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COVID-19 vaccine discussion


Texas Jeff

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Lulz, I just managed to secure a j&j timeslot last night here in Austin. There were choices of all 3, but I picked it due to the 1 shot delivery. so now my choices are between blood clots and growing a pecker out of my forehead in 20-30 years? May have to consult Alex Jones on this one...

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1 hour ago, Heme Doc said:

A major mistake IMO

Unbelievably stupid. The risk of people dying from Covid is WAY higher than the risk of dying from blood clots from the vaccine. Once again, the CDC's messaging SUCKS ASS. Do they not think that this messaging will impact the other vaccines? So fucking dumb.

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we were all going to be guinea pigs on this to some extent. anyone who didn't think there was a risk doesn't understand vaccines.

now if our fearless leader can just fucking message that once you get the vax you can get back to normal maybe we can overcome this.

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1 hour ago, Blotto said:

Lulz, I just managed to secure a j&j timeslot last night here in Austin. There were choices of all 3, but I picked it due to the 1 shot delivery. so now my choices are between blood clots and growing a pecker out of my forehead in 20-30 years? May have to consult Alex Jones on this one...

the clots were all in women so you should be fine.

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This is so insanely stupid. 6 cases, 1 death on 7 million doses.  Given the oft-quoted "Covid ain't played no one Pawwwwwl" survival rate of 99.7%, 7 million Covid cases will result in 21,000 deaths. 21,000 to 1, yet we are choosing more cases over more doses. Humanity just can't overcome caveperson brain.

Same shit with autonomous cars. 35,000 Americans a year die in human-driven auto crashes, but 1 death in autonomous car situation is SHUT ER DOWN TIME.

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On 4/11/2021 at 12:00 PM, SizzleChest said:

I'm calm.  I just hear this some doctor or someone who knows said this or that all the time and it's just bullshit excuses for not considering vaccination.  It's usually some political motivation or social-media generated hysteria.  Or a podcast involving a Weinstein and the phrase "well, you know, we just don't know".  These dipshits are not trying to fight the fucking battle right in front of us, they've jumped ahead to fighting the ones in 2050 to "inform their listeners and help them think about it".

If you've looked and can't find anything online to corroborate what Dr. Pretty Solid told you, then there's no point to this discussion rn.  If you are able to corral him and get something concrete, then by all means, post it here when you find out.

I'm just going to sit here and enjoy my coffee.  I can get you a toe.

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2 hours ago, Cheeseweasel said:

Continue Season 9 GIF by The Office

Thousands of people die in car accidents all the time, but we don’t say “shut down driving”. All of us get into our cars with the understanding that there’s a very small risk that we will wreck and possibly die. And we do it anyway, not because it’s perfectly safe but because the benefit outweighs the risk. But with this COVID shit we’ve gone insane. “Can I live a normal life after getting vaccinated?” Nooo!!! something bad could happen. We don’t act that way about anything else.

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3 hours ago, Heme Doc said:

https://www.nytimes.com/2021/04/13/us/politics/johnson-johnson-vaccine-blood-clots-fda-cdc.html#click=https://t.co/NkjtHukwHQ
 

Shit.  Not good.  A major mistake IMO

I guess it’s time for ol HemeDoc to weigh in vis a vis the clotting and platelet issues surrounding the AZ vaccine and now maybe J&J...so let me wave something shiny in front of you monkeys.

The AZ vaccine has reported a rare form of blood clots plus low platelets. ~60% involve veins of brain.  Almost all after 1st dose. 

Risk from the UK is about 1 in 250,000 people

Risk of dying: 20-25% of people with these clots have died

Approximately half of the deaths in the UK (11 of 19) were under age 50. 

The benefits of the AZ vaccine according to regulators appear to outweigh risks in all except those less than age 30.

While blood clots occur at a certain rate in population what is unusual about these clots is the association with low platelets. Platelets help make blood clots & when platelets are low we are at risk of bleeding not clotting. 

Low platelets in context of blood clots is unusual.  This type of combination of low platelets and blood clots occurs in patients exposed to heparin (HIT).  It can also occur with hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and sometimes with antiphospholipid antibody syndrome.

Emerging data suggest that the mechanism of the clots may involve antibodies generated (presumably by the vaccine - most likely the adenovirus vector) that target platelet factor 4 (PF4), similar to the process that happens in some people after exposure to heparin (HIT)

I would assume that it is something related to the Adenovirus vector. However, from the article that I quoted above, it appears to be a possibility whenever extracellular RNA is present. Maybe it is two separate mechanisms since Adenovirus would result in less (rather than more) extracellular nucleic acid compared to the Moderna and Pfizer vaccines. Maybe the Adenovirus triggers something extracellularly when it is in the bloodstream or maybe there is some intracellular signalling that occurs after the Adenovirus enters the cell.

