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September 24, 2021
What A Day
What Have You Got To Boost? with Dr. Abdul El-Sayed

In This Episode

  • A CDC advisory board unanimously said that people 65 and older should be allowed to receive a booster shot of the Pfizer-BiONTech COVID vaccine. It also agreed that younger people who might be at high-risk could get a booster as well, but NOT those who are at high risk of being exposed to COVID at their jobs. Dr. Abdul El-Sayed, epidemiologist and the host of America Dissected, joins us to breakdown vaccine news.
  • And in headlines: the U.S. special envoy to Haiti resigns, New York City lawmakers move to protect and establish rights for delivery workers, and the White House prepares for a government shutdown.

 

 

Transcript

 

Gideon Resnick: It’s Friday, September 24th. I’m Gideon Resnick.

 

Priyanka Aribindi: And I am Priyanka Aribindi, and this is What A Day, where we’re calling for Chris Pratt to be recast in the animated Mario movie as the voice of the tube.

 

Gideon Resnick: Yeah. He was announced as Mario yesterday, but he could also settle for the sound the mushroom makes when it hits your head, the like star noise—any of these things he’d be great at.

 

Priyanka Aribindi: There’s a lot of options

 

Gideon Resnick: On today’s show, the US special envoy to Haiti has resigned. Plus, West Virginia’s governor could be spending all of his time fighting COVID, but instead he has been fighting to coach high school basketball recently. Good priorities.

 

Priyanka Aribindi: Very, very good. But first, we have a lot of news on the vaccine front, about boosters and advocacy and authorizations. So just yesterday, a CDC advisory board unanimously said that older adults should be allowed to receive a booster shot of the Pfizer-BioNTech COVID vaccine. That means that people 65 and older might be able to get a third shot. Also in line would be people younger than that who might be at high risk, but not those who are regularly exposed to COVID in their jobs, which is different from what an FDA advisory board suggested earlier this week. The final decision on Booster’s, however, rests with the full CDC itself, but generally the agency usually follows what the advisory board suggests.

 

Gideon Resnick: Yeah, before all of that, on Tuesday we got some long-awaited Johnson & Johnson News. The company announced that a two-dose version of their coronavirus vaccine that is given two months apart is 94% effective against symptomatic COVID-19. The company also said that adding a booster dose six months after the first shot is even more effective than that.

 

Priyanka Aribindi: OK, very exciting news for J&J hive.

 

Gideon Resnick: A big moment for us.

 

Priyanka Aribindi: Huge. With all of these developments and ongoing discussions about boosters, I wanted to take some time to talk to an expert about some of the big questions that are still out there, and honestly, just to help make sense of all of this news. So who better to do that with than Dr. Abdul El-Sayed? He is an epidemiologist, the host of America Dissected, and honestly, he has been on this show more times than I have at this point. Abdul, welcome back to the show.

 

Dr. Abdul El-Sayed: Priyanka, it’s an honor, as always, to join you. And congratulations on the new role and really excited to discuss.

 

Priyanka Aribindi: Thank you. Let’s start with the state of boosters right now, maybe a little scene setting heading for everybody. Can you tell us about the latest guidance in the U.S. about who should be getting booster shots, and then if you think that guidance will stay the same?

 

Dr. Abdul El-Sayed: Yeah. So let’s step back for a second. The whole premise of booster shots has been the fact that there has been, as Dr. Fauci would use the word, a ‘diminution’ in the effect of a regular course of vaccinations, not against protecting against symptomatic illness with COVID-19 in the Delta variant in particular, but against infection and the possibility of transmission. And so those two pieces don’t necessarily go hand in hand. This secondary endpoint has become a real focus, particularly when it comes to the Delta variant, which we all know is far more transmissible. And so the question was, do we boost the vaccine? And is there evidence that boosters can reduce the probability of infection, particularly among the most vulnerable folks whose immune systems tend to be the weakest, whether you’re immunocompromised at any age, or over the age of 65, which is something that tends to happen with aging. So that sets the stage for this conversation about where we are now.

 

Priyanka Aribindi: Right. I want to ask you a little bit more about those people who are at risk because of, you know, their work situations. Maybe they are doctors or teachers or whatnot. So the CDC voted to exclude them from this guidance on booster shots. Can you tell us about what you think about this choice, if it’s a good one? All of that.

