New COVID vaccine has fewer side effects

Erin Kissane, a co-founder of the COVID Tracking Project, rolled up her sleeve for the Novavax COVID-19 vaccine in midOctober soon after it was finally recommended in the United States. Like many people with autoimmune diseases, she wants to protect herself from a potentially devastating COVID infection.

Kissane’s autoimmune arthritis seems to make her susceptible to unusual vaccine side effects. After getting an mRNA booster last year, her joints ached so painfully that her doctor prescribed steroids to dampen the inflammation. She still considers the mRNA vaccines “miraculous,” knowing COVID could be far worse than temporary aches.

Nonetheless, when the pain subsided, she pored through studies on Novavax’s shot, a vaccine that is based on proteins rather than mRNA and has been used since early 2022 in other countries. Data from the United Kingdom found that people more frequently reported temporary reactions — like low fevers, fatigue, and pain — as their immune system ramped up in the days following booster vaccination with Moderna’s mRNA vaccine versus the one by Pfizer. And those boosted with Novavax’s had fewer complaints than either of those. That finding was corroborated in an analysis of international data published last year.

Such studies have driven people with long COVID and chronic fatigue syndrome (also known as myalgic encephalomyelitis, or ME/CFS) to seek out Novavax, too, since the FDA and the Centers for Disease Control and Prevention green-lighted Novavax’s vaccine — updated to protect against recent omicron coronavirus variants — about three weeks after recommending updated mRNA vaccines in September.

Waiting paid off for Kissane, whose arm was briefly sore. “It was a dramatically different experience for me,” she said. “I hope that plays out for others.”

Another group who waited on Novavax are biologists who geek out over its technology. When asked why he opted for Novavax, Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai, replied on X, formerly known as Twitter: “Because I am (a) vaccine nerd, I like insect cell produced vaccines.” Whereas mRNA vaccines direct the body to produce spike proteins from the coronavirus SARS-CoV-2, which then train a person’s immune system to recognize and fight the virus, Novavax simply injects the proteins. These proteins are grown within moth cells in a laboratory, while other protein-based shots use cells from mammals. And Novavax has said that a special ingredient derived from the bark of Chilean soapbark trees enhances the vaccine’s power.

Research suggests that the Novavax vaccine is about as safe and effective as the mRNA shots. Its main disadvantage is arriving late to the scene. Vaccine uptake has plummeted since the first shots became widely available in 2021. Nearly 70% of people got the primary vaccines, compared

Serum Institute of India for Novavax/Associated Press with fewer than 20% opting for the mRNA COVID boosters released last year. Numbers have dwindled further: As of Oct. 17, only 5% of people in the United States had gotten the latest COVID vaccines, according to the Department of Health and Human Services.

Daniel Park, an epidemiologist at George Washington University, said low rates might improve if people who felt lousy after their last mRNA shots gave Novavax a try. It protects against severe illness, but researchers struggle to specify just how effective this and other vaccines are because studies have gotten tricky to conduct: New coronavirus variants continuously emerge, and people have fluctuating levels of immunity from previous vaccines and infections.

Still, a recent study in Italy suggests that Novavax is comparable to mRNA vaccines. It remained more than 50% effective at preventing symptomatic COVID four months after vaccination. Some data suggests that mixing and matching different types of vaccines confers stronger protection — although other studies have found no benefit.

Given all this, Park held out for the Novavax vaccine on account of its potentially milder side effects. “Between a demanding full-time job and two young kids at home, I wanted to stay operational,” he said. His arm was sore, but he didn’t have the 24-hour malaise accompanying his last mRNA shot.

Most people don’t strike a fever after mRNA shots. Even when they do, it is brief and therefore far less detrimental than many cases of COVID. In fact, most reactions are so minor that they’re hard to interpret. During clinical trials on mRNA vaccines, for example, up to a third of people in the placebo group reported fatigue and headaches after injection. People with ME/CFS and long COVID — a potentially debilitating condition that persists months after a COVID infection — have responded to COVID vaccinations in a wide variety of ways. Most participants with long COVID in an 83-person Canadian study said their levels of fatigue, concentration, and shortness of breath improved following vaccination. Inflammatory proteins that have been linked to long COVID dropped as well.

However, larger studies have yet to corroborate the hopeful finding. Jennifer Curtin, a doctor who co-founded a telehealth clinic focused on long COVID and ME/CFS, called RTHM, said vaccines seem to temporarily aggravate some patients’ conditions. To learn how Novavax compares, she posted polls on X in late October asking if people with long COVID or ME/CFS felt that their symptoms worsened, improved, or stayed the same after Novavax. Most replied: unchanged.

