The Vaccine Thread

[KSera]

35 minutes ago, teachermom2834 said:

It has been pretty consistently about 13% for total hospitalizations and 11% for ICU/ventilator. 

That’s an unusual breakdown compared to all the other ones I’ve seen, so maybe it would be reassuring to you to look at the ones from other hospitals. I’ve never seen that high a percentage of those hospitalized being in ICU and on a ventilator. There’s usually a significant gap between those three numbers. (But also don’t discount that even those numbers would show a very significant protective effect from being vaccinated.)

I shared some hospital dashboards the other day, but don’t have time to look them up right now. I can try later. I haven’t found anywhere that has them all in one place. That would be really handy.

[wathe]

Well, this is promising:

"Breakthrough infections are less likely to lead to long covid, study suggests"

It was a prospective case control study published in The Lancet. Link to paper

ETA quote:

The study, which was published in The Lancet Infectious Diseases journal on Wednesday, also provides more evidence that the two-shot Pfizer-BioNTech, Moderna and AstraZeneca vaccines offer powerful protection against symptomatic and severe disease.

“This is really, I think, the first study showing that long Covid is reduced by double vaccination, and it’s reduced significantly,” said Dr. Claire Steves, a geriatrician at King’s College London and the study’s lead author.

 

Edited September 2, 2021 by wathe

[Paige]

1 hour ago, teachermom2834 said:

Our local vaccination rate is 37% fully vaxxed. Our hospital puts out statistics and it seems admissions/ICU/ and ventilator use is running about 13% vaccinated vs. 87% unvaccinated. 
 

I am not good enough at math to figure out what the effective usefulness is of the vaccine here but I am smart enough to realize with more of the population unvaccinated, even if all other things were equal the number of unvaccinated in the hospital would be higher than the vaxxed. But it seems as if that is a higher number of vaccinated in the hospital than I would have hoped for. We are all vaccinated here and I am glad for it but it seems the numbers are not as great as I would have hoped for and initially believed they would be. 
 

The stats aren’t very informative without the numbers from which they come. If your hospital system is rather small, for instance and the total number of hospitalized patients and available beds are low, than the numbers aren’t much better than anecdotes. If we’re looking at thousands of patients, then the numbers are more significant. 
 

Anecdotally, I know more people who’ve had breakthrough infections than I am comfortable with. None of them have been hospitalized however.
 

 

[Corraleno]

50 minutes ago, wathe said:

Well, this is promising:

"Breakthrough infections are less likely to lead to long covid, study suggests"

It was a prospective case control study published in The Lancet. Link to paper

ETA quote:

The study, which was published in The Lancet Infectious Diseases journal on Wednesday, also provides more evidence that the two-shot Pfizer-BioNTech, Moderna and AstraZeneca vaccines offer powerful protection against symptomatic and severe disease.

“This is really, I think, the first study showing that long Covid is reduced by double vaccination, and it’s reduced significantly,” said Dr. Claire Steves, a geriatrician at King’s College London and the study’s lead author.

 

That doesn't seem like great news to me — full vaccination only cuts the risk in half? I've seen estimates of long covid that range from 5% to 20%, depending on the definition. Even at the very lowest rate, if fully vaccinated people have a 1 in 40 chance of getting long covid, that really sucks, and at the high end it's a seriously scary 1 in 10. That is not what I would call good news.

I think the biggest issue with getting good, useful data on long covid is that everyone defines it differently. IMO, studies (like this one in the Lancet) that define long covid as "still having some symptoms at 4 weeks" are not very helpful. It's not uncommon for someone with, say, a bad case of flu, to feel pretty bad for a couple of weeks and still have lingering symptoms, like tiredness or the remnants of a cough, at 4 weeks from onset. I have had that happen myself a few times, but symptoms always resolved completely within another week or two. I don't think that's what people who are concerned with "long covid" are really worried about.

One of the reports I saw on long covid interviewed a woman who was a triathlete and a physical therapist, who had a moderate case of covid but ended up completely debilitated. She could barely get off the couch and could not handle basic daily tasks like cooking or cleaning, let alone return to work. That's the sort of thing I think most people are worried about. I would love to see a study that looked at symptoms 3, 6, 9, 12 months later, where it's clear this is a separate, long-term condition, distinct from temporary residual covid symptoms, and these symptoms directly impact the person's ability to complete normal daily tasks. That's what I think most people are concerned with, not that they may still have a bit of a cough at 4 weeks.

Edited September 2, 2021 by Corraleno

[mommyoffive]

FDA calls meeting of its advisers to discuss Covid vaccine boosters (msn.com)

 

Ugh I am not happy they are going to halve the dose of Moderna.  

"We are pleased to initiate the submission process for our booster candidate at the 50 microgram dose with the FDA. Our submission is supported by data generated with the 50 microgram dose of our COVID-19 vaccine, which shows robust antibody responses against the Delta variant," Moderna CEO Stéphane Bancel said in a statement.

That's a half dose -- Moderna's vaccine provides 100 micrograms in each dose for initial vaccinations.

 

[Laura Corin]

1 hour ago, wathe said:

Well, this is promising:

"Breakthrough infections are less likely to lead to long covid, study suggests"

It was a prospective case control study published in The Lancet. Link to paper

ETA quote:

The study, which was published in The Lancet Infectious Diseases journal on Wednesday, also provides more evidence that the two-shot Pfizer-BioNTech, Moderna and AstraZeneca vaccines offer powerful protection against symptomatic and severe disease.

