137 Comments

Looks like my spell correct gave out on the final edit, so that email is just going to be filled with shame forever.

Fixed now, but that's going to be a new PTSD trigger for a while.

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Don, Can’t thank you enough for all of the time you have put in on this.

I went out of state and got my Novavax and plan to travel to a second state next month to get my second shot. I am hoping to get the booster within six months of the first shot with my main concern being that Novavax has only emergency use authorization and not knowing when the Feds may end the public health emergency. Heard rumor that authorization set to end in January may not be extended.

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Yeah, ignore the rumors.

There is plenty of time to shape that, and the winter surge is going to be nutty af.

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Our hospitals in MA are reportedly down 19,000 positions with ED waits at times reaching 8 hours. The system capacity strain will likely get worse as winter approaches and may increase the pressure to extend the public health emergency.

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If the CDC was handling this is a public health emergency, they would not be continuously announcing a new stage of unmasking advice.

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Can you explain how going out of state helps? I have had 3 full mRNA doses (immunocompromised) and one mRNA booster. It has been 11 months since booster. They won’t give me novavax in Florida because of that booster.

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Three ways vaccines are tracked.

1) state public health database

2) health insurer or PBM

3) retail establishment

If you go out of state, you address 1).

If you say you do not have insurance coverage, you address 2).

If you do not go to the retail establishments where you had your previous vaccines, you address 3).

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Yes and my point is that if you can go out of state that is preferable to lying about your identity.

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Whether you lie out of state about your previous vaccination status, or lie in state about certain details connected to your identity, I don't see one as preferable. Both are lies to get around unethical and immoral bureaucracy, and do not do any harm to anyone else. From my perspective, getting a vaccine closer to home limits carbon emissions (many coastal Californians would be looking at well over 20 hours of drive time to get the 3 vaccines in another state).

Regardless, I presume we are on the same team here, which is in favor of access to Novavax and against the rationing of life saving vaccines in anti-science ways. I appreciate your efforts to try to help people access Novavax!

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If you are able to go out of state or maybe just not use insurance or go to same retail provider within your state, you may not need to construct a new identity with DOB. Misrepresenting identity takes it to a whole other level that may not be warranted, imo. I was not asked about ID. I was asked for my DOB twice.

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In a big state like California, getting to another state is not going to be physically or financially accessible to everyone. I am merely sharing that at county public health departments in CA, insurance and ID are not required and personal information can be self reported. I think people can determine what is going to work best for their circumstances.

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In California at public health departments they generally won't turn you away if you do not produce id (as in, they are not supposed to). So, there is an opportunity to self report information like DOB and address that does not connect with your name to evade #1. Not providing advice; just information. Do what you will with the facts.

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You need to address all 3 so you won’t be tracked.

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I followed you on twitter and followed you over to here. I got my Novovax shot as a “booster” from a local clinic. How soon would I need to get another shot since I need it as a new primary?

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7-8 weeks

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Thank you for this! I always appreciate more info I can share with family and friends. Question: should the booster come within 8 months after the 1st dose or the 2nd? And what timing would you recommend between doses 1 and 2?

My experience:

3x mRNA: I received mRNA Jan ‘21, Feb ‘21, and a booster Dec ‘21. I had really unpleasant side effects (fevers ~102°, aches, headaches, and violent chills for 2-3 days) after each dose.

1x Infection: I got COVID June ‘22. Felt like a bad cold (about the same as my mRNA side effects), plus a Pax rebound.

2x Nova: I “started over” with Novavax in Sept ‘22 and just got my second dose (no side effects either time, I’m thrilled!) I’m hoping that the supply will be available for me to get a booster in May (assuming 6 months from 2nd dose is best)

Other: I work from home, wear a 3M Aura when around others indoors, and carry an Aranet CO2 monitor (leaving places with poor ventilation).

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I added the timing to the article... but its first two within 8 weeks, third at 5-6 months, then possibly a fourth a few months later... should have more data on that soon

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Nov 12, 2022
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He's an expert in his field but not at this.

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Nov 13, 2022
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possibly... you should stick to the timing both me and the company said.

I don't say this specific timing because it's optional, I say it because it's how to do it best from the data we have.

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What’s the earliest you could get your third shot after your second ?

