# Most people with Omicron didn't even realise they had COVID-19, study finds



## Eric

Strange how it really hits some hard and others have no idea they even had it, no wonder it's so hard to write guidelines around.









						Most people with Omicron didn't even realise they had COVID-19, study finds
					

This "low level of infection awareness has likely contributed to the fast spread of Omicron," said Dr Susan Cheng.




					news.sky.com
				





> Most people who were infected with the Omicron variant didn't even realise they had COVID-19, according to a new study from Cedars-Sinai Medical Centre in the US.
> 
> The lack of public awareness about being infected means that people can't take steps to prevent themselves transmitting the virus further, which is a major stumbling block for addressing new waves of the pandemic.
> 
> "More than one in every two people who were infected with *Omicron* didn't know they had it," said Dr Susan Cheng, a corresponding author of the study which is published in JAMA Network Open.




The new booster is about to come out that should cover Omicron, looking forward to getting it personally. I want no version of this thing (though I think I've already had it) and will continue to take whatever measures that come available.


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## mollyc

This does not suprise me, but how was it determined they actually had it? Are there omicron specific antibodies they can test for?


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## Herdfan

mollyc said:


> This does not suprise me, but how was it determined they actually had it? Are there omicron specific antibodies they can test for?




Not me either.  I had a scratchy throat for 3-4 days and a slight cough, but not consistently.  Only way I knew for sure was a rapid test.  Wife was a little worse, but still milder than our usual winter cold.


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## mollyc

Herdfan said:


> Not me either.  I had a scratchy throat for 3-4 days and a slight cough, but not consistently.  Only way I knew for sure was a rapid test.  Wife was a little worse, but still milder than our usual winter cold.



well if you tested, then you became aware. The language in the article (the part that is in the excerpt, I didn't click on it), seems to imply that people never, EVER, knew, which indicates no testing at all.


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## Eric

mollyc said:


> well if you tested, then you became aware. The language in the article (the part that is in the excerpt, I didn't click on it), seems to imply that people never, EVER, knew, which indicates no testing at all.




From the article:


> Scientists at Cedars-Sinai have been conducting research into the effects of *COVID-19* and the impact of vaccines for more than two years.
> 
> At the beginning of the study they began collecting blood samples from healthcare workers, and then in the autumn of 2021 they began collecting samples from patients too.
> 
> Of the 2,479 healthcare workers and patients who had given blood samples around the beginning of the Omicron surge, the researchers found 210 people who were infected with the variant based on newly positive levels of antibodies in their blood.
> 
> The researchers then surveyed the study participants to get updates on their health status, and during these surveys only 44% of participants who had the antibodies were aware of being infected.
> 
> The majority were not only unaware of any infection, but only 10% reported having any symptoms at all - and those that did believed they were caused by a cold or another infection.


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## mollyc

Eric said:


> From the article:



it does help if you read it all, doesn't it.  thx.


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## Herdfan

I guess I need to further clarify.  Had my wife not bought the tests and tested herself first, I wouldn't have tested and would never have known.

It was really that mild.


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## mollyc

We test for everything....scratchy throat, sniffles...we just stockpile tests and assume we have covid until we test. The kids both had it, my husband and I have not (at least none that ever registered on a rapid test).


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## Eric

Herdfan said:


> I guess I need to further clarify.  Had my wife not bought the tests and tested herself first, I wouldn't have tested and would never have known.
> 
> It was really that mild.



This was my experience also, had mild symptoms that could've been attributed to anything really but knew I was around someone exposed and decided to test, got a faint line. Still up in the air on whether or not I had it though.   



mollyc said:


> We test for everything....scratchy throat, sniffles...we just stockpile tests and assume we have covid until we test. The kids both had it, my husband and I have not (at least none that ever registered on a rapid test).



Same here, my wife was all sniffles last night and I just gave her a look... "do you want me to test?"


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## lizkat

I still get my groceries delivered, and the meet-and-greet reunions w/ neighbors have all been outdoors so far.  I joked to a friend the other night that maybe I'm most likely to end up with a variant of covid just from showing up to my wellness check or going to the pharmacy for a flu shot later on this fall.  But that won't stop me from such appointed rounds.  Anyway so far so good:  I haven't even sneezed yet at the bumper crop of goldenrod starting to wave its fluffy wares.


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## DT

lizkat said:


> Anyway so far so good:  I haven't even sneezed yet at the bumper crop of goldenrod starting to wave its fluffy wares.




Right?  Covid or this ...


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## Eric

lizkat said:


> I still get my groceries delivered, and the meet-and-greet reunions w/ neighbors have all been outdoors so far.  I joked to a friend the other night that maybe I'm most likely to end up with a variant of covid just from showing up to my wellness check or going to the pharmacy for a flu shot later on this fall.  But that won't stop me from such appointed rounds.  Anyway so far so good:  I haven't even sneezed yet at the bumper crop of goldenrod starting to wave its fluffy wares.



I'm very much the same, ironically I was exposed by a close friend who was taking all the right measures but I still won't hang out inside with anyone but am glad to make outdoor events.