“This is really, I think, the first study showing that long Covid is reduced by double vaccination, and it’s reduced significantly,” said Dr. Claire Steves, a geriatrician at King’s College London and the study’s lead author.

 

Unfortunately it's very much a self selected self reporting study. I'm a big fan of Zoe, but I  think it's difficult to get good data on Long Covid from their design.

[Syllieann]

49 minutes ago, mommyoffive said:

FDA calls meeting of its advisers to discuss Covid vaccine boosters (msn.com)

 

Ugh I am not happy they are going to halve the dose of Moderna.  

"We are pleased to initiate the submission process for our booster candidate at the 50 microgram dose with the FDA. Our submission is supported by data generated with the 50 microgram dose of our COVID-19 vaccine, which shows robust antibody responses against the Delta variant," Moderna CEO Stéphane Bancel said in a statement.

That's a half dose -- Moderna's vaccine provides 100 micrograms in each dose for initial vaccinations.

 

I think the half dose is better.  Lots of people had side effects with the 100 micrograms that were bad enough to discourage them from getting boosted (my dh, for example, was in rough shape for a full week and said there's no way he's doing that again if what he has now is enough to keep him out of the hospital) and now we have the myocarditis concern as well.  I don't want a microgram more than I need, lol.

[Corraleno]

30 minutes ago, mommyoffive said:

FDA calls meeting of its advisers to discuss Covid vaccine boosters (msn.com)

 

Ugh I am not happy they are going to halve the dose of Moderna.  

"We are pleased to initiate the submission process for our booster candidate at the 50 microgram dose with the FDA. Our submission is supported by data generated with the 50 microgram dose of our COVID-19 vaccine, which shows robust antibody responses against the Delta variant," Moderna CEO Stéphane Bancel said in a statement.

That's a half dose -- Moderna's vaccine provides 100 micrograms in each dose for initial vaccinations.

 

 I'm guessing they didn't get any better response with 100 than they got with 50, and probably had significantly fewer adverse effects. Their booster dose is still considerably higher than Pfizer's original dose (30 micrograms).

[mommyoffive]

36 minutes ago, Syllieann said:

I think the half dose is better.  Lots of people had side effects with the 100 micrograms that were bad enough to discourage them from getting boosted (my dh, for example, was in rough shape for a full week and said there's no way he's doing that again if what he has now is enough to keep him out of the hospital) and now we have the myocarditis concern as well.  I don't want a microgram more than I need, lol.

Ha, I want all the micrograms.  Dh and I had no reaction to the Moderna shots.  Me just a slight sore arm but I get that with everything.  And with how things have been coming out about M. being more protective than P. I would rather have more.   With Delta and the next variant coming around I would rather have more then find out the lower dose wasn't enough.  But I get I am not the scientist and everything is new and changing everyday.  

Edited September 2, 2021 by mommyoffive

[mommyoffive]

Secret vaxxers: These Americans are getting COVID vaccinations but not telling anyone (msn.com)

 

Biden Faces Booster Pushback; Israel Hits Record: Virus Update (msn.com)

[KSera]

2 hours ago, Corraleno said:

That doesn't seem like great news to me — full vaccination only cuts the risk in half? I've seen estimates of long covid that range from 5% to 20%, depending on the definition. Even at the very lowest rate, if fully vaccinated people have a 1 in 40 chance of getting long covid, that really sucks, and at the high end it's a seriously scary 1 in 10. That is not what I would call good news.

I wish it was much lower than that also, though the nature of the data does make it hard to know just what we’re talking about, yet I also think it’s better than you say above. People vaccinated may have a 1 in 40 to one in 10 chance of getting long Covid if this is to be believed, but the chances of getting Covid are still much lower than if they weren’t vaccinated, so together, that reduces the overall risk a good deal.

[mommyoffive]

Could There Be a Daily COVID Pill? What We Know About Pfizer Drug Trial (msn.com)

[mommyoffive]

US Coronavirus: Three doses of Covid-19 vaccine are likely needed for full protection, Fauci says (msn.com)

[Corraleno]

Meanwhile in rural Oklahoma, ERs are overrun... with people ODing on horse wormer:

"Dr. Jason McElyea said patients are packing his eastern and southeastern Oklahoma hospitals after taking ivermectin doses meant for a full-sized horse, because they believed false claims the horse de-wormer could fight COVID-19. “The ERs are so backed up that gunshot victims were having hard times getting to facilities where they can get definitive care and be treated,” he said.

That’s something McElyea said is now backing up ambulance systems as well. “All of their ambulances are stuck at the hospital waiting for a bed to open so they can take the patient in and they don’t have any, that’s it,” said Dr. McElyea. “If there’s no ambulance to take the call, there’s no ambulance to come to the call.”

“Some people taking inappropriate doses have actually put themselves in worse conditions than if they’d caught COVID,” said the doctor.... Patients are suffering from nausea, vomiting, muscle aches and cramping, and that’s only in minor cases. “The scariest one that I’ve heard of and seen is people coming in with vision loss,” he said.

https://kfor.com/news/local/patients-overdosing-on-ivermectin-backing-up-rural-oklahoma-hospitals-ambulances/

 

[Matryoshka]

24 minutes ago, Corraleno said:

Meanwhile in rural Oklahoma, ERs are overrun... with people ODing on horse wormer:

"Dr. Jason McElyea said patients are packing his eastern and southeastern Oklahoma hospitals after taking ivermectin doses meant for a full-sized horse, because they believed false claims the horse de-wormer could fight COVID-19. “The ERs are so backed up that gunshot victims were having hard times getting to facilities where they can get definitive care and be treated,” he said.