“It’s not scientific, but we need to figure it out since these folks don’t want to get COVID,” Curtin said. “My patients are all wondering about what vaccine to get right now.”

Adding to the uncertainty, the rollout of Novavax and mRNA vaccines has been bumpy as pharmacies struggle to predict demand and insurance companies figure out how to reimburse providers for the shots.

Unlike previous vaccine offerings, these options are no longer fully covered by the federal government.

A testament to this season’s struggle to get vaccinated is that at least one do-gooder has created an online tool to find open appointments for Novavax.

Buoyed by anecdotes of relief from others with long COVID, Hayley Brown, a researcher at the Center for Economic and Policy Research who has the condition, opted for Novavax recently. Unfortunately, her symptoms have flared. She said a temporary discomfort will still be preferable to risking another infection. “As someone with long COVID,” she said, “the idea of getting COVID again is terrifying.”

Any Waxmen writes for California Healthline, a part of KFF News (formerly known as Kaiser Health News), an independent national newsroom that produces in-depth journalism about health issues.

A five-bedroom, 10,000square-foot home in Russian Hill, just a block up from San Francisco’s famous crooked stretch of Lombard Street, was listed for $20 million just over a year ago — the same price the owner paid for it in January 2020. But last month it sold for half that: just under $10 million.

The 50% price drop for the home at 2626 Larkin St. was “very unusual,” according to Patrick Carlisle, chief market analyst for the Bay Area real estate group Compass.

However, it’s also indicative of the softening in San Francisco’s luxury real estate market this year, as a declining stock market and high mortgage rates have affected all buyers, making even the wealthy more hesitant about big purchases.

Though the Russian Hill home is an extreme example, Carlisle noted that homes in the highest price range tend to see larger drops from the original list price than the general market, as there are fewer buyers at the very top of the market and such homes can be difficult to price. He added that the luxury home market in San Francisco has been affected by the “drumbeat of negative news” about the city’s economic and social struggles and the “absurdly overdone speculation about the city being in a ‘doom loop.’ ”

Data shows that the higher a home is priced, the more likely it is to sell under the asking price. So far in 2023, homes in San Francisco in the $7.5 million-and-above range are selling for around 90% of the asking price — slightly lower than in 2021 and 2022, but far above the 50% cut seen in the sale of the Larkin Street home.

And Carlisle said that economic indicators for the city have recently turned more positive, which could mean a stronger market in 2024.

The real estate agent who sold the property, Nina Hatvany, said she could not comment on this sale specifically, as she signed a nondisclosure agreement. Public records show that the home’s deed was transferred to a limited liability company that was created days before the sale. That LLC is registered to a corporation in Glendale that files business information with the state on behalf of other businesses, a tactic people use to protect their privacy.

Last year, in a feature story about the home, Hatvany told the Real Deal that the owners — Leslie Stretch, the former CEO of software company Medallia, and his wife, Heather — were selling because the youngest of their four children had left for college and they wanted to downsize to a pied-a-terre in the city. She added that the family had also bought “several ‘spectacular’ ” second homes during the pandemic.

Stretch retired from the CEO position in March of this year after 41⁄2 years in the role, and transitioned to an “advisory role” with the company, according to a news release.

Google Street View

Hatvany also said that the couple had spent hundreds of thousands of dollars upgrading the smarthome features of the house and added two car lifts to make room for five cars in the three-car garage.

At the time, she also told the Real Deal that her team had other homes on the market in the $18 million to $25 million range, “and not one of them is as done as this house is.”

In an email to the Chronicle, Hatvany said her team was finding that “some sellers are more willing to take offers below their asking price,” and that the data is showing that “there has been a downward adjustment in values, even for single family homes in the most desirable neighborhoods.”

In general, home sales above $5 million in San Francisco tend to spike in the spring and slump during midwinter, according to Compass’ December market report. Hatvany said that price per square foot also rises in the spring, flattens in the summer and declines slightly toward the end of the year.

The data indicates that the end of the year “brings out buyers seeking a ‘deal’ and sellers willing to participate,” she said.

Photos by Reliable Robotics

The Novavax shot, which is based on proteins rather than mRNA, is as effective as the COVID vaccines from Moderna and Pfizer but with fewer side effects.