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## lizkat

DT said:


> Right?  Covid or this ...
> View attachment 16872




Yep!  We had all this incredible rain in June this year, long enough to keep people from battling the jungle for early control of gardening spots...  and that let the goldenrod attain stalk heights of almost 6' now in any later neglected corners.   Of course lately the weather is almost as dry as a bone,  so the goldenrod's trying for an Olympic medal as it blooms.  I'm lucky that I don't react much to pollens,  and I feel badly in advance for my friends already sneezing as the first few stalks put forth their flowers and advertise the onslaught to come.


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## Runs For Fun

I caught it again a week and a half ago. It was even milder than it was the previous time I had it. I'm guessing it was probably Omicron. I had an extremely mild sore throat and some light congestion for a couple days. The worst thing I felt was just the fatigue. Finally starting to feel back to normal now. If it hadn't been for that I probably wouldn't have thought it was Covid.


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## Herdfan

Eric said:


> I'm very much the same, ironically I was exposed by a close friend who was taking all the right measures but I still won't hang out inside with anyone but am glad to make outdoor events.




More ironic are our neighbors.  They have been super vigilant since this all started.  They refused to go to a local restaurant because one of the servers was wearing her mask under her nose.  

She has now had it 3 times and he has had it twice plus a rebound from the second time.


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## fischersd

Is your fall booster the same as ours (in Canada)?  (that it's going to be protection against the original Omicron variant, not against BA.5?) - if so, I'm beginning to think that there's little point.  Most of us have had Omicron and possibly BA.5.  I'd like to see the stats on what additional protection a booster could provide if you've already had the two?

As many people had adverse reactions to the shots (my spouse included), they really need to demonstrate what the benefits are going to be.  She's not planning on having any more shots, due to how bad her reaction to her third Pfizer was.


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## Roller

Herdfan said:


> More ironic are our neighbors.  They have been super vigilant since this all started.  They refused to go to a local restaurant because one of the servers was wearing her mask under her nose.
> 
> She has now had it 3 times and he has had it twice plus a rebound from the second time.



It depends what you mean by super vigilant. At a restaurant, for example, it doesn’t much matter if the servers are properly masked if there are unmasked patrons around. 

The transmissibility of the recent omicron variants and sub-variants is so high, it doesn’t take much exposure to be infected. So even people who’ve been quite cautious are getting COVID-19. But I don’t subscribe to the notion that no precautions are needed because everyone will get it anyway. I continue to mask indoors to, hopefully, limit the number of episodes in the long run and keep flu and cold viruses at bay.


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## DT

Herdfan said:


> I guess I need to further clarify.  Had my wife not bought the tests and tested herself first, I wouldn't have tested and would never have known.
> 
> It was really that mild.




We had this scenario, where two people got it, likely exposed at the very same time, one person had pretty visible (very bad cold-lke) symptoms 3 days later, the other person had none, and wouldn't have even checked if not for symptomatic person.

Interestingly, the second person got symptoms about 3-4 days later (than the 1st person), and tested negative about 3-4 days later than the first person (so the same, assuming, exposure date, but her positive/symptoms/negative window pushed later by 3-4 days).  When her symptoms peaked it was pretty nasty for about 24 hours, like moderately bad flu-like.  And it was close to 10 days from the first positive to negative (home antigen test).

FWIW, both of these people had both shots, both boosters, which we were thankful for, given their symptoms weren't exactly "mild".


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## Eric

fischersd said:


> Is your fall booster the same as ours (in Canada)?  (that it's going to be protection against the original Omicron variant, not against BA.5?) - if so, I'm beginning to think that there's little point.  Most of us have had Omicron and possibly BA.5.  I'd like to see the stats on what additional protection a booster could provide if you've already had the two?
> 
> As many people had adverse reactions to the shots (my spouse included), they really need to demonstrate what the benefits are going to be.  She's not planning on having any more shots, due to how bad her reaction to her third Pfizer was.



The way I see it is I can't know for sure one way or the other without antibody tests and most are not getting those, so I see no harm in this booster and if it means I can finally be in public without a mask (at least with that sense of security) I'll gladly take it. I'm a high risk group so I'm sure Kaiser will notify me as soon as its available.


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## Renzatic

Eric said:


> This was my experience also, had mild symptoms that could've been attributed to anything really but knew I was around someone exposed and decided to test, got a faint line. Still up in the air on whether or not I had it though.




I'm beginning to believe that I more than likely caught it earlier this year. About a month ago, an old friend of mine was flown up to Mayo Clinic to get a surgery he's needed for awhile now. He ended up getting covid on the flight, which was confirmed at the clinic.

Of course I had to laugh about it, cuz I'm a bastard, and if the poor dude didn't have bad luck, he wouldn't have any luck at all. Though I did ask him what his symptoms were while he was suffering from it, and what he described was EXACTLY what I went through earlier this year.

It all started with an incredibly sore throat that felt like someone ran a woodchipper on my tonsils. That went away within 24 hours, and I was left with the sniffles and a low grade fever for the next three days. Besides the sore throat, the worst thing about it was the fatigue. Didn't lose my sense of taste or smell, didn't have any trouble breathing, and didn't experience any of the other tale-tell symptoms of covid.

