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The Vaccine Thread


JennyD

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44 minutes ago, SKL said:

I know we don't need to quarantine, but certain pockets of public opinion (including on this board) believe differently.  Who knows what the CDC will say tomorrow or the next day.

The recommendations are not solely based on science but also on practicability.

As a vaccinated person, I can still infect another person. The probability is smaller. The CDC guidelines reflect that it may not be practical to require quarantine if balanced against the risk.
That does not mean an individual may not come to a different conclusion for their individual behavior, weighing the inconvenience of quarantine against the risk to a vulnerable person.

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4 hours ago, ieta_cassiopeia said:

The NHS does, because being able to use natural infection saves it a lot of money it can use elsewhere. Especially if this turns out to be something requiring several vaccinations - if natural infection turns out to be something the NHS can treat as equivalent to one of those doses, then it could potentially save a lot of money each time there is a new wave.

 

Which may explain why natural immunity has already been studied, and why it has been found a significant number of people who had natural immunity revert to non-immune even within the 6-month period the NHS currently considers "immune" for COVID app purposes. Even Israel managed to get vaccines to go 6 months before losing immunity, and that was with spacing that would now be considered too close for optimal protection.

I do wonder if having mRNA for dose 1 (more effective in the short term) and something like OxfordAstrazeneca for dose 2 (early signs of being more effective in the medium term), 8-16 weeks apart, might turn out to be optimal for someone who's not had an infection (with the potential to skip one of the doses if an infection occurred in the appropriate window)? That's going to take quite a bit of research.

A single dose of vaccine also generates antibodies, which is how the UK is on 92% of the population with antibodies. For comparison, that's about the same proportion who have antibodies against measles in the UK (almost all of which is through vaccination).

 

 

I think a lot of people heard "95% protection", "62/70/90% protection" and "66% protection" and assumed those headline figures were going to hold, based on their knowledge of stable viruses (or of percentages that are meant to hold until the next scheduled dose, in the case of flu). The concepts of waning immunity and vaccine evasion aren't taught in practical terms to most people until times like this, only maybe covered in the midst of a bunch of theory in high school-equivalent biology class.

It's rather hard to consider the possibility of waning immunity when it's only presented as a thing that happens in practise after immunity starts waning... (I get the feeling the journalists weren't told it was a practical risk rather than a theoretical one either, because not even the usually-responsible ones mentioned it).

And for the record, I had believed that places like the UK and USA could vaccinate hard enough and fast enough to at least create bubbles of safety within those countries (that would work much like New Zealand, where most of the time, most aspects of life are normal) while arrangements were made to vaccinate everywhere else.

Yes, I can see how one could just assume that it is like the other vaccinations they received as a child.

 

I heard a lot about depends on "waning immunity", "rate of mutations", "more like flu vaccine" when I was reading but there is still a human bias to hope for the best which I suppose makes us forget. 

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1 hour ago, SKL said:

I'm not talking about Delta, I'm talking about waning effectiveness, which is a different issue.

 

But it is related. You need higher effectiveness against Delta, because there is a higher viral load in most people - if multplies faster to outrun the immune system and is more contagious. So for Delta, you need a vaccine that is more effective than you need against Alpha or the original Covid. So the level of effectiveness we have at say, 8 months, is likely plenty if we were dealing with Alpha still. But against Delta, it isn't always enough. 

1 hour ago, Not_a_Number said:

I have no clue. Is it irrational? I think she should get a booster ASAP and then take care of her mental health, because it does matter. We aren’t going to be able to get risk to anywhere near zero. We just aren’t.

But she doesn't know if and when she can get a booster. And giving Covid to her mom would not help her mental health, I don't think. So until she either isn't careing for her mom, or has a booster and her mom has one, or something else changes, it makes absolute sense that she's being cautious in order to avoid giving it to her mother. 

Given that you yourself are not back to normal and don't have an ill family member to care for and are living in an area where there is very little spread, I can't show how you think it would make sense for her, who has an ill, elderly family member, and lives in a disaster of a hot spot, to go back to normal. 

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2 hours ago, SKL said:

I'm not just talking since the EUAs, I'm talking since they started studying the vaxes in order to get to the EUA.  There's been plenty of time for it to become apparent that effectiveness wanes - if they were looking, which they should have been.  I mean, now, we're told we are idiots if we didn't expect effectiveness to wane by 8mos.  Well if I'm an idiot, what does that say about the specialists whose life work is to study and report on these things?

Or did they actually know about this and choose not to inform people?

Phase 3 vaccine trials for both Pfizer and Moderna began at the end of July, and they started booster trials in late February (Pfizer) and early March (Moderna), roughly seven months from the start of the original trials. How could they have data on waning immunity before immunity started to wane? The possibility of needing boosters has been widely reported on since February.

Edited by Corraleno
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Here's a news story from January, less than month after the vaccines began rolling out in the US, in which an infectious disease specialist explicitly says that immunity "may last longer than a year, but it’s unlikely to be permanent the way two doses of measles vaccine is. So at some point, it’s likely that we will need to boost people, but we don’t know how frequently that will need to be.”

https://www.abc4.com/coronavirus/will-i-need-to-get-the-covid-19-vaccine-annually-like-the-flu-shot/

Article from February stating that the NHS plans for annual covid boosters shots:

https://www.ft.com/content/26b256d0-d021-46ac-ae3d-e3ea823c033d

In April both Pfizer and Moderna stated explicitly that boosters would be needed:

Pfizer CEO Albert Bourla: "There are vaccines like polio that one dose is enough, there are vaccines like pneumococcal vaccine that one dose is enough for adults, and there are vaccines like flu that you need every year. The COVID virus looks more like the influenza virus than the polio virus."

Moderna CEO Stéphane Bancel: "I hope this summer to get the vaccine authorized for a boost so that we can help people getting boosted before the fall, so that we all have a normal fall and not a fall and winter like we just saw in the last 6 months."

This information was out there and was widely covered in the media. "I wasn't aware of that" does not equal "I was lied to."

