To vaccine or not to vaccine

[Scarlett]

3 hours ago, PeterPan said:

Oh that's interesting. Do you think the recommendations are changing as they see the data from so many people getting it or was it more pressure on the doctor?

I think it is recommendations changing. But 🤷🏻‍♀️

[Scarlett]

41 minutes ago, Spryte said:

 

Oh wait!  Hold on.  Sorry.  Too many meds!  It was Tramadol.  Gaaaah.  Tramadol gave me the big scary reaction.  Yeesh.  You’d think I could keep this stuff straight.   How embarrassing.
 

Toradol rocks.  I’m allergic to almost all the narcotics, it’s a real problem.  Toradol and Tramadol were my go-tos.  Now I’m down to Toradol, I think.  If that one’s still ok.  Eek.

T/j but I too am deathly allergic to all narcotics I have ever tried. But never tried tramadol or toradol.  Interesting.  

[ScoutTN]

1 hour ago, kand said:

 

Yikes. I have a kid with a lot of headaches and several days of severe cramps each month. I worry about how much ibuprofen she uses, and now I don’t feel any better! On the other hand, I was given toradol when I had a kidney stone, and it was amazing! I had never had it before, but boy did it work well, with none of the narcotic loopiness (they wanted to give me morphine, but I declined because I had had to drive myself to ER with my kids, so they were there with me). 

Acupuncture can really help with debilitating PMS. It’s very gentle. 

[melmichigan]

4 hours ago, ktgrok said:

You know your family, but I will say that in my county a full 1/3 of hospitalized patients are people under 45 years of age...I can't imagine all of them expected they were high risk. It seems to be a theme that they are seeing younger people sicker - in various places. Not sure if that is due to one of the variants or what. Something to look into, perhaps. 

This is the case here in Michigan as well, although it may be even higher than your 1/3.  Our hospitalization rate is increasing faster than it did this fall. Our case numbers (county) far exceeded our records from this fall. The hospitals here (county) are actually full, they are transferring patients out.  Our county now has the highest positivity in the state and our state has the highest positivity in the nation. We made national news today. 😪 

Florida is just a tad bit ahead of us in total variant case counts last I looked.

Edited March 30, 2021 by melmichigan

[wathe]

4 hours ago, ktgrok said:

You know your family, but I will say that in my county a full 1/3 of hospitalized patients are people under 45 years of age...I can't imagine all of them expected they were high risk. It seems to be a theme that they are seeing younger people sicker - in various places. Not sure if that is due to one of the variants or what. Something to look into, perhaps. 

Here 46% of hospital admissions are people are under 60 - this was just published today (see chart on page 8).  Compared to 30% in December.   More younger people are requiring hospitalization - both proportionately and absolute numbers.   Our variant of concern rate is about 65% of cases provincially.

ETA to be clear, these numbers are for hospital admissions over the specified periods, not hospital census counts (does not reflect relative lengths of stay, for example)

Edited March 30, 2021 by wathe

[PeterPan]

Here's an article saying they're now seeing breakthrough cases in fully vaccinated people. https://www.clickorlando.com/news/local/2021/03/29/dozens-in-central-florida-contract-covid-19-after-being-fully-vaccinated/

[kiwik]

The UK is delaying the second dose for logistics and supply reasons.  They are saying 80% of the protection comes from the first dose.

[ktgrok]

8 hours ago, PeterPan said:

Here's an article saying they're now seeing breakthrough cases in fully vaccinated people. https://www.clickorlando.com/news/local/2021/03/29/dozens-in-central-florida-contract-covid-19-after-being-fully-vaccinated/

Yeah, when it is 90-95% effective, you still get 5% that will get it. And we are vaccinating many thousands a day, so that seems about righ, to have a dozen cases since we started vaccinating. 

For perspective, Orange County is at an average of 375 new cases a day. If you assume that number for the last 3 months (and it was higher during our spike so that's a low estimate) that's over 3,300 cases in unvaccinated people in the past 3 months, vs the dozen vaccinated cases. 

Edited - my numbers were WAY too low...we had over 1K cases a day in my county some days this January, so have had a LOT more cases in the past 3 months than I was estimating. so a dozen cases in vaccinated people isn't so surprising. And as a physical therapist, she's right up close with people breathing heavily all day. 

But yeah, not time to be "back to normal" yet. Vaccines will be the key though. 

Photo shows daily cases in just one county in Florida. 

Edited March 30, 2021 by ktgrok

[*Jessica*]

44% of our hospitalized patients are under 64. 

[kbutton]

11 hours ago, PeterPan said:

Here's an article saying they're now seeing breakthrough cases in fully vaccinated people. https://www.clickorlando.com/news/local/2021/03/29/dozens-in-central-florida-contract-covid-19-after-being-fully-vaccinated/

I think not everyone realizes, cares, or pays attention to the fact that even after you're fully vaccinated, you need two weeks-ish (longer for J and J?) for the vaccine to have optimum protection. 

The higher the percentage of people who get immunized, and the less we let variants take hold by using precautions, the fewer people will get sick though. We know that not everyone develops immunity to all diseases they contract or are immunized for. I know someone that had chicken pox multiple times, for example (before they had the effective vaccine). But in the population as a whole, enough people now have chicken pox vaccinations that she is no longer getting chicken pox every year because she's not being exposed every year.

Vaccines are wonderful, but they rely partly on most people getting them to do all that we expect them to do. And every organism we vaccinate for has a different profile--the illnesses that mutate a lot mean yearly shots, like the flu, and while they confer immunity to some degree, they most definitely do a good job of keeping people from dying and keeping us from having pandemics (though we are still susceptible to having a novel flu pandemic from wildlife sources). The one and done illnesses fit our collective understanding of vaccine immunity much better, but not everything behaves the same way. 

[ktgrok]

1 hour ago, kbutton said:

know that not everyone develops immunity to all diseases they contract or are immunized for. I know someone that had chicken pox multiple times, for example (before they had the effective vaccine). But in the population as a whole, enough people now have chicken pox vaccinations that she is no longer getting chicken pox every year because she's not being exposed every year.

Vaccines are wonderful, but they rely partly on most people getting them to do all that we expect them to do.

