Three years later most of the SARS-Covid viral epidemic has dissipated but still remains endemic. In other words, it is with us 'forever'. Covid is now relegated to the ordinary flu-like syndrome. The risk of long Covid remains as a small percentage of overall Covid infection. Now we have a risk of adverse reactions to Covid vaccination.
Covid vaccination gave birth to msRNA production of a portion of the virus capsid, in this case, a protein spike. The newer form produces a myriad of complications that are not seen in the classical vaccines produced by attenuated whole vaccines. Covid 19 mutated rapidly through a number of mutations too numerous to elaborate in this article.
As Covid has evolved, so too have vaccinations and treatments. In the world of virology, small things matter (no pun intended) and small things rapidly evolve.
61% of circulating variants are now XBB.1.5 and 22% BQ.1.1 – what use are C19 mRNA injections targeting BA.4 and BA.5?
“As of January 20, 2023, >90% of circulating SARS-CoV-2 variants in the United States, specifically Omicron BQ.1, BQ.1.1, XBB, and XBB.1.5 sublineages, are unlikely to be susceptible to the combined monoclonal antibodies, tixagevimab and cilgavimab (Evusheld) used for preexposure prophylaxis against SARS-CoV-2 infection (1).
“The FDA pulled Evusheld because it is not effective against 95% of the omicron subvariants circulating in the U.S. This includes the XBB subvariants which are now causing 64% of new cases, as well as the BQ family that is responsible for 31% of reported infections.”
The latest variants estimated to be circulating in the US from the CDC
With a tabulation of the current estimated prevalence of each variant here:
Information for Persons Who Are Immunocompromised Regarding Prevention and Treatment of SARS-CoV-2 Infection in the Context of Currently Circulating Omicron Sublineages — United States, January 2023
The Food and Drug Administration announced on January 26, 2023, that Evusheld is not currently authorized for preexposure prophylaxis against SARS-CoV-2 infection in the United States (2). It is important that persons who are moderate to severely immunocompromised,* those who might have an inadequate immune response to COVID-19 vaccination, and those with contraindications to receipt of COVID-19 vaccines, exercise caution and recognize the need for additional preventive measures (Box). In addition, persons should have a care plan that includes prompt testing at the onset of COVID-19 symptoms and rapid access to antivirals if SARS-CoV-2 infection is detected
For those with an immunocompromised system here is a plan:
Personal COVID-19 action plan§ (only for those with compromised immune systems) Not for the general public.
Persons should consider how to protect themselves and others around them should they become ill with COVID-19 or if the community's COVID-19 transmission level changes. The plan should include:
ways to protect oneself and others including considerations in case of illness, such as finding a room in which to isolate actions to take in case of exposure or symptom onset, what to do in the event of receipt of a positive SARS-CoV-2 test result
Persons should share their COVID-19 plan with their families, friends, and healthcare providers so they can support prevention and preparation steps. CDC suggests that people consider how others can help them if they get ill. It is important to adhere to treatment plans, keep routine healthcare appointments, and ensure that prescriptions are filled. Persons should make alternative plans for work, child care, and other responsibilities that might cause stress if they become ill.
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