The two home tests I took looked like they came up negative, but did have the faintest of faint lines that I dismissed as just being there. The more professional test, which was still the swab, though the results were sent to a lab, came up negative as well.

At first, I thought it was a rough cold. But with my symptoms matching others, and all these stories about false negatives floating around, I can't help but wonder.


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## DT

@Renzatic

Have you ever tested positive?

I've tested probably 10-12 times, never positive, even with the situation described above with some direct exposure to the two people who got it.


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## Clix Pix

Yesterday while I was out walking around the lake, I sneezed several times and immediately thought, "oh, no!"  Then I realized that, hey, this is heading into late August and undoubtedly it is either ragweed or goldenrod that my system is picking up somewhere out here....  Sure enough, when I came back into the house, all was fine, no more sneezing.    Guess I'd better check my supply of Zyrtec, as I know from past years this allergic response will increase significantly and I'll need some relief.    Every spring and every early autumn I go through this.

As far as COVID, inasmuch as I can tell, I have never had it and hope that I stay this lucky!


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## Renzatic

DT said:


> Have you ever tested positive?
> 
> I've tested probably 10-12 times, never positive, even with the situation described above with some direct exposure to the two people who got it.




I haven't taken any tests since then, so no.

To put things in perspective here, I took the first home test the day after my fever broke. The 2nd, I took a couple of days after. The 3rd, which was the professional test, came 3 days later, when I drove my dad to the local clinic to get the test, since whatever I had, I gave to him, and he had the same symptoms. Since I was there, I thought I might as well.

We both came back negative. I was recovered, and he was in the midst of it.


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## DT

Yeah, I've done a test where there was a higher probability of exposure with symptoms 2-4 days later, never positive.

Generally if I get some symptoms and I've been in a pretty exposure free pattern, I won't test.

But I've definitely had some exposure that I can't believe didn't result in contracting it.   Either I've been super lucky, or it was still not enough direct exposure possibly combined with vaccinations[?] or I don't test positive on rapid antigen type tests (not sure if that's even a thing).

We're pretty sure the daughter and I had it in early 2020 (Jan-Feb), before it was named,  she had a severe, long lasting set of flu symptoms (cough and sore throat and a persistent low grade fever) and it was even a bit perplexing to her doctor.  I got the same, really severe, had moderate symptoms for like 10-14 days, probably some perceptible symptom for a month.

Then my folks in DC, in March '20 said to cancel my trip, and of course, shit hit the fan.

Maybe surviving the early version of Covid made me immune.


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## throAU

i just picked up covid via test on tuesday.

i had a sore throat, currently have mild common cold symptoms (4x pfizer). i can be pretty sure it’s omicron as dominant strain here at the moment.

i was somewhat shocked to finally test positive as its my first covid and i’ve tested many many times (ten rat tests in 10 days for one bout all negative) and become far more sick last year without getting a positive test. but this test was absolutely undoubtedly positive.

so given the last 2 years, previous waves and increasing complacency i can totally tell how someone might not know they had it until well into the infection.


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## throAU

Renzatic said:


> The two home tests I took looked like they came up negative, but did have the faintest of faint lines that I dismissed as just being there.



ANY red in the test zone after giving the test the required time is a positive result.

unless the test zone is 100 percent clear you are positive on a RAT.  You tested positive.

my test yesterday was totally unambiguous though.


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## Roller

throAU said:


> i just picked up covid via test on tuesday.
> 
> i had a sore throat, currently have mild common cold symptoms (4x pfizer). i can be pretty sure it’s omicron as dominant strain here at the moment.
> 
> i was somewhat shocked to finally test positive as its my first covid and i’ve tested many many times (ten rat tests in 10 days for one bout all negative) and become far more sick last year without getting a positive test. but this test was absolutely undoubtedly positive.
> 
> so given the last 2 years, previous waves and increasing complacency i can totally tell how someone might not know they had it until well into the infection.



You should do well, and your risk of long-COVID is considerably reduced by vaccination.

I think the reason many people weren’t aware of their infection wasn’t that they were asymptomatic, but rather had symptoms that were similar to seasonal allergies and common viral URIs.


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## throAU

Roller said:


> You should do well, and your risk of long-COVID is considerably reduced by vaccination.
> 
> I think the reason many people weren’t aware of their infection wasn’t that they were asymptomatic, but rather had symptoms that were similar to seasonal allergies and common viral URIs.



agreed. 100%. it’s allergy season here right now. i reckon i may have been infected 2-3 days before testing when symptoms became persistent enough.  i’m still not coughing more than once per hour and it feels honestly like a mild head cold. 

i wrote the sore throat off as acid reflux at least once, and the lethargy as my cat waking me up several times at 3am. in hindsight it was most definitely covid.


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## Renzatic

throAU said:


> ANY red in the test zone after giving the test the required time is a positive result.
> 
> unless the test zone is 100 percent clear you are positive on a RAT.  You tested positive.
> 
> my test yesterday was totally unambiguous though.
> 
> View attachment 16993



The results gave me the faintest, faintest red line,  you couldn't see it unless you stood near a light to look at it. 