 

Dr. Abdul El-Sayed: Yeah. Remember, the whole conversation here isn’t about whether or not you’re protected from getting sick or hospitalized or dying. What the CDC is guiding from is the available evidence that’s shown that there may be some added benefit against your risk of getting ill and or passing it on but we just don’t have the evidence that is conclusive, that demonstrates that, in fact, a third booster protects you from either being infected or passing it on if you’re under the age of 65. And so the CDC is basically saying, well, if we’re not going to recommend this for anyone, we’d be going off of the data, away from the evidence to recommend it for people who have higher risk of exposure. And they’re saying we want to be a little bit conservative about how we’re interpreting this evidence. And the other point here is just to say that we are still in a scenario where the biggest issue is not who gets a third dose, the biggest issue is who gets a first dose.

 

Priyanka Aribindi: Totally. So this guidance, as you said, it’s all about the Pfizer vaccine. But earlier this week, we got some new news about J&J, which was very exciting for the crew here. There was a small, like small but vocal crew that has all received J&J, we all kind of circulate the news that we get. But they released their own study about boosters showing that a second dose of their vaccine two months after the first provides 94% protection against moderate to severe COVID symptoms. I would love to know what your thoughts were on that study and the results that are there.

 

Dr. Abdul El-Sayed: Well, you know, it’s not surprising. I mean, this whole time we’ve been comparing one shot of J&J to two shots of everything else. And so the fact that it was as effective as it was in one dose really should be heartening to folks who took J&J. What’s going to happen is that this evidence is going to be reviewed by the FDA and then again reviewed by the CDC around a second dose. And I do expect that the conversation around boosting J&J is going to look a little bit different than that it does for boosting Pfizer & Moderna simply because, again, you’re comparing one dose of J&J to two doses of Pfizer & Moderna at baseline. And so I think a lot of the conversation about over 65 or under 65, that, that, that’s not going to be as, follow the same pathway.

 

Priyanka Aribindi: Got it. OK, so to our knowledge and on this conversation, the only place that’s authorized a booster for people with the J&J shot is the San Francisco Health Department. So several weeks ago they allowed those people to get a booster, but with one of the mRNA vaccines, so Pfizer or Moderna. I was wondering if you could tell us a little more about this mixing and matching concept—is this a good idea, should you definitely not do this? Any guidance you can give us there?

 

Dr. Abdul El-Sayed: I personally believe that it’s always worth reviewing the quality of evidence and waiting for a body like the FDA that generally has very stringent guidelines around what they approve, to approve of something like this. And I think for folks who’ve taken the J&J and sort of feel like they’ve been a bit left out, that evidence is on the way and recommendations, I think, are going to be short in coming. And so I hope folks will sit tight. Obviously, this is all demonstrating the fact that science is a imperfect process, right, that sort of tends to lead us over the long term in the right direction. But I tend to follow the recommendations, though, of the FDA and CDC that have sort of a tighter set of data that they admit when they’re making these decisions, and I recommend that folks do the same.

 

Priyanka Aribindi: Right. That sounds like good advice to me. So as I was saying, Gideon, me, several other people in Crooked, we are all in the J&J squad. We kind of send each other little news that’s out there. It kind of feels like there is not as much. I am curious, do you think this is a failing of health officials and the media, or is it just because less people have received this shot?

 

Dr. Abdul El-Sayed: I think a lot of it has just been, the focus on the boosters has been driven by the interests of the corporations themselves. And Pfizer was the first to market, they were the first to have data, and for that reason, they’ve sort of dominated the conversation about boosters. And so I think this is probably why we’re hearing so much about them. I know that there’s been a lot of, a lot of investigation into how to maximize the protection of J&J, and I think that data is going to be coming. It’s probably not going to be covered as loudly simply because the first of anything tends to be the one that’s covered the loudest. But I’m glad that you guys are going to have a Slack channel and you’re going to be covering it just as loudly as the media ought to be.

 

Priyanka Aribindi: Yeah, loudly. Pfizer seems like the real Marcia Brady of the conversation. I’ll just put that out there.

 

Dr. Abdul El-Sayed: Oh, there’s no doubt. Absolutely no doubt.

 

Priyanka Aribindi: 100% Thank you. OK, so this is going to sound a little bit like it’s a me question, but I do think that there are people out there who this will be applicable to so I’m just going to go ahead and ask.

 

Dr. Abdul El-Sayed: Well, if you’ve got the question, there’s definitely somebody out there that has got it too.

 

Priyanka Aribindi: Exactly. That was my logic here. OK, so I’m a relatively healthy, relatively young person. Obviously, I got a vaccine as soon as I could. I see the stats. I hear the news about boosters, I think, you know, that’s great. Obviously, I’m not a top priority. I know I shouldn’t be and I don’t think I deserve that, but, you know, I’m kind of like, oh, why wouldn’t I want more protection from COVID down the line if that was made available to me? But given what we know, kind of what you’re telling us, is that, like, even the mindset I should be in, or do I need a booster shot or would I need a booster shot at all? Or is that instinct to be as protected as possible, you know, the right one in this situation?

