A Long-Overdue Booster For COVID-19 Booster Shots...and the Lessons of Influenza, Shingles, Polio and HIV

THE DOCTOR IS IN - While there is a great deal of confusion and mixed messaging (and NO, Dr. Fauci or President Biden, you've not been the best communicator to the American People with respect to a clear approach to dealing with the COVID-19 virus), the need for vaccination and booster shots to COVID-19 has never been more clear.

And I can't think of a better way to DISCOURAGE more people to not get vaccinated than to make things political, racial, or socioeconomic with respect to public health. After all, the same left-leaning political morons who've let homeless camps proliferate without any consideration for COVID-19, Hepatitis A, Typhus, and Tuberculosis are screaming about "right-wingers not following the science". 

And the same right-leaning political morons screaming about "our rights to do what we want with our own bodies" are both ignoring the soaring numbers of COVID-19 cases in states with lower numbers of vaccinated populations (and YES, even ICU admissions and deaths, which are by far more important a metric than the number of cases alone)...

...and the impact on those who cannot be vaccinated or will be unable to mount a sufficient response to the vaccine to ensure their safety. So in the world of public health, the need for a person to vaccinate is to protect the population in general--it's more than the safety of a single person to get vaccinated. 

And let's make something clear: those not getting vaccinated exist among the Left as well as the Right, and those not getting vaccinated exist among the Educated and those Less Educated. 

So WHY do the overwhelming majority of physicians (at least 95%) get vaccinated for COVID-19? 

Because we learned a thing or two about Virology and Infectious Disease in medical school, and despite the FDA taking way too damned long to approve the Moderna and Pfizer COVID-19 vaccines from Emergency Use Authorization to official approval and (in my own solitary and strong opinion) to approving booster shots for the Moderna and Pfizer vaccines...

...it's NOT about the CDC, the FDA, or any politician or public figure being "right" or scoring political points. It's about saving lives. Using this article as a single example (accept or reject it if you so choose), I don't get a paid a dime to write it.

But I do want any and all of you reading this to have your life and health saved. And daily I answer and confront the big questions from my patients (many of whom take immune-altering drugs for their conditions) in dermatology and related rheumatology and other specialty conditions: 

1) The lessons learned from the Influenza/Flu: For over six months, and in these CityWatch articles, I repeatedly warned about the need for booster shots. 

Every year the flu virus mutates, and infectious disease experts do their darndest to predict which variant of the flu virus (based on the proteins on the outside of the virus which we make vaccines and antibodies against) will arise in any given year. Furthermore, in any given population, the effectiveness and ability of past flu shots goes down in some of us more than others. 

We push for vaccination in the late summer and fall BEFORE the winter months when we go indoors with colder weather and the cases of the flu go frighteningly up. Sounds like COVID-19, right? 

So the CDC and FDA are finally moving towards booster shots for the immunocompromised, and for those of us (like me) who got vaccinated in January or February. Pretty common sense for those who understand our strategy against the flu...and so there's considerable resentment and reproach that should be earned against those "experts" who predicted that booster shots weren't needed. 

2) The lessons learned from Shingles: Shingles is a local recurrence of the chickenpox virus, or herpes zoster ("herpes" is from the Latin/Greek term "to hide", and the chickenpox virus is hiding in your spinal cord if you got it as a child or adult). It is not herpes simplex, but it's in the same family of viruses.

Early vaccines against the very painful shingles had decreased effectiveness and sometimes increased side effects. Early vaccines have been repeatedly improved with later versions or mechanisms of action. and the current Shingrix vaccine is by far better than previous versions and is recommended for ALL of you reading this who are 50 years of age or older. 

Will vaccines for COVID-19 in the future be better than the Moderna or Pfizer vaccines? Of course, but right now, these two vaccines are the best hopes we have NOW. You can wait for better ones to come out over the years to come, but these two have come out in record time because of the mRNA technology that can custom-make vaccines in timeframes previously impossible. 

So is waiting for something better a good idea? No... because (see the next two paragraphs)... 

3) The lessons learned from Polio: Please be informed that MOST people who got the polio virus got nothing more than a case of diarrhea to which few paid attention. However, enough people died or became crippled for life to warrant vaccination.

So just because most of us will get little to nothing more than a slight flu-like syndrome with COVID-19, those few who've died, suffered with long-term respiratory, circulatory, and smell/taste-related disabilities are very real people. So gambling with COVID-19 is as smart as gambling with polio was in decades before...and we STILL vaccinate against polio. 

4) The lessons learned from HIV and Hepatitis C: Sadly, horribly, these two viruses mutate so fast that NO vaccine will ever likely work based on all science and virology principles to date. COVID-19 mutates, but it's more akin to the flu and may be even less mutating--but still in need of booster shots.  

So please get vaccinated, for both yourself and for others around you. You can gamble, but you're doing so with your own life and the lives of your friends, family, and neighbors. We may not be at the point where we're requiring people to get vaccinated against COVID--19 any more than we do for annual flu vaccinations, but we know what "best practices are" for most of us. 

I don't really care about your political or religious views when I urge you to get vaccinated, and I don't get paid a dime to repeat this urging.

But I do very much want to save your life, and the lives of those around you. And I am tired of seeing more people die--often needlessly so. 


(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He was termed out of the Mar Vista Community Council (MVCC) twice after two stints as a Board member for 8-9 years and is also a Board member of the Westside Village Homeowners Association. He previously co-chaired the MVCC Outreach, Planning, and Transportation/Infrastructure Committees. He was previously co-chair of the CD11 Transportation Advisory Committee, the grassroots Friends of the Green Line (which focused on a Green Line/LAX connection), and the nonprofit Transit Coalition, and can be reached at [email protected]. The views expressed in this article are solely those of Dr. Alpern.)