Today I went to see my immunologist/asthma doctor for an allergy test. I mentioned that I had COVID for the first time a couple of weeks ago and he noted that I was boosted at the end of November. He told me not to get another COVID booster shot because in his experience, it was raising the risk of infection.
I can’t find any research to support this claim, not that I’m knowledgeable enough to analyze said research anyway. It sounds dubious to me, but he seems an otherwise competent doctor.
Is there any truth to this?
Assuming it’s false, I’m also wondering where it came from.
My husband sent me this article, written last year. Apparently it’s theoretically possible but not proven:
It’s plausible that repeated boosting may make it harder to respond to future variants. Theoretically, repeated exposure to an older variant formula may drive our immune system to concentrate too much on old features and not on new features. But despite some truly surprising evolutionary leaps of the virus (like Omicron) we have not seen any convincing evidence of OAS among humans, which is great news.
I can’t see a doctor suggesting that a covid vaccine was making it more likely to get a covid infection unless their an anti-vaxxer or, as Kayaker said, confirmation bias.
Regarding the anti-vax possibility, I did find this:
Also found this which may or may not be related:
Regarding the confirmation bias, that’s been an issue for a while now. Since such a high percentage of the population has received the vaccine it should be expected that more of the people that catch covid will be from the vaccinated crowd. Sometimes you have to remember to take a step back and look at the big picture. If a million people get vaccinated and 50 get sick and of 10,000 unvaccinated people, 30 get sick, the vaccine still wins. But it’s really easy to misinterpret that data and it’s even easier to use numbers like that as anti-vax propaganda.
But will the booster be an old variant? The last two boosters I have received, has been new vaccines effective against the current widespread variants. The one in 22 was against Omicron.
ETA so was the 23 vaccine, a newer vaccine, but still against Omicron.
This falls into a “yes, and no…” type of bucket. @Joey_P posted a link above to a brief message from Dr. Labos at McGill trying to explain the findings of a Cleveland Clinic study.
The Cleveland Clinic followed 52,000 employees (link points to the peer-reviewed version, not the pre-print) after the Omicron BA4/BA5 bivalent vaccine became available. They estimated that the bivalent vaccine had a vaccine effectiveness of about 29% during the time BA4-5 were the primary variants circulating. Not as much as we might have hoped, but if you were frail or had comorbidities, even a 29% VE would be of some value for you. But they problem is that it’s really hard to keep up. As soon as a new variant became prevalent, the VE for that bivalent dropped to nearly nothing.
Now, what got the anti-mandate and anti-vaccine types (not the Cleveland Clinic, but those who didn’t put much thought into possibilities) up in arms was Figure 2 (Link to Figure 2 because as a newbie, I can’t place an image). I wish the authors would have gone into more detail about these findings and the types of cofounders that can affect them.
Anyway, Figure 2 shows that indeed, those with 4 or 5 doses had a higher chance of reinfection than those with 3, those with 3 doses more than those with 2 doses, and so on.
I’m just spitballing, but it could well be that those with more doses had sought to obtain more doses specifically because they were the type of person more likely to catch Covid again. Elderly with tired immune systems, people with comorbidities (esp. overweight) that made them more likely to catch it again.
Versus the crowd who got dosed once or twice and gave up on it because “Hey, I’m young, I’m healthy, I got it before and it was no big deal” so they didn’t bother to get more doses.
Sorry for the long comment but that’s what I meant about it being a “yes but maybe no…” sort of thing. It’s possible that it is just as simple as “more doses = more chance of reinfection” but it’s also possible that my explanation, or another explanation I haven’t thought of, might be driving the phenomenon.
And those with comorbidities or compromised immune systems are more likely to report or be hospitalized with a COVID-19 infection, which also creates a reporting bias. Given the extent of asymptomatic (or at least unreported) infection and the wide variation of vaccine uptake and spacing, trying to draw any conclusions about vaccine effectiveness without some obviously and distinct trend is like herding tadpoles.
For the o.p. (and anyone else) receiving seemingly nonsensical guidance from a physician, bear in mind that most doctors are not trained scientists, many have only the bare prerequisites of biology and biochemistry in pre-med education, and a surprising number have no real grounding in statistics or critical interpretation of medical studies. One would think that an immunologist would have more than the mean as well as more than a superficial degree of knowledge about epidemiology but I’m often shocked to discover how narrow the knowledge of medical specialists is, and how much physicians are just as prone to misleading pop-med bullshit and conspiranoia as the ‘man on the street’ when it comes to anything outside of their direct training.
The notion that a vaccine would make you more prone to infection is almost entirely gibberish; at most, a vaccine might make you prone to antibody-dependent enhancement (ADE) resulting in a more severe presentation if there is some confounding factor between a live attenuated virus vaccine of one strain and infection by another (or serial infection by two different strains). This has been known to happen with dengue fever (which has five unique serotypes) and suspected to be a potential cause of the unique virulence of the 1918-1920 Spanish flu. This has not been seen with SARS-CoV-2, and while its high mutability offers a potential for enhanced virulence or infectivity or divergence into a genuinely unique viral strain, the use of an mRNA vaccine which stimulates the immune system with the spike protein is unlikely to cause ADE.