That’s something McElyea said is now backing up ambulance systems as well. “All of their ambulances are stuck at the hospital waiting for a bed to open so they can take the patient in and they don’t have any, that’s it,” said Dr. McElyea. “If there’s no ambulance to take the call, there’s no ambulance to come to the call.”

“Some people taking inappropriate doses have actually put themselves in worse conditions than if they’d caught COVID,” said the doctor.... Patients are suffering from nausea, vomiting, muscle aches and cramping, and that’s only in minor cases. “The scariest one that I’ve heard of and seen is people coming in with vision loss,” he said.

https://kfor.com/news/local/patients-overdosing-on-ivermectin-backing-up-rural-oklahoma-hospitals-ambulances/

 

Okay, let's review what this article seems to be saying are overloading the ERs in rural Oklahoma...

1. Unvaxxed people with Covid (okay, this doesn't point this out specifically, but...)
2. People OD'ing on horse dewormer
3. People with gunshot wounds

Not people, with strokes, heart attacks, appendcitis, car accidents - all three seem to be self-inflicted (in the case of the unvaxxed people, if they got vaxxed they might still get sick but they wouldn't be clogging the hospital ER...)

[Syllieann]

@Matryoshka  where are you seeing the gsw victims are self-inflicted?  I'm not finding that anywhere.  Or do you mean that other lifestyle choices result in a higher likelihood of being shot?

[mommyoffive]

UK panel does not recommend COVID vaccines for healthy 12- to 15-year-olds (yahoo.com)

[mommyoffive]

I want this on a shirt!

 

[Matryoshka]

37 minutes ago, Syllieann said:

@Matryoshka  where are you seeing the gsw victims are self-inflicted?  I'm not finding that anywhere.  Or do you mean that other lifestyle choices result in a higher likelihood of being shot?

Running around with guns is a choice. I don't think this is, say, gang violence.  How are there so many gunshot wounds in a rural ER that they're a bigger problem than anything else after Covid and apparently horse dewormer ODs? If they're all hunting accidents, and maybe they are, perhaps they need more range/target practice if they keep hitting their friends instead.  Don't run around with a gun unless you can hit what you're aiming at...

Maybe I just lack imagination.  What do you think that quantity of gunshot wounds would be from?

[Matryoshka]

25 minutes ago, mommyoffive said:

UK panel does not recommend COVID vaccines for healthy 12- to 15-year-olds (yahoo.com)

That's nuts.  All the studies they are basing this on are pre-Delta, ending with data from Jan/Feb of this year.  They need to look across the pond at the pediatric ICUs filling up.

[mommyoffive]

Top federal health officials warn that booster shots initially may be limited to Pfizer recipients (msn.com)

[KSera]

2 hours ago, Matryoshka said:

Okay, let's review what this article seems to be saying are overloading the ERs in rural Oklahoma...

1. Unvaxxed people with Covid (okay, this doesn't point this out specifically, but...)
2. People OD'ing on horse dewormer
3. People with gunshot wounds

Not people, with strokes, heart attacks, appendcitis, car accidents - all three seem to be self-inflicted (in the case of the unvaxxed people, if they got vaxxed they might still get sick but they wouldn't be clogging the hospital ER...)

I thought the story was really odd for that reason. I would want to see something backing up what he says. He doesn’t even say anything about Covid clogging the ER. It’s ivermectin overdoses and gun shop wounds. That seems really odd to me, and dare I say, implausible. (I don’t doubt they’re dealing with ivermectin overdoses, I’m just thinking it seems more likely that maybe there was one particular instance where a gunshot wound couldn’t get into a small ER that was currently dealing with a couple ivermectin doses on top of whatever else. But it’s hard to imagine that’s the general situation in Oklahoma right now.

Edited September 3, 2021 by KSera
Implausible—autocorrect fail

[Matryoshka]

12 minutes ago, KSera said:

I thought the story was really odd for that reason. I would want to see something backing up what he says. He doesn’t even say anything about Covid clogging the ER. It’s ivermectin overdoses and gun shop wounds. That seems really odd to me, and dare I say, impossible. (I don’t doubt they’re dealing with ivermectin overdoses, I’m just thinking it seems more likely that maybe there was one particular instance where a gunshot wound couldn’t get into a small ER that was currently dealing with a couple ivermectin doses on top of whatever else. But it’s hard to imagine that’s the general situation in Oklahoma right now.

Yes that's what stuck out to me... why mention that in particular as the big problem with ER clog... so many ivermectin ODs that the gunshot victims can't be seen. Like that's the next biggest group of acute cases.  Who is shooting all these people???

Edited September 3, 2021 by Matryoshka

[Laura Corin]

45 minutes ago, mommyoffive said:

UK panel does not recommend COVID vaccines for healthy 12- to 15-year-olds (yahoo.com)

https://www.theguardian.com/society/2021/sep/03/uk-rules-out-covid-vaccinations-for-children?CMP=Share_AndroidApp_Other

[KSera]

13 minutes ago, Laura Corin said:

https://www.theguardian.com/society/2021/sep/03/uk-rules-out-covid-vaccinations-for-children?CMP=Share_AndroidApp_Other

Since they acknowledge the benefit is greater than the risk, what is the reason thought to be that they don’t find it to be a big enough benefit to be worth it? Is that a financial meaning of “worth”? 

[Syllieann]

1 hour ago, KSera said:

Since they acknowledge the benefit is greater than the risk, what is the reason thought to be that they don’t find it to be a big enough benefit to be worth it? Is that a financial meaning of “worth”? 

