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October 14, 2021

In the past two years, there have been major controversies over the questions “What does the science tell us about COVID -19?” and “What is true or not true?” But ultimately, the passage of time gives us the answers. The ICUs are full of individuals who have not had COVID-19 vaccinations, and only a very rare individual who has been fully vaccinated. This tells us that not being vaccinated is a problem not only for those in the ICUs but those with whom they have had contact, including the vulnerable, such as a myeloma patient. The distraught and overworked health care workers not only know this but have lived the reality of this for weeks and months. 

The good news, STAT reports, is that “the Food and Drug Administration advisory panel voted unanimously Thursday in favor of authorizing booster shots of the Moderna Covid-19 vaccine to people 65 and older, those 18 to 64 with risk factors for severe Covid-19, and those whose jobs put them at high risk of serious complications of Covid-19, such as health care workers.”

Where common sense is working

In Germany, strong mandates have been in place to guide the responses to the COVID-19 pandemic. As New York Times Opinion columnist Alec MacGillis notes, Germany is a country where “the mitigation measures are practical.” Wearing masks on public transport (like trains) is required and the people comply in part because when they are in a safer environment outdoors, they are not required to wear masks. The requirement is clear, easily understood, and doable. Do we have full scientific data on all the situations where masks really make a difference and where they are not needed? No! 

But giving sensible, flexible guidance leads to compliance and better results for everyone. Health authorities have yet to catch up with the changing risks related to COVID-19, especially related to the Delta variant. For example, air transmission is the key feature for the Delta variant. The presence of virus on surfaces is less important. 

Thus, it is possible to take more practical approaches to cleaning, and touching buttons and surfaces when risks of new transmission are very low. Rules that can be understood and accepted will absolutely prevail. 

Getting a booster shot 

Again, the role of booster shots can be assessed in many ways. For a myeloma patient the information is clear. Many myeloma patients do not get good antibody responses or immunity with the traditional two doses of Pfizer or Moderna vaccinations or single-shot J&J vaccinations. Boosting these low levels with an additional shot is basically a “no-brainer.”

The Pfizer booster has already been approved and it is now promising that the Moderna and J&J boosters will also be approved very shortly. The Moderna booster will most likely be a half dose. This is great news!  The role of what is called mixing and matching remains unclear. However, taking the Pfizer booster after Moderna vaccination appears to be safe and effective. It seems that taking a Pfizer or Moderna booster after a J&J vaccination can give a particularly helpful increase in antibody levels. 

Preparing mentally for the future 

A recent article, called “What the Future May Hold for the Coronavirus and Us,” discusses the likely scenarios in the coming years. It is best to be geared up to be protected against COVID-19 and defend against what will be community infections in the years to come. Vaccination will be the norm and prudent use of masks will become an established routine, as has been the case in Asia for many years. Global travel will be very much influenced by the ultimate vaccination patterns from country to country and region to region. Pockets of unvaccinated individuals will be at risk for new infection when virus arises in surrounding communities, and even globally, because of travel. Ramping up protective health measures will be the key. 

And life goes on 

Despite the traumas of the last two years, life goes on. The IMF is privileged to work with physician experts, healthcare professionals and patients around the world. The advantage of the Zoom world we live in today is that many more can be connected and educated. 

Asian Myeloma Network

One very active group is the Asian Myeloma Network, comprised of myeloma experts from China, Hong Kong, Malaysia, Taiwan, Japan, South Korea, Singapore, and Thailand, and supported by the IMF. In a virtual setting, the 2021 AMN Annual Summit activities are currently ongoing. Last week the first joint Asian Patient Meeting brought together patients from the eight member countries to discuss and share resources and plan future, hopefully, in-person meetings. Robin Tuohy, IMF Vice President, U.S. Support Groups, presented the online resources (“toolbox”) available to patients in the U.S. This example was extremely well received and will used as a model in Asia. 

Upcoming is a Master Class for Asian physician education, followed next week by the two-day Virtual Summit, with a range of presentations and working group activities similar to the annual International Myeloma Working Group Summit held earlier this year. All in all, a comprehensive continuation of these collaborative efforts is so greatly appreciated by all participants.  

Staying grounded and strong 

Thus, in these challenging times it is important to remember that common sense wisdom is not to be ignored and may well be the best guide to remain sane and have a positive perspective moving forward. We will get through this together! 

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