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17 minutes ago, Corraleno said:

Here's a news story from January, less than month after the vaccines began rolling out in the US, in which an infectious disease specialist explicitly says that immunity "may last longer than a year, but it’s unlikely to be permanent the way two doses of measles vaccine is. So at some point, it’s likely that we will need to boost people, but we don’t know how frequently that will need to be.”

https://www.abc4.com/coronavirus/will-i-need-to-get-the-covid-19-vaccine-annually-like-the-flu-shot/

Article from February stating that the NHS plans for annual covid boosters shots:

https://www.ft.com/content/26b256d0-d021-46ac-ae3d-e3ea823c033d

In April both Pfizer and Moderna stated explicitly that boosters would be needed:

Pfizer CEO Albert Bourla: "There are vaccines like polio that one dose is enough, there are vaccines like pneumococcal vaccine that one dose is enough for adults, and there are vaccines like flu that you need every year. The COVID virus looks more like the influenza virus than the polio virus."

Moderna CEO Stéphane Bancel: "I hope this summer to get the vaccine authorized for a boost so that we can help people getting boosted before the fall, so that we all have a normal fall and not a fall and winter like we just saw in the last 6 months."

This information was out there and was widely covered in the media. "I wasn't aware of that" does not equal "I was lied to."

The January link was some dudes in Utah musing about whether or not this will be like the flu or not ... and they said it will not, but they didn't know much else.  (The flu shot is different every year to address different flu strains, as most of us know.  That is not what they are discussing re a mRNA booster.)

The February link is behind a paywall, and it's not a US article.

As for the Pfizer quote you pasted, they are now saying it's like the flu?  Then why use the exact same vax to boost it almost a year later?

And the Moderna quote you pasted implies it's not like the flu since the booster would be the same as the original vax.

And there were/are plenty of other messages declaring that the vax would almost certainly last longer than natural antibodies, and that there was/is no reason to believe boosters would be appropriate for most people.

This asks a lot of lay people who are/were thinking:

  • They change the message every single day.  I'm going to stop listening to all this noise.
  • Of course the manufacturers want us to get boosters - they make more money that way.  What's the evidence for boosters and has it been reviewed by disinterested parties?  (I actually think a lot of responsible policy makers are also thinking that right now.)
  • Why get the vax in the spring, if effectiveness will go down before the really bad season hits?  (Before Delta was rampant in the US, summer was supposed to have low case rates.)
  • I told you this vax was BS.  First it was one shot, then two, then annually, now every 8 months - do you really think this is ever going to end?  Didn't I tell you so?

Ultimately, if the case were strong for boosters across the board, there should have been plenty of highly convincing evidence long before now.  I can't blame folks who doubt the accountability / transparency of the manufacturers.

(FTR I didn't say I've been lied to, but I can understand why people feel a lack of trust in this matter.)

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1 hour ago, Corraleno said:

 

This information was out there and was widely covered in the media. "I wasn't aware of that" does not equal "I was lied to."

You probably need to say that louder to make sure the people in the back really hear it. ETA: And probably also add in "I didn't understand that" does not equal "I was lied to."

Edited by Pawz4me
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4 hours ago, regentrude said:

But that risk is an average over many people with very different behaviors. Most of us still take precautions to lower our personal driving risk: wear seat belts, don't text, don't drive intoxicated. Some people are even more careful and avoid driving overtired or in heavy rain.

Not to mention that if getting into a minor fender bender (asymptomatic infection) meant that your unvaccinated or immune compromised family member would be likely to get into a major accident, most of us definitely would alter our driving patterns.

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1 hour ago, Corraleno said:

Here's a news story from January, less than month after the vaccines began rolling out in the US, in which an infectious disease specialist explicitly says that immunity "may last longer than a year, but it’s unlikely to be permanent the way two doses of measles vaccine is. So at some point, it’s likely that we will need to boost people, but we don’t know how frequently that will need to be.”

https://www.abc4.com/coronavirus/will-i-need-to-get-the-covid-19-vaccine-annually-like-the-flu-shot/

Article from February stating that the NHS plans for annual covid boosters shots:

https://www.ft.com/content/26b256d0-d021-46ac-ae3d-e3ea823c033d

In April both Pfizer and Moderna stated explicitly that boosters would be needed:

Pfizer CEO Albert Bourla: "There are vaccines like polio that one dose is enough, there are vaccines like pneumococcal vaccine that one dose is enough for adults, and there are vaccines like flu that you need every year. The COVID virus looks more like the influenza virus than the polio virus."

Moderna CEO Stéphane Bancel: "I hope this summer to get the vaccine authorized for a boost so that we can help people getting boosted before the fall, so that we all have a normal fall and not a fall and winter like we just saw in the last 6 months."

This information was out there and was widely covered in the media. "I wasn't aware of that" does not equal "I was lied to."

Right. I was reading all this stuff way back then, and I know that I was VERY interested in the question of waning immunity.

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1 hour ago, SKL said:

The January link was some dudes in Utah musing about whether or not this will be like the flu or not ... and they said it will not, but they didn't know much else.  (The flu shot is different every year to address different flu strains, as most of us know.  That is not what they are discussing re a mRNA booster.)

The February link is behind a paywall, and it's not a US article.

Those were just examples I pulled up in a 2-second search, demonstrating that health policy people have been discussing the likelihood of boosters since the vaccines were first rolled out. The fact that someone was not aware that boosters were being discussed since vaccines were first rolled out, and therefore assumed that 2 doses provided permanent immunity, doesn't mean they were "lied to."

 

1 hour ago, SKL said:

As for the Pfizer quote you pasted, they are now saying it's like the flu?  Then why use the exact same vax to boost it almost a year later?

And the Moderna quote you pasted implies it's not like the flu since the booster would be the same as the original vax.

Surely you understand that "more like the flu than polio" does not mean "exactly like the flu in every possible way," right?

Both Pfizer & Moderna are trialling boosters that are specific to Delta and other VOC. The data Pfizer released showed that a 3rd dose of the original vaccine produced much higher antibody levels than the original 2 doses, and this level was highly effective against Delta. It was also highly effective against Beta, and I have read that they felt boosting with the original vaccine would provide broader protection against multiple variants versus using a booster specifically targeted at Delta.