 

https://www.pnas.org/content/104/15/6388.short

Upon vascular injury, locally controlled haemostasis prevents life-threatening blood loss and ensures wound healing. Intracellular material derived from damaged cells at these sites will become exposed to blood components and could contribute to blood coagulation and pathological thrombus formation. So far, the functional and mechanistic consequences of this concept are not understood. Here, we present in vivo and in vitro evidence that different forms of eukaryotic and prokaryotic RNA serve as promoters of blood coagulation. Extracellular RNA was found to augment (auto-)activation of proteases of the contact phase pathway of blood coagulation such as factors XII and XI, both exhibiting strong RNA binding. Moreover, administration of exogenous RNA provoked a significant procoagulant response in rabbits. In mice that underwent an arterial thrombosis model, extracellular RNA was found associated with fibrin-rich thrombi, and pretreatment with RNase (but not DNase) significantly delayed occlusive thrombus formation. Thus, extracellular RNA derived from damaged or necrotic cells particularly under pathological conditions or severe tissue damage represents the long sought natural “foreign surface” and provides a procoagulant cofactor template for the factors XII/XI-induced contact activation/amplification of blood coagulation. Extracellular RNA thereby reveals a yet unrecognized target for antithrombotic intervention, using RNase or related therapeutic strategies.

 

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I wonder how this J&J thing would have played out even 20 years ago much less 30-40 years ago. Probably a few day pause that nobody is even aware of.  This is a problem that there is really no getting around quickly.  For say 70% of folks in this country the information age and the ability to make more informed decisions has and will continue to be an amazing advance in our civilization.  The problem is the other 30% lack intelligence, education, critical thinking skills and need to be told what to do.  The solution would seem to be better education etc but I'm afraid that Clevon's genetics are making that an Everest to scale.  

Edited by Surly Bevo
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17 minutes ago, Surly Bevo said:

I wonder how this J&J thing would have played out even 20 years ago much less 30-40 years ago. Probably a few day pause that nobody is even aware of.  This is a problem that there is really no getting around quickly.  For say 70% of folks in this country the information age and the ability to make more informed decisions has and will continue to be an amazing advance in our civilization.  The problem is the other 30% lack intelligence, education, critical thinking skills and need to be told what to do.  The solution would seem to be better education etc but I'm afraid that Clevon's genetics are making that an Everest to scale.  

I think you have your percentages backwards.

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2 hours ago, TXSooner518 said:

This is so insanely stupid. 6 cases, 1 death on 7 million doses.  Given the oft-quoted "Covid ain't played no one Pawwwwwl" survival rate of 99.7%, 7 million Covid cases will result in 21,000 deaths. 21,000 to 1, yet we are choosing more cases over more doses. Humanity just can't overcome caveperson brain.

Same shit with autonomous cars. 35,000 Americans a year die in human-driven auto crashes, but 1 death in autonomous car situation is SHUT ER DOWN TIME.

image.gif.5d7be44a71fe0f103919e38fbe893b10.gif

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3 hours ago, Viper said:

the clots were all in women so you should be fine.

HEB made the decision for me and cancelled on me due to the CDC. I'd still take the shot today as its one shot/ 2 weeks, but i guess its back to the line for Moderna/Pfizer

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14 minutes ago, Blotto said:

HEB made the decision for me and cancelled on me due to the CDC. I'd still take the shot today as its one shot/ 2 weeks, but i guess its back to the line for Moderna/Pfizer

Costco opened up some slots yesterday and I grabbed one for Moderna #1.  Worth taking a look.

 

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1 minute ago, Anastasis said:

I don't think that the FDA had another alternative, and after a short pause they will resume JNJ administrations. But to put things in perspective.

 

 

It's no so much the overall (very low) rate as the graphic shows, but the fact that most of the cases come from specific group. In this case <40 year old females.

I'd be okay to pause this specific vaccine to this specific demographic, but keep them going to all others. 

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1 minute ago, Nightfly said:

It's no so much the overall (very low) rate as the graphic shows, but the fact that most of the cases come from specific group. In this case <40 year old females.

I'd be okay to pause this specific vaccine to this specific demographic, but keep them going to all others. 

Yep.  Also have to consider the relatively low COVID exposure risk in most states at the moment in that calculus as well (sorry Michigan and Minnesota).  I think that we see a restriction in women <40 at minimum and maybe just a broad restriction in both men and women. 

 

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Got to normalize to person-time based exposure. Let's just assume 1 month average duration of follow-up person time which is probably an overestimate, so only about a 30% reduction vs. upper end of the background rate or a 3-fold increase from the low end estimate, back of the envelope math gets me to ~11 cases per 1MM person years of exposure to JNJ.  I am sure that the JNJ numbers are undercounts at the moment, but if you take them for what they are worth, I think that's the math. 

