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JennyD

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Warmly recommend this recent episode of TWIV.  So much good info on immune response in both vaccinated and infected folks.  The gist is that vaccination seems to provide considerably broader protection against variants, but infection may give longer-lasting immunity to the same variant.  But the killer combo is infection followed by vaccination -- people who were infected and then got vaccinated can go out and lick doorknobs, sounds like.

 

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2 hours ago, mommyoffive said:

Dang, I thought this meant they were expediting things, but they're just saying the same thing they've been saying for months: they'll have the data by the end of September, submit application for EUA sometime in October, hope to get approval "at some time point late fall or more likely early winter." Sigh.

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55 minutes ago, Corraleno said:

Dang, I thought this meant they were expediting things, but they're just saying the same thing they've been saying for months: they'll have the data by the end of September, submit application for EUA sometime in October, hope to get approval "at some time point late fall or more likely early winter." Sigh.

I am holding out hope. Trying to. It is less 20 days to October. I feel myself just keep swimming, just keep swimming.

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On 9/8/2021 at 12:54 PM, RootAnn said:

Our local high school had marchimg band last year. (Full sports, too) I'm thinking pep band in the basketball stands this winter will be a bigger spread contributor.

A pep rally for football that was mandatory, 🙄, was a spreader in youngest high school. There was a big Twitter argument about it because the principal refused to let students go to the library or cafeteria. Mine and his friends got permission to leave from one teacher, then as they were exiting the gym they were stopped. My poor son has basically been in quarantine for three weeks. 

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4 hours ago, JennyD said:

Warmly recommend this recent episode of TWIV.  So much good info on immune response in both vaccinated and infected folks.  The gist is that vaccination seems to provide considerably broader protection against variants, but infection may give longer-lasting immunity to the same variant.  But the killer combo is infection followed by vaccination -- people who were infected and then got vaccinated can go out and lick doorknobs, sounds like.

 

Well, hopefully the other way around - vaccination and then infection, works just as well or better. And with way less danger than being infected first. 

We have been joking that DS 22 who was infected after being vaccinated can lick door knobs. 

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@Lanny I tried to reply in the other thread but I guess it got locked right when I hit post.

I just wanted to comment on the 3 Japanese men who died after being vaccinated. First of all I am really sad they died and will be really sad if it was related to the vaccine. But I wanted to tell you that we have had more than double that number of men, in that age group - 30s and 40s, die of Covid in our little podunk ICU alone, just in the last 2 months.

I hope you don’t mind me saying this Lanny, but the risks in your age group are somewhat higher, so I hope so much you are able to get vaccinated, with a vaccine you feel confident in, very soon.

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6 hours ago, JennyD said:

Warmly recommend this recent episode of TWIV.  So much good info on immune response in both vaccinated and infected folks.  The gist is that vaccination seems to provide considerably broader protection against variants, but infection may give longer-lasting immunity to the same variant.  But the killer combo is infection followed by vaccination -- people who were infected and then got vaccinated can go out and lick doorknobs, sounds like.

 

I dunno, somehow choosing "the killer combo" doesn't sound that good to me.

Bill

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On 9/8/2021 at 9:32 AM, Dmmetler said:

Also, if a school has a music program, that's another potential source of spread. Masking for wind instruments is only partially effective because the player has to breathe in, not just out, and while you can use masks with holes and cover openings on the instruments, wind instrumentalists typically breathe in through the mouth unless they're circular breathing, which isn't standard. I'm particularly concerned about schools doing marching band this fall. 

Two local conservatories in CA have made the policy to only conduct classes for wind instruments (and performances) in the open patios of the college. They are taking several other strict precautionary measures and this is one of them. 

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1 hour ago, Laura Corin said:

Risk of death from Covid after vaccination. Large sample. 

BBC News - Covid deaths rare among fully vaccinated - ONS
https://www.bbc.co.uk/news/health-58545548

 

I'm not a virologist, but I wonder if the UK, by spreading out the time between doses much longer than the US does, stumbled upon more effective protection than the 3 or 4 week schedule that the US administers?  Perhaps this spacing means UK folks already have the equivalent of a third booster that we in the US will need?

