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Dontshootrude

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Posts posted by Dontshootrude

  1. On 9/7/2021 at 9:39 PM, Parliament said:

    Re: boosters.  I'm pretty sure my 1st 2 shots where Pfizer.  Will my eventual booster need to be Pfizer as well?  Or is Moderna good too?  I don't wanna do it wrong and grow hooves.

    This is the subject of multiple studies right now.  Preliminary evidence out of the UK suggests that mixing and matching the different technologies (mRNA [Pfizer, Moderna], adenovirus vector [J&J, Astrazeneca], and subunit vaccines [Novavax]) might drive a better and longer lasting immune response compared to sticking with one company.  This makes a lot of sense because the different technologies are going to stimulate different cell signaling pathways.  For example, mRNA mechanisms are better at stimulating the B-cell driven antibody response whereas the adenovirus vector vaccines are going to do a better job at building cellular (T cell) immunity.  

    gr1_lrg.jpg.9b7c7f5c3c7e4bbdd6cfffd9f2e848f2.jpg

    On 9/8/2021 at 7:59 AM, TexEx15 said:

    Well had to sign my oldest up for a COVID test.  While on the ARC app it also let me schedule my booster - it actually specifically called out boosters starting in September.  Answered truthfully about not being immunocompromised and it only asked if it has been greater than six months from last shot.  At first I thought it was going to limit booster option to Pfizer given the full approval but was able to select Moderna and get scheduled for tomorrow.  I’m just over 7 months out from the second shot.  My Texas CARES number was 994 a few weeks ago.  Any reason not to do the booster?

     

    It probably won't hurt you (we don't have large controlled trials to be sure), but I don't think you will really benefit much.    

    On 9/8/2021 at 1:57 PM, Bevo said:

    He isn't against the booster. I would say he is somewhat on the fence and taking a wait and see approach. A high number of breakthrough cases would probably change his opinion. Conversely, adverse events or a decrease in efficacy/increase in humoral response against lipid encapsulation would lead him to forgo the booster.

    Right, I'm not against boosters, but breakthrough cases are not the metric I'm looking at.  The outcome of those cases is the key metric.  As long as the vaccine is preventing severe disease (which it is) I don't see much reason to get a booster.  And as I've outlined in prior posts there might be advantages to waiting and see how more experiments and trials play out before deciding when to get boosted and which shot to take.  

    There is precedent for using infection outcomes rather than infections themselves in our recommended vaccine schedule.  Pertussis (whooping cough) used to kill thousands of infants.  In the 1930's a vaccine was developed by killing whole pertussis cells and injecting them into people.  It worked well, but because of toxins normally found in the bacteria that were not affected by the inactivation, a small number of people had significant side effects after vaccination.  This lead to the development of the modern day Pertussis vaccine, the acellular Pertussis vaccine (aP), which is found in the combination TDaP and DTaP vaccines.  This vaccine injects a small amount of the actual protein responsible for all the horrible symptoms of whooping cough, thereby programming your immune system to essentially convert Pertussis from whooping cough into an asymptomatic bacteria that can live in your respiratory tract.  Recent studies have shown that people (and monkeys) can transmit Pertussis, and might even be able to transmit it more easily than an unvaccinated person because they have no idea they are sick.  This is why the Pertussis vaccine schedule is so aggressive, particularly in infants.  They get shots at 2, 4, 6, 15 months, another one at age 4, and then intermittently from then on out and in pregnant women.  This aggressive schedule, combined with antibiotics, are the reasons whooping cough deaths have remained incredibly low.     

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  2. 17 hours ago, Huckleberry said:

    He's talking about this:

    image.png.73d6f57198ddda7239734f866343fa67.png

    20/71 = 28% of vaccinated hospitalizations have resulted in death
    186/1984 = 9.4% of unvaccinated hospitalizations have resulted in death

    Now some stupid people will run with that as a reason not to get vaccinated. They will ignore the case rate and hospitalization rate. Hospitalization rate for unvaccinated is 1.90 versus 0.04 for vaccinated, so it's 47.5 times higher. So if you get to the point if hospitalization, the numbers say you're 3 times as likely to die if you're vaccinated. There are lots of possible explanations for this, including that maybe hospitalizations only happen to the extremely vulnerable members of the vaccinated population (who would have been hospitalized if they were unvaccinated as well). Either way, if you're 47.5 times more likely to be hospitalized if you're unvaccinated but then 1/3 as likely to die once hospitalized, you guessed it, this means that unvaccinated people are about 16 times more likely to die from COVID than vaccinated people.

    All numbers only based on the San Diego data, obviously.