I considered it a negative.


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## throAU

Renzatic said:


> The results gave me the faintest, faintest red line,  you couldn't see it unless you stood near a light to look at it.
> 
> I considered it a negative.



yup, understandable and many do take that as a false negative. but again - it’s either there or it isn’t. and if there’s red there, it’s a positive.


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## Renzatic

throAU said:


> yup, understandable and many do take that as a false negative. but again - it’s either there or it isn’t. and if there’s red there, it’s a positive.




Guess I had the rona then.


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## Alli

My son finally tested negative. One of those cases where he felt fine, but the test kept coming up positive.


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## throAU

So my partner is still testing negative.

I reckon i had it for 1-2 days before testing positive.  We both accepted the fact (and discussed 2 years ago) that living together, if one of us gets it we're both inevitably going to get it so we haven't been isolating from each other.  Covid is wierd.

Shes isolating at home with me as a close contact.


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## throAU

GF still negative, but has some pretty obvious symptoms now (she's 3x vac).  Interestingly, for her its the cough, not so much runny nose and more of a tickle on the throat than sore.  Its clear that RAT tests do take a while to come positive.  This time she did a saliva test though (not a swab) and others I've talked to reckon they're useless.  Government sent those ones out for free though and we only have 6 nasal swabs which we'll need when I'm coming out of it for testing prior to return to work - or we'll need to get more delivered.

I'm on the mend sort of I think.  Head cold, sinus pain/headache, but I've had much worse.  No breathing issues, no "brain fog" other than a headache/watery eyes.  Second night I had fever, fairly intense shivering, but not the third night.  Decent night sleep.  Still up and about doing things around the house.

Its weird.  I can sleep mostly fine with it and can breathe easy, etc. laying down (which with normal head cold I can't).  But when I'm up and active is when I want to sneeze/blow nose, etc.

I'm still barely coughing at all (can count number of times on one hand in the 6 hours I've been awake so far today).  The worst symptom is headache, then runny nose and sinus pressure.


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## Cmaier

Walgreen’s is already accepting reservations for the updated booster, so I have a reservation next week. I’ll be an early guinea pig again


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## Eric

Cmaier said:


> Walgreen’s is already accepting reservations for the updated booster, so I have a reservation next week. I’ll be an early guinea pig again



Really? I've been watching Kaiser and haven't heard anything yet. Maybe I'll check them out.


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## Cmaier

Eric said:


> Really? I've been watching Kaiser and haven't heard anything yet. Maybe I'll check them out.



Yep.  See red box at the top of this page:



			https://www.walgreens.com/topic/promotion/covid-vaccine.jsp
		


It’s a little confusing because when you go through the process of signing up it never again mentions the “updated” booster.  But in the email confirmation I got, it says “COVID-19 Updated Booster (pfizer-biontech).”   Maybe they should name it something different (Pfizer II or something) so it’s clear what’s going on. 

Also signed up for the flu shot while I’m there.  Didn’t occur to me that it’s already september, and i usually get mine around october.


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## Eric

Cmaier said:


> Yep.  See red box at the top of this page:
> 
> 
> 
> https://www.walgreens.com/topic/promotion/covid-vaccine.jsp
> 
> 
> 
> It’s a little confusing because when you go through the process of signing up it never again mentions the “updated” booster.  But in the email confirmation I got, it says “COVID-19 Updated Booster (pfizer-biontech).”   Maybe they should name it something different (Pfizer II or something) so it’s clear what’s going on.
> 
> Also signed up for the flu shot while I’m there.  Didn’t occur to me that it’s already september, and i usually get mine around october.



Done and done, thanks! Going in on Wed.


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## Cmaier

Eric said:


> Done and done, thanks! Going in on Wed.



Me too  see you there.


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## Chew Toy McCoy

Cmaier said:


> Walgreen’s is already accepting reservations for the updated booster, so I have a reservation next week. I’ll be an early guinea pig again




I'm getting mine next Wednesday which is great timing because I'll be in Florida for a week starting Saturday.     Before this I just fell under the age (50) of being able to get one sooner.  I'll be turning 50 the end of the month.


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## Eric

Chew Toy McCoy said:


> I'm getting mine next Wednesday which is great timing because I'll be in Florida for a week starting Saturday.     Before this I just fell under the age (50) of being able to get one sooner.  I'll be turning 50 the end of the month.



My wife is going on a trip to Hawaii the week after her shot (I get to stay home with the dogs) but she'll be close to the two-week mark, hopefully she'll be spared.

I'm going on a photoshoot with a buddy this weekend but he knows I'm totally paranoid and is great about masking up in the car.


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## Chew Toy McCoy

Eric said:


> My wife is going on a trip to Hawaii the week after her shot (I get to stay home with the dogs) but she'll be close to the two-week mark, hopefully she'll be spared.
> 
> I'm going on a photoshoot with a buddy this weekend but he knows I'm totally paranoid and is great about masking up in the car.




I'll be hitting the trifecta of likely to get covid - 2 cross-country flights.  Florida.  Disneyworld.  

