Yesterday, I went down to the local pharmacy to get my 5th Covid-19 vaccination having previously had two Astra-Zeneca doses in June and September 20211, and two Pfizer boosters subsequently, the first in the middle of January 20222 and the second in late June 20223.
The vaccination I had today was an adapted bivalent mRNA vaccine targeting the Omicron subvariants BA.4 and BA.54. These two omicron subvariants came to dominate infections worldwide in the second half of 2022, and were first detected in South Africa in January and February 2022, respectively. They are offshoots of the Omicron variant BA.2, and their additional mutations seem to have given them an advantage in that they are more transmissible. In the second half of 2022, the World Health Organization (WHO) stated that BA.5 then accounted for over 50% of the world’s cases, while BA.4 accounted for just over 10%. Why BA.5 has overtaken BA.4 is unknown, because they are very similar5.
The reason the vaccine had to be adapted was because the effectiveness of the original vaccines against the earliest strains of SARS-CoV-2, had begun to wane against Omicron variants5. The Therapeutic Goods Administration of Australia provisionally approved the Pfizer Bivalent Omicron BA.4-BA.5 vaccine for use as a booster COVID-19 vaccine in people aged 12 and older on January 20, 20236.
Studies have shown that adults aged over 55 who received the Pfizer bivalent BA.4-BA.5 vaccine developed higher antibody levels to the BA.4-BA.5 Omicron subvariant than those who received the original Pfizer vaccine. The efficacy against the even newer BQ.1.1 and XBB.1 subvariants was also higher than with the original vaccine. Similar trends were seen in 12-17 and 18-55 age groups6. A US study showed vaccine effectiveness (VE) against hospitalisation or death with a bivalent BA.4-BA.5 booster (either Pfizer or Moderna) was 61.8% compared with an original booster VE of 24.9%. A cohort study conducted in Nordic countries during July-December 2022 found VE against hospitalisation for a second booster of bivalent BA.4-BA.5 vaccine of 80.5% and for an original vaccine second booster of 64.9%, both relative to not receiving a second booster6.
When I was in the pharmacy waiting for my appointment (they were running half an hour late), it was very busy, with as many as 20 customers in the place at any one time. Of those, only about 6 or 7 who breezed through while I waited, were wearing masks. I always wear a mask when in indoor public spaces. Why the assorted state governments and the federal government do nothing regarding the wearing of masks is beyond me, as masks have been shown to be very effective at decreasing the rate of transmission, and the WHO has recommended that anyone “in a crowded, enclosed or poorly ventilated space” should wear a mask7. The pharmacy was certainly enclosed and crowded, so I wore my mask.
At the time (late January 2023) I wrote about the efficacy of mask wearing (again), I noted that 703 Australians had died from Covid-19 in the first 20 days of 20237. In the subsequent two months another 1500 Australians have died from Covid-198. I also noted at that time that there had been 674 million Covid-19 cases and 6,751,754 deaths across the globe. The number of new cases was then about 215,000 per day, while the deaths were at about 1,413 per day. Since that time, there have been about another 10 million cases, and another 80,000 deaths, with the number of new cases currently being at about 79,000 per day while the number of deaths is about 525 per day9. Of those daily deaths, about 15 are Australians8.
Why would the assorted governments not encourage the wearing of masks? Is it because it is mostly older people who die from Covid-19 and this is a way of decreasing outlays for the aged pension? Is it because many of those older people are in aged care, which is subsidised by the government and this is another way of decreasing their outlays? Is it because many of the people who die have underlying conditions and this may decrease the outlays for the National Disability Insurance Scheme and the Pharmaceutical Benefits Scheme?
How does this lack of action by Australian federal and state governments to encourage mask wearing differ from the lack of action by those in the US Congress to prevent mass shootings when they have the power to do so?
Wear a bloody mask!
Spot on. 👍
As with Admin, I also had my fifth vaccination this week–had the same Pfizer BA4/BA5–we delayed our fifth jab until it was available. Re masks, we are continuing to wear masks while at the supermarket and other enclosed spaces. The Covid numbers increased again this week in SA and are predicted to keep increasing, and, of course, the Covid numbers are probably at least double the numbers that are reported. Despite this, I saw only one other person with a mask at the local shopping centre this morning. This is one of the reasons that the hospital system is being clogged up, despite government assurances that there are enough beds for everyone, when there clearly are not.
Victorian Government Health Department states that Staff, Volunteers and visitors to Aged Care MUST wear a mask. No idea what the rule is in other states
It is the same in the ACT nursing home where an elderly relative of mine is ensconced.
This morning I received my sixth Covid vaccination at a small pharmacy in our local area. I write this not as an exercise in one-upmanship, but as helpful (and potentially life-saving) information for anyone who cares to read it – particularly those who are of advanced age (I’m 75).
The nurse at the pharmacy was initially hesitant to vaccinate me on discovering that I had already received five shots, saying (inter alia) “we’re mostly dealing with third, fourth and fifth vaccinations”, “the government hasn’t given us any guidelines yet about sixth vaccinations”, and “it’s a grey area”.
I said I was exactly following government recommendations – which suggest anyone over 65, whose last Covid infection or vaccination (whichever is the more recent) was more than 6 months ago, should make an appointment for a booster vax. Yes, she said, she was aware of the six-month advice, “but it’s still a grey area”.
Hmmm. As everyone in this forum will be aware, I am meticulously polite in interpersonal communications, both written and spoken, so I calmly referred to the current ATAGI advice (https://www.health.gov.au/news/atagi-2023-booster-advice?language=en), which as it happened I had checked out just yesterday and which includes the words “regardless of the number of prior doses received”. That’s not what I would call “a grey area”.
Conclusion: with the best will in the world, people can (and sometimes do) fail to read, or misread, or read and misinterpret, clear unambiguous information and advice. Speculation: some other poor old sod could easily have accepted the “grey area” statement and walked out without receiving ongoing protection against what can still be a killer disease, especially for elderly people with dodgy health.
Some may already have done so, in that pharmacy and elsewhere. We’ll never know, even if Covid, for no fault of their own, causes their demise.
People get stuff wrong. Never apologise for correcting an error, no matter how trivial, and no matter how many times they tell you it’s unimportant.
Thanks Arthur (and BA). ATAGI couldn’t have been much clearer. I’ve been a bit slack and haven’t read advice since Jan when they left 4 jabbers to decide for themselves (based on health, etc etc). We’re booked in a couple of weeks hence for number 5.
We had almost no adverse reactions to the bivalent vaccine; unlike the previous Pfizer version. Best of luck. Let me know how you get on.
I presume the 5th dose you had was not the bivalent BA4/5 as it was only approved early this year. I presume the dose you received today was the bivalent version; is that so?. The reason I ask is that my local GP has stopped giving Covid vaccines; that was the reason I went to the pharmacy. When my partner talked with their doctor and mentioned this, he said that I should make sure I ask for the bivalent version.