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3 minutes ago, PaxEtLux said:

 

I'm not a virologist, but I wonder if the UK, by spreading out the time between doses much longer than the US does, stumbled upon more effective protection than the 3 or 4 week schedule that the US administers?  Perhaps this spacing means UK folks already have the equivalent of a third booster that we in the US will need?

It's going to be so hard to work out, with all the other variables - when Delta arrived in different countries, use of different vaccines, etc.  However, the most vulnerable - including my 97-y-o mother - actually had the jab - Pfizer - on the original schedule before Christmas.  It was only later that the UK went for the 12-week schedule.  Very messy data if you try to go beyond the big picture.

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21 minutes ago, Not_a_Number said:

I'd love to know how they came up with this. What data are they reviewing? Are they looking at international data at all? 

They seem to be focusing exclusively on the data for hospitalization and death, and they say up front that that is what public health policy should be based on, not illness. Since the vast majority of the vaccinated do not (currently) end up hospitalized or dead, the US should be sending their doses to other countries rather than doing boosters. So it's not a scientific conclusion as much as it's a political opinion backed with selective data.

They've also said that approving boosters might discourage those who aren't vaccinated yet, by making them think the vaccines aren't effective enough. Maybe these folks should stick to facts instead of trying to outguess and outmaneuver antivaxxers, which only ends up hurting the people that are trying to be safe (e.g. when they prematurely announced that vaxxed people didn't need masks in response to Tucker Carlson and social media ranting about how making vaxxed people mask means vaccines don't work).

And it annoys the hell out of me that none of the pubic health people who have argued against boosters have said one word about long covid, which has the potential to impact millions of lives and cause huge health care problems down the road. 

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14 minutes ago, Corraleno said:

They seem to be focusing exclusively on the data for hospitalization and death, and they say up front that that is what public health policy should be based on, not illness. Since the vast majority of the vaccinated do not (currently) end up hospitalized or dead, the US should be sending their doses to other countries rather than doing boosters. So it's not a scientific conclusion as much as it's a political opinion backed with selective data.

I agree. But even the hospitalization data starts to look kind of cruddy at 6 months, no? I mean, way better than nothing, but waning for sure… or am I misremembering?

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1 hour ago, Corraleno said:

Since the vast majority of the vaccinated do not (currently) end up hospitalized or dead, the US should be sending their doses to other countries rather than doing boosters. So it's not a scientific conclusion as much as it's a political opinion backed with selective data.

I'd feel much better about foregoing a booster if this actually happens in time to make a difference either in preventing variants or in actually taking us from pandemic to endemic more smoothly. What are the odds it will happen that way?

I can't remember if anyone is doing a clinical trial type of study about boosters for those who are not immune compromised. If there is any chance that we could all have a booster and be immune long-term (I would consider that to mean something like not needing another shot for 5-10 years after a 3 shot series), I feel like someone needs to ensure we get this data so that we're not backed into a corner a year or two from now, wishing we'd taken a more hybrid approach or a totally different approach.

 

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1 hour ago, kbutton said:

I can't remember if anyone is doing a clinical trial type of study about boosters for those who are not immune compromised. If there is any chance that we could all have a booster and be immune long-term (I would consider that to mean something like not needing another shot for 5-10 years after a 3 shot series), I feel like someone needs to ensure we get this data so that we're not backed into a corner a year or two from now, wishing we'd taken a more hybrid approach or a totally different approach.

Pfizer's Phase 3 RCT on boosters includes 10,000 participants from the original 2-dose trial who will get either a placebo or a 3rd dose 175 days or more after the 1st dose. The trial started in July and I assume they will have preliminary data at some point this fall, but the completion date is the end of September of 2022. The Phase 2 trial included ~300 people; that's where the data came from about the 3rd shot boosting neutralizing antibodies 5-11x against Delta and 15-21x against Beta. 

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2 hours ago, Not_a_Number said:

I agree. But even the hospitalization data starts to look kind of cruddy at 6 months, no? I mean, way better than nothing, but waning for sure… or am I misremembering?