I think the issue might be that the risk is fixed, but the benefit is constantly changing depending on rates, hospital capacity, personal exposure level, and comorbidities.  When the risk and benefit are closer together you will get more kids who are better off without it.  When they're further nearly all kids are better off getting the vaccine.  I think they could recommend it for all 12-15 year old girls and possibly only do the first shot for the boys.  Maybe that will be forthcoming, or maybe that is too complicated for the general public to grasp, idk.

[historically accurate]

On 9/2/2021 at 11:47 AM, teachermom2834 said:

It has been pretty consistently about 13% for total hospitalizations and 11% for ICU/ventilator. 
 

I also think there is some kind of bias in here that the unvaxxed wait longer to seek treatment. Part of the denial of the whole thing whereas the vaxxed people are more likely to seek treatment sooner. I don’t know. I just know that the anti-vaxxers I know don’t even want to be tested or seek any kind of treatment unless it is dire. They want to prove it is just a cold and will go away. So does that influence the fact that the unvaccinated that come to the hospital are in worse shape?

I don’t know. I’m just trying to make sense of the numbers and frame them in a way that is better for the vaccinated than what it looks like. But it just doesn’t look as promising as I thought it would. 

I have a friend who is a doctor in central IL. She shares her hospital's Covid stats weekly now that Delta has started ramping up. 

https://www.facebook.com/SBLHS/photos/a.520985247916001/4790361574311659/

 

26 hospitalized, 1 of those vaccinated.

8 of the 26 are in ICU, all of them unvaccinated. 

That seems to be pretty close to the usual amounts if I remember correctly. 

Edited September 4, 2021 by historically accurate
Typo

[MooCow]

I actually had a neighbor call me today to discuss vaccines. She has a tendency to believe some whacky stuff, so I've been distancing myself. I very simply told her that my youngest has pretty much been in quarantine since school started and I decided I needed to get vaccinated because I do not want my child thinking he did something if I get covid. I told her why I chose the vaccine I did and how I felt after. She seemed to be listening. We discussed the neighbor that passed away last week, then that another neighbor was in ICU. She then started talking about them not being safe.....after a few minutes I said I had to go. I don't think anything I said had any effect on her. 😟 

Please don't quote

 

[bookbard]

I had some local guy tell me that he saw on the internet that you had 2.5 years to live once you were vaccinated. He then looked it up on his phone to show me. I said sharply, "I don't want to see that, that's nonsense. You can't believe everything that's on the internet.'

He stared at me blankly and said, 'But it's a scientist.' I don't think anyone had ever called him out before. 

[regentrude]

32 minutes ago, bookbard said:

I had some local guy tell me that he saw on the internet that you had 2.5 years to live once you were vaccinated. He then looked it up on his phone to show me. I said sharply, "I don't want to see that, that's nonsense. You can't believe everything that's on the internet.'

He stared at me blankly and said, 'But it's a scientist.' I don't think anyone had ever called him out before. 

who makes up this nonsense???

[mommyoffive]

The leaders of the FDA and CDC are reportedly pushing back on Biden's booster-shot plan, saying they need more time and data (msn.com)

[Not_a_Number]

31 minutes ago, mommyoffive said:

The leaders of the FDA and CDC are reportedly pushing back on Biden's booster-shot plan, saying they need more time and data (msn.com)

They are going to have blood on their hands at this rate. I have no patience with them.

[KSera]

25 minutes ago, Not_a_Number said:

They are going to have blood on their hands at this rate. I have no patience with them.

I don’t know. In this case, I think there are good reasons to not be overly hasty with the decision. We want decisions to be data driven, right? OTOH, in the middle of a pandemic, making the wrong decision on this has big consequences, so it’s hard. If this is the wrong decision in hindsight, it will become evident and that could be bad. But it may be that enough data comes in soon enough to make a good decision. This article was just published in the Atlantic and seems relevant here (it’s not paywalled):

What We Actually Know About Waning Immunity Reports of vaccines’ decline have been greatly overstated.

[Corraleno]

 

11 minutes ago, KSera said:

What We Actually Know About Waning Immunity Reports of vaccines’ decline have been greatly overstated.

IMO that article just dances around the issue without actually addressing what it claims to address.

First the author discusses how the immune system works, emphasizing that we have T and B cells, not just antibodies, so a decline in antibodies doesn't necessarily mean you have no immunity. Which is true, but it is also generic information that doesn't answer the specific question of whether immunity from the US-approved covid vaccines continues to provide adequate protection, in the real world, in people who were vaccinated 6-8 months ago.

Then, after admitting that efficacy has fallen to "the 60s and 70s," she claims that vaccines are still really effective against symptomatic illness even with Delta, saying that recent studies show efficacy rates "in the 80s" against symptomatic illness — but the data in the two studies that are cited as evidence are from May or earlier, when most of the study population would have been recently vaccinated, so again this is not really relevant to the question of whether immunity is waning at 6-8 months. (And actually one of the two studies she cites had Pfizer's efficacy against Delta at only 56%, not "in the 80s" — and that was in recently vaccinated people.)

She then largely dismisses the data from Israel by saying that the people who got the first vaccines were elderly or HCWs, so they probably would be more likely to get sick anyway, and she cites one person who thinks the data from Israel might be overestimating the problem. The case rate in Israel right now is literally the highest it has ever been, despite the high level of vaccination; I don't think it can be dismissed as easily as "well it's mostly old people and it's probably not as bad as it seems."

And then in conclusion she states that rich countries shouldn't do boosters when so many other countries don't have enough. So there's no real science in that article that actually addresses the question of whether immunity from covid vaccines is significantly waning after 6-8 months.