 

1 hour ago, SKL said:

Ultimately, if the case were strong for boosters across the board, there should have been plenty of highly convincing evidence long before now.  I can't blame folks who doubt the accountability / transparency of the manufacturers.

Pfizer's booster trial was just completed a month ago, and they immediately released the data. I think you are just making stuff up here — what "highly convincing evidence" do you think they should have produced "long before" the actual trials concluded? The trials showed a 5-fold increase in antibodies compared to 2 doses for under 55s and an 11-fold increase in antibodies in over 55s. What more "accountability and transparency" should be expected of manufacturers beyond releasing data from RCTs as soon as the data is available? 

The question being debated by the CDC and FDA is not whether boosters will improve immunity and reduce infections and spread, the question is whether reducing infection and spread is a big enough deal to be worth pissing off the WHO by distributing boosters to Americans when other countries haven't had first doses yet, or whether the fact that the original two doses still generally protect against hospitalization and death is good enough. And that is a largely political decision that has nothing to do with the "transparency and accountability" of the manufacturers.

 

 

Edited by Corraleno
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And it should be said that polio is not one shot and done anymore anyway. It was one dose when we used a live virus version - but since that sometimes gave people polio we don't use that anymore. The inactivated version used in the USA is FOUR doses. 

DTaP is 5 doses, PLUS a dose of TDaP later (same stuff, different strength), plus boosters for life

Hep B is 3 doses

Etc etc

We started with two doses, and then honestly it was playing it by ear from then on out. 

 

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5 minutes ago, Corraleno said:

Those were just examples I pulled up in a 2-second search, demonstrating that health policy people have been discussing the likelihood of boosters since the vaccines were first rolled out. The fact that someone was not aware that boosters were being discussed since vaccines were first rolled out, and therefore assumed that 2 doses provided permanent immunity just like measles or polio, doesn't mean they were "lied to."

 

Surely you understand that "more like the flu than polio" does not mean "exactly like the flu in every possible way," right?

Both Pfizer & Moderna are trialling boosters that are specific to Delta and other VOC. The data Pfizer released showed that a 3rd dose of the original vaccine produced much higher antibody levels than the original 2 doses, and this level was highly effective against Delta. It was also highly effective against Beta, and I have read that they felt boosting with the original vaccine would provide broader protection against multiple variants versus using a booster specifically targeted at Delta.

 

Pfizer's booster trial was just completed a month ago, and they immediately released the data. I think you are just making stuff up here — what "highly convincing evidence" do you think they should have produced "long before" the actual trials concluded? The trials showed a 5-fold increase in antibodies compared to 2 doses for under 55s and an 11-fold increase in antibodies in over 55s. What more "accountability and transparency" should be expected of manufacturers beyond releasing data from RCTs as soon as the data is available? 

The question being debated by the CDC and FDA is not whether boosters will improve immunity and reduce infections and spread, the question is whether reducing infection and spread is a big enough deal to be worth pissing off the WHO by distributing boosters to Americans when other countries haven't had first doses yet, or whether the fact that the original two doses still generally protect against hospitalization and death is good enough. And that is a largely political decision that has nothing to do with the "transparency and accountability" of the manufacturers.

 

 

My point is that, if effectiveness wanes within 8 months to the point of everyone needing a booster, they should have known this for sure, with reliable numbers, by Spring 2021 (which was a full year after they started testing).

And maybe they did know it, but were wishy washy about it because it could influence the public in ways they didn't want.  Or maybe it isn't actually bad enough to justify boosting everyone, as is the position taken by many policy makers.

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1 minute ago, SKL said:

My point is that, if effectiveness wanes within 8 months to the point of everyone needing a booster, they should have known this for sure, with reliable numbers, by Spring 2021 (which was a full year after they started testing).

And maybe they did know it, but were wishy washy about it because it could influence the public in ways they didn't want.  Or maybe it isn't actually bad enough to justify boosting everyone, as is the position taken by many policy makers.

Except from what we can tell, in Spring we had mostly Alpha, and the vaccine works so well on that one that even waning efficacy at all wouldn't be a big deal. Not a need to booster. Nor do scientists agree even now that we "need" a booster - depends on the criteria. And back then we were concerned about having enough vaccine, as well. wE didn't anticipate that huge swaths of people would just refuse to get vaccinated. 

Edited by ktgrok
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24 minutes ago, SKL said:

My point is that, if effectiveness wanes within 8 months to the point of everyone needing a booster, they should have known this for sure, with reliable numbers, by Spring 2021 (which was a full year after they started testing).

Huh? Are you saying that April 2021 does not count as "Spring 2021"? Because that's when Moderna and Pfizer formally announced that they believed boosters would be needed.

 

24 minutes ago, SKL said:

And maybe they did know it, but were wishy washy about it because it could influence the public in ways they didn't want.  Or maybe it isn't actually bad enough to justify boosting everyone, as is the position taken by many policy makers.

People keep trying to explain the shades of gray in this issue and you keep insisting it's black and white — either there is clear evidence that EVERYONE needs a booster or there is clear evidence that NO ONE needs a booster, and the fact that experts are not in 100% agreement on this means something sketchy is going on.

There is no question that boosters increase immune response; the trials clearly show that. Boosters will reduce the number of infections substantially, and will also reduce hospitalizations and deaths but to a lesser degree — because the first two doses still provide reasonable protection against those outcomes. 

HOW MANY preventable infections, hospitalizations, and deaths are acceptable, from a public health standpoint, without authorizing boosters is the debate. That is not a question with a yes/no answer. There is no clear line between what is "bad enough," as you put it, and what is "not bad enough" when it comes to illness and death. What counts as "bad enough" to authorize boosters is a question that involves social, economic, and political factors, not just medical ones. And one of those political factors is the WHO strongly pressuring the US to send all their doses to other countries instead of doing boosters (even though we are already donating half a billion doses whether we do boosters or not). 

Edited by Corraleno
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6 hours ago, Mrs Tiggywinkle said:

People were so excited because they had been told it was our ticket back to a normal life.  The pamphlets we handed out definitely led people to believe that.  I think people needed optimism and the messaging was too optimistic, probably to convince people to get vaccinated.

I think it's still our ticket to normal, but the scenery on that journey is going to be much different than we expected, the journey longer, and the destination not quite as perfect as we had hoped.