Yes!!!

Here we have such high cases that those few prcent who don't have a strong immune response to the vaccine have a high exposure rate and are more likely to catch it than if we can get rates down. If MOST people are immune, and it isn't prevalent in the community, then the few who are not protected by the vaccine will be protected simply by not being exposed so much. 

It's why even though a significant percentage of women are not immune to rubella we don't really worry that much about exposure to unborn kids - because most people are immune and it isn't running rampant in the community. 

[kbutton]

3 minutes ago, kand said:

Just as footnote for anyone who’s reading the thread, but doesn’t click through to read that article, the vaccinated person who is the subject of that article only knew that she was infected because she’s in a health profession where she gets tested weekly. It’s not even that she got actually sick. It does sound like at least one of her family members got symptoms. Everyone is fine, though. This is why precautions in public until everyone is vaccinated.

I wish weekly testing was being done in all healthcare settings. My DH works in healthcare and has yet to have a test (or be symptomatic). He's full vaccinated and careful, careful, careful. His new job has him getting more training on high risk procedures though, so I am hoping most people here will get vaccinated (fat chance with what I see on social media).

[kbutton]

2 hours ago, kand said:

a loss of trust due to the medical profession not always being fully honest about certain things or even educated about them. Having pediatricians give such bad advice about things like breastfeeding, car seats, circumcision all made me very much feel I had to be the one to learn all the things and figure out what was best for my kids because the pediatrician couldn’t be trusted to have the right info.

I agree! 

11 minutes ago, Ordinary Shoes said:

It's strange to me the things that we expect pediatricians to know. My DD is 11 now and they pretty much stick to medical discussions with me now but when she was a baby, it was clear that they expected me to ask them about sleep training, breastfeeding, etc. The pediatrician/patient relationship is different from that of other kinds of doctors. Perhaps that's how they end up voicing opinions about subjects that are beyond their scope of expertise. When they get it wrong, people loss faith in the areas that they do know about like childhood vaccinations. 

Well...most of the entire medical profession divests themselves of the responsibility to know anything about breastfeeding (and the rest), and it can be difficult to access good information on these things (if we're talking more than a mommy blog) when you need it. Learning ahead lacks a lot of context and can make a person paranoid by turns. Then, if you get a kid that fits NO ONE'S advice, you've done a lot for nothing but heartache and revilement (yes, I used that word on purpose--I have been treated like utter crap over my kids and their issues, as if I am stupid). It's been almost 12 years since I breastfed, but given the content of most wellness sites I've been seeing during the pandemic and on my social media feed, I assume it's worse rather than better now.

Almost nothing that I needed to know to parent or educate my kids has been available easily.

Every book on earth tells you that whatever advice you take, the buck stops with the pediatrician, or it goes the other way and tells you that pediatricians are dummies and you need to do all kinds of quack stuff.

It's just not simple.

And frankly, a lot of doctors get a lot of things wrong that aren't personal preferences or part of the mommy wars. I can't begin to tell you how out of date and often horrible a lot of advice from cardiologists is about aneurysms, for instance. It's dangerous and almost always wrong. Yet, you need a cardiologist to learn about this stuff and to diagnose an aneurysm. (FYI, The Marfan Foundation and The John Ritter Foundation are good places to go, and thankfully they have robust public information campaigns, or I'd have relatives with some really bad advice.)

I say this as someone who is married to a mid-level practitioner, lol! 

[Not_a_Number]

5 minutes ago, kbutton said:

And frankly, a lot of doctors get a lot of things wrong that aren't personal preferences or part of the mommy wars.

My last OB was basically innumerate. They first estimated my due date using my last period, which suggested that I was further along than I actually was by about a week, because my periods aren't on a 28-day cycle and therefore I ovulate a week LATER than that estimate suggests, then she ignored me when I said that wasn't a meaningful estimate, then she ignored the 6-week ultrasound that agreed with me that it was actually a week less like I thought ("the ultrasound is consistent with the period estimate! So we'll keep the period estimate!"), and then eventually DD4 was measuring "too small" and I had to have some extra ultrasounds.... even though if we had gone with the more sensible 6-week ultrasound predicted date, she'd have been measuring big enough for us to skip that. 

I finally rebelled and got them to push my due date back when it was closer to the due date, as I tend to run late anyway, and I didn't want to have an even earlier induction (I wound up induced anyway.) 

But the whole thing was really frustrating and involved her ignoring basic arithmetic. 

Edited March 30, 2021 by Not_a_Number

[Corraleno]

If people are deciding against the vaccine because friends and family were only mildly ill with the original strain, they need to be aware that the new variants are hitting younger and healthier people much harder. 

The B117 (UK) variant is both more infectious and more deadly. Luckily the vaccines seem to be very effective against this strain; efficacy is only slightly lower compared to the original strain, and is still very high. This strain already accounts for more than a third of US infections and is expected to become the dominant strain within days.

The B1351 (SA) and P1 (Brazil) strains are also far more infectious and they have mutations that allow them to avoid certain antibodies. Brazil is seeing a huge jump in hospitalizations of young, healthy people. Studies in SA indicated that infection with the original strain provided no protection against reinfection with B1351. Vaccine efficacy against milld illness with these strains seems to be quite a bit lower, but efficacy against severe illness and death is still quite good — and even 50% protection against mild illness beats 0%.  The B1351 and P1 strains are also currently circulating in the US, although in lower numbers than B117. 

We also have multiple "home grown" variants, including several from CA and NY, that share a lot of mutations with B117, and some of them also share the dangerous E484K mutation that allows B1351 and P1 to avoid certain antibodies. 

In Europe, where B117 is dominant and other variations are more widespread than in the US, France, Germany, Italy, and the Netherlands have seen cases double in the last six weeks, and Poland, Hungary, and Ukraine have seen them more than quadruple. In Brazil, cases and deaths are at the highest levels since the pandemic began. India went from 11,000 cases/day six weeks ago to 58,000 cases/day now. 

