLY good at infecting vaccinated (or previously-infected) people.

Even if breakthrough infections are relatively milder (which is what we're crossing fingers for, based on the early reports from South Africa), it means vaccinated people don't serve as a "firewall" to stop it moving through the population.

It might seem like there's no point in getting a booster at all. Wouldn't it be truer to say the vaccine is not as good at preventing transmission of Omicron but it still has some effect and it's the best chance we've got of reducing R without having restrictions on social contact. Not to mention that, although there is some cause to be optimistic about the severity of illness from Omicron, there's still a chance that it'll fuck you or your gran up so best to give yourself the best protection available.

I think either I'm communicating badly (very possible, too little sleep and not nearly enough coffee) or you're misreading or both, but either way, you're right that this is super-important to clarify:

Omicron is really good at infecting people who have had two doses of vaccine.

We're hoping that those two doses still provide some solid protection against getting severely ill if you do get infected, but they just got a lot less useful at stopping you from getting infected in the first place (especially if you had AZ, like me). Which also means you can potentially transmit to other people, too.

(Whence the worry, because it means Omicron can move very fast through a population even though loads of people have had two doses.)

HOWEVER.

Evidence is showing that a booster dose does wonders at kicking protection way back up again. Omicron can get past two doses worryingly well, but three block it (about as well as two doses do with Delta).

The data on that is REALLY POSITIVE and a huge relief. At three doses, it is as good at blocking the virus as before.

(In fact, those of us who had AZ get an upgrade to our protection, because we get in on that funky mix-and-match action.)

So yeah, the takeaway shouldn't be "the vaccines don't work, don't bother", it should be "thank fuck the vaccines still work IF you get the booster, so do that a.s.a.p. and hopefully we can get through this with as little disruption as possible".

[slab_happy]

Exponential growth mixed with small-%-of-a-big-number-is-still-a-big-number mixed with uncertainty about what exactly Omicron will do to the projections, I believe.

Plus Omicron's immune escape capacity -- it's REALLY good at infecting vaccinated (or previously-infected) people.

Even if breakthrough infections are relatively milder (which is what we're crossing fingers for, based on the early reports from South Africa), it means vaccinated people don't serve as a "firewall" to stop it moving through the population.

And it makes Delta look slow-moving.

Ok, I won't be rushing for a vaccination then (recent covid antibodies so other variants still in circulation aren't a concern). Seems the best precaution for me is to be diligent about hygiene and take a LFT before social interactions.

See my subsequent clarification -- Omicron's good at getting past two doses of vaccine, but stops short at three. Which is why the all-out push for boosters right now.

Have you been vaxxed at all?

If not, I wouldn't rely on antibodies alone because again, Omicron seems pretty good at getting past antibodies to Delta; it's heavily mutated so the antibodies made for Delta don't work against it as well.

However, if you add vaccination to previous infection, you get to be "super-immune", and that does seem to hold pretty strongly against Omicron -- it's the funky hybrid immunity people are trying to simulate with mix-and-matching different types of vaccines:

https://twitter.com/JanineKimpel/status/1468700628922904591

(B.1.1.529 is Omicron; "super-immune" is figure h, and you can see how that protection holds up very well against Omicron where most have a sharp drop-off.)

So yeah, if you can get in on that action and haven't already, go for it, it's fucking awesome!

[Will Hunt]

Thanks for that. This:

Evidence is showing that a booster dose does wonders at kicking protection way back up again. Omicron can get past two doses worryingly well, but three block it (about as well as two doses do with Delta).

The data on that is REALLY POSITIVE and a huge relief. At three doses, it is as good at blocking the virus as before.

is a huge difference to how I was thinking about this before. I'd understood it to be that Omicron was still very good at evading boosters but, meh, it's the best chance you've got. Thanks for the info.

I find myself now very pro booster because I'd really like to keep using 36Chambers' board and going out to look at wet boulders.


Incidentally, do we know why is this the case:

Omicron can get past two doses worryingly well, but three block it (about as well as two doses do with Delta).

I'd assumed that vaccine effectiveness followed an exponentially relaxing curve, with more doses improving protection but at a decreasing rate. Unless the 2-dose-bad 3-dose-good thing is an artefact of the timing of when vaccines were given (i.e. if you've had two doses its likely that your 2nd dose is now a bit old and "wearing off") then why is there such a step change between 2 and 3 doses?

[Adam Lincoln]

Daily deaths have been at about the same level since August so why all the recent fuss? I see there's another new variant (isn't there always?), but why are restrictions suddenly coming back now?

Exactly. People need to get a bloody grip.

[RobK]

(In fact, those of us who had AZ get an upgrade to our protection, because we get in on that funky mix-and-match action.)

Does this work for other types too?. I.e. as someone who had two Pfizer doses, given the choice, should I get a Moderna booster?