Our state case rates and hospitalization rates among the vaxxed are climbing, but doctors are saying it's not due to waning immunity. They are saying it's mostly older people and those with comorbidities that are most at-risk, but our state distributed by age, so they are also the people who've had the vaccine the longest. 

https://patch.com/connecticut/vernon/s/hsdd1/ct-coronavirus-breakthrough-cases-on-rise-yale-study?utm_source=alert-breakingnews&utm_medium=email&utm_campaign=alert

 

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37 minutes ago, whitestavern said:

Our state case rates and hospitalization rates among the vaxxed are climbing, but doctors are saying it's not due to waning immunity. They are saying it's mostly older people and those with comorbidities that are most at-risk, but our state distributed by age, so they are also the people who've had the vaccine the longest. 

https://patch.com/connecticut/vernon/s/hsdd1/ct-coronavirus-breakthrough-cases-on-rise-yale-study?utm_source=alert-breakingnews&utm_medium=email&utm_campaign=alert

 

The good waning immunity data is from Israel, which vaccinated its population early enough that they had a large variety of age groups who got the vaccine early. They concluded there is waning immunity. 

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1 hour ago, whitestavern said:

Our state case rates and hospitalization rates among the vaxxed are climbing, but doctors are saying it's not due to waning immunity. They are saying it's mostly older people and those with comorbidities that are most at-risk, but our state distributed by age, so they are also the people who've had the vaccine the longest. 

https://patch.com/connecticut/vernon/s/hsdd1/ct-coronavirus-breakthrough-cases-on-rise-yale-study?utm_source=alert-breakingnews&utm_medium=email&utm_campaign=alert

 

This is currently happening to a family friend. She is in the hospital and had blood clots successfully removed from her lungs yesterday in emergency surgery. Today, she's having heart issues. 😞

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1 hour ago, Not_a_Number said:

The good waning immunity data is from Israel, which vaccinated its population early enough that they had a large variety of age groups who got the vaccine early. They concluded there is waning immunity. 

Oh I agree with you. Just don’t understand how everyone can say we don’t need boosters when you see indications that there is waning immunity. 

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Re boosters ... I was trying several possibilities to get my kid in for a Covid test yesterday, and I called one of the pharmacies to ask a question.  I got a recording saying that anyone who wants a booster can schedule one now.  Does anyone know if they are just letting everyone do this without meeting any criteria (other than being age 12 or older)?

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Myocarditis, preprints, and the UK - by Katelyn Jetelina - Your Local Epidemiologist (substack.com)

For parents that want the full U.S. context…

On May 23 (1 month after EUA for adolescents) the CDC/FDA found a safety signal in the adolescent surveillance data: vaccines may cause mild and temporary inflammation of the heart. On June 23, the CDC met to review all of the data and conduct an extensive risk/benefit decision (here are the cliff notes). They concluded two things:

There was a causal link between mild myocarditis after vaccination, especially among young boys;

The benefits greatly outweighed the risks.

After this meeting, further research found that this is happening because the mRNA vaccine triggers the immune system which then temporarily inflames the heart. This is why myocarditis is more common for the second dose compared to the first dose.

This is such a hard time for parents to navigate, but please consider the broader context when preprints are circulated or decisions are made overseas. In the United States, it’s strongly recommended that anyone 12+ years get vaccinated right away. The benefits continue to greatly outweigh the risks.

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From the Jerusalem Post: Leader of Israeli anti-vaxx movement, who claimed "there is no epidemic" and urged his followers not to take the "dangerous" vaccine, has died of covid while continuing to insist that he didn't have it. He told followers that police must have poisoned him and that if he died they should consider it an assassination. 
 

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21 hours ago, SKL said:

Re boosters ... I was trying several possibilities to get my kid in for a Covid test yesterday, and I called one of the pharmacies to ask a question.  I got a recording saying that anyone who wants a booster can schedule one now.  Does anyone know if they are just letting everyone do this without meeting any criteria (other than being age 12 or older)?

My elderly parents, who were vaccinated in January,  have twice tried to get boosters but to no avail -- the pharmacists here require written proof that you are on one of the listed immunosuppressants.  

