COVID-19 update – boosters, oral molnupiravir for COVID-19

Boosters

There are now two very large studies showing profound reduction in hospitalization rates after the 3^rd mRNA vaccine from Pfizer and Moderna.

The original booster study from Isreal showed an 85-95% reduction in hospitalization rates after the booster. Another study published this week showed a 93% reduction rate in hospitalizations after the third vaccine.

Getting a third vaccine also appeared to be safe in both studies. The chances of having a more severe reaction to the third vaccine than with the first two was exceedingly rare when pooling the two studies with a combined group size of over 1.6 million people.

Immunocompromised individuals and the initial series of Pfizer or Moderna

In a study released this week, hospital rates were reduced by 90% in healthy individuals after the first series of two vaccines from Pfizer and Moderna. People with a significant immunocompromised condition had a 77% reduction in risk of hospitalization.

Although the 77% number is less in these people than the 90+% in healthier folks, it is still significantly less than some other studies had previously suggested. Some studies suggested that they may not respond at all to the vaccines. This is encouraging for this group of people for whom there was concern that they would not get much immunity to the mRNA vaccines.

Please see my previous articles about what immunocompromised really means from October 1 and October 7.

Autoimmune conditions and diseases do not represent an immunocompromised condition. In the case of those conditions one’s immune system is over-active and may need suppression to avoid further damage to organs.

Molnupiravir for COVID-19 (not ready for prime time)

This drug from Merck was approved this week for treatment of mild-moderate COVID-19 illness in the UK. Hailed as a great breakthrough, caution seems appropriate at the present time, giving its limited clinical experience.

The available data supporting its use is not very convincing. Plus its mechanism of action and findings of cancer and fetal malformations in animals raises concern for its true safety in humans. All human studies appear to be very short-term with small numbers of participants for a convincing clinical trial.

A remarkably erudite and discriminating article on this drug can be found (surprisingly) at Forbes.com under the title of The Dangers Of Molnupiravir, part 1 and 2.