My personal belief is that the folks at the CDC and FDA know that boosters after 6 months or so will decrease both transmission and breakthrough cases. But there is a lot of pressure from the WHO not to do boosters, and as long as vaccinated Americans aren't getting hospitalized or dying at high rates, they may consider that "good enough" from a public health standpoint. But "good enough from a public health standpoint" and "optimal protection for me as an individual" are two different things.

If the FDA refuses to approve boosters, primarily for political rather than scientific reasons, then all that will do is force people to either find a doctor who will do it off-label or they will do what a million people have already done and cheat by pretending they haven't already had 2 shots. So people with means or connections will get boosters anyway, but it will be difficult or impossible to track who's had boosters, and the data will be a total mess. Most likely what will happen is that the CDC & FDA will hem and haw and drag their feet until it's really obvious that boosters are needed, and It's obvious that people are already getting them, and then they'll approve them. I sure wish they would be proactive for once, instead of always waiting until reality smacks them in the face and then reacting in slow motion. 

[KSera]

18 minutes ago, Corraleno said:

I sure wish they would be proactive for once, instead of always waiting until reality smacks them in the face and then reacting in slow motion. 

 I can agree with this for sure. 

[Ausmumof3]

2 hours ago, KSera said:

I don’t know. In this case, I think there are good reasons to not be overly hasty with the decision. We want decisions to be data driven, right? OTOH, in the middle of a pandemic, making the wrong decision on this has big consequences, so it’s hard. If this is the wrong decision in hindsight, it will become evident and that could be bad. But it may be that enough data comes in soon enough to make a good decision. This article was just published in the Atlantic and seems relevant here (it’s not paywalled):

What We Actually Know About Waning Immunity Reports of vaccines’ decline have been greatly overstated.

A lot of health Twitter peeps seem to be on the fence about boosters for now.

I know I quote him a million times here but coronacast the other day suggested maybe we should think of them less as boosters and more as a three shot vaccine.  That if things hadn’t been as rushed it would always have ended up with three shots.  I know I’d feel better about a third shot than six monthly ones though there’s no evidence either way yet.

[Laura Corin]

8 hours ago, KSera said:

Since they acknowledge the benefit is greater than the risk, what is the reason thought to be that they don’t find it to be a big enough benefit to be worth it? Is that a financial meaning of “worth”? 

Could be. Or could be to do with more general resources - strain on the health system through all those extra appointments when so many people are waiting for other treatment. 

[Laura Corin]

4 hours ago, regentrude said:

who makes up this nonsense???

And how would anyone claim to know it was 2.5 years since no one has been vaccinated that long?

Edited September 4, 2021 by Laura Corin

[bookbard]

1 hour ago, Laura Corin said:

And how would anyone claim to know it was 2.5 years since no one has been vaccinated that long?

Yep. I mean, the local guy could have completely misunderstood the viral video - he is not intelligent or educated - he wouldn't be able to follow anything much with an argument. But I think I'm the only one who has said clearly to him that it's nonsense and that just because it's on the internet by a 'scientist' doesn't mean it's true. 

[Spy Car]

3 hours ago, Corraleno said:

 

IMO that article just dances around the issue without actually addressing what it claims to address.

First the author discusses how the immune system works, emphasizing that we have T and B cells, not just antibodies, so a decline in antibodies doesn't necessarily mean you have no immunity. Which is true, but it is also generic information that doesn't answer the specific question of whether immunity from the US-approved covid vaccines continues to provide adequate protection, in the real world, in people who were vaccinated 6-8 months ago.

Then, after admitting that efficacy has fallen to "the 60s and 70s," she claims that vaccines are still really effective against symptomatic illness even with Delta, saying that recent studies show efficacy rates "in the 80s" against symptomatic illness — but the data in the two studies that are cited as evidence are from May or earlier, when most of the study population would have been recently vaccinated, so again this is not really relevant to the question of whether immunity is waning at 6-8 months. (And actually one of the two studies she cites had Pfizer's efficacy against Delta at only 56%, not "in the 80s" — and that was in recently vaccinated people.)

She then largely dismisses the data from Israel by saying that the people who got the first vaccines were elderly or HCWs, so they probably would be more likely to get sick anyway, and she cites one person who thinks the data from Israel might be overestimating the problem. The case rate in Israel right now is literally the highest it has ever been, despite the high level of vaccination; I don't think it can be dismissed as easily as "well it's mostly old people and it's probably not as bad as it seems."

And then in conclusion she states that rich countries shouldn't do boosters when so many other countries don't have enough. So there's no real science in that article that actually addresses the question of whether immunity from covid vaccines is significantly waning after 6-8 months.

My personal belief is that the folks at the CDC and FDA know that boosters after 6 months or so will decrease both transmission and breakthrough cases. But there is a lot of pressure from the WHO not to do boosters, and as long as vaccinated Americans aren't getting hospitalized or dying at high rates, they may consider that "good enough" from a public health standpoint. But "good enough from a public health standpoint" and "optimal protection for me as an individual" are two different things.

If the FDA refuses to approve boosters, primarily for political rather than scientific reasons, then all that will do is force people to either find a doctor who will do it off-label or they will do what a million people have already done and cheat by pretending they haven't already had 2 shots. So people with means or connections will get boosters anyway, but it will be difficult or impossible to track who's had boosters, and the data will be a total mess. Most likely what will happen is that the CDC & FDA will hem and haw and drag their feet until it's really obvious that boosters are needed, and It's obvious that people are already getting them, and then they'll approve them. I sure wish they would be proactive for once, instead of always waiting until reality smacks them in the face and then reacting in slow motion. 