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Hi Don,

I had my first Novavax booster 4 days ago. The different between this and my MRNA experience is, well, mind blowing. I was flattened for 5 days with my Pfizer booster - so much so that I waited for nearly a year, and for Novavax to become available, to get a second boost. The only side effect with Nvax has been slight chest heaviness. No headache, fever, or body aches. What a difference. Question: This is my fourth shot (3x MRNA). Do I now require a second Nvax 7-8 weeks from now or does this build on what has been ‘seeded’ by the original shots? Thanks!

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I believe it’s best to treat it like a new series. Ideally we want 3 shots - your second one 7-8 weeks after the first and the third is what really drives up immunity. This one, I believe should be at the 5-6 month mark. I’m in Canada and trying to figure out how to manage that.

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Thanks for responding, Julie! I’m also in Canada and trying to work this out.

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Is it 3 shot 5-6 months after the second or first shot?

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Its the third shot... so it comes after the 2nd shot...

Primary series is two shots, third is automatically after those two

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Another Canadian here! Just want to make sure I'm reading the timing right.

For the third shot, is it 5-6 months after the first dose, or after the second?

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First dose. For reference, the phase 2 trial administered the second primary dose on the 21st day and a subsequent booster on day 189. Nevertheless, within 8 mo from the first dose is endorsed by WHO. In my opinion you have to make a personal risk assessment to guide your urgency. I opted for the shortest interval possible because of my exposure risk. Don’t let perfect be the enemy of good.

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Ok so if you received your first dose in July, second in September, you’d be ok to get the third in December? (3 months after the second/5 months after the first?)

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If you’re attempting to replicate the interval used in the trial just count 168 days from the second dose.

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I’m not 100% sure on that part. I’m thinking after the second but would be good to have it verified.

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Thank you for this. Now I feel a need to vent, and for my mental health's sake I'm going to do it now. I hadn't expected the mucosal immunity, but long suspected the Novavax vaccine created a better general immunity to all variants, vs. a tightly focused immunity on a small protein segment by the mRNA vaccines (not because they are mRNA, but because they picked the lazy option for an easy response which also happens to be a site where frequent changes already take place). The depressing thing for me is the extreme corruption in Canada's Health authority coupled with Novavax much lower ability to grease their palms by handout to relatives, donations, etc. has caused the supply of Novavax to disappear from much (all?) of Canada. :-(

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Well, the best thing to do is make more Canadians know that it does this and make them demand it... It's pretty much the only answer.

Education and organizing are ALWAYS the answer.

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My GP organized me getting it. 11 months past 3 Pfizers, First last month, no reaction but a little itchiness at site, 2nd at end of month. (Lost a day with the 2 and 3rd Pfizer reactions)

Thanks for all the info!

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Can I ask how (if you are in the U.S.) you got your GP to organize you getting it? I'm like you, had 2x Pfizer in April 2021 and a Moderna booster a year ago, but want a Nova boost. My Dr. said he'd write me a letter saying I had a bad reaction from the mRNA but he's not sure pharmacies will use that to let me get a Nova instead. (And anyway, he still hasnt' sent me the letter... SIGH) Thanks!

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Hi Don, thanks so much for this article. I’m wondering if I got my first dose of novavax late July and my second dose mid October, did I mess up the timing since that was more than 8 weeks?

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I only say 8 weeks for American regulations, Novavax has said that three months is fine.

In canada, you can only get it every three months and that might be the same deal with the new regulations in America... so this is all very fluid and not rigid in the absolute sense.

If you went over 5 months between the first two doses, I would say do a new primary series... but technically we don't have data on that yet... I could very well be wrong.

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Thank you!!

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Hi Don. You back up on Twitter, Mastodon?

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@justanewsletter on Twitter

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@don ford -Is getting the second dose of nova at 7-8 preferred / potentially of greater efficacy than getting it at 3 weeks?

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yeah, I need to update the article, but it seems like the more we stretch out some of the spacing the longer the reaction...

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So dose 1, wait 8 weeks, dose 2, wait 7 months, dose 3?

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I think I know the answer to this. But looking for opinions.

2/28/2021 Pfizer 1st dose (full)

3/21/2021 Pfizer 2nd dose (full)

9/18/2021 Moderna full dose

3/29/2022 Moderna booster dose (half-dose)

9/3/2022 Novavax 1st dose

9/15/2022 COVID infection

10/29/2022 Novavax 2nd dose

Should I bother with the bivalent booster in between waiting for Novavax booster in April 2023?