Cases are already climbing in 21 states, and many others have plateaued and will likely see an uptick as B117 becomes dominant and the other variants become more widespread. Michigan has one of the highest rates of B117 in the country, and daily cases have gone from 1000 a little over a month ago to 5000 now. B117 accounts for around half of current infections in Minnesota, where cases have doubled in less than a month. Cases in Florida are up 15% compared to 2 weeks ago, with positivity at 9%. 

The fact that case numbers in your state (generic you) are lower than they were in December doesn't mean they won't spike again when the more infectious variants hit. The fact that your cousin/friend/coworker/whatever had a mild case of the original strain doesn't mean that you will have a mild case of a strain that is more infectious, more deadly, or able to avoid antibodies. 

[kbutton]

43 minutes ago, Not_a_Number said:

But the whole thing was really frustrating and involved her ignoring basic arithmetic. 

That is frustrating! I have a short cycle, and my OB was not difficult, but he had to keep changing expectations with my first. I could feel movement early. As we neared the end, he was cautioning me that most first time moms go over a week or two...then it was, "I think you'll be on time." In the last couple of weeks, he was like, "You'll be delivering before the weekend." I had both kids 5 or 6 days early, but they were clearly well cooked.

[melmichigan]

3 hours ago, Corraleno said:

The fact that case numbers in your state (generic you) are lower than they were in December doesn't mean they won't spike again when the more infectious variants hit. The fact that your cousin/friend/coworker/whatever had a mild case of the original strain doesn't mean that you will have a mild case of a strain that is more infectious, more deadly, or able to avoid antibodies. 

Five weeks ago (2/19) we had less than 100 cases/week in our county.  Positivity was 3%.  This last week we had almost 1,200 cases and our positivity is 26%.  Our hospitals are full, and today's case count doubled yesterdays record. We have community spread of B.1.1.7.  It's down right scary with only my husband fully vaccinated.

[1234]

Dh has had his first dose, I get my first dose today, and this morning we scheduled both dc to have the first dose in three weeks (we’re all getting Pfizer)! So, we’ll all be fully vaccinated by June. 

[DawnM]

I did a little research on the vaccine before getting it.  I needed to feel comfortable with it.   I just got my first dose a couple of weeks ago and will get my 2nd in mid April.

I work with people all day every day.  

Edited March 31, 2021 by DawnM

[Scarlett]

2 hours ago, DawnM said:

I did a little research on the vaccine before getting it.  I needed to feel comfortable with it.   I just got my first dose a couple of weeks ago and will get my 2nd in mid April.

  

This was the same for me.  I was one of the ones who initially said I wanted to wait a while.  Then as the death toll continued to rise and I was seeing that it was all over the map who was the worst affected....I just read a bunch and decided that the benefit of getting the vaccine outweighs the risk of not getting it.  

[Halftime Hope]

On 3/30/2021 at 6:38 PM, Corraleno said:

If people are deciding against the vaccine because friends and family were only mildly ill with the original strain, they need to be aware that the new variants are hitting younger and healthier people much harder. 

The B117 (UK) variant is both more infectious and more deadly. Luckily the vaccines seem to be very effective against this strain; efficacy is only slightly lower compared to the original strain, and is still very high. This strain already accounts for more than a third of US infections and is expected to become the dominant strain within days.

The B1351 (SA) and P1 (Brazil) strains are also far more infectious and they have mutations that allow them to avoid certain antibodies. Brazil is seeing a huge jump in hospitalizations of young, healthy people. Studies in SA indicated that infection with the original strain provided no protection against reinfection with B1351. Vaccine efficacy against milld illness with these strains seems to be quite a bit lower, but efficacy against severe illness and death is still quite good — and even 50% protection against mild illness beats 0%.  The B1351 and P1 strains are also currently circulating in the US, although in lower numbers than B117. 

We also have multiple "home grown" variants, including several from CA and NY, that share a lot of mutations with B117, and some of them also share the dangerous E484K mutation that allows B1351 and P1 to avoid certain antibodies. 

In Europe, where B117 is dominant and other variations are more widespread than in the US, France, Germany, Italy, and the Netherlands have seen cases double in the last six weeks, and Poland, Hungary, and Ukraine have seen them more than quadruple. In Brazil, cases and deaths are at the highest levels since the pandemic began. India went from 11,000 cases/day six weeks ago to 58,000 cases/day now. 

Cases are already climbing in 21 states, and many others have plateaued and will likely see an uptick as B117 becomes dominant and the other variants become more widespread. Michigan has one of the highest rates of B117 in the country, and daily cases have gone from 1000 a little over a month ago to 5000 now. B117 accounts for around half of current infections in Minnesota, where cases have doubled in less than a month. Cases in Florida are up 15% compared to 2 weeks ago, with positivity at 9%. 

The fact that case numbers in your state (generic you) are lower than they were in December doesn't mean they won't spike again when the more infectious variants hit. The fact that your cousin/friend/coworker/whatever had a mild case of the original strain doesn't mean that you will have a mild case of a strain that is more infectious, more deadly, or able to avoid antibodies. 

Corraleno,  you've compiled this data in a concise and meaningful way.  Could you provide references?  I need to share this with decision-makers at my workplace.  

[Corraleno]

3 hours ago, Halftime Hope said:

Corraleno,  you've compiled this data in a concise and meaningful way.  Could you provide references?  I need to share this with decision-makers at my workplace.  

I don't have the sources saved (I should start doing that, actually), so I will need to find them again. Some will be easy to find (e.g. there's a good NYT article on the mutations in different variants, and the numbers on the spikes in Europe are easy to pull from Worldometer), but I can see just by skimming through the post that there are at least a dozen other individual sources for the other facts and stats, some of which may take a little more digging. I will try to work on that tomorrow.

[Penelope]

On 4/1/2021 at 12:07 AM, Halftime Hope said:

Corraleno,  you've compiled this data in a concise and meaningful way.  Could you provide references?  I need to share this with decision-makers at my workplace.  

While we still need to be cautious out there, there is not universal agreement among virologist and other scientists that B117 is more transmissible and more deadly, or that P1 is more of a problem than any other variant. There are many confounding factors that could have resulted in the numbers and results that have been seen with the variants. 

