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The Vaccine Thread


JennyD

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1 minute ago, Penelope said:

But I don’t know why it should be offensive to say that if you just look at the numbers, it isn’t currently the top concern the average person should have for their health, either. One concern among others. 

The top two causes of death, as you say, are heart disease and cancer.  No, I am not even remotely concerned about those slow-moving lifestyle and genetic diseases compared to picking up a contagious disease spread through the air that can kill within a week or two.  Not even a little.

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12 hours ago, Penelope said:

Yeah, that study looks like bad news, no doubt about it. What I read is the idea that this was a very small study, that there is real world data that looks better, and that there are other suggestions that AZ would have some benefit against this variant.
 

There are lab studies on T cells, and there was one study that showed that one dose of AZ after natural infection was superior against B.1.351 compared to two doses of Pfizer in people without previous infection. (To me, that could also just mean that natural infection is better than any vaccine against certain variants, because it gives immunity to more parts of the virus than vaccines do, but I’ve seen this study promoted as suggestive that AZ must have some benefit). 
 

I shouldn’t have said it’s wrong to say it’s ineffective, because it all depends on how “effective” is defined. 

It’s odd that Johnson and Johnson was over 50% effective in South Africa in their trial, but AZ would be worse than that even though it’s a similar vaccine. Maybe it is, but I wonder why that would be. 

Yes Penelope, it is bad news for Australians who only have access to the AZ vaccine, because of a gov decision.

For clarity, the Sth African research research, which was a small sample, showed that the AZ vaccine had no beneficial effect in preventing mild to moderate infection from the B.1.351 variant.  The study was not relevant to severe infection only because in the total study there were no severe infections.  ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214

A similar article https://www.news-medical.net/news/20210321/ChAdOx1-nCoV-19-vaccine-does-not-protect-against-South-African-SARS-CoV-2-variant.aspx , comments "The results of a double-blind, randomized, multisite placebo-controlled trial that was conducted in South Africa show that Oxford’s ChAdOx1 nCoV19 (AZD1222) vaccine has no efficacy against the B.1.351 variant in preventing mild-to-moderate coronavirus disease 2019 (COVID19), and shows reduced
neutralization properties of developed antibodies."

Though it is a small-scale study it is particularly alarming to me, as the Aus gov prevents me accessing any alternative vaccine, I am old, have weak lungs, and a simple cold virus inevitably lands me in hospital for two weeks on oxygen, sometimes in a critical condition.  At home, I live connected to an oxygen concentrator.  I have never smoked (anything); I have asbestosis.

Just like the UK variant, the Sth African variant has spread to numerous countries.  In Aus it is regularly detected in citizens returning from overseas, however our strict quarantining has so far stopped that variant from being locally transmitted.  But like the US and elsewhere the controls are slowly being lifted.  There has been zero mention of the risk by our Gov-employed medical representatives.

Pen, anyone, are there better studies of AZ and 351?

Take care everyone,

Doug

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On 5/13/2021 at 12:11 AM, Matryoshka said:

Okay, here's some perspective.

US deaths in World War 1 (1917-18)  116,516 (58,258 per year) 

US deaths in World War 2 (1941-45)    405,399  (81,079 per year)

US deaths in Vietnam War (1965-75)   58,220  (5822 per year)

US deaths from Covid, in just ONE year   583,000  

Yep you're right.  Comparing this to deaths in world wars makes it look much better.  Thanks for the perspective.

United States in ww ii

For US deaths in WW II, I am assuming you took a KIA number and divided by 5.

that is really not accurate. We lost approximately 350 merchant marines in 1940 and 1941, and about 2400 people in Pearl Harbor. This was before war was declared, technically. 

So then after, Pearl Harbor, formal war was declared in dec 41.

VJ day was 8/15/45 but formal surrender 9/2/45 (6 years 1 day after Hitler invaded Poland)

in effect, U.S. was in war for approx. 3 years 8 months... so that KIA number per year is higher than what you got.

i didn’t look at your other war numbers

 

 

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3 hours ago, pinball said:

United States in ww ii

For US deaths in WW II, I am assuming you took a KIA number and divided by 5.

that is really not accurate. We lost approximately 350 merchant marines in 1940 and 1941, and about 2400 people in Pearl Harbor. This was before war was declared, technically. 

So then after, Pearl Harbor, formal war was declared in dec 41.

VJ day was 8/15/45 but formal surrender 9/2/45 (6 years 1 day after Hitler invaded Poland)

in effect, U.S. was in war for approx. 3 years 8 months... so that KIA number per year is higher than what you got.

i didn’t look at your other war numbers

No, that's not the combat death number; that's only about half of that number (2K something) No idea if it includes Pearl Harbor, but I have no idea how a few thousand more deaths changes a comparison thats off by year by an order of magnitude and anyway apples/oranges (again, not my idea to throw these numbers in the mix, responding to another poster implying we don't compare these... like if we did it would make the Covid numbers less startling). 

