4th COVID vaccine. It’s time.

A newly discovered XE COVID-19 variant is considered to be highly transmissible and contains a combination of genetic material from the BA.1 and BA.2 variants of omicron. (NIAID/NIH via AP, File)

While COVID-19 cases continue to decline, we again find ourselves with news circulating on COVID-19 vaccine boosters and a spreading omicron sub-variant (BA.2 and XE). We know many of you have questions, and we hope this blog provides some answers and clarifies who is eligible for a fourth dose (second booster).

Recently, the FDA approved, and CDC updated its recommendations around the use of a second booster dose of either mRNA vaccine (Pfizer or Moderna) and has released the following information:  

  • All adults ages 50 years and older may choose to receive a second booster dose of an mRNA COVID-19 vaccine at least 4 months after the first booster dose.
  • Individuals ages 12 years and older who are severely immunocompromised may choose to receive a second booster dose of an mRNA COVID-19 vaccine at least 4 months after the first booster dose (note that the Moderna COVID-19 vaccine is only authorized for people aged 18 and up while the Pfizer product is authorized for people from age 12 and up).
  • Individuals who received the Janssen COVID-19 vaccine as both a primary dose and a booster dose and are between the ages of 18–49 years may receive a second booster dose using an mRNA COVID-19 vaccine at least 4 months after the Janssen booster dose.

With multiple updates a day on the latest Omicron sub-variant, BA.2 and XE, in the United States, it’s important to remember that booster shots increase the strength of your antibody response and may offer additional protection against a new variant. As for specific effectiveness against BA.2, so far, the mRNA vaccines appear to offer a similar degree of protection against BA.2 as they do against the original Omicron, meaning they modestly reduce the risk of getting a COVID-19 infection and are more strongly protective against severe disease, hospitalization, and death. There is not much known about whether vaccines work against the XE variant, however, we recommend for all patients to be up to date with their vaccine.

Special Guidance for FD

We have been recommending to everyone with FD the following guidance that will help reduce all of those symptoms and therefore prevent an autonomic crisis.

The evening following the vaccination, we recommend starting taking ibuprofen around the clock (or acetaminophen if you have kidney disease) and continuing this for 2-3 days. To do this, we recommend taking the weight-appropriate dose (check the label of whichever medication you have) every 6 hours, including during periods of sleep. We recommend including periods of sleep, especially that first night following the dose because some people with FD have awakened with a fever and had autonomic crisis immediately from this.

Likewise, some people have only wanted to take ibuprofen or acetaminophen once they measured or felt fever or otherwise felt bad, and in these cases, autonomic crises may have already started along with those other symptoms. But so far, everyone who has followed this advice and taken their antipyretic (antifever) medication every 4-6 hours, they have felt fine and had no issues with increased autonomic crisis.

How can I have my antibody levels checked?

But if you are a patient at the Dysautonomia Center and would like to have your antibody levels checked, please email us at nyudysautonomiacenter@nyulangone.org with your name, date of birth, and your lab of choice (NYU, Labcorp, or Quest).

How do I help protect my family member with FD, PD or MSA?

Close contacts and household members should get vaccinated to provide increased protection to their loved ones. People should continue to wear a mask, stay 6 feet apart from others they don’t live with and avoid crowds and poorly ventilated indoor spaces.

How to get 4 more at-home COVID tests for free

Americans are now eligible to order a second set of four at-home COVID-19 tests online for free as part of the Biden administration’s push to increase testing for the coronavirus.

The program is run in partnership with the U.S. Postal Service (USPS), and all you have to do is enter your home address on COVIDtests.gov, which will create an order for four tests. You can click on the link below to order more tests: https://www.covid.gov/tests

Households that already received four at-home tests from COVIDtests.gov are eligible to receive a second shipment.

We care about your health and appreciate your ongoing support as we continue our commitment to helping keep our community safe. Thank you for everything you do to protect yourself and others from getting COVID-19.