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  • COVID-19 vaccine discussion


    Texas Jeff

    I thought it might be helpful to have a separate topic related to the vaccine.  If this is too much duplication, mods please delete this thread.  I thought it would be good to talk about who can get the vaccine, where they can get it, what side effects people are seeing, and in general what is going on with distribution.

    The CDC has published vaccine distribution guidelines, and if you care, they are worth reading.  They are dividing the timeline into:

    • Phase 1 - Potentially limited supply of COVID-19 vaccine doses available
    • Phase 2 - Large number of vaccine doses available
    • Phase 3 - Sufficient supply of vaccine doses for entire population

    Who you are will determine if you are eligible for a vaccine in the various phases.

    Phase 1 is divided into a Phase 1a and a Phase 1b:

    • Phase 1a - Mostly healthcare workers
    • Phase 1b - Other essential workers, people with higher risks, people over 65

    If you are eligible to get the vaccine and they have in in stock and you want to get it, it is important to go get it.  Both of the first two vaccines can spoil, so if a dose is sitting there and you aren't there to get it, they might have to throw it away.

    Both vaccines require two shots.  It is important to go get that second shot.

    Who fits in phase 1b and who has to wait until phase 2 might be a sticking point.  The "people in higher risks" category includes a lot of folks, maybe more than you would think might be in that category.  Hopefully we can quickly get to phase 2 so that we don't spend too long arguing about who is or is not in Phase 1b.

    Anyway, I'm interested in everyone's experience with the vaccine and especially getting the word out for those that can go get it, so that every dose ends up in an arm rather than in the trash.

     

     


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    The recognition of nucleic acids is a pretty old and evolutionarily conserved arm of the immune system, regulated by receptors called 'Toll Like Receptors' (named because the German scientist who discovered them in the lab called them 'toll', meaning 'cool'.). Their whole role is to recognize 'coatings' that are used by bacteria, or nucleic acids (single, or double-stranded RNA) used by viruses or bacteria. 

    While the nanoparticle coating could potentially diminish 'free' RNA from floating around, I'm not sure that's the mechanism here as TLR receptors cycle into the intracellular space, basically to monitor for the presence of infection. This pathway gets abnormal in people with autoimmune disease, for instance, where the body starts making an immune response to normal cellular RNA and DNA (like in lupus). Basically, there immune system evolved to deal with the threat of nucleic acids floating around that don't belong there. 

    I think what's being seen with those with severe allergic hypersensitivity will see it with either RNA vaccine, or at least thats my guess. Again, these are people who have such hypersensitivity they have to travel around with EpiPens, so it's not just people like me that sneeze in contact with anything flowering or furry. 

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    No, and the recognition of 'self' nucleic acids is definitely a pathway for the onset of autoimmune disease. Basically, if a cell dies quietly, you're less likely to have issues. But apoptosis in the context of other inflammatory signals can definitely break self-tolerance. 

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    11 hours ago, Txzen said:

    The recognition of nucleic acids is a pretty old and evolutionarily conserved arm of the immune system, regulated by receptors called 'Toll Like Receptors' (named because the German scientist who discovered them in the lab called them 'toll', meaning 'cool'.). Their whole role is to recognize 'coatings' that are used by bacteria, or nucleic acids (single, or double-stranded RNA) used by viruses or bacteria. 

    While the nanoparticle coating could potentially diminish 'free' RNA from floating around, I'm not sure that's the mechanism here as TLR receptors cycle into the intracellular space, basically to monitor for the presence of infection. This pathway gets abnormal in people with autoimmune disease, for instance, where the body starts making an immune response to normal cellular RNA and DNA (like in lupus). Basically, there immune system evolved to deal with the threat of nucleic acids floating around that don't belong there. 

    I think what's being seen with those with severe allergic hypersensitivity will see it with either RNA vaccine, or at least thats my guess. Again, these are people who have such hypersensitivity they have to travel around with EpiPens, so it's not just people like me that sneeze in contact with anything flowering or furry. 

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    18 minutes ago, TwiceHorn said:

    Should the previously infected get it?

    We have this vague notion out there that people can be reinfected, does the vax help/hurt/whofuckingknows?

    Was wondering the same thing myself, along with other random questions like what happens if you get the first stage of the vax then contract covid before you get the 2nd?

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    29 minutes ago, Cheeseweasel said:

    That sucks. I want to wear a shirt that says "I'M IMMUNE FROM YOUR BULLSHIT".

    I was like wtf at first but I think she said they are going on an 80% effective  rate and can't have an asymptomatic nurse or doc walking thru the ICU because the vaccine didn't work on them.

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    13 minutes ago, rpspeed said:

    I was like wtf at first but I think she said they are going on an 80% effective  rate and can't have an asymptomatic nurse or doc walking thru the ICU because the vaccine didn't work on them.

    Well, I was promised a T-shirt.

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    51 minutes ago, Anastasis said:

    AdComm endorses the vaccine for 16+ years of age. Total waste of time and resources. FDA better have an EUA ready to roll tomorrow. 

    In the spirit of Waco light tours - “Den let's get our roll on"

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    Happy EUA Day for Pfizer vaccine!  If we don’t see the FDA issue an EUA today, they should be lit on fire.  Also, who were the four “no” votes on the committee?  I’d like to kick them in the balls repeatedly.  

    I got an email from my Pfizer trial location basically letting me know that I’d be unblinded once the EUA was issued and if I received placebo (unlikely), then they’d get me in ASAP for the real vaccine because I’m in healthcare.  
     

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    20 hours ago, TwiceHorn said:

    Should the previously infected get it?

    We have this vague notion out there that people can be reinfected, does the vax help/hurt/whofuckingknows?