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I don't want to say there is no benefit, but it's unclear what the benefit might be.

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Want to second that: thank you Don for the public service you are doing.

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Thanks Don this is very helpful. If you don't mind answering, my schedule has been:

Pfizer Comirnaty: 4 Jun 2021

Pfizer Comirnaty: 8 Jul 2021

Moderna Spikevax: 22 Dec 2021

Novavax Nuvaxovid: 8 Jul 2022

Novavax Nuvaxovid: 12 Nov 2022

From here, should my strategy be (a) all set; (b) get Novavax number "3" in April 2023; or (c) treat 12 Nov as my 1st shot and look for number "2" in 7-8 weeks time?

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That spacing is pretty significant, so I would treat the newest shot like a first but then get your next at 3 months... then another at 7 months and you should be good and we will have more data before then to work off of.

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Next at 3 months ☑️ (had to be quite, ahem, creative to get it)

Hope you don’t mind me checking if “another at 7 months” is still the best way forward?

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Hi! Thanks for all you do! I first came across your huge long covid article many months ago, which is where I got my first taste for upgrading masks - which has made me feel so much safer.

I got my initial mRNA vax series in 2021 and ended with the booster in Dec '21. I had never had covid and no reaction to the mRNA vaccines. A few weeks after my booster at the end of Dec '21, I was infected for the first time. I've since had long covid this entire year. I'm very hesitant to take another vax because I don't want to make my LC worse... but I also don't want to get reinfected and worsen my LC before it heals. I'm in quite a pickle.

My antibody levels are sky high from others I've seen, sitting at 23,000 U/ml. I've seen one doctor on Twitter suggest not getting vaccinated until levels are less than 5,000. I'm also considering the bivalent booster to see if I can tolerate that before doing Novavax.

Have you seen a difference in vax tolerance b/w people with viral persistence vs autoimmune/inflammation as the cause? I appreciate any insight as I try to navigate making a decision & greatly appreciate it so much, thank you!!

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Just saw this, sorry for not responding. Do not get more RNA if you have Long COVID. There are a variety of things that can make things much worse for you.

Yes, folks in your situation can have a reaction to any vaccine but the RNA can wipe you out for months, some folks have symptoms get much worse.

Novavax is far less likely to make your Long COVID worse though it will like still give you a headache or make something wonky for a day or two, but nothing long term. Side effects are normal in your situation as long as the immunity sticks.

And yes, wow, those are high antibodies, but not all antibodies are equal and if you do get Novavax it has "Spreading" quality that makes your existing antibodies react better and that would give you protection against more variants, at least as I understand it.

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"And yes, wow, those are high antibodies, but not all antibodies are equal and if you do get Novavax it has "Spreading" quality that makes your existing antibodies react better and that would give you protection against more variants, at least as I understand it."

Yes, I think that's correct that it enhances the quality of antibodies!

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Thank you for the response!

My main concern is that my extremely high antibody count is a result of lots of virus still lingering in my body. And I'm afraid that novavax might aggravate them and make symptoms worse longer term.

Is there info on who gets worse with novavax vs who improves & why that may be? I'd like to know my chances before making a decision. I'd think based on my high antibody count that I may have excess virus and might potentially improve with novavax as I've heard it can help clear the remaining gunk. What are your thoughts?

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I think those who have Long COVID caused primarily by persistent virus would usually benefit from the vaccine, while those who have Long COVID caused primarily by autoimmune issues would be taking a higher risk than other people by being vaccinated. You could use honeysuckle tea and an azelastine nasal spray, as recommended on the labels, for two weeks and see if that helps to clear up some of the persistent virus if you suspect that.

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I would expect that the bivalent mRNA booster would be much more likely to cause adverse reactions than the Novavax vaccine.

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I have received a primary series of Novavax with the second shot 8 weeks after the first. Now I wait for the booster. Also, after my first Novavax shot, it cleared this inflammation in my body that I was experiencing after I got covid back in March. It disappeared. I can only relate it to Novavax. There’s no other explanation.

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So if I've had a mixture of Pfizer and Moderna, most recently the bivalent Pfizer, how would I go about switching to Novavax? And do you think it will be approved for 12-17 in Canada?

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