This week Fred Goldstein is off to a conference and travelling internationally so has been navigating the requirements for exit and entry into countries and even states. He is also adding to his travel bag a newly acquired CO2 sensor he plans to use at the conference to understand what it can tell him about air circulation, how easy is it to use and what information does it provide
We talk the latest in boosters guidance from the CDC and FDA – who should be getting boosters which for Moderna and Pfizer is for those deemed in a vulnerable population and over 65. After we recorded this episode the FDA panel came out with additional guidance for the J&J Janssen vaccine second dose booster that is recommended for everyone over the age of 18
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And this is Fred Goldstein with accountable health here helping employers, payers and others with their population health improvement programs.
Nick van Terheyden
So Fred, you’re off on a conference circuit trip. And you’re, you’ve got a new addition to your travel bag, tell us about it.
Fred Goldstein
I do, I do, I’ve been getting a little pressure about some of my travels to flies, you know, you got to bring the mask. Yeah, some people travel with some rapid tests, etc. Obviously, your hand cleaning stuff are very important. But we all know now this whole issue of how good is the air where I am. So I literally have just gotten this, they rang the doorbell I believe, right before our show here today. And this is a co2 meter that measures how much co2 is in the air, which gives you a sense of whether or not the air is being changed in that room. Because obviously, as we breathe, we breathe in oxygen, we breathe out co2, and the levels go up if you don’t have air circulation in there. So this is my new travel kit.
Nick van Terheyden
So I’m making light of it just because I’m imagining Fred, pacing around the conference facilities pointing this at various places, and potentially upsetting people. And I don’t mean to make light because it is actually a very serious point. This is a great proxy for air circulation. And if the co2 level rises, we’ve actually seen this with a number of our clients, they’re doing this, it’s a great way of getting some insight into the level of air circulation. And if you’re circulating and keeping that co2 level down with lots of people, and you’re doing a good job. So if you’re at a conference, and you see this guy walking around with two masks, and an orange thing that he pointed at you then you know, he’s Fred, just say hi, Fred.
Fred Goldstein
Yeah, it’s gonna be really interesting, because actually, this is more of a research experiment. Anything else, I want to see what this looks like how it works, because you talked about we do have clients and others who are measuring the co2 content, you’re seeing a lot of corporations begin to bring that in as they bring people back to work. It’s an important tool that can be used, and I’ve seen many of them now sit up on the walls, and and show those measurements. The other thing we wanted to discuss this week, Nick is we keep hearing more and more about boosters. And we’re now beginning to see approvals, etc. So what’s going on in that space?
Nick van Terheyden
Well, so I think it’s, I was about to say clear, but nothing ever seems to be clear in this pandemic. as clear as we can be at this point, it is looking very much like we are advocating or advising for boosters, but in a particular subset. And let’s clarify we have three approved vaccines in this country, Pfizer, Madonna, and the Johnson and Johnson or Janssen vaccine, which is the single dose, the approved protocol was two doses of the first two for Madonna and Pfizer and a single dose for the Johnson and Johnson, the first two messenger RNA viruses with two doses you are considered fully vaccinated, the vaccine schedule is now likely to change for over 60 fives and for those that are vulnerable vulnerable, is categorized as people living with folks working in specific circumstances it can encompass a lot of things it’s designed to do so because you need to make that decision in conjunction with your medical provider. Obviously, if you’re over 65 that qualifies. And the reason for that is that our immune system doesn’t respond as well as we get older it’s not as robust in its response and we want to see this improved or increased levels and based on the data and the research that’s been carried out certainly for those two I think we’ll see it Johnson and Johnson we’re still waiting on the data but they’re probably going to be looking at a similar project goal or an additional dose and you know, booster dose second dose as part of the protocol. The one thing to point out here is that there’s some interesting research currently ongoing I don’t think the data is out that says do you mix and match with different vaccines I know you know the advice has been cleared don’t do that as part of the protocol that wasn’t what we tested but we are testing it now. And it looks like that might be even better from a response and immune response giving you a more robust response so we might see some of that happening but none of it settled as yet.
Fred Goldstein
So could you quickly come in on one thing Nick I know a lot of the people are gonna say well does this mean the vaccines don’t work and maybe talk about the issue between severe illness etc and and infection?
Nick van Terheyden
Yeah, I that’s a great point and I you know, I’m I apologize for laughing It is a very serious point. And, you know, I understand that because we’ve all been tuned, it’s you know, it’s a bit like FedEx tune does to be expecting absolutely minute by minute updates of when our packages going to arrive where it’s going to arrive, the fact somebody is at the door, all of that has changes to that sort of behavior. Same is true with vaccines. Prior to COVID-19, people took the flu vaccine, and that had variable effectiveness vaccine effectiveness anywhere from you know, 40 to 60, sometimes higher. But it wasn’t fully protected. So I certainly had the flu vaccine and suffered a dose of flu in the past. But I didn’t consider that the vaccine had failed, because it prevented me from getting serious disease and certainly prevented me from being admitted to hospital. And that’s what the vaccines are still doing, still doing very effectively, they prevent severe disease at a very high rate and an even higher rate, they prevent admission to hospital. And that is with the two doses and certainly, and the one dose for the Johnson and Johnson in the case of the existing protocol with people that have robust responses, for those that don’t are in special categories. We’re looking at the data and and trying to interpret as best we can. Reason that’s difficult as the immune system is highly complex. And just measuring levels of antibodies doesn’t answer the question as to whether you’re immune, but real life data is telling us you probably needed in these instances, but it’s not through failure. It’s let’s just improve the response.
Fred Goldstein
fantastical, Thanks for answering that really important issue. And if you’re at the conference or anywhere, and you see me with this thing, and I go running out of the room, don’t worry, it’s not a radioactive measurement tool, but the co2 levels might be a bit high in there and you might want to join me.
Nick van Terheyden
You need a Geiger counter on your phone clicking away.
Fred Goldstein
So thank you all so much for joining us. This is Fred Goldstein with accountable health. If you’d like more information, please go to accountable health. llc.com
Nick van Terheyden
and this is Dr. Nick, I’m the incrementalist here with incremental insights for better business, better health.