I think if more people had been vaccinated and kids had been eligible, this would be quite a bit different. I think if we had a big outbreak of a known flu and got vaccines out that quickly for all age groups (no need for testing, etc. because we have existing flu shots), and we had really good vaccine uptake, it would've been a different story. Instead, we inserted it all into a changing scenario, had relatively poor uptake, and we had a big change in variants.

Early numbers really did show promising stuff. So, kind of overoptimistic, but I think that depends greatly on context. If I lived someplace different where more were vaxed and cautious, for instance, I could largely return to life as normal. I think we were overly optimistic about who would and would not get vaxed, how many would get vaxed, and how well it would protect those not yet eligible given that the second year of the 1918 pandemic sickened a different demographic than the first wave. 

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3 hours ago, Not_a_Number said:

I bet she can, lol. There are pharmacies everywhere that don’t ask too many questions.

On one of the Covid FB pages I follow, the admin got a booster due to living with or being a caretaker for someone immune-compromised. 

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1 hour ago, kbutton said:

I think it's still our ticket to normal, but the scenery on that journey is going to be much different than we expected, the journey longer, and the destination not quite as perfect as we had hoped.

I think if more people had been vaccinated and kids had been eligible, this would be quite a bit different.

Exactly. If everyone was vaccinated and masking, life would be normal right now. Vaccinated people with waning immunity aren't the ones overwhelming hospitals. Since we only have half the population fully vaxxed, we're about halfway back to normal — except that it's not evenly distributed, it's basically an average between the people who are living their lives as if the pandemic doesn't exist and the cautious people who are still significantly restricting activities. Why people who are still restricting activities would blame that on vaccine manufacturers or "the government" instead of the jerks who are refusing to get vaccinated or mask or take any other precautions makes no sense to me.

Edited by Corraleno
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4 minutes ago, Corraleno said:

Since we only have half the population fully vaxxed, we're about halfway back to normal — except that it's not evenly distributed, it's basically an average between the people who living their lives as if the pandemic doesn't exists and the cautious people who are still significantly restricting activities.

Once again, the analogy that this pandemic is like the worst group project ever come to mind!

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14 minutes ago, kbutton said:

 

On one of the Covid FB pages I follow, the admin got a booster due to living with or being a caretaker for someone immune-compromised. 

There have been several reports of that on the cancer board I belong to.

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21 hours ago, Roadrunner said:


Inak glad so many of you don’t think 55% efficacy rate after 6 months is OK. Sure, it’s better than nothing. Anything is better than nothing. 

I am one of those who really doesn’t want to get Covid, so I certainly wish that efficacy against transmission had remained at the level it was when the vaccines first came out. However, I’m still super, super grateful that they are very highly protective against hospitalization and death. While I don’t want Covid, what I want even less is to be hospitalized or to die of it.  If I had to choose between a vaccine that remained 95% affective against transmission, but then if I got the disease, I would be just as likely to die of it as if I weren’t vaccinated, or one where it lowered my risk of disease by just half, but I was almost assured to survive even if I did catch it, no question I would choose the latter.

7 hours ago, Mrs Tiggywinkle said:

You’re not stupid.  It’s complicated science.  
Frankly, this really was the messaging people were getting.  I gave hundreds, maybe even a thousand, vaccines.  People were so excited because they had been told it was our ticket back to a normal life.  The pamphlets we handed out definitely led people to believe that.  I think people needed optimism and the messaging was too optimistic, probably to convince people to get vaccinated.

 

The messaging was accurate for what it was, though. They had no way to predict the future and know that Delta was to come along. There were warnings that if transmission remained high due to not enough people being vaccinated, we could end up in the situation, but otherwise, things could’ve been back to normal if everyone had been vaccinated with vaccines as effective as they were against Alpha, when most of them were given. 

6 hours ago, SKL said:

I'm not just talking since the EUAs, I'm talking since they started studying the vaxes in order to get to the EUA.  There's been plenty of time for it to become apparent that effectiveness wanes - if they were looking, which they should have been.  I mean, now, we're told we are idiots if we didn't expect effectiveness to wane by 8mos.  Well if I'm an idiot, what does that say about the specialists whose life work is to study and report on these things?

I was aware long before I got a vaccine that we wouldn’t know yet just how long they would last. How could we?  I also knew before that point that whether we continue to see such good results from the vaccine dependent largely on how many people and how quickly they got vaccinated, in order to avoid this very situation we have ended up in, with a new variant at the vaccines aren’t quite as effective against. Thank goodness they’re still highly effective against serious disease and death, but if we continue to have such a large population on vaccinated,  there’s nothing to say we won’t end up with something worse 😞.  These things were all highly publicized in the media all along. Maybe it depends where people get their media.

Also, another thing that I don’t think has been mentioned in this discussion is that all of Moderna and Pfizer‘s studies were using moderate to severe illness as end points. In order to be able to figure out most quickly whether the vaccines worked, they went with that as the goal and they weren’t doing testing on asymptomatic subjects. That has since happened in later studies, but none of the initial studies were looking for asymptomatic or mild illness.  Since the vaccines performed so very well against moderate to severe disease, I don’t think it’s at all surprising that there was no waning seen until Delta came along and until studies were done that looked at asymptomatic disease as well.

6 hours ago, vonfirmath said:

Either its not the same antibodies as the disease or my vaccine did nothing

I've given blood several times since being vaccinated (Twice) and they used to test for antibodies (up until the end of July) and those never showed up for me.

There are different antibody tests for those produced in response to disease and those produced by the vaccine.

 

this factcheck.org article about the boosters addresses lots of the things we’re talking about on this thread. I think it’s worth a read, and it comes from a very balanced perspective:

Biden’s Controversial COVID-19 Vaccine Booster Plan

It might make some people who are feeling disappointed in the change in how the vaccine does with Delta feel a bit reassured. 

Edited by KSera
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6 hours ago, vonfirmath said:

Either its not the same antibodies as the disease or my vaccine did nothing

I've given blood several times since being vaccinated (Twice) and they used to test for antibodies (up until the end of July) and those never showed up for me.