 

Dr. Abdul El-Sayed: What you’re highlighting here is the long consequence of this conversation, which is that it has shaken the trust that people have in the vaccines that they’ve already gotten. The recommendation that I give to folks is that, you know, at this time, if you were to really, really want a third dose, the preponderance of the evidence suggests that not an unsafe thing to do and that there’s probably some minuscule advantage. And at the same time, there is a reason that the CDC and the FDA have not authorized and or recommended these third boosters simply because the two-dose regimen when it comes to Pfizer is both safe and effective against the probability of getting sick and or being hospitalized or dying.

 

Priyanka Aribindi: But if more Americans get booster shots, are we taking away shots from people abroad who wouldn’t be vaccinated yet? How does that work?

 

Dr. Abdul El-Sayed: So if there’s a large demand for a third dose here, there are vaccine shipments that are going to be routed to places in the United States rather than routed abroad. In the long term, right, yes, there’s going to be enough vaccine to go around. But the long term is a very long term and people are dying today. On my podcast, America Dissected, I interviewed Scott Gottlieb, who is a former FDA commissioner, last week, and we had a pretty robust conversation about this. But every third dose that we give in the United States is the first dose that we’re delaying in another country.

 

Priyanka Aribindi: Totally.

 

Dr. Abdul El-Sayed: And you know, what I’m going to choose to do is I’m going to follow the recommendations of the FDA, the CDC. I know that as a as a healthy 30 something that I’m not at risk. And thankfully, I have a competent immune system. But as a young person, I don’t want to add to a stampede of added demand, so that, you know, Pfizer is going to ship more vaccine here to meet that demand, making more money, rather than shipping it abroad to get it to people who need it before, need a first dose before I get my third.

 

Priyanka Aribindi: Right. That is really helpful. Thank you so much. Dr. Abdul El-Sayed, host of Crooked Media’s America Dissected. Thank you so much for all of this. This has been great.

 

Dr. Abdul El-Sayed: Well, Priyanka Aribindi, co-host of Crooked Media’s What A Day, it has been a privilege and look forward to doing this more often, OK?

 

Priyanka Aribindi: I hope so. Thank you so much. This is great.

 

Gideon Resnick: Yeah. And you can hear more of Dr. Abdul El-Sayed in that conversation that he mentioned with former FDA Commissioner Scott Gottlieb. That is actually on the latest episode of American Dissected. You can find it on Spotify, Apple podcast, or wherever you get your podcasts. And that is latest for now. We will be back after some ads.

 

[ad break]

 

Gideon Resnick: Let’s wrap up with some headlines.

 

[sung] Headlines.

 

Gideon Resnick: The Biden administration’s special envoy to Haiti resigned yesterday. This comes as the White House faces widespread criticism for deporting upwards of 1,000 migrants from the southern border and for public health concerns at the makeshift migrant camp. In Ambassador Daniel Foote’s resignation letter, he wrote, quote, “I will not be associated with the United States’ inhumane, counterproductive decision to deport thousands of Haitian refugees.” According to the Associated Press, Foote, a career diplomat, was already frustrated with the US government’s lack of urgency to improve conditions in Haiti. Roughly 14,000 Haitians arrived at the Texas-Mexico border last weekend after their country was thrown into turmoil this summer due to the assassination of their president and an earthquake that killed more than 2,000 people. Foote announced he was stepping down immediately, and the State Department criticized him for resigning at such a crucial moment.

 

Priyanka Aribindi: I don’t know if the State Department should be criticizing anybody right now.

 

Gideon Resnick: Yeah.

 

Priyanka Aribindi: New York City council members passed several bills to protect and establish rights for delivery workers in their city, yesterday. The measures created a minimum for payments per trip, put limits on how far a worker can be asked to travel, blocked apps from charging workers fees or tips, and required most restaurants and bars to let delivery workers use their bathrooms—which is the bare minimum.

 

Gideon Resnick: Right.

 

Priyanka Aribindi: Yeah, this is huge for a group of workers that have been relied upon heavily, especially throughout the pandemic. Studies have shown that delivery workers are often susceptible to things like wage theft and physical assault. In California, Governor Gavin Newsom signed into law a bill that restricts warehouse employers from setting productivity quotas. This bill subtly targets Amazon, which set unsafe quotas that sometimes prevents warehouse workers from taking much-needed breaks. Under the new law, workers can legally sue their employer if they are forced to operate under quotas.

