Iowa Specialty Hospital

COVID-19 Update from Dr. Michael McLoughlin 12/20/2021

December 20, 2021

There have been many recent developments related to the COVID-19 pandemic and so we wanted to provide some updates on common questions.

1. What’s the deal with booster vaccinations?

In short, we now have good evidence that a 3rd dose lowers the risk of severe illness in adults of any age more than having had only 2 doses of COVID-19 vaccine. The benefits of a third dose are greater than the risks/side effects (which tend to be similar to the 2nd dose) and so I would recommend that anyone older than 18 receive a third dose. It is not clear whether there will be a need for ongoing boosters as it may be that we simply need to consider the initial vaccine series as a 3 dose series but will not need frequent boosters beyond this (there are multiple other vaccines that work best as a 3+ dose series already, so this wouldn’t be surprising).

2. What should I do if I got the Johnson and Johnson vaccine initially?

For most people, I would recommend a booster dose of either the Pfizer or Moderna vaccines. There is evidence that the antibody response when one of these vaccines is added to an initial J&J vaccine is better than when a second J&J vaccine is given. There have also been more serious side effects with the J&J vaccine than the Pfizer or Moderna vaccines. While serious side effects from any of the 3 vaccines are much more rare than serious effects of COVID-19, we no longer recommend J&J for most people since it increasingly appears the others are even safer.

3. If I do get COVID-19, is there any treatment that I can receive?

Yes! We have several different antibody treatments that can decrease the risk of severe illness or need for hospitalization. These are just like antibodies that our own immune systems make but have been made in a lab. They bind to the virus and help the immune system eliminate it. These treatments are most effective when given early in the illness. They are IV treatments and so need to be given in a hospital. We have these treatments available at Iowa Specialty Hospital. Anyone who has a high risk of severe illness (which includes anyone who is overweight, over age 65 or with certain medical conditions) is a candidate for this treatment. I would particularly recommend this treatment for individuals who meet the criteria and have not been vaccinated, since unvaccinated individuals are at much higher risk of severe illness.

There are also new oral medications that have been developed to treat COVID-19 but none have yet been approved for use in the United States.

4. What should I know about the Omicron variant?

The short answer is that we’re still learning a lot about it. It is clear already that it spreads even more easily than the Delta variant. There is some evidence that suggests it may be less likely to cause severe disease than the Delta variant, but this is very preliminary and not yet something I’d hang my hat on. If it does prove to be less severe, that would be a wonderful thing. Even if that proves to be the case, as long as the prior variants continue to circulate (Delta is still most common in our area), the risk of severe illness remains very high, particularly for anyone who has not been vaccinated.
 

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