Example (and there are others to be found)https://www.medrxiv.org/content/10.1101/2021.03.16.21253534v1

”The course of the SARS-COV-2 pandemic in the UK seems highly predicted by an earlier model based on the lockdown stringency, humidity and temperature and unaltered by the emergence of a newer viral genotype.”

 

https://www.thestreet.com/latest-news/there-are-no-covid-super-strains-yet-says-virologist-vincent-racaniello
““People don’t really know what they are talking about,” says the researcher. “I understand, because you talk to doctors and scientists and you figure they would know what they are talking about, but they don’t always.”

”I just saw an article today that showed that the U.K. variant ... made no difference in the outbreak in the U.K. It made no difference. The people who know, they are not worrying that the vaccines are going to be compromised by a variant. That’s what I can say with certainty. “

 

 

[Not_a_Number]

1 minute ago, Penelope said:

While we still need to be cautious out there, there is not universal agreement among virologist and other scientists that B117 is more transmissible and more deadly, or that P1 is more of a problem than any other variant. There are many confounding factors that could have resulted in the numbers and results that have been seen with the variants. 

Example (and there are others to be found)https://www.medrxiv.org/content/10.1101/2021.03.16.21253534v1

”The course of the SARS-COV-2 pandemic in the UK seems highly predicted by an earlier model based on the lockdown stringency, humidity and temperature and unaltered by the emergence of a newer viral genotype.”

 

https://www.thestreet.com/latest-news/there-are-no-covid-super-strains-yet-says-virologist-vincent-racaniello
““People don’t really know what they are talking about,” says the researcher. “I understand, because you talk to doctors and scientists and you figure they would know what they are talking about, but they don’t always.”

”I just saw an article today that showed that the U.K. variant ... made no difference in the outbreak in the U.K. It made no difference. The people who know, they are not worrying that the vaccines are going to be compromised by a variant. That’s what I can say with certainty. “

But there are plenty of people who do think it's more transmissible. Mind linking those as well? Because currently you're only linking one side, as if it's definitive, which it isn't. 

[Penelope]

43 minutes ago, Not_a_Number said:

But there are plenty of people who do think it's more transmissible. Mind linking those as well? Because currently you're only linking one side, as if it's definitive, which it isn't. 

😂 Um, no? You are welcome to add some if you would like.

Someone on this thread and others on multiple threads have stated the point as though it is definitive. I agree with what you said, that it isn’t definite. I provided some counterpoint.

Edit- There are a bunch of variants. If you are talking about B117, then I think there is wide agreement that it usually (but has not always) spread faster where it comes into the population. As I have heard virologists explain, that doesn’t technically mean it must be inherently “more transmissible” but could have greater fitness for some other reason. So there is some disagreement about how much of a difference that particular variant makes. 

I think there is a lot of fear mongering in the news about the variants. But there are a number of people behind the scenes who say that this is unwarranted. 

 

 

Edited April 7, 2021 by Penelope

[Corraleno]

Large, matched cohort study published last month in BMJ found 64% higher death rate in those infected with B117:
https://www.bmj.com/content/372/bmj.n579.short

Separate study published in Nature showing 61% higher risk of death with B117:
https://www.nature.com/articles/s41586-021-03426-1

Study published in Science last month showing B117 is 43-90% more transmissible:
https://science.sciencemag.org/content/early/2021/03/03/science.abg3055

Study published in Nature showing B117 is 50-100% more transmissible:
https://www.nature.com/articles/s41586-021-03470-x

Those are all peer-reviewed studies published in highly respected journals.

[Penelope]

7 minutes ago, kand said:

That second article was a good one. What he saying is in step with what I’m seeing other virologists and immunologists saying—they are still very optimistic that the vaccines are going to win out. The article is almost a month old, and I’m wondering if it came out before the study showing the Astra Zeneca vaccine doing so poorly against B1.351 (South African) variant. I didn’t find the article to be addressing the issue of whether B.117 is more contagious or deadly, though. There’s one part that you quoted above where he appears to say something about the variant not changing the course of the pandemic, but it’s also the one place where they edited something out in the middle of that sentence there and I’m not sure what it was that he actually said. Because other than that one edited sentence, there’s nothing in the whole rest of the interview that’s on that topic at all so it seemed a little out of place. Good interview, though.

 

The other link, to the pre-print, doesn’t bear out what we are so far seeing in the real world data of infections with B.117. We’re starting in the US to see big spikes in areas where B.117 is starting to predominate, and the nature of who’s infected has shifted in those places to be infecting younger people overall, and a lot more children. 

The article was published April 4 2021. It’s not a month old.

We haven’t authorized Astra Zeneca in the US, but the point of the article is about variants in general and that antibodies are not the whole story. 
 

We have seen surges over a year plus, whether or not we had B117. Why would a surge “prove” that? You would have to have more granular kinds of data to show that, and as I already agreed, most do think it spreads more readily. But as far as big picture, real world data, there could be many reasons for upticks in infections that have nothing to do with variants. 

[Penelope]

7 minutes ago, kand said:

I still don’t think the second article has anything to do with whether variants are more transmissible or dangerous, but rather it’s just focused on whether the vaccines will work against them and eventually defeat them, for which the evidence still looks very, very good.

 You’re right. The pattern of surges currently happening isn’t enough to prove the variants are the cause of the surges and shifts in demographics, but based on lab studies showing much higher concentration of viral particles exhaled with the UK variant, coupled with now a number of large studies showing significant increase in transmissibility and likely mortality, it’s not looking like the variants are something we want to dismiss or wave off as insignificant to the course of the pandemic. I don’t even know what the benefit would be of doing that at this point.

It was just a response to much concern “out there” that we need to pay attention to variants. There are experts saying it is not settled science as to their effects, and we do not need to worry. Not that everyone who talks about it is worrying, some of us are just very interested.

But I see where the poster was originally talking about people who did NOT want a vaccine and that they would take their chances. 
I think whether B117 or any other variant is more deadly or not is somewhat controversial, which is why leaders are careful to say “could be” or “might be”. And I generally think it’s a bad idea to try to scare people into a vaccine. I think this can sometimes have the opposite effect intended. They wait a little longer, and then something else comes out that says it might not be true, and they further lose trust. 