    Good post.  To add to this, you need to look at the data on a more granular level.  Those that get vaccinated and die are usually older and have significantly more risk factors than their unvaccinated counterparts.  This isn't happening in healthy populations.

    https://www.sciencedirect.com/science/article/pii/S1201971221006391

    https://www.sciencedirect.com/science/article/pii/S1198743X21003670?casa_token=QHZFcwIxbkoAAAAA:H-3DziM-WVQ15B8vmvnh880fhYJIndOQBVihSs1NmJKqH40oQ05asC7s6Tn6AjhF-rzqaXK2tw

      

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  3. 11 minutes ago, midtown said:

    For people running out and getting boosters.  Read the FAQ.  The Texas cares studies states that they do not know the significance of the anti-body number.  I asked this before but maybe someone who understands the vaccines better.  My understanding is that its not the antibodies but its the t-cells left behind with their memory that are the mechanism for fighting an infection.   Anyone?

    You can have memory B and T cells.  There hopefully will also be these things called long lived plasma cells generated after vaccination.  These are B cells that hang out in your bone marrow and secret antibodies continuously.  If we are still detecting antibodies in vaccinated individuals years from now that will indicate that they are present, and will be a very good sign for long term immunity post vaccination.  We have encouraging preliminary data that this may be occurring.

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  4. 6 hours ago, Trey3216 said:

    Because we're never going to crush the pandemic, because it's fucking endemic and just getting going.  

    Crush the pandemic = widespread immunity such that our healthcare system is no longer in danger of being swamped with cases and COVID becomes the next cold virus.  You are right that it will be here forever, but once it isn't able to cause a significant amount of severe disease it is no longer an emergency.

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  5. 1 minute ago, Lobo said:

    BCOM/BS&W, UTSys Med Centers, and Ascension-Seton all informally indicate they expect first shot deployment in December.  Barring some unforeseen circumstance.  You know like stupid Texas parents being stupid Texas parents.  We'll find a way to fuck this up, don't worry.  

    I anticipate the vaccination rates in young kids will be remarkably low unfortunately.  Check out the rates in the 12-18 age group.....it is depressing.  

  6. 5 minutes ago, cactusflinthead said:

    @Dontshootrude I have already gotten dangerously close to replying with what would be appropriate in CR and frowned upon here.

    I appreciate your efforts to educate the vaccine reluctant. That's great. It's not going to work on the vaccine violent. Or how else do I call ones in denial on their deathbed? 

    Maybe you're new around here. We are an aggressively stupid world. People would rather shit out their guts than admit they were wrong.

    Ultimately the "vaccine violent" (great term!) are all going to get it and develop immunity via the high risk route.  Eventually this will end, and COVID won't be a danger to our healthcare system.  It is what it is.  I'm not really concerned about these people on an individual level, particularly once the danger to our overall healthcare system has passed.  It is a classic example of "play stupid games win stupid prizes."   

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  7. 59 minutes ago, tbone_ said:

    Are other countries having issues getting people to get the damn shot or is this an American phenomenon?

    Unfortunately there are plenty of other countries where people are hesitant.  A couple of studies:

    https://www.mdpi.com/2076-393X/9/2/160

    https://www.mdpi.com/2076-393X/9/1/42

     

    55 minutes ago, Lobo said:

    It would be tough to measure that because we also awash in extra doses that are going unused (I think 15mm at last count).  it's one thing to avoid the vaccine because not enough people in your nation have gotten it yet and you are unsure.  But we've distributed hundreds of millions of doses and 9 people have died from but we're still like, "Meh, let's see how things shake out in Andorra before I put that needle in my arm."  

    If Aggies and other ignorant subsets of the population are dying of the virus despite a chance to be vaccinated, I fail to see what the problem is.  We're clearing the Dumb American South like a fucking wildfire right now and I'm pissing myself laughing.  

    I largely agree with this, but it becomes an everyone problem when your healthcare system is stretched to its limit and anyone seeking care will have a harder time receiving care for all the other problems normally present.  

    55 minutes ago, cactusflinthead said:

    Uh huh. Sounds great. How exactly are we going to get the horse dewormer eaters to get a shot?

     

    I think a good start would be to communicate quality information and avoid the perception that you are always trying to spin the audience.  Too much of the messaging from the public health officials and the media has been overly negative, an attempt to boost ratings/clicks, or contained half truths.  As a result a lot of credibility has been lost.  There will always be a subset of the population that is not going to get it no matter what, but I do think there is a decent number of people that are genuinely confused and don't know who or what to believe.  If we stopped treating people like children, presented higher quality information that would help people understand the risks of the vaccine versus the risks of getting COVID, and have recommendations that are more grounded in science, it might help bump our numbers up.    