Knowing this is your take is validating.

My take as well, but I know which of us is better informed (and that ain't me).

I am SO HAPPY that I acted and got "boosters" for my wife and I.

As I was certain would be the case, my wife had a child in her autism room at school who came to school with a fever this week, tested positive for Covid, and now the students are quareenteening. 

I think CDC et al are being far to slow based on the evidence available and agree that pressure from WHO is likely a part of the problem. How are are they going to let the pandemic re-erupt before acting? It is nutz.

Bill

 

[ieta_cassiopeia]

12 hours ago, Matryoshka said:

That's nuts.  All the studies they are basing this on are pre-Delta, ending with data from Jan/Feb of this year.  They need to look across the pond at the pediatric ICUs filling up.

NICE rules means American studies (let alone observational data such as "children filling American ICUs") can't be taken as read, since USA rules for a valid study are different from the rules for a valid British study. Both studies and observational data are helpful for framing British study questions and direction, but it will take some months for the data to come in because children currently don't make up a large proportion of the British COVID patients - either testing positive in the first place (7.1% of the total confirmed cases this week were in under-25s, and except for Scotland, the peak for under-25s is in the 16-19-year-old group who were allowed to get vaccinated recently enough that most are still on their first jab) or in hospital (even in Scotland, there are only 10 under-10s in hospital with COVID, meaning there are below 30 under-25s in Scottish hospitals with COVID, and some of those are children in for other reasons who also happen to have COVID).

I fully expect the former to change when English students go back to school this coming week due to intensive in-schools testing (Scottish students are already back, for them all school-age categories are close to the 16-19 level of case quantity) but are only perhaps 1/13 of the total students in the UK) and it remains to be seen whether the hospitalisations track that increase by the end of September.

 

7 hours ago, mommyoffive said:

The leaders of the FDA and CDC are reportedly pushing back on Biden's booster-shot plan, saying they need more time and data (msn.com)

Not surprised; OxfordAstrazeneca has shown less reduction of protection over time, and it's possible that might also apply to other non-Pfizer vaccines (we'll likely know better in a couple of months, when early UK OxfordAstrazeneca recipients are as far removed from their doses as the early Israeli Pfizer recipients. Note the earliest UK recipients also got their vaccines on a three-week interval; the 12-week interval only got implemented a few weeks after the process got rolled out to the less urban care homes.
 

12 hours ago, KSera said:

I thought the story was really odd for that reason. I would want to see something backing up what he says. He doesn’t even say anything about Covid clogging the ER. It’s ivermectin overdoses and gun shop wounds. That seems really odd to me, and dare I say, implausible. (I don’t doubt they’re dealing with ivermectin overdoses, I’m just thinking it seems more likely that maybe there was one particular instance where a gunshot wound couldn’t get into a small ER that was currently dealing with a couple ivermectin doses on top of whatever else. But it’s hard to imagine that’s the general situation in Oklahoma right now.

COVID clogging up ER is relatively old news. Ivermectin for horses is the latest new mistake people make, and is more likely to yield attention.

Gunshot wounds make sense if people who are stuck at home (due to COVID/feeling unsafe, unemployment due to businesses not re-opening afterwards or any other reason) are getting depressed and there's a gun around.
 

12 hours ago, KSera said:

Since they acknowledge the benefit is greater than the risk, what is the reason thought to be that they don’t find it to be a big enough benefit to be worth it? Is that a financial meaning of “worth”? 

More perceived benefit to persuading vaccine-hesitant adults to vaccinate, of which Britain still has a few million. Especially since some of them are empowered to withhold consent for 12-15-year-olds to get vaccinated (16+ can override a parental objection to most medicines if they themselves want to be vaccinated). Vaccine-hesitant parents don't generally let their children be vaccinated until they are convinced the vaccine is suitable for adults to take (since pediatric medicine is frequently trickier than adult medicine). Whereas virtually every parent who has had at least one dose and not landed in hospital for it is likely, on past experience with other vaccines, to permit their children to have the same vaccine. As GPs start to have (in some cases) a bit more time to deliver personalised care, there's a feeling in some areas that the individual conversations with hesitators' own doctors that has been found to help so much with persuasion will gradually become more feasible.

If Britain's vaccine-hesitant were as a whole more fervent in their beliefs, which appears to be the case in the USA, then that would have changed the risk/benefit profile more in favour of vaccinating teenagers below the age of personal consent. If British schools were allowed to mandate vaccination, that would also change the risk/benefit profile, but that's unlikely ever to happen due to state schools being traditionally the backstop position for those who otherwise would get no education at all (including those with least access to medical care in general). Finally, if adults start taking fewer risks (this is the most likely to change, since the UK still holds lockdowns as a last-ditch reserve option), that changes the risk profile too - I think there are parts of the USA where people are more cautious than the UK, as well as some other parts where more risks are being taken.

 

At some point, the risk profile may change due to increasing rates of adult vaccination (the more adult vaccination, the less opportunity cost in giving the vaccine to children vs adults), so it's not just the benefit profile that makes it possible this position will be revised.
 

8 hours ago, bookbard said:

I had some local guy tell me that he saw on the internet that you had 2.5 years to live once you were vaccinated. He then looked it up on his phone to show me. I said sharply, "I don't want to see that, that's nonsense. You can't believe everything that's on the internet.'

He stared at me blankly and said, 'But it's a scientist.' I don't think anyone had ever called him out before. 