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On 9/13/2021 at 8:04 PM, SKL said:

Re boosters ... I was trying several possibilities to get my kid in for a Covid test yesterday, and I called one of the pharmacies to ask a question.  I got a recording saying that anyone who wants a booster can schedule one now.  Does anyone know if they are just letting everyone do this without meeting any criteria (other than being age 12 or older)?

Not in our state.  Only those who are considerably immunocompromised are allowed it now.  That's not even elderly people, people with cancer necessarily, or a lot of other things that you might think would qualify a person.  From what I understand, it's for people who are actually undergoing some kind of treatment that results in a severely weakened immune system.  So, if you have cancer and are being treated with chemotherapy, that would qualify you.  And I believe some types of medications for autoimmune conditions have the effect of greatly diminishing your immune system, so those people would qualify.  

My parents are 93, and a loved one has cancer (and is being treated with immunotherapy, not chemotherapy), but none of them are actually severely immunocompromised.  They do not yet qualify for the booster.

ETA:  I'm actually okay with this right now.  If boosters aren't necessary yet for those who aren't immunocompromised, then there's no point in getting them early.  I imagine they'll become available to a larger crowd later in the fall or early winter.

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35 minutes ago, Plum said:

Super long 

 

Vaccinating people who have had covid-19: why doesn’t natural immunity count in the US? - TheBMJ

“It’s a lot easier to put a shot in their arm,” says Sommer. “To do a PCR test or to do an antibody test and then to process it and then to get the information to them and then to let them think about it—it’s a lot easier to just give them the damn vaccine.” In public health, “the primary objective is to protect as many people as you can,” he says. “It’s called collective insurance, and I think it’s irresponsible from a public health perspective to let people pick and choose what they want to do.”

But Klausner, Gandhi, and others raise the question of fairness for the millions of Americans who already have records of positive covid test results—the basis for “recovered” status in Europe—and equity for those at risk who are waiting to get their first dose (an argument being raised anew as US officials announce boosters while the virus spreads in countries lacking vaccine supply). For people who did not have a confirmed positive result but suspected previous infection, reliable antibody tests have been accessible “at least since April,” according to Klausner, though in May, the FDA announced that “antibody tests should not be used to evaluate a person’s level of immunity or protection from covid-19 at any time.”26

Unlike Europe, the US doesn’t have a national certificate or vaccination requirement, so defenders of natural immunity have simply advocated for more targeted recommendations and screening availability—and that mandates allow for exemptions. Logistics aside, a recognition of existing immunity would have fundamentally changed the target vaccination calculations and would also affect the calculations on boosters. “As we continued to put effort into vaccination and set targets, it became apparent to me that people were forgetting that herd immunity is formed by both natural immunity and vaccine immunity,” says Klausner.

Gandhi thinks logistics is only part of the story. “There’s a very clear message out there that ‘OK, well natural infection does cause immunity but it’s still better to get vaccinated,’ and that message is not based on data,” says Gandhi. “There’s something political going on around that.”

“If you listen to the language of our public health officials, they talk about the vaccinated and the unvaccinated,” Makary tells The BMJ. “If we want to be scientific, we should talk about the immune and the non-immune.” There’s a significant portion of the population, Makary says, who are saying, “‘Hey, wait, I’ve had [covid].’ And they’ve been blown off and dismissed.”

Patrick Whelan, of UCLA, says the “sky high” antibodies after vaccination in people who were previously infected may have contributed to these systemic side effects. “Most people who were previously ill with covid-19 have antibodies against the spike protein. If they are subsequently vaccinated, those antibodies and the products of the vaccine can form what are called immune complexes,” he explains, which may get deposited in places like the joints, meninges, and even kidneys, creating symptoms.

Other studies suggest that a two dose regimen may be counterproductive.34 One found that in people with past infections, the first dose boosted T cells and antibodies but that the second dose seemed to indicate an “exhaustion,” and in some cases even a deletion, of T cells.34 “I’m not here to say that it’s harmful,” says Bertoletti, who coauthored the study, “but at the moment all the data are telling us that it doesn’t make any sense to give a second vaccination dose in the very short term to someone who was already infected. Their immune response is already very high.”