 

Gideon Resnick: That is right. Just like campus police dealing with a rager, the White House is preparing for a shutdown. Thank you very much. That’s according to a report in The Washington Post which said the White House Budget Office was informing federal agencies to get ready for such a scenario yesterday, which would mark the first potential shutdown during the pandemic. Funding is set to expire on September 30th. And administration officials say this adheres to traditional procedures seven days ahead of a possible shutdown, it doesn’t necessarily reflect whether or not they think a deal can be struck in Congress. Earlier this week, House Democrats did pass a measure to fund the government and suspend the debt ceiling, but it is not expected to pass in the Senate, where Republicans do not want to lift said ceiling. Circling back to that college rager comparison that everyone thought was pretty unique and clever, they do not want to raise . . . the roof.

 

Priyanka Aribindi: Nooooooo.

 

Gideon Resnick: OK. Meanwhile, Democratic leaders in Congress said that there had been a framework reached with the White House on funding Biden’s multitrillion dollar domestic agenda in advance of Monday. That is when a House vote on the infrastructure package is expected. Let’s get back to the party metaphor really fast: this is the part where you’ve woken up the next day and realize that you have to cram for an exam.

 

Priyanka Aribindi: So you lost me on the metaphor a little while ago, but I know that that is not a good feeling so I’m just going to trust you. Leading a state with the nation’s lowest vaccination rate and highest COVID hospitalization rate, West Virginia Governor Jim Justice is keeping his eye on the ball, specifically the basketball in a high school gym. He spent a good part of the last month fighting to be allowed to coach the boys’ team at a school near his home. On Tuesday, Justice backed down, publishing a letter that contained the sentence, quote, “I refuse to spend time fighting hate.” OK. But here is how we got to this point: Justice already coaches the girls’ team at Greenbrier East, and as of August, he was poised to start coaching the boys’ team as well.

 

Gideon Resnick: Wow.

 

Priyanka Aribindi: Then the local education board voted three to two against hiring him, citing concerns such as his existing job as the governor. Like you might be busy.

 

Gideon Resnick: A little bit, a little bit.

 

Priyanka Aribindi: Who knows? As if to prove his other gig was really easy, Justice made protesting this decision his full-time job, filing a grievance against the board, which said his qualifications, quote, “towered above those of any other applicant.” That grievance didn’t go anywhere. So Justice will go back to being a one basketball team governor and dealing with a lousy and boring pandemic instead of making his hoop dreams come true. Sad.

 

Gideon Resnick: A person may look at this and may call it poetic justice, and I might just be that person. I’m sorry. I’m really sorry. Strike everything I’ve said today from the record. And those are the headlines.

 

Priyanka Aribindi: Two more things before we go. First, Lovett Or Leave It: Live or Else is back in Los Angeles. Vaxx up and mask up to join Jon Lovett and friends every week at Arena Cinelounge outdoors. Next week guests include B.J. Novak and Ashley Ray. Lovett: those are good guests, congratulations! For updates, you can check out Crooked.com/events.

 

Gideon Resnick: Also, we have a second very important announcement to make, which makes us both very sad and very proud: this is the last day for one of the founding members of the WAD team, Sonia Htoon. So Sonia started with us back in 2019 when it was still OK for us all to sit at one big table in an enclosed space sharing aerosols as a family. She’s been an essential part of the team, an indispensable one, producing amazing segments, highlighting underreported stories, and giving very good music recommendations. We could not do what we do every day without her. She is our team’s coolest member by far, and her departure will have just devastating effects on our grip on the culture. We’re going to miss her a lot, but we are so, so excited about what she’s going to do next. Bye Sonia. Thank you so much again.

 

Sonia Htoon: Aw. Thank you, Gideon.

 

Priyanka Aribindi: Bye Sonia!

 

[different speakers] Bye Sonia. Love you. We’ll miss you.

 

Priyanka Aribindi: You’re the best.

 

Sonia Htoon: Thank you, guys.

 

Gideon Resnick: That is all for today. If you like this show, make sure you subscribe, leave a review, quit your third job as a basketball coach, and tell your friends to listen.

 

Priyanka Aribindi: And if you are into reading, and not just opening credits that say “Chris Pratt as the tube” like me, What A Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Priyanka Aribindi.

 

Gideon Resnick: I’m Gideon Resnick.

 

[together] And we’ll miss you Sonia.

 

Gideon Resnick: Yeah, if I don’t hear some music recommendations in my life just know, I will have no music recommendations to pass on to anybody else and seem cool. What A Day is a production of Crooked Media. It’s recorded and mixed by Charlotte Landes. Sonia Htoon and Jazzi Marine are our associate producers. Our head writer is Jon Millstein, and our executive producers are Leo Duran and me. Our theme music is by Colin Gilliard and Kashaka.

 

What A Day