My point was: it doesn't, and it's a silly comparison anyway (which to answer the poster who asked is why no one is making it).  Ballpark numbers are fine to make that point.

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57 minutes ago, Matryoshka said:

No, that's not the combat death number; that's only about half of that number (2K something) No idea if it includes Pearl Harbor, but I have no idea how a few thousand more deaths changes a comparison thats off by year by an order of magnitude and anyway apples/oranges (again, not my idea to throw these numbers in the mix, responding to another poster implying we don't compare these... like if we did it would make the Covid numbers less startling). 

My point was: it doesn't, and it's a silly comparison anyway (which to answer the poster who asked is why no one is making it).  Ballpark numbers are fine to make that point.

MY point is that we did not fight in the Second World War for 5 years. 

Since you wrote “409355 (81079 per year)” I am assuming you divided 409355 by 5. 

Whether you use battle deaths OR battle deaths plus other deaths in service,  the US only fought from Dec 1941 to Aug 1945, plus like I said some deaths from merchant mariners before Dec 41...

3 years 8 months-ISH

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On 5/10/2021 at 7:42 AM, TCB said:

Using your post as a jumping off point - even if it were true - which from what I’ve researched it does not appear to be - why would forming antibodies to the spike protein from the vaccine be a problem, but forming antibodies to the spike protein of the virus is not? It just seems illogical to me. It’s like wave after wave of illogical stuff is thrown out there, gets answered or refuted, simply slips out of the narrative and then the next thing is thrown out there. What is the point of doing this. 
I feel really frustrated by it all. By all means let’s look at real possible side effects and find out all we can. But this is like a certain part of the human race is working their butts off to deal with the virus and find answers, and another part is throwing out whatever obstacle they can to make it even harder. What is the motivation? I say again, I’m all for logical, real questioning, but it almost seems like an endless stream of attempted gotchas and to what end? 🤷‍♀️


This sounds almost like a genuine logical, real question itself? 

 

Send me a PM if you are actually open to a different view than your own.

 

 

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On 5/9/2021 at 3:34 PM, JennyD said:

In the last few weeks I have been to two different doctors, the dentist, and had a life insurance physical/interview.  All did some sort of Covid symptom screening, but -- to my utter bafflement -- none of them asked about my vaccine status.   If you're worried that patients might have covid, surely the #1 thing you'd want to know is if and when they've been vaccinated?

The life insurance interview was especially mystifying.  Several questions along the lines of, "In recent months, have you had substantial weight loss, chills, night sweats, or unexplained skin lesions?"  But no questions about whether I have been vaccinated against the #1 cause of death in the US RIGHT NOW.  I realize that insurance companies move slowly, but come on. 

You can still get covid even if you're fully vaccinated.   If so, recovery is usually much faster, and symptoms are less.  Since you can still get it - it makes sense they would ask about symptoms.

and people can have an active covid infection, and not have any symptoms.  (a couple friends right now.)

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6 hours ago, Lucy the Valiant said:

Excellent news continuing to emerge for durability of immunity following natural infection showing as strong (or stronger) than vaccine (in this case Pfizer). 

Prior SARS-CoV-2 infection and Pfizer-BioNTech’s COVID-19 vaccine provide similar immunity

 

On one of the EBV groups to which I belong, someone's functional med dr said there is evidence Pfizer has had a positive effect on  EBV.  He has access to world wide dr/medical comment boards that discuss vaccines and the after effects.   Several people on the EBV board who had Pfizer also reported improvement of their EBV symptoms after their 2nd dose.

I've been paranoid about getting any vaccine given my compromised immune system - but this has made me willing to do Pfizer.  (which was hard to find here - though moderna is readily available.)  So I'm getting my first dose tomorrow - and I appreciate they space the second dose three weeks instead of two weeks.

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21 minutes ago, gardenmom5 said:

On one of the EBV groups to which I belong, someone's functional med dr said there is evidence Pfizer has had a positive effect on  EBV.  He has access to world wide dr/medical comment boards that discuss vaccines and the after effects.   Several people on the EBV board who had Pfizer also reported improvement of their EBV symptoms after their 2nd dose.

I've been paranoid about getting any vaccine given my compromised immune system - but this has made me willing to do Pfizer.  (which was hard to find here - though moderna is readily available.)  So I'm getting my first dose tomorrow - and I appreciate they space the second dose three weeks instead of two weeks.

Good luck tomorrow! I hope you don’t get any side effects! 

Keep rubbing your arm afterward — doing that really helps prevent me from getting a sore arm, so maybe it will help you, too! I have also heard that drinking a lot of water the day before your shot and in the next few days afterward is helpful, as well. 

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19 hours ago, Matryoshka said:

The top two causes of death, as you say, are heart disease and cancer.  No, I am not even remotely concerned about those slow-moving lifestyle and genetic diseases compared to picking up a contagious disease spread through the air that can kill within a week or two.  Not even a little.

Good for you, if as an individual that makes sense to you. The average person, though, might do well to be a lot more concerned about those things. The risks for dying of heart disease are primarily the same risk factors that make someone much more likely to have severe Covid or to die of it. 