My elderly parents just got back from an Alaskan cruise, masked as often as possible, but tested positive with 2 days left on the trip.  Thankfully they're doing ok which freed me up to at least temporarily have the "can you be any more of an elderly covid cliche?!?" thought.


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## Renzatic

I'll call in for mine on Monday.


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## mollyc

is the updated booster for everyone? or just over 50/immunocomprimised? i’m not eligible for a second booster since i’m still under 50.


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## Renzatic

mollyc said:


> is the updated booster for everyone? or just over 50/immunocomprimised? i’m not eligible for a second booster since i’m still under 50.




I believe it's for everyone. From my understanding, it's basically this year's covid shot, akin to the seasonal flu shots.


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## AG_PhamD

mollyc said:


> is the updated booster for everyone? or just over 50/immunocomprimised? i’m not eligible for a second booster since i’m still under 50.






Renzatic said:


> I believe it's for everyone. From my understanding, it's basically this year's covid shot, akin to the seasonal flu shots.




@Renzatic is correct… or mostly correct . The new “bivalent” vaccine is for age 12+ with Pfizer and age 18+ with Moderna AND have completed the first series of previous vaccines AND has been at least 2 months since your last dose. 

As a provider I resent the fact they are calling this new vaccine series a “booster”. It’s going to create too much unnecessary confusion. 

I imagine I will have to get the vaccine sooner rather than later for work, which is fine. For older adults I would consider waiting until later this fall (ie a few weeks before Thanksgiving knowing it takes a little time for immunity to form) given that’s historically when COVID spikes (like the flu) and mRNA vaccines seem to have limited longevity (especially in the elderly + we won’t know for sure for quite some time). If you’re around school aged children, earlier might be reasonable- it’ll be interesting to see how things progress in terms of school cases. But that’s a decision that should be calculated between you and your providers. 

Amazingly I have yet to catch COVID… unless I caught it in 2019. I had an antibody test when those came available (May 2020?) which came back negative but those aren’t very reliable. And I have had twice weekly PCR testing for ages now.


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## Eric

Cmaier said:


> Walgreen’s is already accepting reservations for the updated booster, so I have a reservation next week. I’ll be an early guinea pig again



Wondering how this worked out for you, we made the appointment for today, even got a reminder this morning and when we showed up they had no idea who we were and said the new vaccine had not arrived yet.


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## Colstan

So, I just got the latest booster yesterday at around 4:00pm, the new bivalent vaccine, targeting both the original strain of SARS-CoV-2 and the BA.4/5 omicron sub-variants, which share the same spike protein and are currently the dominant variants circulating. Since the initial release, I've been exclusively using Moderna. While there are no current studies comparing the latest vaccines, the previous booster seemed to be more favorable with Moderna than Pfizer, which is why I stuck with Moderna and recommended to my family members to switch.

My mother actually took part in the initial Pfizer clinical trials, having traveled an entire state away, and was fortunate enough to be in the 50% that received the real vaccine. Hence, she has received all of the vaccines recommended for folks her age. One of our local pharmacies got the new booster just yesterday, so I took her to get the vaccine with me. She's had so many jabs, that they had to staple her vaccine cards together; at some point it's going to be as big as a phone book. Many of my family members have a needle phobia, so it's good to have me walk them through it.

As of this writing, it's been approximately 19 hours since I got the injection. I'm too young to qualify for the second booster (fourth jab), so it's been a substantial amount of time since I received the first booster. Considering that this dosage targets both the original SARS-CoV-2 and BA.4/5, I think it has more side-effects, at least for myself and my mother, than previous boosters. I had the worst reaction to the second initial dosage, with mild symptoms with the first booster, and I'd say that this was the most unpleasant since the original second dose.

Approximately six hours after receiving the Moderna booster, I began having symptoms. Primarily, a low-grade fever, aching joints, moderate pain at the injection site, and a headache. Also, strangely enough, I had muscle pain in the arm that didn't receive the jab. I don't know if this is sympathy pain, or more likely, a result of general pain from expected symptoms.

The most unpleasant side effect was the inability to sleep. Typically, when one gets a mild fever, it produces chills and a desire to sleep it off. I felt like I was overheated, and had terrible insomnia. So, I felt too bad to do anything except lay in bed, but my mind wouldn't let me fall asleep. I got maybe three hours last night, while waking up every ten or twenty minutes. I didn't have insomnia with my previous three injections, so I see this as a sign that this new booster is indeed different from the previous ones that I have received.

At this point, almost all symptoms have abated, and I am doing much better, so expect this to last at least half a day, once symptoms start becoming noticeable. I had a few errands to do this morning, so that was unpleasant, and should have budgeted my time better to take it easy. I had assumed that the side effects would be similar to the first booster, but this was more impactful. Of course, the results will be different for everyone, my mother is currently fast asleep, so it could take her more time to recover. I'm also going to make sure other family members get the vaccine as soon as possible, despite their needle phobias.

It takes approximately two weeks for the vaccine to reach maximal efficacy. Thus, I recommend everyone get their injection as soon as possible. Just make sure you don't have a lot to do the following day. As I said, I'm doing much better now, but would have preferred to stay at home, in bed, the following day after receiving this booster.

