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Over the pandemic

Started: 2022-09-24 21:04:59

Submitted: 2022-09-24 23:04:48

Visibility: World-readable

What if this is as good as it gets?

I got my bivalent COVID-19 vaccine booster on Thursday, in a week in which the dominant conversation in the news was whether the pandemic was really "over" as President Biden told 60 Minutes on Sunday.

As an otherwise-healthy adult under the age of fifty, I was only officially eligible for one booster, which I got in December last year, until the introduction of the new bivalent booster that was actually (finally!) updated to cover the spike protein the dominant Omicron sub-variant strains now forming most of the infections in the US. This time around the FDA approved the updated vaccine without the rigor of an exhaustive (and exhausting) clinical study, on the theory that it's "just" an update to the mRNA so they ought to be able to approve it without taking the time to study it, because a vaccine that probably works now is better than a vaccine that certainly works nine months from now, at which point two or three more variants will have emerged.

I knew I was going to get the updated shot as I read the news, but I didn't feel like I had to be first in line. Then my siblings made plans to travel to visit my parents in Walla Walla at the beginning of October to celebrate my father's 70th birthday, and it seemed reasonable that I ought to get my shot far enough in advance to get upgraded immunity prior to getting on an airplane next.

When I changed jobs last month I took the opportunity to join Kaiser, in an attempt to figure out whether their technologically-mediated HMO is really that much better than any other insurance. The best experience I ever had with primary medical care was when I was working at Google and they had One Medical set up shop in their buildings, so there was a doctor a couple of floors above me (in San Francisco) or in another Google office across the street (in Seattle). I could get same-day in-person appointments with the click of a mouse. Apple's Wellness Center was also very good, with the most meaningful difference being that I was not nearly as close to my corporate office so it was a bigger hassle to actually get there. But I digress.

Once I figured out how to sign up for Kaiser's portal (which was more complicated than it needed to be, because their identity verification questions sourced from credit reporting agencies were wrong, so they had to send me a password by mail because obviously that's more secure) I checked for COVID-19 vaccine shots offered by Kaiser, and they didn't have any. (The user experience could have used improvement: first they asked me to select the location, then the shot, and only then did they tell me they didn't have appointments at that specific location, without giving me the opportunity to concurrently check other nearby locations. (There's an office in Santa Cruz and another nearby in Scotts Valley, and if I had to I could drive to Watsonville or Santa Clara or San Jose; but I had to search each one individually.)

Then I checked pharmacy chain CVS and they had appointments on Tuesday (if I wanted to drive to Watsonville) or one appointment on Wednesday afternoon (if I wanted to drive to the other side of Santa Cruz) or a bunch on Thursday if I only wanted to drive downtown. I double-checked my calendar and picked option 3. Then they offered to give me a flu shot at the same time while I was there (they did not say "twice the fun" but I took it as given) and I said sure why not and checked that box too.

Getting the COVID-19 vaccine booster shot at a CVS on the edge of downtown Santa Cruz was considerably different from getting my first shot at Levi's Stadium last year. There were no crowds and the queue was shorter. The waiting area was a couple of chairs set up on the edge of the store, with a partition partially surrounding the one seat to get the shot. Only some of the people in the store were wearing masks. I had less vaccine FOMO for the booster, just a vague sense of resignation about where we are in the pandemic. (It was also much closer to my house; I could walk there if I was willing to take 45 minutes.)

The only minor complication was that CVS didn't take Kaiser insurance for the flu shot, so I figured I'd get it at Kaiser instead. I got the COVID-19 vaccine booster shot in my arm, and that's what I wanted.

Jaeger after his COVID-19 booster
Jaeger after his COVID-19 booster

So far, forty-eight hours after the shot, my only side effect is a sore arm — and it's better than some flu shots I've had. I haven't felt any fatigue (my first shots felt like jet lag), but I have complete confidence that the mRNA in the vaccine has hijacked my cells to make the spike protein to get an immune response, and that by the time I visit my parents in Walla Walla I'll have stronger protection against the current variant strains.

What remains unclear, though, is how much protection is "enough", for any value of "enough". It's clear that many people have decided that they're done with the pandemic, but it's also clear that people are still getting sick and dying (or surviving but getting Long COVID). Mortality is still higher than the flu (not that the flu mortality was all that great for at-risk groups), and morbidity is off the charts. It feels premature to declare "Mission Accomplished", but it's also clear the acute crisis has passed.

The science around the vaccine tells us that the vaccine provides a high degree of protection against the virus, but also that the protection provided is not absolute. What we do with that information is outside the realm of science: it's up to everyone to figure out the appropriate trade-offs, guided but not dictated by the science. My risk from the virus is low (but not zero) so I'm still comfortable with my harm-reduction approach: I wear my mask inside and in crowds, and I'll prefer to sit outside to eat, but I will still eat inside if it's inconvenient otherwise. Wearing a mask is an easy mitigation, and it's probably worth a couple of micromorts.

I'm not sure what comes next in the pandemic, but I feel ok where we are, at least for me and my household and family, and that's going to be good enough for now.

Sun sets over Seabright Beach
Sun sets over Seabright Beach