3 hours ago, Matryoshka said:

No, that's not the combat death number; that's only about half of that number (2K something) No idea if it includes Pearl Harbor, but I have no idea how a few thousand more deaths changes a comparison thats off by year by an order of magnitude and anyway apples/oranges (again, not my idea to throw these numbers in the mix, responding to another poster implying we don't compare these... like if we did it would make the Covid numbers less startling). 

My point was: it doesn't, and it's a silly comparison anyway (which to answer the poster who asked is why no one is making it).  Ballpark numbers are fine to make that point.

It IS a very silly comparison, which is what I thought about it every time the media made it with Covid, over and over and over again. I didn’t ask why no one is making it. 
 

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Posted (edited)
5 hours ago, gardenmom5 said:

and I appreciate they space the second dose three weeks instead of two weeks

Who/what spaces the second shot two weeks?

The CDC announced today they will no longer be tracking (publicly posting separate numbers for) mild/moderate vaccine breakthrough cases.

I personally think this is a PR move more than a manpower move. I think tracking even the mild/moderate cases by type of vaccine, genetic makeup  (variant), and length of time since full vaccination will be important for public policy going forward. 

https://www.cnn.com/world/live-news/coronavirus-pandemic-vaccine-updates-05-14-21/h_b488e80713b26c43c67a86584dbe2593

Quote

 

Starting Friday, the US Centers for Disease Control and Prevention says it will no longer collect and publish data on all Covid-19 breakthrough cases, only severe cases that result in hospitalization and death.

.....

“This was done in order to focus on the cases of greatest clinical and public health importance,” the CDC spokesperson told CNN.

Previously, states reported all cases of breakthrough infection, regardless of severity, to the CDC. States will continue to report all positive cases of Covid-19 to the CDC — including any mild or asymptomatic breakthrough cases — but the agency will not differentiate between mild or symptom-free cases in vaccinated versus unvaccinated people.

It is unclear if states will continue to collect mild or asymptomatic breakthrough case data.

 

If states continued to submit it & someone was internally still tracking it, I'd feel better.

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2 hours ago, RootAnn said:

Who/what spaces the second shot two weeks?

 

The vaccine manufacturer/whomever is giving the shots determines recommended spacing.  

The place where I'm getting the Pfizer, does three weeks between doses. 

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8 minutes ago, gardenmom5 said:

The vaccine manufacturer/whomever is giving the shots determines recommended spacing.  

Yep! I am just confused. I've never heard of a two week spacing. Moderna is four weeks.

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7 minutes ago, RootAnn said:

Yep! I am just confused. I've never heard of a two week spacing. Moderna is four weeks.

Everyone I know who got moderna had a two week spacing.  Including dd and dsil in Texas.  Dh here, etc.

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5 minutes ago, gardenmom5 said:

Everyone I know who got moderna had a two week spacing.  Including dd and dsil in Texas.  Dh here, etc.

Weird - also in TX, and it's been a four week spacing for Moderna for me, dh, and dsis.  My vaccine card said anywhere from 24-42 days.

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24 minutes ago, gardenmom5 said:

Everyone I know who got moderna had a two week spacing.  Including dd and dsil in Texas.  Dh here, etc.

Woah. That's just wrong.

https://www.modernatx.com/covid19vaccine-eua/providers/dosing-administration

Dosing and Schedule

The Moderna COVID‑19 Vaccine is administered intramuscularly as a series of two doses (0.5 mL each) 1 month apart.

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37 minutes ago, RootAnn said:

Yep! I am just confused. I've never heard of a two week spacing. Moderna is four weeks.

 

29 minutes ago, gardenmom5 said:

Everyone I know who got moderna had a two week spacing.  Including dd and dsil in Texas.  Dh here, etc.

Moderna is definitely to be four weeks.  WTH, Texas?

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5 minutes ago, gardenmom5 said:

And WA.


gotten where? Could it be an interstate pharmacy chain or a large multi state managed care group that’s messed up? Not 2 whole states? 

 

You should administer the second dose as close as possible to the recommended interval of 28 days after dose1. However, if it is not possible to follow the recommended interval, you may schedule the second dose of ModernaCOVID-19 Vaccine for administration up to 6 weeks (42 days) after the first dose. The

 

 

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4 hours ago, RootAnn said:

Who/what spaces the second shot two weeks?

The CDC announced today they will no longer be tracking (publicly posting separate numbers for) mild/moderate vaccine breakthrough cases.

I personally think this is a PR move more than a manpower move. I think tracking even the mild/moderate cases by type of vaccine, genetic makeup  (variant), and length of time since full vaccination will be important for public policy going forward. 

https://www.cnn.com/world/live-news/coronavirus-pandemic-vaccine-updates-05-14-21/h_b488e80713b26c43c67a86584dbe2593

If states continued to submit it & someone was internally still tracking it, I'd feel better.

I agree completely. 