Finally, I know it sounds weird, but I'm sure many of us feel a sense of accomplishment after the injection. Even though it's a mild inconvenience, staying current with the latest boosters is the best way to avoid either being infected, or substantial severity of an infection. It is also the right thing to do for our families, friends, and human kind in general. This is a good reminder to get your influenza vaccine, as well. There are no restrictions with taking them together, just make sure to switch arms. Last year's flu vaccine was a miss with little to no protection, because COVID dominated global sickness, but hopefully the predictive methods used will improve its efficacy this year.

So, the short version is to get the COVID booster for the new variants as soon as it is available in your area, call around if you have to like I did, and do your civic duty to protect both yourself and everyone around you. I survived the latest injection, and I recommend getting it as soon as possible.


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## Eric

Appreciate you sharing your experience, I've always been hit pretty hard with side effects so I'll expect it here, too. It's still worth a bad day to have that coverage, it does give you a sense of protection and security and I would love to go into the store without a mask for a change.

Unfortunately, our Walgreens has not been getting any of the new vaccine in as they anticipated so we can't get ours yet and they've cancelled our appointments. Best hope is next week some time.


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## AG_PhamD

Eric said:


> Wondering how this worked out for you, we made the appointment for today, even got a reminder this morning and when we showed up they had no idea who we were and said the new vaccine had not arrived yet.




I’ve heard a number of cases of this occurring, or more specifically getting a phone call cancelling the appointment because the vaccine is not yet available. 

I’ll have to talk to my colleagues in the community side of pharmacy to find out what’s going on. I’m surprised they would not know how many doses they’re getting. Maybe they’re overbooking people with the expectation a certain percent cancel? Or it’s a distribution problem?

Frustrating none the less.


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## Eric

AG_PhamD said:


> I’ve heard a number of cases of this occurring, or more specifically getting a phone call cancelling the appointment because the vaccine is not yet available.
> 
> I’ll have to talk to my colleagues in the community side of pharmacy to find out what’s going on. I’m surprised they would not know how many doses they’re getting. Maybe they’re overbooking people with the expectation a certain percent cancel? Or it’s a distribution problem?
> 
> Frustrating none the less.



Right, my wife isn't too happy about it mostly because they confirmed our appointment by text that same morning just to tell us they didn't have it when we arrived. I think they're just at the mercy of supply chain though, some seem to have gotten them while others haven't. My guess is within a week they'll have it all straightened out.


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## Cmaier

Eric said:


> Right, my wife isn't too happy about it mostly because they confirmed our appointment by text that same morning just to tell us they didn't have it when we arrived. I think they're just at the mercy of supply chain though, some seem to have gotten them while others haven't. My guess is within a week they'll have it all straightened out.



I actually got there and they didn’t have any vaccine. They claimed they tried to call everyone and cancel. Nope. In fact, I got an automated text message that day reminding me to come in.  Stupid walgreens.


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## Chew Toy McCoy

My booster appointment was a nightmare but I did get it.  

About a half hour before my appointment they left a voicemail asking me to come a half hour later than my appointment because starting at my appointment time they would be closed for lunch.  Then why make that time slot available?

So I got there about 15 minutes before my new appointment time.  There was only 1 other person waiting at the time and both of us sat in provided chairs.  Then more people started shuffling in, no real orgainization.  When they finally opened the widow it became a free for all.  Nobody in the pharmacy made any kind of announcement asking who was there for an appointment or what time.  It was just "I'll help next in line" with no actual line and people just selfishly deciding they were next with no regard to the people around them.  

2 people who got to the window before me had an appointment an hour after mine.  I asked a woman standing next to me if she had an appointment, she said no, she's just picking up medication.  I said I had a 4 o'clock appointment and it was currently 5.  Knowing my frustration when they said "next in line" she just rushed to the window.  Un-fucking-believable.  

At one point a guy sweating and sniffling without a mask on just kind of forced his way to the front where they weren't able to help with whatever it was he was looking for, but thanks for freaking us all out with possibly infecting us.

With what I thought would be a quick in and out 4 o'clock appointment I didn't get out of there until 5:45.


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## Eric

Cmaier said:


> I actually got there and they didn’t have any vaccine. They claimed they tried to call everyone and cancel. Nope. In fact, I got an automated text message that day reminding me to come in.  Stupid walgreens.



Exact same, although they did call yesterday to let us know today's wouldn't be in. They're obviously not synced up with their online automated system.

I scheduled on on Monday with Kaiser, hoping it will be here by then.


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## Cmaier

Eric said:


> Exact same, although they did call yesterday to let us know today's wouldn't be in. They're obviously not synced up with their online automated system.
> 
> I scheduled on on Monday with Kaiser, hoping it will be here by then.



I just made an appointment via Stanford Health about a week and a half from now. It turns out i got all my shots from them, anyway, so this will likely work out much better.


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## AG_PhamD

Eric said:


> Right, my wife isn't too happy about it mostly because they confirmed our appointment by text that same morning just to tell us they didn't have it when we arrived. I think they're just at the mercy of supply chain though, some seem to have gotten them while others haven't. My guess is within a week they'll have it all straightened out.