Are we sure this scientist isn't a bot in disguise? Or at the very least a scientist who hasn't done the research when it comes to parsing vaccination outcomes (not all scientists work in biology, for a start)?
 

5 hours ago, Corraleno said:

Then, after admitting that efficacy has fallen to "the 60s and 70s," she claims that vaccines are still really effective against symptomatic illness even with Delta, saying that recent studies show efficacy rates "in the 80s" against symptomatic illness — but the data in the two studies that are cited as evidence are from May or earlier, when most of the study population would have been recently vaccinated, so again this is not really relevant to the question of whether immunity is waning at 6-8 months. (And actually one of the two studies she cites had Pfizer's efficacy against Delta at only 56%, not "in the 80s" — and that was in recently vaccinated people.)

What percentage efficacy is CDC using for approvals? In the UK, it's 50%, so strictly speaking Pfizer would still be considered effective there at 56% - although boosters for groups of people who are definitely below 50% (e.g. immunocompromised people) would make sense (because people expect their vaccine to at least give them the minimum effectiveness they have been told to expect).

If CDC is using a stricter metric than the UK for defining efficacy, then boosters for everyone is a reasonable call politically, even if releasing vaccine batches to other countries might be more effective at reducing general risk levels.
 

3 hours ago, Ausmumof3 said:

A lot of health Twitter peeps seem to be on the fence about boosters for now.

I know I quote him a million times here but coronacast the other day suggested maybe we should think of them less as boosters and more as a three shot vaccine.  That if things hadn’t been as rushed it would always have ended up with three shots.  I know I’d feel better about a third shot than six monthly ones though there’s no evidence either way yet.

We don't know how many-shot a vaccine this is, and in the UK, resistance to COVID controls in general increased once it was realised that whatever it was, it wasn't a two-shot affair. Telling people to treat it as three-shot risks worse backlashes if it turns out to be more like a rabies vaccination (initial dose, then boosters every so often for the rest of one's life if needed).
 

3 hours ago, Laura Corin said:

And how would anyone claim to know it was 2.5 years since no one has been vaccinated that long?

COVID-19 itself has only existed for a little over 2.5 years - if he has information, that was the fastest vaccine development ever, and all by stealth too!

Edited September 4, 2021 by ieta_cassiopeia
Added paragraph explaining differences between Britain and the USA that may explain country-specific reasons why it is reasonable both countries have different answers regarding vaccine boosters.

[Not_a_Number]

8 hours ago, KSera said:

I don’t know. In this case, I think there are good reasons to not be overly hasty with the decision. We want decisions to be data driven, right? OTOH, in the middle of a pandemic, making the wrong decision on this has big consequences, so it’s hard. If this is the wrong decision in hindsight, it will become evident and that could be bad. But it may be that enough data comes in soon enough to make a good decision. This article was just published in the Atlantic and seems relevant here (it’s not paywalled):

What We Actually Know About Waning Immunity Reports of vaccines’ decline have been greatly overstated.

This article mostly seems to be fluff. It’s not really  talking about the data, which is mostly coming out of Israel:

https://www.science.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

A quote from this article:

 

As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion) who has consulted on COVID-19 for the government. “One of the big stories from Israel [is]: ‘Vaccines work, but not well enough.’”

 

At this point, we basically know that elderly people ought to have boosters. But lots of people won’t get them against CDC advice and lots of doctors won’t prescribe them against CDC advice (that’s why my in-laws haven’t gotten theirs.) 

And I’m terrified about that. They had to go to the ER last night for something unrelated… they are no longer locked down. It’s only a matter of time until they get COVID. And if the two shots aren’t nearly as good protection against hospitalization for vulnerable folks, that’s just scary. 

(Yes, I can run the 59% number myself and see that this is still not bad at all given rates of vaccination in older folks. But the problem is that being 80% effective is a lot less comforting when the disease is rampant than when the disease is not.)

[Laura Corin]

17 hours ago, Matryoshka said:

 They need to look across the pond at the pediatric ICUs filling up.

But the UK had predominantly Delta before the US did and I'm not hearing about that here. This article suggests,  by comparing vaccination rates in different states, that background vaccination rates are protective of unvaccinated children. Quotation at foot of message.

https://www.nytimes.com/2021/09/03/health/delta-children-hospitalization-rates.html

 

Around 52 percent  of the US population has been vaccinated vs. around 63 percent in the UK.

https://ourworldindata.org/covid-vaccinations

Edited September 4, 2021 by Laura Corin

[ktgrok]

7 hours ago, Ausmumof3 said:

A lot of health Twitter peeps seem to be on the fence about boosters for now.

I know I quote him a million times here but coronacast the other day suggested maybe we should think of them less as boosters and more as a three shot vaccine.  That if things hadn’t been as rushed it would always have ended up with three shots.  I know I’d feel better about a third shot than six monthly ones though there’s no evidence either way yet.

I agree, and noticed Fauci seems to be steering the conversation this way lately. 

If as they are saying immunity is higher after 3 doses than shortly after 2, that makes it a 3rd dose. Not a booster, which would just be taking it back up near the 2 dose level. 

[KSera]

4 hours ago, ieta_cassiopeia said:

What percentage efficacy is CDC using for approvals? In the UK, it's 50%, so strictly speaking Pfizer would still be considered effective there at 56% - although boosters for groups of people who are definitely below 50% (e.g. immunocompromised people) would make sense (because people expect their vaccine to at least give them the minimum effectiveness they have been told to expect).

The US was using 50% as well. I’m extremely glad we ended up with vaccines that are way more protective against hospitalization and death than that. 