All of a sudden, it seems like the powers-that-be are trying to minimize the virus. They’re loosening restrictions like masking, and they are deciding not to inform the public about breakthrough cases. 

To be honest, I’m pretty disgusted about it. 

Are they figuring that people won’t get vaccinated if they hear about breakthrough cases? My feeling is that if the only breakthrough cases they tell us about, are the very serious cases, that will make people far more hesitant to be vaccinated than if they give us all of the information, which will hopefully show that the vaccines are working to prevent serious illness. 

I’m also extremely disappointed in the guidance about masks, and am not happy with Trader Joe’s, Walmart, and Costco, who have all decided that vaccinated people don’t have to wear masks in their stores any more. 

Yeah, right. Because nobody is going to LIE about that!!! 

I feel like we are taking giant steps backward, and I don’t understand why they are doing this before a much larger percentage of the population is fully vaccinated. 

I’m feeling very discouraged right now.

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2 minutes ago, Catwoman said:

Yeah, right. Because nobody is going to LIE about that!!! 

I feel like we are taking giant steps backward, and I don’t understand why they are doing this before a much larger percentage of the population is fully vaccinated. 

I think they really thought that this would be a way to show people the benefits of being vaccinated and people would be more likely to do so knowing they can change their behaviors once they do. Which would be all well and good, IF we could count on people to do the right thing with regard to masking. Which we can’t. 

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On 5/11/2021 at 4:42 PM, Dreamergal said:

Keep hearing about deaths and positive cases among the vaccinated for Astra Zeneca.

Opinion | Barkha Dutt: I lost my father to covid-19 — and my faith in India’s government to protect our people - The Washington Post

This death because he had the first shot, was due to get the second shot  and became sick enough to need hospitalization and oxygenation. He was 84. I did not know vaccinated people could still get sick like needing hospitalization after a first dose. 

While rare, yes, people can still get sick enough for hospitalization, and even death. 

https://www.msn.com/en-us/health/medical/cdc-limits-review-of-vaccinated-but-infected-draws-concern/ar-BB1gx1au?ocid=uxbndlbing

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Oregon is now setting county risk level by vaccination rate. My county is now one of two in the state that will go to low risk because we've already hit the 65% vaccinated target (over 16, at least one shot). Goal is to have the state hit 70% by June. This means that dd will get a graduation with the whole class at once (outside) instead of split in half by alphabet. And while the May prom was cancelled, they may get one in June. We still have plenty of new cases but I personally am liking the idea that life becomes more normal as you get most people protected from severe disease consequences.

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12 hours ago, Catwoman said:

They’re loosening restrictions like masking, and they are deciding not to inform the public about breakthrough cases. 

To be honest, I’m pretty disgusted about it. 

Are they figuring that people won’t get vaccinated if they hear about breakthrough cases?

I think maybe they optimistically figured people were able to do the math and understand that 95% doesn't mean 100%. 

Obviously, that is not true, since people seem shocked that some people are still able to get infected after vaccination. 

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On 5/14/2021 at 4:37 AM, Doug4907 said:

Yes Penelope, it is bad news for Australians who only have access to the AZ vaccine, because of a gov decision.

For clarity, the Sth African research research, which was a small sample, showed that the AZ vaccine had no beneficial effect in preventing mild to moderate infection from the B.1.351 variant.  The study was not relevant to severe infection only because in the total study there were no severe infections.  ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2102214

A similar article https://www.news-medical.net/news/20210321/ChAdOx1-nCoV-19-vaccine-does-not-protect-against-South-African-SARS-CoV-2-variant.aspx , comments "The results of a double-blind, randomized, multisite placebo-controlled trial that was conducted in South Africa show that Oxford’s ChAdOx1 nCoV19 (AZD1222) vaccine has no efficacy against the B.1.351 variant in preventing mild-to-moderate coronavirus disease 2019 (COVID19), and shows reduced
neutralization properties of developed antibodies."

Though it is a small-scale study it is particularly alarming to me, as the Aus gov prevents me accessing any alternative vaccine, I am old, have weak lungs, and a simple cold virus inevitably lands me in hospital for two weeks on oxygen, sometimes in a critical condition.  At home, I live connected to an oxygen concentrator.  I have never smoked (anything); I have asbestosis.

Just like the UK variant, the Sth African variant has spread to numerous countries.  In Aus it is regularly detected in citizens returning from overseas, however our strict quarantining has so far stopped that variant from being locally transmitted.  But like the US and elsewhere the controls are slowly being lifted.  There has been zero mention of the risk by our Gov-employed medical representatives.

Pen, anyone, are there better studies of AZ and 351?

Take care everyone,

Doug

I am so sorry to hear you are in this position. 
 

I think that Australia is in a difficult position now. You all have benefited from low disease for so long, but now getting back to normal has some hurdles. Other countries unfortunately have become “accustomed”, for lack of a better word, to some level of disease, but as a result also had significant levels of population immunity in the higher-mixing segments of the population, and that really added a lot to the vaccination immunity. 
 

