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How much each incremental booster helps (or does not help) is something that we really don’t have a good grip on prospectively. For example, we didn’t really know a second booster was needed among 50+ year olds. We kind of guessed and relied on data from Israel (and the recent articles suggests why 50 might be a key age). Retrospectively, we can see that this was certainly the right policy call. But, the FDA needs to require pharmaceutical companies to test B cell and T cell functions—not just neutralizing antibodies—to assess the added benefit, instead of retrospectively determining good or bad policy.

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Originally posted by Mikhailoh:
Interestingly Walgreens website said it was proven safe to get all three at once.

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So, I got my booster Friday afternoon - the Moderna SpikeVax, because it was the one that was available closest to me - and I scheduled it for Friday because I knew I'd be sick on Saturday. I didn't know I'd be THAT sick, though.

About 5 hours after the shot, my arm got really sore. Big deal. Then it got so sore that I couldn't move it, and my hand ached like it wasn't getting enough circulation. My back and neck - on that side only - came next, and I found it odd that these sxs followed the neural distribution. I was so sore that I couldn't sleep because there was no position where I wasn't in a lot of pain. I finally got up at 4 AM and took some tylenol, and that took the edge off for a couple of hours. The next day I got a fever, and when it got up to 101° I said, screw this, I'm going for the ibuprofen. That nailed the fever for a few hours and also worked on the muscle aches. The fever came back but not as high, and I was out of it all day but not in as much pain. I took more ibuprofen before I went to bed. By Sunday morning I was much better, just really tired and a little achy.

My take home points:

I'm going for the Novavax next time. Would have this time but it wasn't available yet, it had been 10 mos. since my last booster and I see patients.

I'm really glad I didn't get the flu shot at the same time. It may have made my sxs worse. The word is that it is somewhat better (exactly how much, no one knows) to wait about 2 weeks between shots, but the CDC is afraid that people won't go back for a 2nd shot (and my bet is that people would not go back for a COVID shot).

I've since found out that with a vaccine, anti-inflammatories are not good to take before the shot because they reduce your response, but have no effect on protection if you take them after sxs develop. That's because your immune system has recognized the intruder, and the unpleasant side effects, while they can work against a real virus (for instance, by raising your temp), don't contribute to enhancing the immune response to a vaccine. I've also been told that ibuprofen is only mildly anti-inflammatory unless you take a handful. 2 worked really well. A study showed that people who took ibuprofen for the vaccine side effects had a slightly better immune response - but that's likely not due to the drug but rather that they needed to take it. So, next time I'm reaching for the Motrin much sooner.

It has been said that people who have lots of side effects have a robust immune system. I think that only accounts for a tiny part of the effect, because people who have no side effects have a very similar amount of protection. I think it has more to do with genetic differences, and I wonder if the same people who have nasty side effects also get really sick from COVID.

Just my thoughts while we continue to figure this all out.

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isn't seeing any difference between boosted and non-boosted when it comes to severity of infection

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"down in Florida" is about all you need to know, I guess..