Some antigen tests look for antibodies to the nucleocapsid (N) protein rather than the spike (S) protein. If the blood donation place was specifically looking for evidence of infection, not vaccination, they may have purposely used an N protein test, in which case you might have super high levels of antibodies to the spike protein and it wouldn't show up at all on the test.

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46 minutes ago, Corraleno said:

Some antigen tests look for antibodies to the nucleocapsid (N) protein rather than the spike (S) protein. If the blood donation place was specifically looking for evidence of infection, not vaccination, they may have purposely used an N protein test, in which case you might have super high levels of antibodies to the spike protein and it wouldn't show up at all on the test.

When the Red Cross took my blood earlier this year, they could tell from the antibody test that they did that I had both been vaccinated and that I had not been infected with covid.

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1 hour ago, Lady Florida. said:

He recently transported a dad to the hospital who later died from Covid. A week later he had to transport the mother. There were young children and he didn't want to leave them home alone so he brought them to the hospital until a family member could come and get them. The mother also died. Both were unvaccinated. 😪

I keep wondering this, but haven't seen anything address it: Do we have any idea why it seems like an unlikely number of couples where both people die of covid? It makes some sense for related family members, but why would that happen for unrelated people at what seems like a much higher than chance rate? (Perhaps the answer is that it isn't any higher than chance, and it's just that with so any people having covid, just chance will lead to this many couples both dying.)

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1 minute ago, KSera said:

I keep wondering this, but haven't seen anything address it: Do we have any idea why it seems like an unlikely number of couples where both people die of covid? It makes some sense for related family members, but why would that happen for unrelated people at what seems like a much higher than chance rate? (Perhaps the answer is that it isn't any higher than chance, and it's just that with so any people having covid, just chance will lead to this many couples both dying.)

Viral load?  If they are both living their lives with no precautions, their viral load could be higher making them more likely to have serious disease.   Or one gets a big load, then they are spending a lot of time together since they are a couple so the other also gets a big viral load. 

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4 minutes ago, KSera said:

I keep wondering this, but haven't seen anything address it: Do we have any idea why it seems like an unlikely number of couples where both people die of covid? It makes some sense for related family members, but why would that happen for unrelated people at what seems like a much higher than chance rate? (Perhaps the answer is that it isn't any higher than chance, and it's just that with so any people having covid, just chance will lead to this many couples both dying.)

Couples usually share close space, so if one is infected, the other one has a very high chance of being infected as well. Couples very often share lifestyle, i.e. similar risk factors and precautions.
We have not, in the recent history in the developed world, dealt with an epidemic of a dangerous, highly infectious disease. We are used to seeing people die from cancer or cardiac events - not from infectious disease.
I would assume this was a very normal pattern back when infectious disease was a leading cause of death.

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8 minutes ago, regentrude said:

Couples usually share close space, so if one is infected, the other one has a very high chance of being infected as well. Couples very often share lifestyle, i.e. similar risk factors and precautions.
We have not, in the recent history in the developed world, dealt with an epidemic of a dangerous, highly infectious disease. We are used to seeing people die from cancer or cardiac events - not from infectious disease.
I would assume this was a very normal pattern back when infectious disease was a leading cause of death.

That’s true. I guess it just seems to me that I would expect a whole lot of couples to both be infected, but not for it to be so serious and/or deadly for both of them as often as it seems to be. I suppose with so many cases, even if it’s 1/200 chance of death for each person in their 30s to 40s, that combined 1/400 chance it will happen to them both is going to happen not infrequently. 

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3 minutes ago, KSera said:

That’s true. I guess it just seems to me that I would expect a whole lot of couples to both be infected, but not for it to be so serious and/or deadly for both of them as often as it seems to be. I suppose with so many cases, even if it’s 1/200 chance of death for each person in their 30s to 40s, that combined 1/400 chance it will happen to them both is going to happen not infrequently. 

Plus in many cases there are likely to be shared lifestyle factors that lead to similar comorbidities, especially obesity with all the other issues (diabetes, hypertension, heart disease, low Vit D, etc.) that often go along with that. Odds of serious illness and death are much higher than 1/200 for people who are morbidly obese. And couples are more likely to share political views and be on the same page re: not getting vaxxed, which astronomically increases the odds of becoming severely ill or dying if they get it.

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2 minutes ago, Corraleno said:

Plus in many cases there are likely to be shared lifestyle factors that lead to similar comorbidities, especially obesity with all the other issues (diabetes, hypertension, heart disease, low Vit D, etc.) that often go along with that. Odds of serious illness and death are much higher than 1/200 for people who are morbidly obese. And couples are more likely to share political views and be on the same page re: not getting vaxxed, which astronomically increases the odds of becoming severely ill or dying if they get it.

Not being vaxed doesn't "astronomically increase the odds" of non-elderly people becoming severely ill and dying of Covid.  Yes, the % will be multiples of the tiny rate for vaxed people with identical health situations, but you make it sound like severe Covid illness isn't rare even for unvaxed people of childbearing age.

I would agree there might be lifestyle-related and/or environmental comorbidities within a household.  I also think sometimes there may be another acute illness occurring at the same time as Covid.  I've learned that when they test for Covid, they don't generally test for other illnesses.

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1 hour ago, SKL said:

Not being vaxed doesn't "astronomically increase the odds" of non-elderly people becoming severely ill and dying of Covid.  Yes, the % will be multiples of the tiny rate for vaxed people with identical health situations, but you make it sound like severe Covid illness isn't rare even for unvaxed people of childbearing age.

I would agree there might be lifestyle-related and/or environmental comorbidities within a household.  I also think sometimes there may be another acute illness occurring at the same time as Covid.  I've learned that when they test for Covid, they don't generally test for other illnesses.

I guess it depends what your definition of rare is. It’s happening far too often for me to be anywhere near comfortable with it. In my area, the chances of dying of Covid for someone my age are 40 times higher for those who aren’t vaccinated. I think a large part of the whole reason we are in this stage of the pandemic still is because most people don’t think it would happen to them. I’m hearing lots of doctors and nurses commenting on and freaked out by the number of young, previously healthy people they have in their ICUs. 
 

i’m also confused by the last part of your post (“I also think sometimes there may be another acute illness occurring at the same time as Covid“). Are you saying in the cases where there are couples where both have died of Covid, you’re hypothesizing that it’s actually some other acute illness that killed them and not Covid?