I hope for your sake that you don’t have many introductions of B1351 there. It seems that when it is present with some of the other variants, it takes off less, but I think others here have read more about this than i have. 

The study you quoted is the phase 1/2 AZ trial in SA, so its purpose was not to determine efficacy. This is what WHO said in their review: “Although this study indicates that AZD1222 vaccine does not protect against mild to moderate COVID-19 caused by the B.1.351 variant, extrapolating from immunological insights, it may still protect against severe COVID-19. Other vaccine- induced immune mediators, such as Th1 dominated cell-mediated immune responses, including T-helper cytotoxic CD8+ cells, may play a more central role in reducing the risk of severe COVID-19 rather than neutralizing antibodies alone.
Indirect evidence is compatible with protection against severe COVID-19; however, this remains to be demonstrated in ongoing clinical trials and post-implementation evaluations.”


There was a report of outbreak of this variant in a London care home, ten residents, six of which had had one dose of AZ. Asymptomatic or mild symptoms, no deaths. Not much to go on. I think some of the problem with real world effectiveness data is that most countries aren’t sequencing very much. The ones that are do not have a lot of this mutation. Someone tell me if this is wrong, please. 

Here is the paper about one dose of AZ (Covishield) after natural infection resulting in similar or higher antibodies to variants of concern, including B1351, B117 and P1, compared to two doses of mRNA vaccine either with or without previous infection. Like I said, I am not sure if this means much, but has been mentioned as supportive data for AZ with this variant.

https://www.medrxiv.org/content/10.1101/2021.05.08.21256866v1

 

Quote

A single dose of the adenovector vaccine ChAdOx1 nCoV-19 following natural infection elicited a robust serological response with broad neutralizing capacity against SARS-CoV-2 wild type and variants of concern. Neutralizing antibody levels exceeded those after two doses of the mRNA vaccine BNT162b2. Our data support that a single dose of adenovector vaccine serves as an efficacious immune booster after priming with natural SARS-CoV-2 infection up to at least 11 months post infection.

This study shows that T cell immunity is not substantially affected by this variant or others, in either people previously infected with wild type virus or in those vaccinated with mRNA. They did not look at AZ, but the epitopes will be the same (because vaccines all against same spike protein as in wild type virus), and AZ is reported to have good T-cell responses.
https://www.biorxiv.org/content/10.1101/2021.02.27.433180v1

Quote

 

For other variants, better news is that AZ seems to more effective against the variant commonly found in India. Neutralization in the lab at levels that indicate effectiveness, and few breakthrough infections in the real world. Still a lot of infections because of the overall picture in India, but the percentage is reportedly quite low. https://www.thehindu.com/news/national/coronavirus-very-few-post-vaccine-infections-says-icmr/article34378445.ece

There are also suggestions that it would be effective with P1, which has two of the same concerning mutations as B1351. https://www.biorxiv.org/content/10.1101/2021.03.12.435194v2.full.pdf

Finally, Pfizer is less effective against B1351 for symptomatic infections, but is more than 90% effective in preventing hospitalizations and death, in Qatar. AZ might not be this good with the same variant, but this seems to point again to the idea that the failure to prevent infection does not equate to the failure to prevent more severe disease and death.

Apologies if any of these have been posted earlier; some probably have. It’s a long thread.😊 Some here have followed variants more closely than me and might have more about anything more on the one you are most concerned about. 

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3 hours ago, ktgrok said:

I think maybe they optimistically figured people were able to do the math and understand that 95% doesn't mean 100%. 

Obviously, that is not true, since people seem shocked that some people are still able to get infected after vaccination. 

I keep seeing surprise about this, even on this board, and it's really making me scratch my head. I mean, I guess I already knew people have a tenuous grasp on numbers, but I thought people overall understood percent pretty well. Maybe the issue isn't the percent but the very concept of probability?? 

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Posted (edited)
16 hours ago, Catwoman said:

All of a sudden, it seems like the powers-that-be are trying to minimize the virus. They’re loosening restrictions like masking, and they are deciding not to inform the public about breakthrough cases. 

To be honest, I’m pretty disgusted about it. 

Are they figuring that people won’t get vaccinated if they hear about breakthrough cases? My feeling is that if the only breakthrough cases they tell us about, are the very serious cases, that will make people far more hesitant to be vaccinated than if they give us all of the information, which will hopefully show that the vaccines are working to prevent serious illness.

I can’t say what their motivations are, but I think that part of it is that they are now focusing more on the next phase, now that vaccines have been delivered, are available, and work. Next phase is monitoring the hospitalizations, finding out how many are vaccine breakthroughs, and sequencing these to figure out things like if, when, and to whom boosters should be given. They have said for months already that asymptomatic vaccinated people do not need to be tested, so that part isn’t new, right? 
 

And of the breakthrough infections that are mild, do we need to know about those? In some sense the answer is yes, we want to, but I think that some of that data will still be collected and published in study form. 
 

I think it has been pretty clear for a while, if ignoring headlines and hype, that the goal with public health and even with vaccination is not to eliminate low levels of infection, but to move toward a time where these infections are all mild and seasonal. 
 