But yes, for those close to us who are vaccine hesitant, it is definitely something to point out, I agree. 
 

 

 

 

[Spryte]

59 minutes ago, Corraleno said:

Large, matched cohort study published last month in BMJ found 64% higher death rate in those infected with B117:
https://www.bmj.com/content/372/bmj.n579.short

Separate study published in Nature showing 61% higher risk of death with B117:
https://www.nature.com/articles/s41586-021-03426-1

Study published in Science last month showing B117 is 43-90% more transmissible:
https://science.sciencemag.org/content/early/2021/03/03/science.abg3055

Study published in Nature showing B117 is 50-100% more transmissible:
https://www.nature.com/articles/s41586-021-03470-x

Those are all peer-reviewed studies published in highly respected journals.

Thanks for linking these.

[Corraleno]

B1351 (SA), P1 (Brazil), and now B117 (UK), along with several other variants of concern carry a mutation called E484K that allows them to evade antibodies. This is not merely theoretical: vaccine efficacy against B1351 is significantly lower, and both B1351 and P1 have been shown to reinfect people who already had Covid. 

(Note that the data showing that the vaccines were equally, or nearly, as effective against B117 were collected before the E484K mutation was detected in that variant.)

There is good data on B1351 from Novavax, whose South African trials showed that previous infection provided no protection against reinfection with B1351 — people who'd already had the original strain were just as likely to be reinfected with B1351 as those who had never had covid before.

I haven't seen formal studies from Brazil yet, just case studies of reinfections, plus the fact that there has been a huge spike in P1 infections in areas that theoretically should have hit herd immunity, with three-quarters of the population already infected with the original strain.

There is also no question that the vaccines are less effective against B1351 compared to the original strain: 
Novavax was 96% effective against the original strain vs only 55% in South Africa
J&J was 72% effective in the US vs 57% in South Africa 
AZ was 76% effective in the US vs 22% in South Africa

Although Novavax and J&J do still provide solid protection against severe illness and death, the significantly lower efficacy against infection, and therefore potential transmission, combined with the ability of B1351, P1, and possibly now B117, to reinfect those who already had covid, is certainly reason for concern.

 

Edited April 7, 2021 by Corraleno

[Masers]

-

Edited April 9, 2021 by Masers

[TCB]

@Masers I work in a healthcare facility and have talked to a number of people I work with about the vaccine. Everyone I talked to, who said they were not going to get vaccinated, did not seem to know much about it and had not read up on it - I asked them if they had looked into it and  they said no. Several nurses, who were initially hesitant, were encouraged to read some information about the vaccine by one of the drs and they then decided to go ahead and get vaccinated- I was really surprised because they had been quite vocal against it. Also the people around me who were/are hesitant are nurses and housekeeping etc, I don’t think any of the drs were hesitant. Anyway I say all this because I don’t think you can necessarily place a huge weight on the fact that HCWs are hesitant, because I don’t think they are reacting that way from being more informed than the general public - which surprised me too.

ETA - you had a really good summary of the reasons people are hesitant about the vaccine - a couple of them were new to me so very interesting!

Edited April 7, 2021 by TCB

[ktgrok]

8 minutes ago, Masers said:

I think there are plenty of good reasons to not want to get the vaccine, either now or maybe not ever, and it is upsetting to me to see those people attacked and villified. I think because there is such a hypocrisy to it. I am of the “your body, your choice” camp, so it would be very hypocritical of me to then turn around and say, “except for this!” 
-immunity is not known at this point, just that the vaccine decreases symptoms. Therefore, you can still conceivably get and therefore spread Covid. So it’s really not helping “herd immunity” (which is really just a theory, anyway, and the thresholds for it keep changing). Our area was really hard hit earlier this year, so I know tons of people who have had it. While most of them opted to get the vaccine anyway, I can respect those who feel their natural immunity is adequate. There just isn’t a lot of great or extensive data about vaccine immunity vs. natural immunity at this point. 
 

 

1. No one has been attacked nor villified. They have had flaws in their data pointed out, and their reasons have been disagreed with. But no one said, "you are a horrid person and your mama dresses you funny" or any other thing like that. 

2. The second bolded point is factually untrue. We DO now know that vaccines are preventing even asymptomatic infection. And if they prevent infection, they also prevent transmission. Early on, we didn't know yet, but now we do. We have that info. 

3. We actually do have data showing that with the new variants at least, the vaccines work better than natural immunity (from the initial strain). 

[Masers]

13 minutes ago, ktgrok said:

1. No one has been attacked nor villified. They have had flaws in their data pointed out, and their reasons have been disagreed with. But no one said, "you are a horrid person and your mama dresses you funny" or any other thing like that. 

2. The second bolded point is factually untrue. We DO now know that vaccines are preventing even asymptomatic infection. And if they prevent infection, they also prevent transmission. Early on, we didn't know yet, but now we do. We have that info. 

3. We actually do have data showing that with the new variants at least, the vaccines work better than natural immunity (from the initial strain). 

Sorry, I should clarify that I wasn’t referring to this board attacking people. I meant “in real life” and on social media. 
 

2. The Centers for Disease Control and Prevention has walked back the claim made by its director that vaccinated people don’t carry the coronavirus.

CDC chief Rochelle Walensky said earlier this week that “vaccinated people do not carry the virus, don’t get sick.”

But the health agency clarified the statement Thursday,  saying “the evidence isn’t clear” and that Walensky was “speaking broadly.”

“It’s possible that some people who are fully vaccinated could get COVID-19,” a CDC spokesperson told the New York Times. “The evidence isn’t clear whether they can spread the virus to others. We are continuing to evaluate the evidence.” (That was an excerpt from the NY Post a few days ago.) https://nypost.com/2021/04/02/cdc-walks-back-claim-that-vaccinated-people-cant-carry-covid/

3. I have seen a number of doctors opine that natural immunity is preferable to vaccine immunity, which they postulate will wane more quickly and respond differently than a broader natural immunity. Here is one such take. https://www.aier.org/article/if-you-had-covid-do-you-need-the-vaccine/
I just hate the term “the science is settled”, because I don’t think we can make statements that we really KNOW anything right now. The data is constantly changing. And I hope scientists continue to study and learn how the vaccines work, how our natural immunity works, how the virus works. In any case, I am certainly understanding of those who have had the virus and are choosing to forgo the vaccine for that reason. 

