Case Update, September 1st, 2021; FDA approval for Pfizer vaccine, 2 shots of vaccine, or 1 after COVID infection improve protection from Delta.

This is a case update. I’ll also discuss the potential for a Fall peak, new branding for the approved Pfizer vaccine, and whether you should get a vaccine shot if you’ve had COVID.

In the US, cases continue to rise, but the rise is slowing. Numbers from this last weekend suggest we may be seeing a peak in cases, but it’s too early to say. Deaths from the Delta peak are increasing also, but are proportionately less than for previous peaks.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

We are starting to see fewer cases in the South. Last year, the Summer peak was centered in the warmer states, California to Florida, and then we had a very large wave starting in the North starting in October. With cases still high at the start of September, we may see another large surge of cases in the North as we head into Fall.

Endcoronavirus County Level Map, August 31st, 2021. New cases slowly receding in the South and growing in the North. Michigan, Missouri, Nebraska still appear to not have strong outbreaks as of now, likely because of large case numbers during the UK variant wave in the Spring of 2021.
Endcoronavirus State Level Map, August 31st, 2021

New cases continue to fall in California and San Diego. Tentatively, it even looks like deaths are falling as well.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

The Pfizer vaccine recently received FDA approval. The confusing part, is that legally speaking, the approved vaccine is not the same legal entity as the Emergency Authorized vaccine. The Pfizer vaccine we’re used to is called “Pfizer-BioNTech COVID‑19 Vaccine”. The FDA approved one is called “COMIRNATY (COVID-19 Vaccine, mRNA)”. I’m not a legal expert at all, but my understanding from watching some legal analysis is that the original vaccine is still only EUA authorized, and has some liability protection for Pfizer. However, Pfizer does not have liability protection for the COMIRNATY vaccine. According to the approval letter from the FDA, the formulations of the 2 vaccines are the “same formulation” and “can be used interchangeably”.

So why the name change? An analyst I watched said that Pfizer would like to continue to use the original vaccine under the new approval, but avoid liability. So those getting the vaccine now would still be getting the vaccine with liability protection for Pfizer. If you want to get a 3rd shot, you may want to wait until the legally approved COMIRNATY vaccine is available. Again, I am not a legal expert, so my analysis may be wrong on this.

If all this is true, you may regard this as a dirty trick by Pfizer. I try not to be cynical about things that I have only a vague understanding of, but if you thought that, I couldn’t disagree with you.

2nd shot improves protection against Delta, even for those with natural immunity. In a video by Dr. Roger Seheult, he argues that another shot greatly improves the immune response to the Delta variant. This follows both for those with only a single shot of the Pfizer vaccine, or with natural immunity. All this to say, if you’ve had COVID, 1 shot of a vaccine will help protect you from a breakthrough infection from the Delta Variant.

From Planas et al, 2021. Data suggests boosted binding of antibodies to Delta Variant after natural immunity (COVID infection) and 1 shot of the Astra Zeneca or Pfizer vaccine.
From Planas et al, 2021. Data suggests boosted binding of antibodies to Delta Variant after 2 shots of Pfizer vaccine.

Don’t fear, but be smart,
Erik

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