Despite the extensive global spread of the virus, the previously infected population “hasn’t been studied well as a group,” says Whelan. Memoli says he is also unaware of any studies examining the specific risks of vaccination for that group. Still, the US public health messaging has been firm and consistent: everyone should get a full vaccine dose.

“When the vaccine was rolled out the goal should have been to focus on people at risk, and that should still be the focus,” says Memoli. Such risk stratification may have complicated logistics, but it would also require more nuanced messaging. “A lot of public health people have this notion that if the public is told that there’s even the slightest bit of uncertainty about a vaccine, then they won’t get it,” he says. For Memoli, this reflects a bygone paternalism. “I always think it’s much better to be very clear and honest about what we do and don’t know, what the risks and benefits are, and allow people to make decisions for themselves.”

https://doi.org/10.1136/bmj.n2101

It seems the research has been there for a long time now (relatively speaking) that illness plus one shot is sufficient. I definitely think that should be taken into account. I think the logistics of it is the hardest part. On the plus side, more people might get tested if they knew they were going to need those test results to prove they have acquired immunity. 

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15 minutes ago, KSera said:

It seems the research has been there for a long time now (relatively speaking) that illness plus one shot is sufficient. I definitely think that should be taken into account. I think the logistics of it is the hardest part. On the plus side, more people might get tested if they knew they were going to need those test results to prove they have acquired immunity. 

I am so sad that I got my second dose.  It really has made me worse off.  The first shot lessened my long haul symptoms a lot.  I got the second not because I thought I needed it but because I wanted to be fully vaccinated if I had to prove it for something. I didn't think it would matter much and might even made me even better. But that is not what happened ☹️

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7 hours ago, J-rap said:

Not in our state.  Only those who are considerably immunocompromised are allowed it now.  That's not even elderly people, people with cancer necessarily, or a lot of other things that you might think would qualify a person.  From what I understand, it's for people who are actually undergoing some kind of treatment that results in a severely weakened immune system.  So, if you have cancer and are being treated with chemotherapy, that would qualify you.  And I believe some types of medications for autoimmune conditions have the effect of greatly diminishing your immune system, so those people would qualify.  

My parents are 93, and a loved one has cancer (and is being treated with immunotherapy, not chemotherapy), but none of them are actually severely immunocompromised.  They do not yet qualify for the booster.

ETA:  I'm actually okay with this right now.  If boosters aren't necessary yet for those who aren't immunocompromised, then there's no point in getting them early.  I imagine they'll become available to a larger crowd later in the fall or early winter.

Neither of those statements is correct. People who have active cancer do NOT have to be on any particular type of treatment(s). They do have to currently be receiving some type of treatment. Many, many people on the cancer board I belong to are on immunotherapy or targeted drugs as treatment--no chemotherapy--and have gotten the third dose.

What the CDC guideline says is ""been receiving active cancer treatment for tumors or cancers of the blood". That's it. There is no requirement to be on a specific type of treatment.

To the CDC's credit their guidelines for who qualifies for a third dose is really very clear. I don't understand why there's so much confusion, especially by pharmacists. It's not hard to understand. The only thing in that link that's even a little unclear is the reference to "high-dose corticosteroids or other drugs that may suppress your immune response." If you delve into the CDC site more buried somewhere is a list of the "other drugs that may suppress your immune response" that qualifies one for a third dose. It's not a long list, so I think they should have included those right in the bulleted guidelines, and I think they should have defined what constitutes "high dose" steroids. But other than those two things the guidelines really are very, very clear.

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7 hours ago, KSera said:

It seems the research has been there for a long time now (relatively speaking) that illness plus one shot is sufficient. I definitely think that should be taken into account. I think the logistics of it is the hardest part. On the plus side, more people might get tested if they knew they were going to need those test results to prove they have acquired immunity. 

Yup, for months and months I've been saying that there should be an antibody card, or something. Some form like the vaccine card that proves you had Covid, maybe based on PCR testing or antibodies. I think it would get more people to test when ill, so they aren't walking around sick thinking it is "allergies" and those who "might have had it" would get tested for antibodies and confront that nope, they didn't have it. 

Plus better able to make public health decisions based on more data. 

