We recently had a debate in the comments section about the (de)merits of getting multiple vaccinations at once (as in ones designed, safety-tested and approved as individual shots). Reader Daryl reported his contrasting experience with the positive reader reports about getting a Novavax booster, which should by virtue of its more traditional design, cause much in the way of reactions than mRNA jabs:
I’m having my own novavax (+ flu) vaccine experience this morning… woke up with a headache, muscle aches and temperature dysregulation at 2:30 AM after a few hours of poor sleep. About the same effect as the moderna boosters had on me.
Your humble blogger was perhaps not as sympathetic as I should have been, pointing Novavax + flu vaccine is not the same as Novavax in isolation and that IM Doc has seen a lot of his patients having trouble after pharmacies pushed them to get other vaccines at the same time as their Covid booster. As IM Doc had reported by e-mail earlier that month:
Many patients getting all three at the same time flu, Covid and RSV. They are getting really sick with flu like illness. And the story is always the same. Medicare patients going to the pharmacy to get a flu shot and ending up with all 3 at the strong encouragement of the pharmacist. Why not? Patients are now considered “profit centers”. They turn that 85 dollar flu shot “sale” into a 400 something dollar sale with the other two shots…..
We added some additional advice from him:
I would tell you that any of the shingles vaxx should be taken by themselves in isolation for a month or so before or after any other vaccines. They can often be very harsh.
Readers pointed out that supposed informed sources, such as a site called Everyday Health, who in this case had an English major offering medical advice (with the article reviewed by a sole “expert”), that it was “safe” to get Covid and flu vaccine tout ensemble. Note the issue presented was not safety but discomfort. Recall the Covid mRNA shots are deemed safe even with causing many to have to skip a day or two of work after getting them, an outcome hourly laborers cannot afford.
There appear to have been enough people having bad outcomes from a flu + Covid jab combo that the FDA took the rare step of rousing itself to weigh in. And it didn’t result in this practice getting a clean bill of health. From CNN in Covid shots may slightly increase risk of stroke in older adults, particularly when administered with certain flu vaccines:
Vaccines for Covid-19 and influenza may slightly increase the risk of strokes caused by blood clots in the brains of seniors, particularly when the two vaccines are given at the same time and when they are given to adults who are age 85 and older, according to a new study.
The safety signal was detected by experts at the US Food and Drug Administration who analyzed data from Medicare claims.
It is the second study to find an elevated risk of stroke for seniors after Covid-19 and flu vaccinations given together. The US Centers for Disease Control and FDA issued a public communication in January explaining that one of their near real-time vaccine safety monitoring studies — called the Vaccine Safety Datalink — had picked up a small and uncertain risk of stroke for older adults who received a dose of Pfizer’s bivalent Covid-19 vaccine and a high-dose or adjuvanted flu shot on the same day. That study triggered the FDA’s broader look at strokes after vaccination noted in the medical records of seniors on Medicare.
That said, the risk identified in the FDA’s study appears to be very small — roughly 3 strokes or transient ischemic attacks for every 100,000 doses given — and the study found it may be primarily driven by the high-dose or adjuvanted flu vaccines, which are specially designed to rev up the immune system so it mounts a stronger response to the shot….
A few weeks ago, however, Dr. Peter Marks, head of FDA’s Center for Biologics Evaluation and Research, said he was planning to get his Covid-19 vaccine first, followed by his influenza vaccine about two weeks later.
“If you want to minimize the chance of interactions and minimize confusing the side effects from one with another, you wait about two weeks between the vaccines,” Marks said on an FDA stakeholder call in September.
Mind you, this report covered only getting the two vaccines, not Covid + flu shot + RSV vaccine, the new pharmacy trifecta. And it covered only stroke risk, not getting flu-like symptoms….when the whole point is not to get sick or be the functional equivalent of sick.
And that’s before flu vaccines having underwhelming efficacy. From a 2019 article in Vaccine:
Analysis included 20,022 adults aged ≥18 years enrolled during the 2011–12 through 2015–16 influenza seasons; 4,785 (24%) tested positive for influenza. VE among patients aged ≥65 years was not significantly lower than VE among patients aged 18–49 years against any subtype with no significant interaction of age and vaccination. VE against A(H3N2) viruses was 14% (95% confidence interval [CI]−14% to 36%) for adults ≥65 years and 21% (CI 9%-32%) for adults 18–49 years. VE against A(H1N1)pdm09 was 49% (95% CI 22%-66%) for adults ≥65 years and 48% (95% CI 41%-54%) for adults 18–49 years and against B viruses was 62% (95% CI 44%–74%) for adults ≥65 years and 55% (95% CI 45%-63%) for adults 18–49 years. There was no significant interaction of age and vaccination for separate strata of prior vaccination status.
GoodRx similarly notes that flu vaccines typically have 40% to 60% efficacy.
On the CNN article and the vogue for doubling or tripling up on vaccinations:
This is being done against all traditions and recommendations of the past. Now it is Covid + flu shots.
As far as I can tell, this is being done only in pharmacies. Those places where patients are called “profit centers”. An 85 year old walks into Walgreens for a 25$ flu shot, and then suddenly convinced to get a Covid booster at 185$ a pop and then an RSV vaccine for $300. A 25$ visit suddenly becomes 500$. Who cares about the strokes. Or the huge number of them flat on their back for 3 days.
What a joke our entire system has become. If people only knew how much of my day was taken up securing the cash flow for Pharma they would be shocked.
It is depressing the degree to which patients need to be their own advocates and not blindly follow the advice of supposed medical professionals.