Given what I know about psychologists, this doesn’t surprise me in the least. The world is full of professionals who think they are experts because of X years in the field despite being woefully behind in or outright ignoring the latest research on whatever.
I’ll refrain from advancing my opinion of psychology as a research science discipline, but there is a broad belief that physicians are all “medical scientists” even though the work that most clinicians do is really really highly trained and experienced technician work. That’s not just my opinion; I heard the same opinion almost verbatim from a former graduate of the UCLA Medical Scientist Training Program. She said that while the med school academic side was a lot of memorization and the clinical rotations were stressful and exhausting, her PhD research work in virology and epidemiology was far more difficult and intellectually challenging, especially the statistics and ‘wet lab’ work. Her views on the unsolicited opinions of many non-scientist physicians during the COVID-19 pandemic could charitably be described as “depreciatory“. Still, I would expect an immunologist to be better informed about vaccine reactions and issues because it is directly adjacent to and interwoven with their own specialty, so it’s not just a little shocking hearing one recommend against a SARS-CoV-2 booster on the basis of it purportedly causing more infection, especially given the mutable nature of the virus and evidentiary waning immunity over time.
So I looked into his background, he’s apparently a D.O with a subspecialty in Allergy & Immunology. I’m not sure how that differentiates from an “Immunologist” but he’s clearly focused on allergy and asthma, not infectious diseases, which might explain him having this opinion.
I have started to post here at the Dope multiple times about my MAGA-loving brother, who is a doctor, but I inevitably end up deleting my rant. What I will say here is that he has no statistical knowledge whatsoever, and potentially no interest in actually reading any studies anyway, but of course my family members defer to his fuckwittery (Ivermectin, the danger of boosters, pennies sticking to people’s arms). Anytime I actually quote a study, given that I’ve been reading JAMA regularly for almost 4 years now, he just waves his hands and talks about competing theories.
What he has going for him is a prodigious memory, and the willing to grind through any sort of content, and I’m pretty sure he came out of med school with honors.
There is certainly a lot of difference between ID and immunology but you would expect a lot of overlap given how the symptoms of allergy can mask or be essentially identical to pathogenic infection. DOs are sometimes viewed as a little flakey as their practice includes “osteopathic manipulative medicine” (essentially chiropractic manipulation albeit generally without the woo) but their basic medical school education is essentially the same as an MD except for a larger focus on preventative medicine, and their board certifications are essentially identical between ABMS and AOA specialties. I think in practice the difference between the basic training and capability of a MD and DO in a certified specialty is less than the difference between individual physicians.
If your doctor has helped with your asthma, then it sounds like he’s at least a good allergist. I just wouldn’t take his opinions about vaccination with a lot of credibility in absence of a second opinion or some clear evidence.
Yeah, doctors are trained and often actively cultivate an air of authoritative infallibility even though they are just human beings with the same propensity toward personal bias and irrational belief as everyone else. I’ve met some physicians with pretty off the wall notions, and of course neurosurgeon and former Secretary of Housing and Urban Development Ben Carson was fully of nuttery as I noted previously:
You got a recent booster and subsequent Covid. The booster often provides considerable protection from Covid (including a reduction in incidence, symptoms and severity), but not complete protection nor guaranteed protection from future mutations. The most generous interpretation may be “don’t get another booster now” because if more severe mutations happen in a short to medium future, waiting for a hypothetical more helpful booster shot may be prudent. If mutations with more severe symptoms do manifest, not getting a relevant booster makes little sense to me, unless I am misunderstanding things.
Agree in general, but as it relates to this particular case study (which was closely monitored as to only employees of the Cleveland Clinic), I think that reporting bias is less of an issue. I still go back to selection bias - those at more risk, selected more often for further vaccinations & boosters.
Certainly so. Many doctors are well educated flowchart jockeys. But I think that they are trying to do their best - most of them - within the time constraints they have.
I started out in the medical scientist track but soon came to realize I wasn’t that good at or interested in the research part of it, and focused on clinical practice. I didn’t want to be one of those kinds of medical scientists.
@Spice_Weasel Regarding Osteopathic immunology certification vs those of an MD immunologist: The requirements for DO immunology certification are to be AOA board certified in internal medicine or pediatrics and then pass the American Osteopathic Association immunology/allergy exam.
To be an MD immunologist requires similar certification in internal medicine/pediatrics PLUS finishing a 2-3 year training fellowship in immunology/allergy and passing the American Academy of Allergy, Asthma and Immunology exam.
Note that DOs can and do take the 2-3 year fellowship track to obtain the American Academy of Allergy, Asthma and Immunology certification also, if they desire and are able to get into such a program. Those programs are reported to be rather competitive to get into, for MDs and DOs alike.
I’ve had a number of DOs as my colleagues and even personal physicians and have found them to be as good/bad as the wide range of MDs I’ve worked with.
I believe my DO did do this, according to his website. He has a bunch of other letters after his name I don’t recognize, including AAAI something, and it says he did a two year fellowship at University of Michigan. I like him for asthma. Maybe not so much for COVID advice.
Which is why I came here! Because my reaction to hearing that particular opinion was surprise.