Speaker 1: (00:00)
Numbers of new COVID infections are finally going down in California and nationally, but officials are warning everyone not to let their guard down this time. Last year COVID looked like it was in retreat before the deadly winter surge. So questions remain about boosters, about vaccine mandates, about vaccinations for children, and about Halloween. Trick-or-treating joining us for his weekly COVID update. It's a pleasure to welcome back Dr. Eric TOEFL, director of the Scripps research translational Institute in LA Jolla. Dr. Topol, welcome
Speaker 2: (00:35)
Back. Thanks for reading. Always great to be with you. The
Speaker 1: (00:38)
Number of new cases is going down is that because of vaccine mandates,
Speaker 2: (00:44)
That's playing some role. It's hard to quantify precisely. I mean, it's a combination of many things California is doing very well, but our vaccination rates are still, let's say 10% points lower than the best states like Vermont and in new England. But we have had a lot of prior COVID in this state, which has helped build some immunity. Fortunately, a lot of those people also have been vaccinated, which gets terrific immunity built up and the mandates help promote vaccination. So all in all, you know, things are looking good, but of course we're not to a level of containment. So we still have a ways to go.
Speaker 1: (01:19)
Uh, two recent studies, one out of Israel determined that the Pfizer vaccine has a steep drop off of immunity protection after only two months, although it still does offer great protection against serious disease for many months. Should that new information change the way we're approaching booster vaccines?
Speaker 2: (01:38)
Yes, the best data we have from Israel is, uh, on boosters come from Israel and indeed after five or six months in people over age 60, there's a significant drop in protection from hospitalizations, severe illness. So it's really, uh, interesting. It's the older age group, uh, that are the ones that really need to get this extra shot. So that's the high risk group. The cutoff is really occurring at age 60 and the time is about five to six months. After that point, it starts to become increasingly apparent that the benefit of an additional shot will be important
Speaker 1: (02:16)
If you're over age 60 or over age 65, can you just go in and get a booster shot now? And are those the only people who can do that?
Speaker 2: (02:23)
Well, no. The, if you're a healthcare worker essential worker or you have multiple medical coexisting conditions, you also can get, uh, a booster from, uh, local pharmacies that carry them as far as is it only the people older? No, those are the ones at highest risk across the board. We're learning again from Israel, which has such careful collected data, that all people will have the benefit from a third shot. Uh, if they had a maternal or Pfizer, especially Pfizer, but the data from a dura coming into that extra shot prevents symptomatic infections. Why is that important? Well, nobody wants to get COVID, uh, you don't know where it's going to go. It could lead to long-term symptoms. It also could transmit to others. So these are the features that why we want to suppress symptomatic infections. Oh, so it could be Maury that over the weeks ahead, as we get more data, the recommendations will extend beyond where they are right now, which is age 65 in new, as it should be 60. Uh, it could go much slower and it could be, you know, close to across the board, but it's just a little early to make that call right now.
Speaker 1: (03:34)
Our boosters form a dhurna and Johnson and Johnson vaccines approved yet.
Speaker 2: (03:39)
Well, this week is the big week. Unfortunately, there is no Israel for these two vaccines, and we have limited data that the data that's being presented at the FDA meetings this week, basically show that if you give the extra shot to either vaccine modern or J and J you get a nice immune response, but they don't have the ability to suppress the need for hospitalization, the protection from the serious outcome that doesn't exist. So in the FDA briefing documents, we have part of the story and you basically have to bring in other pieces of data like the Pfizer Israeli data to make that conclusion, most likely the FDA will recommend the boosters for all of our vaccines in the U S which include Moderna and J and J. But that's going to be a somewhat controversial because there's some deficiencies in the data that's going to be reviewed.
Speaker 1: (04:30)
And can you mix vaccinations? In other words, if you got a Medina vaccination to have them fully vaccinated, can you get a Pfizer booster?
Speaker 2: (04:38)
Yes. As it turns out just today, that data was just put out on the web as a pre-print, it will be presented at the FDA meeting on mix and match. So they had about 150 people that had each of the three vaccines, Pfizer Madrona, or J and J. And then they gave those people, any of these nine combinations. And, uh, they worked very well in terms of mixing. So th the concerns that we've had with respect to staying in your lane, you've got Pfizer, keep getting Pfizer, Madonna, and on and on that probably is now going to be past tense. This idea of mixing, particularly if you had the J and J vaccine, the response to getting either modern or Pfizer is very post
Speaker 1: (05:20)
Dr. Topol. I have to ask you this question because I've had a couple of people bring this up. Is there anything like having too many antibodies against COVID in your system? I've heard some people who've had, COVID say they don't want to get a vaccine, or they don't want to get a booster because they'll have too many antibodies.
Speaker 2: (05:39)
No, no such thing. Uh, the best thing would have as high, a level of neutralizing antibodies. Those are the important ones, uh, as you possibly can, because that is the ultimate protection. That's basically the inactivation of the virus. So I can't, you know, do anything to a person. So high levels are great and we have no data, no evidence to indicate that the limit there could be, uh, in any way, a negative thing. So that's a miscue, and I hope that, uh, we'll learn, uh, everywhere, everybody that we want to have neutralizing antibodies. That that's the whole idea
Speaker 1: (06:17)
I heard today that the land border between the U S and Mexico will reopen next month for the fully vaccinated. Is that a good idea, in your opinion?
Speaker 2: (06:26)
You know, I think it's has some merits, uh, that we are trying to return to our pre COVID life. That's good. The liabilities are the vaccination cards that we have are not exactly fool-proof as to being authentic. I wish we had that, you know, digitally validated. The other thing is what about people who have been vaccinated and could be carriers that is there, they haven't yet developed the infection symptoms, or they're not going to develop, but they have a COVID infection that can transmit. It's not common, but if we were to do rapid testing, that can be done in minutes, that would take it to another level of safety. So I think it's okay, but we could actually even do better if we had authentication of the vaccination. And we were also using rapid tests to help guide,
Speaker 1: (07:15)
You know, finally Dr. Fowchee says trick or treating outside is okay for kids this year. What do you think about what's? Okay. And what's not for Halloween this year.
Speaker 2: (07:25)
You know, it would have been really nice if we could have had the, uh, age five to 11 or a lot of the trick-or-treaters to be vaccinated, because that would even take it to another level of safety, but that's not, not going to happen. It will likely get the, go ahead in early November, just missing out for Halloween. But I do think, you know, there's nothing to suggest that outdoor transmission is a concern. So since Halloween is an outdoor story, I don't see a problem with that at all. But in the future, as more children get backstage, it's going to become even a safe, ideal situation.
Speaker 1: (08:01)
And finally, governor Newsome and others are warning that we saw declining case rates this time last year, too, before the winter COVID surge, could we see another bed uptick of disease in the coming months?
Speaker 2: (08:14)
Absolutely. You know, we're not out of the woods here. We have plenty of people who are unvaccinated in this state and they are the most likely suspects to get COVID and to spread COVID, although things are looking good right now, we can't let our guard down. We need to keep getting more people vaccinated. And we also have to be careful because just because you're vaccinated doesn't mean that you are fully protected. That's why these booster shots for the high-risk people are going to be necessary. So we are quite a ways from containment, you know, hopefully eventually we'll get there in the months ahead, perhaps even sooner if we can rev up vaccination. But, um, we still have lots of vulnerable.
Speaker 1: (08:51)
I've been speaking with Dr. Eric Topol, director of the scripts research translational Institute in LA Jolla, Dr. Topol as always. Thank you so much. Thank you,
Speaker 2: (09:00)
Maureen.
Speaker 3: (09:01)
[inaudible].