[Masers]

18 minutes ago, kand said:

This was the issue I bumped this thread for, to share a nice explainer for those who are worried about fertility, pregnancy and lactation. There is no contraindication at all for breastfeeding, as the vaccine does not pass into breastmilk, and in fact, getting vaccinated while breastfeeding has the benefit that her baby may be more protected from getting infected with Covid, because the baby will get the benefit of the antibodies against Covid. If she is concerned, you could share this link with her:

https://drive.google.com/file/d/1_wHIYX-tGkGBPwuax7N8BxZPR4PTTCDm/view

Thanks. That’s interesting and helpful. 

[Pam in CT]

re what constitutes The Ultimate Cancel

27 minutes ago, ktgrok said:

1. No one has been attacked nor villified. They have had flaws in their data pointed out, and their reasons have been disagreed with. But no one said, "you are a horrid person and your mama dresses you funny" or any other thing like that. ...

K, the notion that this, only this, constitutes "vilification" pretty much made my day.

 

(This possibly demonstrates that I need to get out more... 7 more days til I'm 14 days post V2 and fully immunized!! ⚡)

[ktgrok]

8 minutes ago, Masers said:

Sorry, I should clarify that I wasn’t referring to this board attacking people. I meant “in real life” and on social media. 
 

2. The Centers for Disease Control and Prevention has walked back the claim made by its director that vaccinated people don’t carry the coronavirus.

CDC chief Rochelle Walensky said earlier this week that “vaccinated people do not carry the virus, don’t get sick.”

But the health agency clarified the statement Thursday,  saying “the evidence isn’t clear” and that Walensky was “speaking broadly.”

“It’s possible that some people who are fully vaccinated could get COVID-19,” a CDC spokesperson told the New York Times. “The evidence isn’t clear whether they can spread the virus to others. We are continuing to evaluate the evidence.” (That was an excerpt from the NY Post a few days ago.) https://nypost.com/2021/04/02/cdc-walks-back-claim-that-vaccinated-people-cant-carry-covid/

3. I have seen a number of doctors opine that natural immunity is preferable to vaccine immunity, which they postulate will wane more quickly and respond differently than a broader natural immunity. Here is one such take. https://www.aier.org/article/if-you-had-covid-do-you-need-the-vaccine/
I just hate the term “the science is settled”, because I don’t think we can make statements that we really KNOW anything right now. The data is constantly changing. And I hope scientists continue to study and learn how the vaccines work, how our natural immunity works, how the virus works. In any case, I am certainly understanding of those who have had the virus and are choosing to forgo the vaccine for that reason. 

Yes, SOME would and could still get Covid and spread it because no vaccine is 100 percent, but the vast majority end up being fully protected, not infected, and therefor unable to spread the virus. We have that data now on at least Pfizer, and Moderna should be very similar given the way it works (the same way). He's walking back the all or nothing 100 percent part, which he never should have implied, but the data is pretty overwhelming now on it the vaccines actually preventing infection. 

And again, the data looks clear that natural immunity does not provide good protection to some of the variants. The vaccines do have some decent protection. 

Oh, and that article was written by people who are way outside their field of expertise..the closest being..a dentist. 

Edited April 7, 2021 by ktgrok

[Corraleno]

8 minutes ago, Masers said:

2. The Centers for Disease Control and Prevention has walked back the claim made by its director that vaccinated people don’t carry the coronavirus.

CDC chief Rochelle Walensky said earlier this week that “vaccinated people do not carry the virus, don’t get sick.”

But the health agency clarified the statement Thursday,  saying “the evidence isn’t clear” and that Walensky was “speaking broadly.”

“It’s possible that some people who are fully vaccinated could get COVID-19,” a CDC spokesperson told the New York Times. “The evidence isn’t clear whether they can spread the virus to others. We are continuing to evaluate the evidence.” (That was an excerpt from the NY Post a few days ago.) https://nypost.com/2021/04/02/cdc-walks-back-claim-that-vaccinated-people-cant-carry-covid/

 

What they are clarifying is that 100% of vaccinated people are not 100% protected against infection. US data showed 90% efficacy against infection and Isreali data showed 94% efficacy against infection — not just symptoms, but any infection as measured by PCR testing. 

That still means that 6-10% of people who have been fully vaccinated may still get infected and although there is also good evidence from Israel that vaccinated people who get infected also carry a much lower viral load and are therefore less likely to spread it, there is still the possibility that a small percentage of those who are vaccinated could spread the virus.

That does not in any way suggest that the vaccines do not protect against transmission. It just means that the vaccines do not provide 100% protection against transmission in 100% of people. The fact that it does protect against any infection or transmission in at least 90% of people is really important.

Edited April 7, 2021 by Corraleno

[Masers]

Just now, ktgrok said:

Yes, SOME would and could still get Covid and spread it because no vaccine is 100 percent, but the vast majority end up being fully protected, not infected, and therefor unable to spread the virus. We have that data now on at least Pfizer, and Moderna should be very similar given the way it works (the same way). He's walking back the all or nothing 100 percent part, which he never should have implied, but the data is pretty overwhelming now on it the vaccines actually preventing infection. 

And again, the data looks clear that natural immunity does not provide good protection to some of the variants. The vaccines do have some decent protection. 

(CDC Chief is a she.)

that is true, butttt there have been a noticeable tick in cases of “breakthrough” cases (aka getting Covid despite being vaccinated), which is discouraging. 
 

Yes, but if you read the article I linked, they do a real deep dive into the evidence and conclude that “immunity caused by natural exposure remains the most robust and durable and successful manner to protect the population.”

——-

I’m not saying you’re wrong. But I’m also not confident enough to say that the (many) doctors, scientists, researchers, etc. who have a different viewpoint are wrong, either. I really strongly despise the “anti-science” malarkey. There is actually a lot of science rejecting the mainstream view and that’s OKAY. If everything was an echo chamber, we’d never learn anything new or have new theories. And the people who choose to follow a dissenting viewpoint are okay, too. It’s not like they are listening to a circus clown or a teenage grocery story clerk. There are lots of credentialed, knowledgeable professionals out there who aren’t getting the vaccine, or aren’t getting the vaccine yet, or see potential problems with the vaccine, and, again, that’s okay. Great, even. I’m a big fan of robust debates and different opinions, because I feel like it’s the only way science advances. 