 

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4 hours ago, Nightfly said:

It's no so much the overall (very low) rate as the graphic shows, but the fact that most of the cases come from specific group. In this case <40 year old females.

I'd be okay to pause this specific vaccine to this specific demographic, but keep them going to all others. 

So your saying I should encourage my wife to get the JNJ? 
 

Wait, wut? 

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I'm curious to know more about these problems for both the JnJ and AZ vaccines. 

6 cases out of 6.8 million seems exceptionally low, but given that all of the cases of CVST occurred in women ages 18-48, I would like to know how many women in that age range received the vaccine, just to give some perspective more specific to the affected demographic.

I would also like to know if any of the affected patients have pre-existing medical conditions or other risk factors for clotting disorders. I'm sure that will be a part of the ongoing investigation.

For the AstraZeneca vaccine, of the original 11 patients, 1 patient had Von Willebrand disease, anti-cardiolipin antibodies, and Factor V Leiden. The study published in NEJM listed the other patients as having no other medical conditions, but did not specifically say one way or the other if other risk factors (oral contraceptives, obesity, pregnancy, smoking) were present. Here is the study for anyone interested:

https://www.nejm.org/doi/full/10.1056/NEJMoa2104840

It is frustrating for this to occur because it will certainly be a talking point for anti-vaxxers and it will likely influence some people who are on the fence to avoid all vaccines.

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12 minutes ago, wild_turkey said:

I'm curious to know more about these problems for both the JnJ and AZ vaccines. 

6 cases out of 6.8 million seems exceptionally low, but given that all of the cases of CVST occurred in women ages 18-48, I would like to know how many women in that age range received the vaccine, just to give some perspective more specific to the affected demographic.

I would also like to know if any of the affected patients have pre-existing medical conditions or other risk factors for clotting disorders. I'm sure that will be a part of the ongoing investigation.

For the AstraZeneca vaccine, of the original 11 patients, 1 patient had Von Willebrand disease, anti-cardiolipin antibodies, and Factor V Leiden. The study published in NEJM listed the other patients as having no other medical conditions, but did not specifically say one way or the other if other risk factors (oral contraceptives, obesity, pregnancy, smoking) were present. Here is the study for anyone interested:

https://www.nejm.org/doi/full/10.1056/NEJMoa2104840

It is frustrating for this to occur because it will certainly be a talking point for anti-vaxxers and it will likely influence some people who are on the fence to avoid all vaccines.

All of these.  Because people are very, very dedicated to being super-bad at math.

Signed, a guy who lives in a country where a significant percentage of people still refuse to wear a seatbelt because "I don't wanna be trapped in my car if I go over a bridge into the water."

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I'm curious to know more about these problems for both the JnJ and AZ vaccines. 
6 cases out of 6.8 million seems exceptionally low, but given that all of the cases of CVST occurred in women ages 18-48, I would like to know how many women in that age range received the vaccine, just to give some perspective more specific to the affected demographic.
I would also like to know if any of the affected patients have pre-existing medical conditions or other risk factors for clotting disorders. I'm sure that will be a part of the ongoing investigation.
For the AstraZeneca vaccine, of the original 11 patients, 1 patient had Von Willebrand disease, anti-cardiolipin antibodies, and Factor V Leiden. The study published in NEJM listed the other patients as having no other medical conditions, but did not specifically say one way or the other if other risk factors (oral contraceptives, obesity, pregnancy, smoking) were present. Here is the study for anyone interested:
https://www.nejm.org/doi/full/10.1056/NEJMoa2104840
It is frustrating for this to occur because it will certainly be a talking point for anti-vaxxers and it will likely influence some people who are on the fence to avoid all vaccines.

Yeah, go check out Alex berensens Twitter. Jfc


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7 hours ago, Nightfly said:

It's no so much the overall (very low) rate as the graphic shows, but the fact that most of the cases come from specific group. In this case <40 year old females.

I'd be okay to pause this specific vaccine to this specific demographic, but keep them going to all others. 

Coming back to this, because it probably makes the most sense to analyze the data in this particular segment (extend the age range to 50 though; cases ranged from 18-48 years of age, all females).  Let's assume that only 10% of the person time comes from this subgroup of females under 50, but all the cases. That ~11 per million becomes 110 per million. I don't know if that 10% figure is right, just something pulled out of my ass, but I think it likely that it's not too far off, and even if the assumption is off by half, we will see a restriction of use in some way, either sex specific or broadly among younger individuals.   

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First normal day in over two weeks.  Very happy. I forgot how great a 1030pm relaxed deep breath feels.  He told me we might not ever know - that’s often the case with these symptoms. I still have a day of tests and my GP appointment next week but it’s going to be uneventful. 

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