[Corraleno]

50% efficacy is the absolute minimum standard for approval of a vaccine — it's just an arbitrary figure selected as the cut-off for a bureaucratic licensing process. It basically means "better than nothing." If there are no other options, then 50% efficacy is indeed better than nothing, but when there are options that can increase efficacy to 80-90%, there is no reason to settle for something that is only 50% effective.

Under what other circumstances would medical professionals purposely recommend a treatment that is only 50% effective when there is a much more effective option with little to no increased risk? What doctor would say "We have a cancer treatment that is 90% effective, but we're going to give you one that is only 50% effective because we think that's good enough"? And in the case of vaccines during a pandemic, significantly reducing the number of people who get sick and/or transmit the disease has far more impact than just successfully treating one individual's illness. 

The question the FDA is pondering isn't "Will a 3rd dose of mRNA vaccines prevent many illnesses and reduce spread?" It's "Will a 3rd dose of mRNA vaccines save enough lives to offset the negative optics of using boosters in a 1st world country?" And that's a political decision, not a scientific or medical one.

[Corraleno]

Seriously concerning study on waning immunity from Qatar, where 80% of the eligible population (12+) is fully vaccinated and routine testing is widespread (roughly 5% of the population is tested weekly). The study period covers January 1 to august 15, with Beta being the dominant variant earlier in the period and Delta becoming dominant during the last few months.

They found that Pfizer's efficacy against infection (including asymptomatic infection) peaked at 72% in the first 5 weeks after the 2nd dose, gradually declined to around 30% in weeks 15-19, and fell to 0% (yes ZERO) after 20 weeks.

Efficacy against hospitalization and death was considerably better, staying in the 86-95% range up to 24 weeks, but fell to 72% after 25 weeks.

This study included 288K people, and roughly 3/4 of the cases were discovered through random testing, contact tracing, requests for testing before travel, etc., so it is not skewed by only including those who sought treatment for symptomatic infection. Also, since Qatar has such a large percentage of foreign workers, the median age in the study was only 31.5 — so these are mostly young healthy people  in whom immunity waned so quickly. This refutes the argument that some have made against boosters on the grounds that data from Israel is biased by the fact that the first to be vaccinated were elderly — the data from Qatar clearly show immunity against infection decreasing to literally nil after 6 months even in young healthy people.

https://www.medrxiv.org/content/10.1101/2021.08.25.21262584v1.full.pdf+html

Edited September 4, 2021 by Corraleno

[KSera]

1 hour ago, Corraleno said:

They found that Pfizer's efficacy against infection (including asymptomatic infection) peaked at 72% in the first 5 weeks after the 2nd dose, gradually declined to around 30% in weeks 15-19, and fell to 0% (yes ZERO) after 20 weeks.

This part is super disappointing. This part:

”Effectiveness against any severe, critical, or fatal disease increased rapidly to 67.7% (95% CI: 59.1-74.7) by the third week after the first dose, and reached 95.4% (95% CI: 93.4-96.9) in the first five weeks after the second dose, where it persisted at about this level for six months.”

is super good news though, that the protection against severe disease persisted throughout the six-month study. I think it’s important to note that this doesn’t mean that after six months, protection did Wayne, it’s just that that was as far as the study measured. They had a very small number of cases that had been in the study long enough to show any results further than 25 weeks out.

i’m in the group that does not want to catch Covid at all if I can help it, and I do everything I can toward that end, but I think with these results it’s important for people to see that the vaccine is still doing an amazing job at what it was originally designed to do: preventing serious illness and death. It sure would’ve been nice if it had also persisted at the high levels of preventing asymptomatic infection that it initially did. It will be interesting to see if the other vaccines do better with that, but that’s also a tricky trade off of whether you take something that has a much higher protection against severe illness and death, but it’s  protection against milder illness wanes, or if you take something that’s less protective against severe outcomes, but lasts for longer. For me, I would go with the first, but I’m willing to get additional doses as needed, also.

[Not_a_Number]

7 minutes ago, KSera said:

This part is super disappointing. This part:

”Effectiveness against any severe, critical, or fatal disease increased rapidly to 67.7% (95% CI: 59.1-74.7) by the third week after the first dose, and reached 95.4% (95% CI: 93.4-96.9) in the first five weeks after the second dose, where it persisted at about this level for six months.”

is super good news though, that the protection against severe disease persisted throughout the six-month study. I think it’s important to note that this doesn’t mean that after six months, protection did Wayne, it’s just that that was as far as the study measured. They had a very small number of cases that had been in the study long enough to show any results further than 25 weeks out.

i’m in the group that does not want to catch Covid at all if I can help it, and I do everything I can toward that end, but I think with these results it’s important for people to see that the vaccine is still doing an amazing job at what it was originally designed to do: preventing serious illness and death. It sure would’ve been nice if it had also persisted at the high levels of preventing asymptomatic infection that it initially did. It will be interesting to see if the other vaccines do better with that, but that’s also a tricky trade off of whether you take something that has a much higher protection against severe illness and death, but it’s  protection against milder illness wanes, or if you take something that’s less protective against severe outcomes, but lasts for longer. For me, I would go with the first, but I’m willing to get additional doses as needed, also.

I'm kind of hoping there's a regimen that's good at both. It was looking kind of likely that mixing up the vaccines might be best, right? 

[KSera]

6 minutes ago, Not_a_Number said:

I'm kind of hoping there's a regimen that's good at both. It was looking kind of likely that mixing up the vaccines might be best, right? 

I’d love to see data on that. Logically, that makes sense to me, though.