[Masers]

4 minutes ago, kand said:

But so far, all evidence points against that. That article is brought to you by the same people who brought the Great Barrington Declaration, which has clearly been shown (as was widely stated at the time) would have been a disastrous approach, as shown by Brazil. These people are not experts in this field.

You don’t think so? The Great Barrington Declaration was written by Dr. Jay Bhattacharya, Dr. Sunetra Gupta and Dr. Martin Kulldorff. I just looked up their credentials: British infectious disease expert Professor Sunetra Gupta, Stanford University researcher and Professor of Medicine Dr. Jay Bhattacharya, and biostatistician Dr. Martin Kulldorff. All three have loads of professional experience in infectious disease.
 

Dr. Kulldorff works on research grants from the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration and the non-profit Fund for Public Health in New York City, some of which is related to COVID-19. He has never accepted or received any funding from pharmaceutical companies, nor from any other large corporation. 

Dr. Bhattacharya research funding over the past 22 years of his career has come almost entirely from grants from the National Institutes of Health, the National Science Foundation, the US Department of Agriculture, and participation on contracts with the Center for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) via a government contracting research group, Acumen, LLC. He has never accepted or received any funding from pharmaceutical companies, nor from any other large corporation. 

Dr. Gupta’s research funding over the last 30 years has principally been through fellowships and investigator awards from the Wellcome Trust and the European Research Council.  She has also received funding from the UKRI, the Royal Society, the Leverhulme Trust, the Emily and Georg von Opel Foundation and the Oxford Martin School. She and Dr. Craig Thompson have developed a novel method for producing a universal influenza vaccine (derived from a mathematical model) and this has now been licensed and is going through early testing. She does not hold any consultancy contracts or stock shares in any commercial company.

See, to me, this goes back to the very hubristic “my experts know more than your experts; I’m right, you’re wrong.” These people have the right to express their (expert) opinion, and other people have the right to agree with them. 

[Masers]

25 minutes ago, Corraleno said:

What they are clarifying is that 100% of vaccinated people are not 100% protected against infection. US data showed 90% efficacy against infection and Isreali data showed 94% efficacy against infection — not just symptoms, but any infection as measured by PCR testing. 

That still means that 6-10% of people who have been fully vaccinated may still get infected and although there is also good evidence from Israel that vaccinated people who get infected also carry a much lower viral load and are therefore less likely to spread it, there is still the possibility that a small percentage of those who are vaccinated could spread the virus.

That does not in any way suggest that the vaccines do not protect against transmission. It just means that the vaccines do not provide 100% protection against transmission in 100% of people. The fact that it does protect against any infection or transmission in at least 90% of people is really important.

I get that, but the jury is still out on a lot that many people want to know before they get vaccinated, and rightfully so. After all, health experts are still recommending that vaccinated people wear masks in public because “more research is needed to confirm whether vaccinated people can spread the virus and variants become more prevalent in the U.S.” (article from USA Today earlier this week.) 

so yes, it appears that transmission is greatly reduced, but we just honestly don’t have a lot of super solid long term evidence for ANY of this! How can we at this point?!

 

[Corraleno]

16 minutes ago, Masers said:

Yes, but if you read the article I linked, they do a real deep dive into the evidence and conclude that “immunity caused by natural exposure remains the most robust and durable and successful manner to protect the population.”

Not only is this not a scientific paper, this was published by the same "free market think tank" that has been arguing all along that the best policy is to "protect the vulnerable" and let everyone else get infected so we can reach herd immunity ASAP.  They are repeating the same arguments about vaccines leading to worse variants that have been presented in YouTube videos by the likes of Geert Vanden Bossche and Simone Gold, for which there is no evidence. There is no evidence that getting covid provides longer-lasting immunity, or more protection against variants, compared to the vaccines. They are simply presenting hypotheticals as if they were facts, in support of an argument that is really about economics, not virology or immunology/

[Masers]

-

Edited April 9, 2021 by Masers

[Corraleno]

19 minutes ago, Masers said:

See, to me, this goes back to the very hubristic “my experts know more than your experts; I’m right, you’re wrong.” These people have the right to express their (expert) opinion, and other people have the right to agree with them. 

Sunetra Gupta was one of the scientists arguing that the UK was already close to herd immunity in spring of last year. Her ideas were widely refuted by other experts, but more importantly, her "estimates" turned out to be 100% wrong. See that little blip around spring of last year? That's when Gupta was arguing that the UK was near herd immunity and should just let healthy people get it, because there would be few additional infections or deaths. Doh!

[Masers]

-

Edited April 9, 2021 by Masers

[Masers]

1 minute ago, Corraleno said:

Sunetra Gupta was one of the scientists arguing that the UK was already close to herd immunity in spring of last year. Her ideas were widely refuted by other experts, but more importantly, her "estimates" turned out to be 100% wrong. See that little blip around spring of last year? That's when Gupta was arguing that the UK was near herd immunity and should just let healthy people get it, because there would be few additional infections or deaths. Doh!

9 minutes ago, Corraleno said:

Sunetra Gupta was one of the scientists arguing that the UK was already close to herd immunity in spring of last year. Her ideas were widely refuted by other experts, but more importantly, her "estimates" turned out to be 100% wrong. See that little blip around spring of last year? That's when Gupta was arguing that the UK was near herd immunity and should just let healthy people get it, because there would be few additional infections or deaths. Doh!

yep, a lot of people have been wrong about a lot of things. On each and every side of the issue. I still listen to what Fauci says, even those he’s been wrong about a lot of stuff, too. 

[Penelope]

1 hour ago, ktgrok said:

. 

3. We actually do have data showing that with the new variants at least, the vaccines work better than natural immunity (from the initial strain). 

I don’t think this is true. Where is this data? Most data suggests that natural infection provides durable immunity for nearly a year, and still strong. For the vaccine, we have some phase1/2 immunogenicity from mRNA vaccines that show the same.

