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The Executive Briefing - Friday, April 1

All your booster questions, answered

ZHH News:

Don’t miss our upcoming webinar!


Wednesday, April 13
3:00 - 4:00 Eastern Time

Managing Sick Employees In Today's Staffing Crisis

In the midst of a staffing crisis, managers can be your best defense or worst enemies when it comes to sick employees. Between norovirus, COVID, allergies, and mental health issues, managers play a big part in deciding who works, who stays home, and for how long. We'll discuss tools managers need to manage call outs, resources for employees and managers alike that can help reduce health-related staffing issues, and how to mitigate the impact of sick calls on the ongoing staffing crisis.

Click here to register today!

COVID Recap:

  • Those who got both the initial dose and booster of J&J are now eligible for a second booster of Pfizer or Moderna, at least 4 months after the first dose. (CDC)
  • The CDC launched a new website, COVID.gov to help Americans access antivirals, tests, vaccines, and masks. (NPR)
  • If you got a single J&J dose, the CDC recommends that you get a booster of Pfizer or Moderna, after research shows they offer better protection than a second dose of J&J. (NY Times)
  • The CDC dropped its risk advisory for cruise ships after two years. (NPR)
  • Delta Air Lines’ Chief Health Officer thinks the federal mask mandate for airports and planes will be lifted before the end of April. (CNBC)
  • The Surgeon General warns that without additional COVID aid funding from Congress, the US is at risk of “backsliding.” (Vanity Fair)
  • A new study showed that Ivermectin, despite its popularity as an alternative treatment, does absolutely nothing to treat COVID. (Fortune)
  • Omicron was more severe for unvaccinated kids than previous strains. (Bloomberg)
  • In about half of US counties, less than 10% of kids ages 5-11 are fully vaccinated. (CNN)
  • Nearly 1 in 3 patients in a new study still had some impaired sense of taste nine months after they had COVID. (CIDRAP)
  • Massachusetts is reporting rising COVID rates, particularly in school-aged kids after schools lifted mask requirements and Connecticut’s positivity rate doubled from 2% to 4% over the last two weeks. (Boston Herald) (Daily Voice)
  • A decline of nearly 75% in PCR testing may hinder early identification of new variants. (ABC News)

Today’s Health News:

  • Avian flu continues to spread in poultry farms across the US and Canada, with at least 6 more states now affected making the total 23 states with confirmed reports.. (CIDRAP)
  • Florida has become a hotspot for a stubborn lung disease that is similar to TB.  (WUSF)
  • Antibiotic resistance is still quite high in common foodborne pathogens like Salmonella and Campylobacter bacteria, which makes them more dangerous. (CIDRAP)
  • A norovirus outbreak associated with raw oysters from British Columbia now has nearly 300 cases in Canada and northwestern US states, according to the Canadian health authorities. (Yahoo Finance)

Best Questions:

Who should get a second booster dose?

Earlier this week, the FDA approved a second booster dose for those over 50 and anyone 12+ who's immunocompromised. They also recommend it for anyone who got a first dose and booster of J&J, if their first dose was more than 4 months ago. But there’s a lot of talk about whether you actually need one now or whether you should wait, and the answer depends really on your own risk, age, and timing. If you’re immunocompromised, and it’s been at least 4 months since you got your first booster, most experts agree that another dose will be crucial, since your body isn’t necessarily mounting the full immune response each time you get a shot. For those who aren’t immunocompromised but are over 50, some doctors think you can safely wait to get a booster if you have no other factors that put you at risk for severe disease, and if case rates are relatively low in your area. But others think that there are very minimal risks, and that the added benefit outweighs them. It’s true that a second booster dose doesn’t provide the same bump in protection as the first, but it does increase your protection, and at very little cost or risk. And nearly all experts agree that the older you are, the sooner you should go get the booster.

We’re in a COVID lull right now. Should I wait for the next wave to get my booster?

We know that protection from antibodies wanes over time, so some recommend that otherwise healthy people wait until case rates start to rise or until their own personal risk increases, either due to their health or something like an international trip. But Dr. Katelyn Jetelina, a leading epidemiologist, warns against this for a few reasons. First, timing is a challenge because boosters take some time to reach their full potential, and trying to time this right to get your dose just before the next wave would be hard. Second, we don’t know what’s coming. Many experts weren’t sure about boosters in the fall, but they were certainly crucial in the Omicron surge in terms of keeping deaths and hospitalizations way lower than they would have been. And her last point was a great one that we hadn’t even considered before - the benefit of sticking to the CDC’s booster schedule so that you’re following the same timeline as future recommendations. “If you go rogue,” she says, “future decisions may be difficult to navigate.”

Does the new booster recommendation change which employees are considered “up to date” on their vaccinations, and therefore don’t need to quarantine if exposed?

Not yet - at least we don’t think so after carefully reading the CDC’s website. The CDC frames the second booster dose as something you’re “eligible” to get if you’re 50+ or moderately to severely immunocompromised. It’s not yet included in their definition of “up to date,” which means employers don’t need to differentiate employees in terms of who is eligible for two boosters versus one, luckily. We’re just guessing, but we don’t expect that the guidelines for who’s considered “up to date” (and therefore exempt from quarantine after exposure) will change until everyone is eligible for a second booster dose, and the CDC changes the language from something people “can” do to something they “should” do.  

Can we consider employees fully protected if they had two doses of vaccine and a confirmed Omicron case?

This is really tricky, but ultimately the FDA and CDC don’t recognize this type of “hybrid” (natural plus vaccine) immunity, so there isn’t any written guidance (or state/local regulations) that acknowledge this as a reasonable alternative to booster doses, even though the science really does support that hybrid immunity works amazingly well to protect people. We still don’t know exactly how long it lasts after an Omicron infection because there hasn’t been time to study it, but earlier studies showed almost a year of increased protection from hybrid immunity from earlier variants (though Omicron will probably shorten this a bit). Are you probably protected for a while? Yes. Do we know how long that protection will last? No. And for that reason, we don’t recommend changing your policy to veer away from the CDC guidelines on this. Especially since we’re seeing more reinfections in a short period of time, it’s just too soon to say that this is another pathway to the same level of protection that a booster dose can provide.

Best Listen:

We haven’t suggested listening to our good friend, Dr. MIke Osterholm, in some time. He has been our voice of reason since day one. His podcast this week is definitely worth a listen.

This Virus Isn't Done With Us



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Disclaimer: This post is meant for general information and educational purposes only and does not constitute, and is not intended as, any form of medical, legal or regulatory advice or a recommendation or suggestion regarding the same.  No recipient of this information should act or refrain from acting on the basis of this information without first seeking legal advice from counsel in the relevant jurisdiction.