Still, I agree that if you look at NYTimes numbers from a few states and wonder if it is a good idea to stop masking. I understand that people with certain health issues or of a certain age are still going to need to be careful. But public health guidelines usually do address the population in general, with special guidance given for certain groups.

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5 hours ago, ktgrok said:

I think maybe they optimistically figured people were able to do the math and understand that 95% doesn't mean 100%. 

I would like to see on-going studies on how many breakthrough infections (%wise) are Pfizer vs Moderna vs J&J along with sequencing for variants which caused the infections. Also, how long since 2nd shot. Why? To formulate policy going forward & determine which vaccines have the best real world efficacy, when boosters would be helpful, and which vaccines work the worst against which variants.

As a citizen who is still making health decisions for my minor children, seeing published numbers and data is important for me & I want someone collecting & publishing this data. If the CDC isn't going to have the states send it to them anymore (which is unclear at this time), who is collecting it? Where is it going to be published? 

There is a big difference between J&J's one shot efficacy & Pfizer's two shot efficacy (or even one shot of Pfizer). 

Would Covid infectioms be surging this much in the Seychelles if they had used the mRNA vaccines? (Note that I understand most of their breakthrough infections are mild/moderate.) Efficacy percentages matter to people who have a choice.

  https://www.cnbc.com/2021/05/13/seychelles-most-vaccinated-nation-on-earth-but-covid-19-has-surged.html

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6 hours ago, Ali in OR said:

Oregon is now setting county risk level by vaccination rate. My county is now one of two in the state that will go to low risk because we've already hit the 65% vaccinated target (over 16, at least one shot). Goal is to have the state hit 70% by June. This means that dd will get a graduation with the whole class at once (outside) instead of split in half by alphabet. And while the May prom was cancelled, they may get one in June. We still have plenty of new cases but I personally am liking the idea that life becomes more normal as you get most people protected from severe disease consequences.

I think this is a smart way to go. I hope it works to get enough vaccinated to hit the target number, and then things can be relaxed and people can see how a highly vaccinated population can live. (Hopefully 70% proves enough. It may not in places that never had very much of their population infected.)

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Posted (edited)
13 minutes ago, HeartString said:

My moderna was 4 weeks.  My sons Pfizer was 3.  I’ve never heard of doing 2.

Now I'm wondering if just maybe part of the reason for more people having more side effects from their second Moderna shots is a bunch o' people getting confused (wait... was the second dose spacing one more week than Pfizer, or one less???)  and giving them way too close together...

I just can't imagine it's good to give them with half the recommended spacing...

Edited by Matryoshka
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Posted (edited)
22 minutes ago, RootAnn said:

 

As a citizen who is still making health decisions for my minor children, seeing published numbers and data is important for me & I want someone collecting & publishing this data. If the CDC isn't going to have the states send it to them anymore (which is unclear at this time), who is collecting it? Where is it going to be published? 

There is a big difference between J&J's one shot efficacy & Pfizer's two shot efficacy (or even one shot of Pfizer). 

 

I feel sure we will see some of it show up in the CDC journals and other ID and epidemiology journals. 
 

I am not sure where the info came from that states aren’t sending breakthrough data to CDC anymore. Is that true?
The only documentation I saw is that CDC does not plan to sequence virus for breakthrough infections unless the person is hospitalized, so they do not want samples for mild cases sent to them. I didn’t take that to mean that no one is collecting data about mild breakthroughs anywhere. In fact, I just heard that they are going to be doing more on Long Covid/PASC putting up very specific case definitions, etc. 

If someone knows more, please correct me.

As to JNJ, it probably isn’t as efficacious for mild disease, but we’d need a direct comparison to know for sure, and I don’t think we will get that. The two dose ENSEMBLE trial will have results eventually. There is one large trial on real world effectiveness for JNJ that is similar to its phase 3 trial, 70+% effectiveness. However, there is no indication that there will be any difference in prevention of more severe outcomes with JNJ compared to mRNA, because JNJ trial actually had that data at time of approval, and Pfizer didn’t. They would have to be compared more directly in current use to know that.

Oh, and one thing I just learned about the reasons for one dose vs. two is that all of the adenoviral vector vaccines seem to “push” (that was the word used) T-cell responses with the first dose, whereas the mRNA vaccines need the two doses to get the full T-cell complement of responses. I realize the other adenovirus vaccines have two doses while JNJ still only has one, and I don’t know why that is, but I just thought it was interesting.

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3 minutes ago, Matryoshka said:

Now I'm wondering if just maybe part of the reason for more people having more side effects from their second shots is a bunch o' people getting confused (wait... was the second dose spacing one more week than Pfizer, or one less???)  and giving them way too close together...

I just can't imagine it's good to give them with half the recommended spacing...

Yeah, two weeks, yikes.

