Covid-19: Vaccines, Boosters, and Outpatient Therapies

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In this Covid Grand Rounds, we bring back Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and member of the FDA’s vaccine advisory committee, to give us an update on vaccines. Paul will cover vaccines and boosters in kids, second boosters in adults, hybrid and infection-related immunity, and how well our vaccines are holding up against the new Omicron variants. In the second half of the session, UCSF’s Annie Luetkemeyer and Sarah Doernberg focus on treatments for Covid in outpatients, with an emphasis on the role and use of Paxlovid and options for immunosuppressed patients.


Paul Offit, MD, professor and director of the Vaccine Education Center, Division of Infectious Diseases, Children’s Hospital of Philadelphia; professor of vaccinology, University of Pennsylvania

Sarah Doernberg, MD, associate professor, Division of Infectious Diseases at UCSF Health; medical director of Adult Antimicrobial Stewardship at UCSF Medical Center

Annie Luetkemeyer, MD, professor of medicine, Division of HIV, ID and Global Medicine at ZSFG

Note: Closed captions will be available within 48-72 hours after posting.

Bob Wachter: Introduction
00:03:41-00:34:34 – Paul Offit, MD (professor and director of the Vaccine Education Center, Division of Infectious Diseases, Children’s Hospital of Philadelphia; professor of vaccinology, University of Pennsylvania)
00:34:37-01:02:26 – Sarah Doernberg, MD (associate professor, Division of Infectious Diseases at UCSF Health; medical director of Adult Antimicrobial Stewardship at UCSF Medical Center); Annie Luetkemeyer, MD (professor of medicine, Division of HIV, ID and Global Medicine at ZSFG)
Bob Wachter: Closing

See previous Medical Grand Rounds:

• April 28: Clinical Problem Solving with Gurpreet Dhaliwal

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• April 21: From UCSF to Kaiser Permanente: What’s Different About Integrated Health Plan and Delivery System?
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• April 14: Is the End of the Tobacco Epidemic Within Reach?
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• April 7: Preparing for Covid’s Next Phase: Tracking Variants and Enacting Wise Policies for the Future
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See all UCSF Covid-19 grand rounds, which have been viewed over 3M times, here:


Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information.

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  1. Did SARS COV2 infection induce low temperature agglutinine like micoplasma infection?
    Why radiologic aspect of mycoplasmatic pneumonia look like SARS COV2 pneumonia?

  2. Did we know at what tissue temperature did SARS COV2 better replicate?
    At TWiV659 at min.29 (sept.2020) Christian Drosten indicate very low temperature better to replicate SARS COV2.

  3. fatigue could mean so many things: lassitude, PEM, myalgia, encephalopathy, orthostatic intolerance, heat intolerance, poor endurance, hypoxia, etc…depending on the causes (i.e. end organ damage, mitochondrial dysfunction, autoimmune and inflammatory processes) and the triggers. looking forward to hearing more about LC. great talk thank you.

  4. May be ,to be safe ,mARN vaccine must injected strict intramuscular, to avoid blood spread of lyposomes.
    May be ,,aspirate before inject,, technique, and avoiding of use deltoid muscle, avoid ,,accidental,, spread.
    To avoid muscular deltoid contraction may be ,we can use an ,,arm sling,,(contenting scarf) ,like after shoulder luxation ,(some hours.)(??)

  5. If ,at TWiV Nr 659 at min29 Christian Drosten indicate corect(?)may be, we can explain protective action of vaccination ,not only by increasing level of neutralyzing antybody ?
    May be besides neutralyzing effect,that antibody increase mucoseal inflamation rapidly in contact with SARS COV2, and ,,calor,, mitigate SARS COV2 infection.?
    Mask wearing ,even we have antiSARS COV2 antybody increase local mucoseal temperature.
    May be high mucoseal respiratory temperature are protective against SARS COV2 infection?

  6. To put in a nutshell. The world has been Shanghaied! The covid-19 Moderna and Pfizer vaccines were developed using the genome sequence for the coronavirus released by China.

  7. Get your VitD level above 50 60 70 80 ngml will protect you take magnesium it activates VitD and k2mk7 it regulates calcium out of the blood and into the bones and teeth and zinc and iodine and selenium NAC probiotics VitC.. your set .. you can add B's and quercetin beta glucan melatonin turkey tail lions mane..lots more.. do your research.