    I’m seeing reports that the previously infected should get it. The vaccine might produce a longer time you are immune. Worse case the vaccine does nothing for you. Outside of implanting the Bill Gates tracker in you, of course.

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    Two more interesting vaccine things...

    It would be nice if we had a quick, readily available test for COVID neutralizing antibodies.  Probably around 60M Americans have already been infected with COVID.  So if you could identify those people, their vaccination could be deferred since it will be in somewhat short supply initially.

    Which transitions to the second thing...Almost all of our commercially available antibody tests are to the N (nucleocapsid) part of the coronavirus.  But these vaccines are all built to elicit antibodies to the S (spike) part of the virus.     So if I get vaccine, my antibody test will be negative for N (assuming I haven’t actually had COVID).  So what Pfizer is doing is checking vaccinated folks for the presence N antibodies, which could only be elicited by actual COVID infection.  So you’ll have your answer if vaccination prevents infection entirely (thus halting transmission) or if it only causes infections to be asymptomatic.  

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    13 minutes ago, Heme Doc said:

    Happy EUA Day for Pfizer vaccine!  If we don’t see the FDA issue an EUA today, they should be lit on fire.  Also, who were the four “no” votes on the committee?  I’d like to kick them in the balls repeatedly.  

    I got an email from my Pfizer trial location basically letting me know that I’d be unblinded once the EUA was issued and if I received placebo (unlikely), then they’d get me in ASAP for the real vaccine because I’m in healthcare.  
     

    I think that at least a couple of the no’s would have supported the eua if it was amended to 18+. Hard to know cause they did not do the customary discussion after the vote. But that was my read based on hearing some of the discussion before. The chair just rammed the motion through and stifled a lot of the discussion by shutting down questions. 

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    5 hours ago, Anastasis said:

    I think that at least a couple of the no’s would have supported the eua if it was amended to 18+. Hard to know cause they did not do the customary discussion after the vote. But that was my read based on hearing some of the discussion before. The chair just rammed the motion through and stifled a lot of the discussion by shutting down questions. 

    I would’ve loved to hear what the no’s were based on. We’ve consulted these experts for a reason, their concerns should’ve been fully voiced. Then people could’ve decided on their own if they were well founded, or just based on a small technicality like the age cutoff. 

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    13 hours ago, Heme Doc said:

    Two more interesting vaccine things...

    It would be nice if we had a quick, readily available test for COVID neutralizing antibodies.  Probably around 60M Americans have already been infected with COVID.  So if you could identify those people, their vaccination could be deferred since it will be in somewhat short supply initially.

    Which transitions to the second thing...Almost all of our commercially available antibody tests are to the N (nucleocapsid) part of the coronavirus.  But these vaccines are all built to elicit antibodies to the S (spike) part of the virus.     So if I get vaccine, my antibody test will be negative for N (assuming I haven’t actually had COVID).  So what Pfizer is doing is checking vaccinated folks for the presence N antibodies, which could only be elicited by actual COVID infection.  So you’ll have your answer if vaccination prevents infection entirely (thus halting transmission) or if it only causes infections to be asymptomatic.  

    That our natural immunoresponse is to the N as you say, could mutations there be the reason people can or have had second infection?  Whereas the spike is a stable piece by replication necessity and thus antibodies for it continue to be useful?

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    12 minutes ago, Pato del Muerto said:

    That our natural immunoresponse is to the N as you say, could mutations there be the reason people can or have had second infection?  Whereas the spike is a stable piece by replication necessity and thus antibodies for it continue to be useful?

    Our natural immune response is against all parts of the coronavirus (Nucleocapsid, Spike protein, etc).  It’s just that what we are testing for primarily right now is antibodies against N.  So we have a way to distinguish immunity through vaccination (should only have antibodies to Spike) vs immunity through infection (should have antibodies to N, Spike, etc)
     

    I’m not sure why people get infected twice, but that is very rare.  Fortunately, coronaviruses are more stable than other viruses like flu, so hopefully we won’t see emergence of mutations affecting Spike protein that will allow it to evade immunity.  

     

     

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    I signed up to help administer the COVID vaccine to medical staff starting next week. Most of the ICU nurses that I work with have passed on getting it. I would have eagerly gotten it if it wasn't for a disqualifying factor (pregnancy). 

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    6 minutes ago, whithou said:

    I signed up to help administer the COVID vaccine to medical staff starting next week. Most of the ICU nurses that I work with have passed on getting it. I would have eagerly gotten it if it wasn't for a disqualifying factor (pregnancy). 

    Why are they passing?

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    43 minutes ago, whithou said:

    I signed up to help administer the COVID vaccine to medical staff starting next week. Most of the ICU nurses that I work with have passed on getting it. I would have eagerly gotten it if it wasn't for a disqualifying factor (pregnancy). 

    Is it only for employees and physicians with privileges at your hospital or can any physician get it?

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    It would be fascinating data to see what percentage of frontline healthcare workers who have been in the shit have had asymptotic cases.  Is it possible to deal with infected patients for nine months and not get infected?

     

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    9 hours ago, Pato del Muerto said:

    Why are they passing?

    Reasons from being "I don't want to be a guinea pig" to "Bill Gates wants to know where I am". I wish I was kidding. When I ask if they have read more about the vaccine most haven't done their own research. 

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    9 hours ago, Bevo said:

    Is it only for employees and physicians with privileges at your hospital or can any physician get it?

    It's only for those that work at my hospital. 

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    Pardon me for a brief threadjack, but what does this mean? (Colonoscopy result - I haven’t been to see my doctor yet):

    DIAGNOSIS:
    Transverse colon, polypectomy:
    -Low grade tubular adenoma.

    GROSS:
    Specimen labeled transverse colon polyp is a single 0.4 cm tan-red
    fragment. Entirely submitted in 1A.

     

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