What I’ve seen and heard is that even 3-4 weeks might be closer than optimal, but time was of the essence to get trials done. One virologist said that the reason the efficacy curves seemed to diverge so early after the second dose could be still from effects of the first dose. I guess immunity takes some time to be optimal. There was a recent study that showed antibody levels were even higher when the doses were given twelve weeks apart. 

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25 minutes ago, Matryoshka said:

Now I'm wondering if just maybe part of the reason for more people having more side effects from their second Moderna shots is a bunch o' people getting confused (wait... was the second dose spacing one more week than Pfizer, or one less???)  and giving them way too close together...

I just can't imagine it's good to give them with half the recommended spacing...

If you have both doses given by the same place, they usually schedule you for the full four weeks.  I think it would be difficult to get it in two even if you wanted to.  

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Just now, Kassia said:

If you have both doses given by the same place, they usually schedule you for the full four weeks.  I think it would be difficult to get it in two even if you wanted to.  

We've had two posters upthread that said in their states (TX and WA), people are getting Moderna in two-week intervals.  I can't explain why - it's wrong.

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9 minutes ago, Matryoshka said:

We've had two posters upthread that said in their states (TX and WA), people are getting Moderna in two-week intervals.  I can't explain why - it's wrong.

I missed the second poster - I saw one poster say that people she knew in two states were getting it in two-week intervals.

FWIW, I'm in TX, and it's all been four-week intervals for Moderna for everyone I know - that poster's experience doesn't match mine at all.

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1 minute ago, Matryoshka said:

We've had two posters upthread that said in their states (TX and WA), people are getting Moderna in two-week intervals.  I can't explain why - it's wrong.

I could see a one off small place maybe, maybe, maybe getting that wrong, but I don’t think this is generally happening. Perhaps someone got confused with the “two weeks after the second shot” being considered fully vaccinated and transposed that in their head to mean the second shot was two weeks after the first. 

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1 minute ago, forty-two said:

I missed the second poster - I saw one poster say that people she knew in two states were getting it in two-week intervals.

FWIW, I'm in TX, and it's all been four-week intervals for Moderna for everyone I know - that poster's experience doesn't match mine at all.

That's actually a relief.  Someone else hypothesized that maybe it's some chain with a contract to give the vaxes that's gotten it wrong (since WA and TX are pretty far afield - and it's a big mistake to be having made multiple times/places...)  But I don't think there was an answer from the people who reported the 2-week intervals as to where they'd seen this happening...

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30 minutes ago, Penelope said:

 There is one large trial on real world effectiveness for JNJ that is similar to its phase 3 trial, 70+% effectiveness. 

Adding this here. Preprint, done through the Mayo Clinic.

https://www.medrxiv.org/content/10.1101/2021.04.27.21256193v1.full.pdf
 

Quote

In this study, we leveraged large-scale longitudinal curation of electronic health records (EHRs) from the multi-state Mayo Clinic health system (MN, AZ, FL, WN, IA). We compared the infection rate of 2,195 individuals who received a single dose of the Ad26.COV2.S vaccine from Johnson & Johnson (J&J) to the infection rate of 21,950 unvaccinated, propensity-matched individuals between February 27th and April 14th 2021. Of the 1,779 vaccinated individuals with at least two weeks of follow-up, only 3 (0.17%) tested positive for SARS-CoV-2 15 days or more after vaccination compared to 128 of 17,744 (0.72%) unvaccinated individuals (4.34 fold reduction rate). This corresponds to a vaccine effectiveness of 76.7% (95% CI: 30.3-95.3%) in preventing SARS-CoV-2 infection with onset at least two weeks after vaccination. This data is consistent with the clinical trial-reported efficacy of Ad26.COV2.S in preventing moderate to severe COVID-19 with onset at least 14 days after vaccine administration (66.9%; 95% CI: 59.0-73.4%). Due to the recent authorization of the Ad26.COV2.S vaccine, there are not yet enough hospitalizations, ICU admissions, or deaths within this cohort to robustly assess the effect of vaccination on COVID-19 severity, but these outcomes will be continually assessed in near-real-time with our platform. 

 

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6 minutes ago, forty-two said:

I missed the second poster - I saw one poster say that people she knew in two states were getting it in two-week intervals.

FWIW, I'm in TX, and it's all been four-week intervals for Moderna for everyone I know - that poster's experience doesn't match mine at all.

I looked back and you're right - it's one person reporting for two states.  Didn't catch that it was the same person.  Hopefully she got it mixed up.

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29 minutes ago, Matryoshka said:

We've had two posters upthread that said in their states (TX and WA), people are getting Moderna in two-week intervals.  I can't explain why - it's wrong.

Just one poster. Gardenmom.

57 minutes ago, Penelope said:

I am not sure where the info came from that states aren’t sending breakthrough data to CDC anymore. Is that true?

As previously posted, it is unclear if states will continue to collect case data. The CDC will not be collecting/publishing it, just lumping all positive cases together.

23 hours ago, RootAnn said:

From the above article:

"Starting Friday, the US Centers for Disease Control and Prevention says it will no longer collect and publish data on all Covid-19 breakthrough cases, only severe cases that result in hospitalization and death."