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28 minutes ago, SKL said:

Not being vaxed doesn't "astronomically increase the odds" of non-elderly people becoming severely ill and dying of Covid.  Yes, the % will be multiples of the tiny rate for vaxed people with identical health situations, but you make it sound like severe Covid illness isn't rare even for unvaxed people of childbearing age.

I guess it depends on what you consider "rare." From the most recent CDC data (for June/July, after Delta was dominant), roughly 1 in 30 covid cases in unvaccinated people aged 18-49 ended up hospitalized. Certainly better than the 1/10 odds for unvaccinated 50-64 year olds and 1/5 for unvaccinated seniors over 65, but personally I don't consider 1 in 30 to be great odds.

According to the CDC, 85% of covid cases, 95% of covid hospitalizations and 96% of covid deaths in ages 18-49 were unvaccinated. Raw numbers for that age group in the 4-week period from 6/20-7/17 = 2,666 unvaccinated hospitalizations vs 146 vaccinated hospitalizations, despite the fact that more people in that age group are vaccinated than unvaccinated. Even if we assume a 50/50 vaxed/unvaxed split in the population, that means unvaxed 18-49 year olds are 18x more likely to be hospitalized than vaxxed 18-49 year olds. If you include all age groups, including the elderly, the unvaxed are still 10x more likely to be hospitalized or die from Delta. 

 

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8 hours ago, regentrude said:

Couples usually share close space, so if one is infected, the other one has a very high chance of being infected as well. Couples very often share lifestyle, i.e. similar risk factors and precautions.
We have not, in the recent history in the developed world, dealt with an epidemic of a dangerous, highly infectious disease. We are used to seeing people die from cancer or cardiac events - not from infectious disease.
I would assume this was a very normal pattern back when infectious disease was a leading cause of death.

Yes. My local cemetery has examples of several family members dying within days in the 19th century. 

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18 hours ago, vonfirmath said:

Either its not the same antibodies as the disease or my vaccine did nothing

I've given blood several times since being vaccinated (Twice) and they used to test for antibodies (up until the end of July) and those never showed up for me.

I think they were testing for antibodies from disease not vaccination, because I would imagine they were wanting to possibly use for convalescent plasma therapy.

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19 hours ago, SKL said:

I'm not just talking since the EUAs, I'm talking since they started studying the vaxes in order to get to the EUA.

The EUAs required information from the very beginning of the vaccine research, thus I was already counting it in the timeframe I discussed.

 

19 hours ago, vonfirmath said:

Either its not the same antibodies as the disease or my vaccine did nothing.

People get different antibodies or mixes of antibodies to the same stimulus, so both options are possible. (Some people are known to have had no reaction to the vaccine, and it would be expected for people to get different antibodies/antibody mixes in response to any vaccine compared to other people who encountered the same one, let alone to people who encountered a different vaccine or a variant of the virus itself. This is one reason why drug testing where antibodies are part of the assumed effect mechanism uses statistical probabilities rather than cast-iron certainties).

  

16 hours ago, Corraleno said:

Article from February stating that the NHS plans for annual covid boosters shots:

https://www.ft.com/content/26b256d0-d021-46ac-ae3d-e3ea823c033d

 

And now I'd like to know why the NHS couldn't have put that on its own web pages about COVID-19 (something it only started doing when the government itself began discussing boosters). How did it expect a consistent message to be given when it decided it wasn't important to communicate the same way on its own site as it apparently did to the Financial Times? (By the way, from the search I did, the Financial Times was the only UK paper reporting this, it wasn't on the NHS site, so anyone checking sources would be more inclined to believe the paper got its facts wrong than to believe it).

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I think when the history of this pandemic is written that today's actions by the FDA advisory group blocking Pfizer boosters for those 16 and up and instead limiting it to those 65 or older or are at high risk of severe Covid-19--assuming the full FDA doesn't overrule this committee--is going to be the biggest screw up by public health authorities thus far.

I'm aghast. This decision will lead to greater spread of Delta--including to children and among front line workers. It will cost lives and expose many to the potential of a lifelong chronic illness (Long Covid).

Very depressing news.

Bill

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I personally would have liked to have had a booster, but I can see from a public health perspective why they aren't recommending it for everyone. All the data I have looked at looks pretty clear that it's getting more unvaccinated people vaccinated that makes a big difference in the pandemic trajectory, not getting boosters/third doses for already vaccinated people. So again, I'm disappointed for myself, but given current information, the decision does make sense on a public health level. The vaccines are holding up very well against severe outcomes, and that will be even more true with the most at risk getting boosters as is now anticipated. What is putting everyone at risk (both directly and by overwhelming hospitals) are all the people who aren't vaccinated at all.

 

On 9/16/2021 at 1:18 PM, KSera said:

this factcheck.org article about the boosters addresses lots of the things we’re talking about on this thread. I think it’s worth a read, and it comes from a very balanced perspective:

Biden’s Controversial COVID-19 Vaccine Booster Plan

 

Another plug for this factcheck page.

Edited by KSera
forgot a word
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FDA: "OK, sure, we can see there are holes in the ship and we're taking on water, but it's only a little water, and there is no evidence to suggest that holes get bigger or that more water actually sinks the ships. But once the pumps can no longer keep up with the influx of water and the boat actually starts sinking and people are drowning, we may consider taking another look at the evidence in favor of plugging holes."

At least Fauci is pointing out the obvious, that increased transmission hurts unvaccinated kids and the immunocompromised and can lead to long covid.

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I find myself wondering how liberally the booster recommended categories will be construed. We have over 65, at high risk for severe disease, and healthcare workers or others at high risk for occupational exposure all recommended at this point (plus third doses for immune compromised). The high risk category could easily be taken in such a way as to include half the adults in the country (obese, hypertension or diabetes would get us there, I'm pretty sure). Then the occupational exposure category could potentially include a very wide range of people--teachers, any public facing job. I haven't listened to any of the hearings themselves--has there been any defining of these terms? I'm just wondering if this actually is going to get us a lot more boosters than it might initially sound on the surface.