Interestingly most of the cases I’ve heard about are with Walgreens. So they definitely have some issue going on. My sister in fact had multiple confirmations only to get a cryptic phone call the day of the vaccination implying the COVID vaccine was unavailable but the flu shot was.

I’m sure they will straighten it out, but these sorts of screwups inevitably dissuade people from scheduling a second appointment. Hopefully they have a system to contact people to reschedule or reschedule people when they call informing of the cancellation. My sister took the initiative to just book with CVS and had no issues.


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## Eric

Kaiser did have them this morning by appointment only (I scheduled Saturday) and when I asked about side effects with this variant she said "I don't know, we just started giving them today". Reassuring lol, but we have feedback from @AG_PhamD which is a little scary, anyone else who wants to chime in is more than welcome.

I also had to get a new card as this is my 5th shot, so now I'm packing two of them around.


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## AG_PhamD

Eric said:


> Kaiser did have them this morning by appointment only (I scheduled Saturday) and when I asked about side effects with this variant she said "I don't know, we just started giving them today". Reassuring lol, but we have feedback from @AG_PhamD which is a little scary, anyone else who wants to chime it is more than welcome.
> 
> I also had to get a new card as this is my 5th shot, so now I'm packing two of them around.




Moderna did a clinical trial addressing safety with 800 participants. Pfizer did the same with 600. Side effects appear to be similar to the original vaccines. I would say it’s too early to know exactly how these compare or if any new adverse effects (aka severe side effects) are possible (or less prevalent), but there are of course phase IV trials ongoing to monitor this. I would expect there would be little difference.

If there are new adverse effects associated with the bivalent vaccines we are not aware of, more than likely they would be extremely rare.

As a healthcare provider, “I don’t know” is terrible answer to provide a patient in this context when there is in fact some data. There’s much better ways to frame uncertainty. You can rarely determine exactly how someone will respond to a pharmaceutical (we won’t get into pharmacogenomics) but you can have a good idea of how most people will.

I will say assuming you still have some degree of immunity it’s common to have more intense side effects with subsequent shots. This is because your immune system has already been primed to respond. Most side effects in this case are not really a result of the vaccine itself, but your body’s response to the vaccine. These new vaccines still contain some of the original (BA.1) vaccine.

I haven’t heard/seen any severe side effects at this point. That said my experience is anecdotal. I didn’t see any major issues with the first vaccine either, granted the known severe side effects are like less than one in a million. 

Let us know what your experience was.


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## Herdfan

Renzatic said:


> I believe it's for everyone. From my understanding, *it's basically this year's covid shot, akin to the seasonal flu shots*.







AG_PhamD said:


> Moderna did a clinical trial addressing safety with 800 participants. Pfizer did the same with 600. Side effects appear to be similar to the original vaccines. I would say it’s too early to know exactly how these compare or if any new adverse effects (aka severe side effects) are possible (or less prevalent), but there are of course phase IV trials ongoing to monitor this. I would expect there would be little difference.




@AG_PhamD 

What type of testing happens with the annual flu shot?  I am guessing it doesn't go through all the layers.  Or is it even tested at all?


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## Eric

Herdfan said:


> @AG_PhamD
> 
> What type of testing happens with the annual flu shot?  I am guessing it doesn't go through all the layers.  Or is it even tested at all?



I'll let AG speak with his expertise since you asked. But as I understand it the base is the same and that's what had to go through all the trials, they just add the latest variants every year, just as they do with the flu shot so there's no need to vet actual vaccine any longer.


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## Eric

Colstan said:


