Mixing & matching covid boosters ‘might be a great opportunity’: Doctor

In this article:

Dr. Jeremy Faust, Emergency Medicine Physician, Brigham and Women’s Hospital, joins Yahoo Finance to discuss the latest on the coronavirus pandemic.

Video Transcript

JARED BLIKRE: COVID statistics around the world and especially in the US are marching in the right direction. We've got new cases down, hospitalization rates down as well across the US. But we're not out of the woods. And we want to talk all things COVID here with Dr. Jeremy Faust. He is the emergency medicine physician at Brigham & Women's Hospital. We also have Yahoo Finance's Anjalee Khemlani here joining us.

Doctor, I want to posit something to you. Not out of the woods yet. I note that in a few states, eight states, they still have fewer than 15% of ICU beds available. But what's the current status of COVID infections in the US?

JEREMY FAUST: Thanks for having me. The current status is that we continue to have a highly contagious variant of the delta variant ripping through communities, especially where vaccination rates are low. When you look here in Massachusetts at the counties with higher vaccination rates, the number of COVID deaths and just the number of all mortality is very low. And when you have areas-- we look at the areas where the vaccination rate is low, that's where the COVID deaths amount to a lot, even today.

So, yes, we're not at that place where we had 3,000 deaths per day in January, and we've come off of a peak, it looks like, nationwide. But considering the fact that we have a vaccine at our disposal that can virtually eliminate all of the death associated with this disease, we are nowhere near done yet.

ALEXIS CHRISTOFOROUS: Doctor, we know that on the booster front, the Pfizer booster is the only one right now that has been authorized for use. Moderna and J&J, we're hoping to come down the pike very soon. But we also heard from Dr. Fauci that mixing and matching boosters, meaning you got your two shots from Pfizer, you're going to go and get a Moderna, you know, booster when the time comes. What does the evidence tell us about this? What is the FDA finding?

JEREMY FAUST: Well, we're going to learn a lot about that in the coming days, when there is a meeting of the various safety panels at the FDA and, again, the CDC. I think that mixing and matching really might be a great opportunity because it might actually have an increased protection. And it hopefully could even come with decreases in rare side effects depending on the doses and how the data play out. This is an area where I think we're watching very closely because boosting with a third dose of Pfizer, which is what's available for some Americans, certainly is going to provide short-term help for some people.

But what we want to know is, as we do this for a long period of time, can we optimize the outcomes so that the most people are benefited and the fewest are harmed? So I think mixing and matching is a really important opportunity. And I'm very eager to see what the data show.

ANJALEE KHEMLANI: On that thread, doctor, I know that we heard from the Swedish health agency this morning, pausing the use of Moderna's vaccine for anyone 30 and under because of those concerns over myocarditis. I wonder how much that is playing into the conversation about boosters and the ability for those who might not be comfortable using one vaccine after knowing the risk to be able to switch to another.

JEREMY FAUST: Yeah, it's a great question. And we have to be very clear about the difference between the initial series in the mRNA vaccines, which is two doses, and boosting, which is the third dose. For every single age group for which we have data on two doses, it's not close. Even for young people who have a much better outcome rate with COVID than older people do, even in that group, teens, young males, we know that the vaccine provides far more protection than any risk associated with the vaccine.

And that's even true myocarditis head to head. COVID causes more myocarditis, which is this inflammatory condition of the heart, than the vaccines do. So, yes, there was an increased signal in myocarditis after vaccination of young males in particular, but actually, that's just dwarfed by the myocarditis rates by letting those same people get COVID.

So it's really a non-issue on the first two doses. And I'm a little confused and bewildered by the decision out of-- I guess, it was Denmark and Sweden that you said-- and I have seen those stories-- because it doesn't really make sense. If someone were to tell me that a third dose in those groups may have not completely had a really perfect risk benefit assessment and that maybe those people don't need a third dose, or it's a tougher call, that would be possible because we just don't know how much benefit a third dose adding for young males in particular. But we haven't seen that.

So for everything I've seen, we're getting more and more data on the rates of myocarditis in young people. And it's real but rare. So you have to compare that against COVID, though. COVID's far worse. Delta's going to reach everybody. The question is, on the third dose, is there any risk? I think for most populations, no, but for some, we still need to find out if there is that risk.

ANJALEE KHEMLANI: Certainly something to watch for. I also wonder your thoughts on the announcement from the White House investing more in rapid testing and making that available. We know that there have been more players authorized by the FDA.

Meanwhile, we know the larger players like Abbott, for example, we just spoke to the CEO yesterday, and he said that there are going to be more tests available by the end of the month. And the White House said that they're trying to quadruple the number of tests available by the end of the year. How do you see that playing out and sort of the need versus the timeline and what the trade-off is going to need to be until then?

JEREMY FAUST: I'm really glad to see an increased interest in rapid testing and increased supplies. I and many of us have been beating this drum for over a year now, that rapid tests were misunderstood as not being sensitive enough when, in fact, they are very, very good at what they're designed to do, which is to pick up contagious illness. Are you contagious? And that, more than anything else, can stop the spread of this disease.

The increase in supplies is really important. And it has to come with a decrease in price. Because any time you roll out an intervention that can help people, there's an immediate concern that you help some people and then you also widen inequities. So part of the plan, going forward for rapid testing or for any intervention we do, has to address that head on. How do we help everybody with the rollout of a new product, whether it's a new drug, a vaccine, or a rapid test? Because these are the tools we have to limit the effect of this horrible disease.

ANJALEE KHEMLANI: I want to talk to you about pricing of that, though. That has been a really big issue. I know when we compare to, say, Europe, it's far cheaper and far more available. We seem to not be able to do that here in the US. It seems like $25 around there is the price point that we're going to be getting these rapid tests at, except for when you're talking about the government purchasing and the test sites. Do you see the need to maybe decrease the retail prices?

JEREMY FAUST: Yes, I think that's really important. The tests that people can't afford might as well not exist, right? They don't help people who can't use them. And I don't see the argument that says that we shouldn't be doing everything we can to subsidize the cost and to reduce the cost because every time you stop the spread of this virus, you not only do the thing that matters the most, which is to help people stay healthy, but you also help local economies.

Economies that are shut down because of outbreaks don't do well. And so, they're spending a few bucks to decrease the price of testing for people who are likely to be in high volume interactions. Think of teachers, people who work in restaurants or in transit, people who may not be able to afford tests. These people need to be tested often to protect themselves, to protect their families, and to protect their whole communities.

And really, all boats rise with the tide. So it's a really smart idea to subsidize these the way Europe has done. This is an area where they have led, and we are just starting to catch up. But as you point out, if we can't afford it, then it's really the same thing as not having it.

JARED BLIKRE: And we're going to leave it there, doctor. Thank you for joining us. Dr. Jeremy Faust, emergency medicine physician at Brigham & Women's Hospital. Plus, Yahoo Finance's Anjalee Khemlani, of course.

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