"Previously, states reported all cases of breakthrough infection, regardless of severity, to the CDC. States will continue to report all positive cases of Covid-19 to the CDC — including any mild or asymptomatic breakthrough cases — but the agency will not differentiate between mild or symptom-free cases in vaccinated versus unvaccinated people.

It is unclear if states will continue to collect mild or asymptomatic breakthrough case data."

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I missed this news when it came out a couple weeks ago. Perhaps it was shared here, but I haven’t heard anything about it. Study showing the reduction in virus transmission in people who contract Covid after just one dose of AZ or Pfizer  

https://www.bbc.com/news/health-56904993.amp

Good news. Shows two doses are definitely important, but I expect that big reduction has been part of what has allowed the delayed second dose strategy to work so well in the UK.

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On 5/14/2021 at 9:08 PM, gardenmom5 said:

Everyone I know who got moderna had a two week spacing.  Including dd and dsil in Texas.  Dh here, etc.

I got Moderna in Texas (January) and the spacing was close to a month. (i'd have to go back and see the exact days. Between 3 and 4 weeks)

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4 minutes ago, KSera said:

I missed this news when it came out a couple weeks ago. Perhaps it was shared here, but I haven’t heard anything about it. Study showing the reduction in virus transmission in people who contract Covid after just one dose of AZ or Pfizer  

https://www.bbc.com/news/health-56904993.amp

Good news. Shows two doses are definitely important, but I expect that big reduction has been part of what has allowed the delayed second dose strategy to work so well in the UK.

Yes, I mean, if one dose is about as effective as a single dose of J&J, it makes sense. I'd be happy if everyone would get even just one dose. 

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One seems to be good so far, but people in the know say you need two doses of mRNA for better T-cell responses, especially CD8+, and that may be more important for longer term immunity and protection against variants. Adenovirus vectored vaccines have better T-cell development with the first dose, or so I read.
 

And I know nothing about Novavax. When will we ever see Novavax? I am more interested in that one, if the youngest kids are to be vaccinated, as it seems to have fewer side effects.

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A letter published on considerations for the vaccination of children.

https://www.bmj.com/content/373/bmj.n1197?utm_source=twitter&utm_medium=social&utm_term=hootsuite&utm_content=sme&utm_campaign=usage

Some excerpts. 

Quote

Hard to justify right now for most children in most countries

Following widespread vaccination against SARS-CoV-2 of older adults and other highly vulnerable groups, some high income countries are now considering vaccinating children; just days ago, the US Food and Drug Administration authorized the use of the Pfizer/BioNTech vaccine in children 12-15 years of age. Young people have been largely spared from severe covid-19 so far,12 and the value of childhood vaccination against respiratory viruses in general remains an open question for three reasons: the limited benefits of protection in age groups that experience only mild disease3; the limited effects on transmission because of the range of antigenic types and waning vaccine induced immunity4; and the possibility of unintended consequences related to differences in vaccine induced and infection induced immunity.5 We discuss each in turn.

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Protection

The cost-benefit balance of any vaccination campaign depends on disease burden in the target population and available resources.6 Covid-19 severity in children under the age of 12 is similar to that of influenza,7and as health resources are stretched thin even in high income countries vaccinating children is unlikely to be a priority. Preliminary data suggest that disease caused by variants of concern remains mild in young children,8910 although close monitoring of newly emerging variants remains essential. Were one to emerge that caused severe disease in children (like Middle East respiratory syndrome), vaccinating children would become a priority.

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Unintended consequences

Unfortunately, as virus circulation decreases, the age of primary infection increases, and since age is directly associated with pathogenicity, vaccinating children would likely lead to lower infection rates but higher case fatality rates.22 Additionally, depending on the relative durations of immunity induced by vaccines and infection, and the rate of viral antigenic change, vaccinating children might increase the frequency of large seasonal epidemics, leading to overall increases in virus induced morbidity and mortality.5

Finally, mRNA vaccines against SARS-CoV-2 induce greater antibody responses than natural infection but may elicit CD8 T cell responses that are less broadly protective against future variants.2324 Further studies on the differences between vaccine and infection induced immunity should be done to explore and quantify these trade-offs.

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Balanced decision

Should childhood infection (and re-exposures in adults) continue to be typically mild, childhood vaccination will not be necessary to halt the pandemic. The marginal benefits should therefore be considered in the context of local healthcare resources, equitable distribution of vaccines globally, and a more nuanced understanding of the differences between vaccine and infection induced immunity.

Once most adults are vaccinated, circulation of SARS-CoV-2 may in fact be desirable, as it is likely to lead to primary infection early in life when disease is mild, followed by booster re-exposures throughout adulthood as transmission blocking immunity wanes but disease blocking immunity remains high.2225 This would keep reinfections mild and immunity up to date.

Monitoring disease severity remains critical, however, in both immunologically naive children and vaccinated or previously infected adults, so we can adapt our control strategies as the virus adapts to

 

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