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Oh dear. I hate all these decisions. We had COVID in June, and the kids and I got our first vaccination doses last week. I'm torn whether or not to get the second dose on schedule, wait a longer period (6-8 weeks, which was my initial thought), or skip it altogether (at least for the two of us who had a positive test). 

At this point, I feel that no matter our choice, it'll be the wrong one. 

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2 minutes ago, alisoncooks said:

Oh dear. I hate all these decisions. We had COVID in June, and the kids and I got our first vaccination doses last week. I'm torn whether or not to get the second dose on schedule, wait a longer period (6-8 weeks, which was my initial thought), or skip it altogether (at least for the two of us who had a positive test). 

At this point, I feel that no matter our choice, it'll be the wrong one. 

There was a recent TWIV podcast with Shane Crotty where he was talking about the vaccinations and immunity from infection. It was really informative I thought.

https://podcasts.apple.com/us/podcast/this-week-in-virology/id300973784?i=1000534769639

 

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2 hours ago, Pawz4me said:

 

Neither of those statements is correct. People who have active cancer do NOT have to be on any particular type of treatment(s). They do have to currently be receiving some type of treatment. Many, many people on the cancer board I belong to are on immunotherapy or targeted drugs as treatment--no chemotherapy--and have gotten the third dose.

What the CDC guideline says is ""been receiving active cancer treatment for tumors or cancers of the blood". That's it. There is no requirement to be on a specific type of treatment.

To the CDC's credit their guidelines for who qualifies for a third dose is really very clear. I don't understand why there's so much confusion, especially by pharmacists. It's not hard to understand. The only thing in that link that's even a little unclear is the reference to "high-dose corticosteroids or other drugs that may suppress your immune response." If you delve into the CDC site more buried somewhere is a list of the "other drugs that may suppress your immune response" that qualifies one for a third dose. It's not a long list, so I think they should have included those right in the bulleted guidelines, and I think they should have defined what constitutes "high dose" steroids. But other than those two things the guidelines really are very, very clear.

That's interesting, but still confusing (not how CDC words it, but with what we're being told).  The person I referred to doctors at Mayo Clinic, and according to his oncologist, he does not meet the requirements even though he is currently receiving immunotherapy for cancer.  His doctor explained that it's because the immunotherapy doesn't actually cause him to be immunocompromised like chemo does.   Maybe that has changed since he last saw him?  (Two weeks ago.)  Or maybe they're assuming that the cancer is no longer "active."

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1 hour ago, ktgrok said:

Yup, for months and months I've been saying that there should be an antibody card, or something. Some form like the vaccine card that proves you had Covid, maybe based on PCR testing or antibodies. I think it would get more people to test when ill, so they aren't walking around sick thinking it is "allergies" and those who "might have had it" would get tested for antibodies and confront that nope, they didn't have it. 

Plus better able to make public health decisions based on more data. 

I wonder if an antibody card is enough, though? We know that actually having a confirmed infection is protective. I have no idea how protective having "some antibodies" is. I'd guess those aren't the same thing. 

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30 minutes ago, Plum said:

I beg to differ. That is some serious generalization coming from someone in public health. 

Right. That's just silly. I mean, I understand why they think people with medical conditions ought to get vaccinated, but there obviously aren't ZERO effects, lol. 

We already know that the vaccine allows herpes-type viruses to reactivate, for example. 

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On 8/17/2021 at 6:50 AM, Not_a_Number said:

I didn’t say it’d keep you from being infected. That doesn’t work with this variant. But it’d probably keep you from getting super sick.

But this wasn’t the promise of the vaccines, right? I am so pissed at everything - supposedly 95% efficacy they promised that turned out to be a pile of garbage, people refusing to get vaccinated, constant fear of being locked up, not being able to see my mom…. I can keep on going. 
I am sorry, but a vaccine that wanes in 6 months and can’t protect me from an infection just isn’t good enough. Today it’s delta, tomorrow it’s gamma, day after tomorrow it’s zeta… sick of it all.

now I am glad I am vaccinated because I have some unique challenges, and will get a booster, but damn it, those companies made billions on promises they couldn’t keep. 

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