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25 minutes ago, KSera said:

I personally would have liked to have had a booster, but I can see from a public health perspective why they aren't recommending it for everyone. All the data I have looked at looks pretty clear that it's getting more unvaccinated people vaccinated that makes a big difference in the pandemic trajectory, not getting boosters/third doses for already vaccinated people. So again, I'm disappointed for myself, but given current information, the decision does make sense on a public health level. The vaccines are holding up very well against severe outcomes, and that will be even more true with the most at risk getting boosters as is now anticipated. What is putting everyone at risk (both directly and by overwhelming hospitals) are all the people who aren't vaccinated at all.

 

Another plug for this factcheck page.

Sure, ideally it would be best to use the doses we have to vaccinate the unvaccinated. But, they won't get vaccinated. And we can't make them, beyond what we are doing. So...that may be the best option, but it isn't an actual option. It's great in theory, but unavailable in practice. 

So letting those who want boosters, those who maybe are around lots of unvaccinated people like school teachers, or those working in healthcare, or those who have vulnerable family members, get boosters, is the next best option. 

I'd happily forgo my booster IF it meant that everyone else got fully vaccinated, which seems to be what they are suggesting. Except, that isn't going to happen. At all. 

The CDC is letting perfect be the enemy of the good, and theory triumph over reality. 

I

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7 minutes ago, KSera said:

I personally would have liked to have had a booster, but I can see from a public health perspective why they aren't recommending it for everyone. All the data I have looked at looks pretty clear that it's getting more unvaccinated people vaccinated that makes a big difference in the pandemic trajectory, not getting boosters/third doses for already vaccinated people. So again, I'm disappointed for myself, but given current information, the decision does make sense on a public health level. The vaccines are holding up very well against severe outcomes, and that will be even more true with the most at risk getting boosters as is now anticipated. What is putting everyone at risk (both directly and by overwhelming hospitals) are all the people who aren't vaccinated at all.

The arguments against boosters aren't actually arguments against boosters — they are arguments that the doses used for boosters would be better used in other ways. But there is no reason to believe that withholding boosters will actually result in those shots going into the arms that people think should get them instead.

(1) There's no question that, from a public health perspective, vaccinating the huge number of vaccine refusers in this country would be more effective than boosters — but those people have had access to vaccines for 6 months now and won't take them. Withholding boosters from people who do want to be protected will have zero effect on current anti-vaxxers.

(2) The argument that recommending a 3rd dose will discourage those who are current unvaxxed from getting vaxxed is the dumbest argument of all. Like there are millions of people who have so far totally refused to get a shot who will say "oh, well, I would have gotten two shots but now that it's three, forget about it!" Like watching hundreds of thousands of people who did get vaccinated eventually get sick because of waning immunity is more likely to persuade them to get vaxxed???

(3) The US has already pledged to donate half a billion doses of Pfizer to other countries, the idea that withholding boosters from Americans means that the US will therefore donate an additional 200 million doses they would have used as boosters is naive. It's not gonna happen. 

Arguments in favor:

(1) Increasing protection against infection, rather than settling for "good enough" protection against hospitalization and death, reduces transmission, helps protect unvaxxed children and the immunocompromised, and reduces the number of people who will get long covid and other potentially life-changing autoimmune diseases. There was an article linked here yesterday on the explosion of diabetes cases in children that doctors think may linked to covid. Their lives may be changed forever, but hey, at least they didn't die (yet).

(2) Many people who are being careful, who got vaxxed, who wear masks, are not going to be comfortable going back to life as usual knowing their protection against disease is wearing off. Want the economy totally back on track? Then the people who want to stay safe need to feel safe. 

(3) There is more than whiff of privilege when a board of academics and government employees who have excellent health insurance and the ability to work from home decide that "probably not going to die" is good enough protection for everyone under retirement age. It ignores the millions of working Americans for whom 2-3 weeks of illness could be financially catastrophic, not to mention the possibility of long covid or other disabilities. 

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5 minutes ago, ktgrok said:

Sure, ideally it would be best to use the doses we have to vaccinate the unvaccinated. But, they won't get vaccinated. And we can't make them, beyond what we are doing. So...that may be the best option, but it isn't an actual option. It's great in theory, but unavailable in practice. 

So letting those who want boosters, those who maybe are around lots of unvaccinated people like school teachers, or those working in healthcare, or those who have vulnerable family members, get boosters, is the next best option. 

I'd happily forgo my booster IF it meant that everyone else got fully vaccinated, which seems to be what they are suggesting. Except, that isn't going to happen. At all. 

The CDC is letting perfect be the enemy of the good, and theory triumph over reality. 

I

I don't think we know that they won't be allowed yet (well, I know we don't know that, as this was just the advisory committee). I'm thinking there's a difference between what is being recommended for everyone and what people might be able to get. It seems to me it's different to say "we recommend everyone should have this" vs "it's not necessary for everyone to get this" but people still being able to get it if they want it. Too soon to know if the latter will be how it happens.

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2 minutes ago, KSera said:

I don't think we know that they won't be allowed yet (well, I know we don't know that, as this was just the advisory committee). I'm thinking there's a difference between what is being recommended for everyone and what people might be able to get. It seems to me it's different to say "we recommend everyone should have this" vs "it's not necessary for everyone to get this" but people still being able to get it if they want it. Too soon to know if the latter will be how it happens.

Fair enough. I'm fine with it being the latter - I would be fine with 2 doses being the "fully vaccinated" line at this point, and a 3rd being optional for better protection for those that are more worried about transmission. 

And this is predicated on having children's vaccines soon. 

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9 minutes ago, KSera said:

I find myself wondering how liberally the booster recommended categories will be construed. We have over 65, at high risk for severe disease, and healthcare workers or others at high risk for occupational exposure all recommended at this point (plus third doses for immune compromised). The high risk category could easily be taken in such a way as to include half the adults in the country (obese, hypertension or diabetes would get us there, I'm pretty sure). Then the occupational exposure category could potentially include a very wide range of people--teachers, any public facing job. I haven't listened to any of the hearings themselves--has there been any defining of these terms? I'm just wondering if this actually is going to get us a lot more boosters than it might initially sound on the surface.

