Restricting Access to a Third Dose of Vaccine Could Be FDA's Worst Idea Yet

My very few regular readers know that I recently took a third dose of Pfizer Covid-19 vaccine. You can read all about the reasons for my decision here. I just got back the results of my first neutralizing antibody titer assay post 3rd dose and the numbers are outstanding. For this most recent test I was able to have the assay run against the Washington (original outbreak) strain, as well as the South African and UK variants. Delta variant was not included as labs across the world are still struggling to expand their stocks as the virus has proven particularly delicate to handle in the lab. Ironic, given how robust this particular variant has proven to be outside the lab. In any case my titer against the South Africa variant increased from 724 to >16,000, and similar large increases were seen for UK and Washington. As a reminder 128 is considered the minimum titer for protection and the higher the number the better. My own numbers, exactly like everyone else's who has been tested had been dropping precipitously and a plot of the data suggested I had 1 or 2months of protection left at best which is one of the reasons I moved to obtain the 3rd dose when I did

I have zero guilt over my decision. There is no vaccine shortage. In fact we are still throwing away millions of dollars worth or vaccine every month due to the known stability issues associated with these mRNA vaccines. Some have asked me if I had to lie at the local CVS where I got the third shot. They have suggested they of course could "never lie" and would not no matter the stakes. First I call bullshit on every single one of those people but second, no, I did not have to lie. At least, not exactly. The only question they ask when you fill out the electronic form to get the vaccine is if you have received any other vaccine in the past 14 days. I had not. The debatable part came when the pharmacist filled out the CDC vaccine record after I got the shot. He wrote in the dose as my first, and I said nothing when he did. I guess you could call it a lie by omission, but I have no regrets and no guilt in any case. The neutralizing antibody titer data suggests the decision was absolutely the correct call. Moreover it is was also clear from my own data (it is complicated to explain exactly how we know this but we do) that I had been recently exposed and exposed heavily to at least one if not more than one of the circulating SARS-CoV-2 variants. I also recently had a positive covid-19 RT-qPCR test. It was a very late amplification suggesting a low level of virus shedding. This aligns perfectly with our current understanding as we know vaccinated people do carry the virus, it can replicate in them, and they can transmit the disease and even get mildly sick. We also know they do not progress to the serious forms of the disease which is why the the vaccines have been effective at reducing morbidity and mortality from covid-19 disease. Or course this protection from serious disease is only good as long as your neutralizing antibody titer against the particular variant you are exposed to remains at protective levels (>128). If it falls below that, all bets are off.

With all that as backdrop we now come to the present day "decision" by FDA to restrict third vaccine doses to so called at risk populations. If this is true, and is a final decision, two things which are almost impossible to say when it comes to FDA, it could very well go down as the most wrongheaded move ever in the entire history of disease protection/prevention. It flies in the face of everything we know about the current status of infection/transmission and how to slow the spread of disease, and is to put it simply, very, very, very dumb. FDA should be out there leading the charge to get everyone who wants one a third dose, and they should have been out there doing this months ago before front line health care workers started getting sick again. They had to know antibody titers were dropping, and dropping fast, and yet they stood on the sidelines and said nothing. No campaigns of awareness, no push to boosters, nothing, radio silence. And now here we are with transmission rates through the roof again, ever more dangerous variants continuing to emerge and now is the time FDA decides to get cold feet about vaccine safety. News flash FDA, nothing has changed. Not one damn thing. The vaccines are exactly as unsafe now as they were when you were pressing everyone to get first and second doses. You can whine all you want about lack of safety data and the fear that some people may get sick, some severely, and some may even die from a third dose, but guess what, the same was true of the first and second dose. I cannot for the life of me understand what FDA is thinking. It seems blatantly obvious to me that they are not. Any voices of reason and sanity that once existed in FDA have apparently flown the coop. Fingers crossed more rational minds eventually prevail at FDA and this decision is reversed.