> So, I just got the latest booster yesterday at around 4:00pm, the new bivalent vaccine, targeting both the original strain of SARS-CoV-2 and the BA.4/5 omicron sub-variants, which share the same spike protein and are currently the dominant variants circulating. Since the initial release, I've been exclusively using Moderna. While there are no current studies comparing the latest vaccines, the previous booster seemed to be more favorable with Moderna than Pfizer, which is why I stuck with Moderna and recommended to my family members to switch.
> 
> My mother actually took part in the initial Pfizer clinical trials, having traveled an entire state away, and was fortunate enough to be in the 50% that received the real vaccine. Hence, she has received all of the vaccines recommended for folks her age. One of our local pharmacies got the new booster just yesterday, so I took her to get the vaccine with me. She's had so many jabs, that they had to staple her vaccine cards together; at some point it's going to be as big as a phone book. Many of my family members have a needle phobia, so it's good to have me walk them through it.
> 
> As of this writing, it's been approximately 19 hours since I got the injection. I'm too young to qualify for the second booster (fourth jab), so it's been a substantial amount of time since I received the first booster. Considering that this dosage targets both the original SARS-CoV-2 and BA.4/5, I think it has more side-effects, at least for myself and my mother, than previous boosters. I had the worst reaction to the second initial dosage, with mild symptoms with the first booster, and I'd say that this was the most unpleasant since the original second dose.
> 
> Approximately six hours after receiving the Moderna booster, I began having symptoms. Primarily, a low-grade fever, aching joints, moderate pain at the injection site, and a headache. Also, strangely enough, I had muscle pain in the arm that didn't receive the jab. I don't know if this is sympathy pain, or more likely, a result of general pain from expected symptoms.
> 
> The most unpleasant side effect was the inability to sleep. Typically, when one gets a mild fever, it produces chills and a desire to sleep it off. I felt like I was overheated, and had terrible insomnia. So, I felt too bad to do anything except lay in bed, but my mind wouldn't let me fall asleep. I got maybe three hours last night, while waking up every ten or twenty minutes. I didn't have insomnia with my previous three injections, so I see this as a sign that this new booster is indeed different from the previous ones that I have received.
> 
> At this point, almost all symptoms have abated, and I am doing much better, so expect this to last at least half a day, once symptoms start becoming noticeable. I had a few errands to do this morning, so that was unpleasant, and should have budgeted my time better to take it easy. I had assumed that the side effects would be similar to the first booster, but this was more impactful. Of course, the results will be different for everyone, my mother is currently fast asleep, so it could take her more time to recover. I'm also going to make sure other family members get the vaccine as soon as possible, despite their needle phobias.
> 
> It takes approximately two weeks for the vaccine to reach maximal efficacy. Thus, I recommend everyone get their injection as soon as possible. Just make sure you don't have a lot to do the following day. As I said, I'm doing much better now, but would have preferred to stay at home, in bed, the following day after receiving this booster.
> 
> Finally, I know it sounds weird, but I'm sure many of us feel a sense of accomplishment after the injection. Even though it's a mild inconvenience, staying current with the latest boosters is the best way to avoid either being infected, or substantial severity of an infection. It is also the right thing to do for our families, friends, and human kind in general. This is a good reminder to get your influenza vaccine, as well. There are no restrictions with taking them together, just make sure to switch arms. Last year's flu vaccine was a miss with little to no protection, because COVID dominated global sickness, but hopefully the predictive methods used will improve its efficacy this year.
> 
> So, the short version is to get the COVID booster for the new variants as soon as it is available in your area, call around if you have to like I did, and do your civic duty to protect both yourself and everyone around you. I survived the latest injection, and I recommend getting it as soon as possible.



Wanted to share my current experience as well, also wanted to say thanks for pointing out how many hours it's been at the time of writing this which gives a true perspective without us having to figure it out from post dates.

It's been about 29 hours for me now, I got it at around noon yesterday. Shot stung a little going in this time but subsided shortly after with no pain, then about 3 hours later I started to feel my arm getting sore which is typical for me. Made it through most of the evening okay but did have a rough time getting sleep, not sure why because I seemed okay otherwise but was restless.

Woke up feeling a bit under the weather this morning, also had an upset stomach and that's been the case most of the day (not a side effect I've ever had with this vaccine to date), there are also no dietary changes worthy of note. Have been having a few hot flashes and feel rundown but no actual fever or chills, yet anyway. I've also had several bouts of nausea but that has abated as well. So far this is one of the milder reactions I've had, a couple of past ones really laid me out.

Also worth noting that this is my 5th Pfizer dose overall, I even had to get a new card lol. Hopefully I'm past the worst of it but if anything changes I'll follow up, if I'm still feeling achy tonight I may take some Tylenol but so far I haven't needed anything for it.

YMMV, good luck everyone!


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## AG_PhamD

Herdfan said:


> @AG_PhamD
> 
> What type of testing happens with the annual flu shot?  I am guessing it doesn't go through all the layers.  Or is it even tested at all?




There is a lot that could potentially be written here but I’ll try to keep it as straightforward as possible.

It is tested quite similarly in terms of other vaccines with human clinical trials to address safety and dosing. Due to the nature of the flu virus however, testing how well it works is a little different than other vaccines. Scientists attempt to predict what mutations will occur by the time the flu spreads around the world for the next season. In premarket trials it is tested for _efficacy_ rather than _effectiveness (_Efficacy refers to theoretically how well it’ll work, effectiveness refers to how well it works in the real world). A “surrogate marker” is used to determine this efficacy- in this case does the vaccine create antibodies that target the viral strains of interest. This isn’t that uncommon in pharmaceutical trials. After the vaccine is on the market follow up trials are done to determine it’s effectiveness by seeing how well it prevents flu cases or reduces symptoms, hospitalizations, etc as well as monitoring for any side effects not detected in the safety trials.

Obviously if we waited until flu season to hit to test its effectiveness, by the time the trials were completed flu season would be over. And because influenza mutates so quickly, the correct strains are not always chosen. So it’s not a perfect way of doing things, but it’s the best we’ve got. Thought not unheard of, intentionally exposing vaccine trial participants to the virus (“challenge studies”) is generally considered unethical, especially if you have a placebo group. 

There are mRNA flu vaccines in trials which would greatly speed up the development process. The most relevant technology currently used is recombinant DNA technology where basically we genetically modify E.Coli to create the vaccine organically- but it’s a complicated process and is prone to problems.

Perhaps even better we also have “universal flu” vaccines in trials, which would mean not having to alter the vaccine ever year and possibly greater dosing intervals than every year.


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