Where is the evidence that more people with prior infection are being reinfected with variants and doing poorly, compared with those who had the vaccine? 

51 minutes ago, kand said:

But so far, all evidence points against that. That article is brought to you by the same people who brought the Great Barrington Declaration, which has clearly been shown (as was widely stated at the time) would have been a disastrous approach, as shown by Brazil. These people are not experts in this field.

I am so not a GBD defender. But Brazil didn’t follow that at all. GBD did not say to just let it rip and do absolutely nothing, and then be totally inept at procuring and administering vaccination. And two of them at least are experts in the pertinent fields of public health, epidemiology, and infectious disease modeling. There are more diverse opinions about what we coulda/woulda/shoulda done about the pandemic in Feb/March than you’d think if you only read standard news media.

Edited April 7, 2021 by Penelope
Typo

[melmichigan]

59 minutes ago, Masers said:

You don’t think so? The Great Barrington Declaration was written by Dr. Jay Bhattacharya, Dr. Sunetra Gupta and Dr. Martin Kulldorff. I just looked up their credentials: British infectious disease expert Professor Sunetra Gupta, Stanford University researcher and Professor of Medicine Dr. Jay Bhattacharya, and biostatistician Dr. Martin Kulldorff. All three have loads of professional experience in infectious disease.
 

Dr. Kulldorff works on research grants from the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration and the non-profit Fund for Public Health in New York City, some of which is related to COVID-19. He has never accepted or received any funding from pharmaceutical companies, nor from any other large corporation. 

Dr. Bhattacharya research funding over the past 22 years of his career has come almost entirely from grants from the National Institutes of Health, the National Science Foundation, the US Department of Agriculture, and participation on contracts with the Center for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) via a government contracting research group, Acumen, LLC. He has never accepted or received any funding from pharmaceutical companies, nor from any other large corporation. 

Dr. Gupta’s research funding over the last 30 years has principally been through fellowships and investigator awards from the Wellcome Trust and the European Research Council.  She has also received funding from the UKRI, the Royal Society, the Leverhulme Trust, the Emily and Georg von Opel Foundation and the Oxford Martin School. She and Dr. Craig Thompson have developed a novel method for producing a universal influenza vaccine (derived from a mathematical model) and this has now been licensed and is going through early testing. She does not hold any consultancy contracts or stock shares in any commercial company.

See, to me, this goes back to the very hubristic “my experts know more than your experts; I’m right, you’re wrong.” These people have the right to express their (expert) opinion, and other people have the right to agree with them. 

Where is this from?  I looked into the first, from Stanford.edu Jay Bhattacharya, MD, PhD.  

https://fsi-live.s3.us-west-1.amazonaws.com/s3fs-public/cv-jay-march2016.pdf

Where is the infectious disease experience?  His research papers include: 

Effects of Obesity on Employer-sponsored Health Insurance

Temperance and the Russian Mortality Crisis

Helping Older Adults to Initiate Exercise Habits

The HIV/AIDS Pandemic and Africa’s Orphaned Elderly

 

Edited April 7, 2021 by melmichigan

[Penelope]

2 hours ago, Corraleno said:

B1351 (SA), P1 (Brazil), and now B117 (UK), along with several other variants of concern carry a mutation called E484K that allows them to evade antibodies. This is not merely theoretical: vaccine efficacy against B1351 is significantly lower, and both B1351 and P1 have been shown to reinfect people who already had Covid. 

(Note that the data showing that the vaccines were equally, or nearly, as effective against B117 were collected before the E484K mutation was detected in that variant.)

There is good data on B1351 from Novavax, whose South African trials showed that previous infection provided no protection against reinfection with B1351 — people who'd already had the original strain were just as likely to be reinfected with B1351 as those who had never had covid before.

I haven't seen formal studies from Brazil yet, just case studies of reinfections, plus the fact that there has been a huge spike in P1 infections in areas that theoretically should have hit herd immunity, with three-quarters of the population already infected with the original strain.

There is also no question that the vaccines are less effective against B1351 compared to the original strain: 
Novavax was 96% effective against the original strain vs only 55% in South Africa
J&J was 72% effective in the US vs 57% in South Africa 
AZ was 76% effective in the US vs 22% in South Africa

Although Novavax and J&J do still provide solid protection against severe illness and death, the significantly lower efficacy against infection, and therefore potential transmission, combined with the ability of B1351, P1, and possibly now B117, to reinfect those who already had covid, is certainly reason for concern.

 

The theoretical herd immunity in Manaus, Brazil, is acknowledged to be most likely the result of one faulty study which was contradicted with other serology estimates. 
 

The only documented reinfections from P1 in Brazil that I’ve seen or heard of is this paper with these three cases. There are probably more, but notably, these three were milder disease than the prior infections, which is completely expected. People have also been reinfected and gotten Covid long before we have known of these variants, and these were also almost all milder than the initial infection.https://www.researchsquare.com/article/rs-318392/v1

So I think that a lot of what we see out there about P1 is simply clickbait.

Pfizer’s recent press release had small numbers, but showed high efficacy against symptomatic B.1.1351 infection. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-confirm-high-efficacy-and-no-serious

Anyway, why do we need to be concerned about these particular variants if our vaccines protect against hospitalization and deaths? 
It would be nice if no one ever got even a fever or a sniffle from this virus ever again, but I don’t see that this has ever been a realistic expectation. 

 

 

[Corraleno]

22 minutes ago, Penelope said:

I don’t think this is true. Where is this data? Most data suggests that natural infection provides durable immunity for nearly a year, and still strong. For the vaccine, we have some phase1/2 immunogenicity from mRNA vaccines that show the same.

Where is the evidence that more people with prior infection are being reinfected with variants and doing poorly, compared with those who had the vaccine? 

Rate of infection with B1351 was 5.2% in those with previous infection vs 5.3% in those without previous infection. So 0% efficacy vs 50% for vaccine.
https://www.medrxiv.org/content/10.1101/2021.02.25.21252477v1https://www.medrxiv.org/content/10.1101/2021.02.25.21252477v1