I really hope they word the recommendation in a way that allows the broadest possible interpretation, so pretty much anyone who wants a booster will be able to get one. Now that Pfizer has a full biologics license,  I think doctors can legally use it off label for a third dose anyway (and luckily the booster dose is the same as the regular dose). 

Telling the people who are being careful, who are carrying the burden of this pandemic, and who want the additional protection, that they can't have it because it would be more useful if it were to be given it to someone who won't be getting it anyway, is just stupid.

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4 minutes ago, Corraleno said:

The arguments against boosters aren't actually arguments against boosters — they are arguments that the doses used for boosters would be better used in other ways. But there is no reason to believe that withholding boosters will actually result in those shots going into the arms that people think should get them instead.

(1) There's no question that, from a public health perspective, vaccinating the huge number of vaccine refusers in this country would be more effective than boosters — but those people have had access to vaccines for 6 months now and won't take them. Withholding boosters from people who do want to be protected will have zero effect on current anti-vaxxers.

(2) The argument that recommending a 3rd dose will discourage those who are current unvaxxed from getting vaxxed is the dumbest argument of all. Like there are millions of people who have so far totally refused to get a shot who will say "oh, well, I would have gotten two shots but now that it's three, forget about it!" Like watching hundreds of thousands of people who did get vaccinated eventually get sick because of waning immunity is more likely to persuade them to get vaxxed???

(3) The US has already pledged to donate half a billion doses of Pfizer to other countries, the idea that withholding boosters from Americans means that the US will therefore donate an additional 200 million doses they would have used as boosters is naive. It's not gonna happen. 

Arguments in favor:

(1) Increasing protection against infection, rather than settling for "good enough" protection against hospitalization and death, reduces transmission, helps protect unvaxxed children and the immunocompromised, and reduces the number of people who will get long covid and other potentially life-changing autoimmune diseases. There was an article linked here yesterday on the explosion of diabetes cases in children that doctors think may linked to covid. Their lives may be changed forever, but hey, at least they didn't die (yet).

(2) Many people who are being careful, who got vaxxed, who wear masks, are not going to be comfortable going back to life as usual knowing their protection against disease is wearing off. Want the economy totally back on track? Then the people who want to stay safe need to feel safe. 

(3) There is more than whiff of privilege when a board of academics and government employees who have excellent health insurance and the ability to work from home decide that "probably not going to die" is good enough protection for everyone under retirement age. It ignores the millions of working Americans for whom 2-3 weeks of illness could be financially catastrophic, not to mention the possibility of long covid or other disabilities. 

You make good points.

On this one:

5 minutes ago, Corraleno said:

(2) The argument that recommending a 3rd dose will discourage those who are current unvaxxed from getting vaxxed is the dumbest argument of all. Like there are millions of people who have so far totally refused to get a shot who will say "oh, well, I would have gotten two shots but now that it's three, forget about it!" Like watching hundreds of thousands of people who did get vaccinated eventually get sick because of waning immunity is more likely to persuade them to get vaxxed???

I totally, totally agree that it's not going to go that way. I DO think there will be lots of people who have refused to get vaccinated who would say "oh, well, I would have gotten two shots but now that it's three, forget about it!" but that's totally disingenuous (like saying they were waiting for FDA approval was for so many of them).

9 minutes ago, Corraleno said:

(1) Increasing protection against infection, rather than settling for "good enough" protection against hospitalization and death, reduces transmission, helps protect unvaxxed children and the immunocompromised, and reduces the number of people who will get long covid and other potentially life-changing autoimmune diseases. There was an article linked here yesterday on the explosion of diabetes cases in children that doctors think may linked to covid. Their lives may be changed forever, but hey, at least they didn't die (yet).

Agree with this as well. I'm in the group not comfortable going back to normal life with things the way they are now (I have unvaxed younger kids is part of it, possibility of long covid for me being another part).

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1 hour ago, Spy Car said:

I think when the history of this pandemic is written that today's actions by the FDA advisory group blocking Pfizer boosters for those 16 and up and instead limiting it to those 65 or older or are at high risk of severe Covid-19--assuming the full FDA doesn't overrule this committee--is going to be the biggest screw up by public health authorities thus far.

I'm aghast. This decision will lead to greater spread of Delta--including to children and among front line workers. It will cost lives and expose many to the potential of a lifelong chronic illness (Long Covid).

Very depressing news.

Bill

Totally agree. With the amount of Covid that we have in this country and our abundant supply of vaccines, I am shocked by this decision. WTF are they thinking? I'm thankful that healthcare workers (and other essential folks) are at least getting boosted, but 65 and above is not enough. So many lives will be lost.

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I am really confused by what I'm reading.  Is the FDA recommending this, the same as the FDA approving it?

My loved one is 91, second dose of Pfizer was 6 months and a few days ago.  He is adamant that he will get the third dose when it is his "turn" but he won't get it until then.  

So, can I say "it's approved for you!  Get in the car!  We're going to CVS" tomorrow morning?  Or is there another step?

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2 minutes ago, BaseballandHockey said:

I am really confused by what I'm reading.  Is the FDA recommending this, the same as the FDA approving it?

My loved one is 91, second dose of Pfizer was 6 months and a few days ago.  He is adamant that he will get the third dose when it is his "turn" but he won't get it until then.  

So, can I say "it's approved for you!  Get in the car!  We're going to CVS" tomorrow morning?  Or is there another step?

No this was just the recommendation of the FDA advisory panel. The CDC meets next Wednesday and Thursday, and then I think there will be an announcement about whether there will be an official EUA for boosters.

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3 minutes ago, BaseballandHockey said:

I am really confused by what I'm reading.  Is the FDA recommending this, the same as the FDA approving it?

My loved one is 91, second dose of Pfizer was 6 months and a few days ago.  He is adamant that he will get the third dose when it is his "turn" but he won't get it until then.  

So, can I say "it's approved for you!  Get in the car!  We're going to CVS" tomorrow morning?  Or is there another step?

There is technically one more step that should come next week. This is the panel that makes recommendation to the full FDA.

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