  8. I despise the manner that scientists, pharma, and government has play supremists over everyone!
    Not only have they increased the life expectancy by the potency of these viruses and vaccines; involuntarily included almost all in these heinous experiments; but they have also created and continue to create various types of monsters, without good sensible foresight.
    The unvaccinated no longer pose a risk to those who are vaccinated, seeing the potency of these vaccines. Those who are unvaccinated, do so at their own risk. That should remain a choice for each and all.

  9. The more I listen to Dr Offit the more he offends my sense of moral compass. He is clearly a clever man but he is part of a group of overpaid people making decisions to coerce and force young healthy people to endure these experimental drugs. The viral sub variants cause mild fever in healthy young people. We do not need to keep pumping these expensive experimental drugs into the arms of the healthy. It's making this worse.

    It's time, as doctors, that you reverse how you look at this. If you assume these drugs have the potential to do harm, which they do, then does that harm outway the mild fever in healthy people. The answer is clearly yes. Use your training and common sense to push back because this is utter nonsense. Start listening to people like Dr vanden Bosche and broaden the conversation because your continued opinion that the vaccine is the saviour is delusional.

  10. As much as I am frustrated about the flippant attitudes that some people have towards COVID and how it will affect our overall progress, I am equally frustrated for our immunocompromised patients. All hospitals (regardless of what level) should require those working with immunocompromised patients have a N95 fitted. I accompanied a Stage 4 cancer patient to their chemo session and the nurse helping with their care was wearing a paper mask and it was obvious she had congestion (coughing under her mask).I get that there is a widespread care shortage but that doesn’t mean care should be compromised. If we know paper masks are ineffective, why aren’t hospital staff required to wear well fitted n-95’s?

  11. I appreciate having the transcript. (Some sentences end in a fade that I cannot hear)
    I find these sessions valuable in understanding new information I hear about this disease.

  12. At TWiV 659 at min29 Christian Drosten indicate low tissue temperature better to replicate SARS COV2.
    May be low fever induced by SARS COV2 infection must not be decreased by use of analgezic antipiretic drugs?

  13. I had This coronavirus 19 june 8 with symptoms fever headache.,increase cough, started Paxlovid on 2nd day ,was drinking 10 glasses water , with taste loss i didnt eat well had diarrhea , and caused my weakness , confusion slight forgetfulness 0n the 5th day on Paxlovid. I was hospitalized for increase weakness and confusion. On ICU hospitalization My serum sodium level was 108 .I have other medical comorbidities, like asthma, DM, Cardiac with 1 stent, HTN. Im unvaccinated . Waiting for a pure vaccine for. Im still very weak and brain fog from this coronavirus 19. i like to get thorough treatment and understanding . My NA Level is 135–137 now.,

  14. HIV, POLIO, COVID viruses etc…we all know is created for fame, money, and power. The work of the devil. The criminals are free while making millions and millions while killing innocent people. The media is also an instrument of the devil to promote lies. I cant wait for GOD vengrance against these evil men.

  15. The Russian Sputnik V vaccine demonstrates effective protection against the COVID-19 omicron strain and a higher antibody titer compared to two injections of the American Pfizer vaccine. This is evidenced by the results of a study by the Spallanzani Institute in Italy, the results of which were published in the medical journal Vaccines, the Gamaleya National Research Center for Epidemiology and Microbiology reported.

    It is known that the titer of virus-neutralizing antibodies to omicron in Sputnik V turned out to be 2.1 times higher in general and 2.6 times higher three months after vaccination. Thus, 74.2 percent of all blood serum samples vaccinated with the domestic drug neutralized omicron (against 56.9 percent from Pfizer).

    Experts found that Sputnik V generates a stronger response due to a wider range of virus-neutralizing antibodies, a heterogeneous vaccine scheme, and a higher degree of infection imitation by the adenoviral platform.

    It is noted that the study was conducted under equal laboratory conditions at the Spallanzani Institute on the basis of comparable serum samples from individuals vaccinated with Sputnik V and Pfizer with similar levels of IgG antibodies and virus-neutralizing activity to the original strain registered in Wuhan, China.


  17. Paul Offit, director of the vaccine education center: the goal of the covid vaccine is to protect against serious illness. Opening statement is a lie. No, that was not the goal; that was made up after it became clear the "vaccines" failed to prevent infection. Then in a rush came the changed definition for vaccine and changed "goal" Not even 4 min Paul you already had to lie LOL thank you for saving my time, not watching this garbage.

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