Peter Salgo, MD: Is there any evidence to suggest that there is a safety and efficacy difference between different manufacturers, Donald’s booster shots?
Donald Alexander, PhD: I will not think Not serious in any way. Meaning, in terms of safety, if we think about what a vaccine is supposed to do, I talked about this first: prevent serious disease, prevent hospitalization, and prevent death in people who get it. There is no difference between those 3 vaccines.
Peter Salgo, MD: Check box number 2. What are the risks associated with a booster compared to the second shot or the initial vaccination of the first shot? Is there any difference? Do we need to worry with our third or second, depending on how you got the first vaccination, we were more concerned with the first 1 Jeff?
Jeff Goode, PharmD, MPH: For example, if you look at the Pfizer data, what they saw in the third dose or booster versus the second dose, they are very similar. The adverse event profile appeared to be similar from dose number 2 to booster, which was greater than dose number 1. I think that’s what we’ll see in other vaccines that people are anecdotally reporting and we’ve seen in studies. There is no difference with the second dose.
Peter Salgo, MD: Check box number 3. It comes all the time. What are your recommendations regarding booster shots in the pregnant and lactating population? Is that a reasonable question, Jason?
Jason Gallagher, FarmD, FCCP, FIDP, FIDSA, BCPS: This is a wonderful question. I’m so glad it came out. I think it is worth more than just the check box because this is a highly under-vaccinated population that is at high risk of complications from COVID-19. Every time it comes up, I think of a specific patient. However, some of the worst results I have personally seen in pregnant women are really heart-wrenching.
Peter Salgo, MD: Let me be very clear. You are saying that some of the worst outcomes are COVID in pregnant patients, not vaccines in pregnant patients?
Jason Gallagher, FarmD, FCCP, FIDP, FIDSA, BCPS: Yes, that’s not my intention at all. I was specifically talking about the COVID outcomes in non-vaccinated pregnant women. Almost everyone with COVID in our hospital is not vaccinated, really. It’s the population that breaks my heart the most because they’re young, they’re healthy, and they’re 2 people. Their results are bad. It is therefore necessary that they are vaccinated and promoted if they are eligible in due course of time.
Peter Salgo, MD: So it is safe and effective in both the lactating population and the pregnant population?
Jason Gallagher, FarmD, FCCP, FIDP, FIDSA, BCPS: Yes. And it has been tracked. At first there was no reason to be concerned, although there were clearly different people. Actually now there is data saying it is safe.
Donald Alexander, PhD: I just want to remind people that in the Modern Trial, some women got pregnant at the time of vaccination. It simply means that she got vaccinated and she became pregnant. The idea is that he followed those women. I think there were about 36 of them. Eighteen of them were in the vaccine branch and then they followed them. No side effects were observed. Moderna also looked at 1,000 rats looking for changes in fertility, changes in the amount of pups they had, and changes in pregnancy in these animals. He didn’t see any ill effects. It was going to ring a bell for women who were pregnant to get it. Of course, ACOG [American College of Obstetricians and Gynecologists] And for the health and welfare of women all government bodies have approved it.
Peter Salgo, MD: Thanks.
Angela Rasmussen, PhD: I just want to add that this is something that ASIP [American Society for Investigative Pathology] reviews from time to time. They see rates of miscarriage and stillbirth in the background, and absolutely no increase in vaccinated pregnant people compared to vaccinated pregnant people.
Peter Salgo, MD: I want to thank you at home for watching this peer exchange discussion. If you enjoyed the content, subscribe to our e-newsletters to receive the upcoming peer exchange and other great content straight to your inbox.
Transcript edited for clarity.