    Take the ivermectin debate.....there is no concrete evidence that it is working.  We do have really good evidence that monoclonal antibody therapy can reduce the risk of severe disease.  It would probably score more credibility points by highlighting this fact and encouraging newly diagnosed people to seek out monoclonal antibody therapy instead of ivermectin.  Instead there have been a lot of people in prominent positions making fun of people with the horse dewormer argument, even going so far as to falsely report the number of people being hospitalized with negative side effects.  This cannot be helping!

    And going back to the vaccine, imagine if you are someone who is completely uneducated on this stuff.  We have a very polarized echo chamber that is just screaming at each other.  One on side you have a politically driven media and public health system that is screaming GET VACCINATED, and then on social media you hear all about these horrible side effects.  There has been no widespread informational campaign to explain why the side effects they see on social media are probably not caused by the vaccine, and help understand the true risks of vaccination versus getting COVID.  Dr. Derek Lowe gave a great explanation on these false side effects.  Unfortunately his blog has been overhauled and the link to the post isn't working.  I'll quote the relevant section here:  

    Quote

    Specifically, if you take 10 million people and just wave your hand back and forth over
    their upper arms, in the next two months you would expect to see about 4,000 heart
    attacks. About 4,000 strokes. Over 9,000 new diagnoses of cancer. And about 14,000 of
    that ten million will die, out of usual all-causes mortality. No one would notice. That’s
    how many people die and get sick anyway.

    But if you took those ten million people and gave them a new vaccine instead, there’s a
    real danger that those heart attacks, cancer diagnoses, and deaths will be attributed to
    the vaccine. I mean, if you reach a large enough population, you are literally going to
    have cases where someone gets the vaccine and drops dead the next day (just as they
    would have if they *didn’t* get the vaccine). It could prove difficult to convince that
    person’s friends and relatives of that lack of connection, though. Post hoc ergo propter
    hoc is one of the most powerful fallacies of human logic, and we’re not going to get rid
    of it any time soon. Especially when it comes to vaccines.

    This is incredibly convincing, and yet nothing like this has been explained to the masses in any clear manner.  

    Unfortunately, our society has become so polarized and the echo chambers so loud that our messaging will become less and less effective, but we've done nothing to help it.  

    Bill Maher gave a great rant that captured my feelings well:

       

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  8. 2 minutes ago, Samson's Wig said:

    A woman I went to high school with is a molecular biologist with a PhD.  She convinced her parents they shouldn't get vaccinated.  Covid killed both of them.  Of all the terrible stories from the last couple of years, that one pisses me off the most.  Yes, she's aggy.

    She should be stripped of her degree.  That is up there for the most aggy thing I've heard in a while. 

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  9. 1 hour ago, Anastasis said:

    Seriously, it is close to a miracle that "we" threaded this needle.  Thirty years of research, covering both the mRNA side to the LNP side, converging to give us a path out from under the pandemic. A few months behind schedule and we might look more like India. 

    Sorry if this has been discussed before, but another mRNA vaccine, CureVac, failed clinical trials.  The only significant difference between it and the Pfizer vaccine was Curevac decided to use the naturally occurring base uracil, whereas Pfizer and Moderna decided to use a psuedobase in its place that was less immunogenic.  That one change dropped the efficacy from 95% to below 40%.  It is hard to believe how lucky we have been.   

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  10. 3 minutes ago, Pato del Muerto said:

    My understanding is that our antibodies are highly specific. This virus is an example, as an additional amino acid pair here or there during transcription is enough to lower the efficacy of our vaccine.  Not sure why the same wouldn’t be true for the lipids.  Buuuuuuut I’m a layperson with a recent crash course in cell-based bioassays for my job, so I’m way out over my skis by opining. 

    Full disclosure: I do not fully understand the lipid capsules.  Very few people do.  I do know they are incredibly complex and require very specific conditions to create and manufacture.  

    I know more about immunology, and I know enough to know our knowledge and understanding of the system are incomplete at best. 

    The mRNA vaccines have been an incredible achievement, and we are extremely fortunate everything came together like they did.  If they had been delayed just a few more months our entire health care system would have completely collapsed during the Delta wave.  To me, the risk of the known unknowns and unknown unknowns with a 3rd shot are not worth it when efficacy against severe disease remains at 90%+ for the majority of those vaccinated.    

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  11. 31 minutes ago, Pato del Muerto said:

    If there’s a response to the delivery vehicle, just change the delivery vehicle. 

    I wish it were that simple, but the delivery was one of the biggest challenges that was worked on over the last 20 years.  We have the lipid capsules for mRNA and a couple proven adenovirus vectors that seem to work well.  You can't just wave a magic wand and come up with a new system. 

  12. 29 minutes ago, Anastasis said:

    Good post with good points.  An immune response to the viral vector is unsuprising and should be an anticipated outcome.  The russians use different vectors in their series to try to get around this.  But for the mRNA shots has there been any evidence of an immune response to the lipid nano particles?  Haven't look specifically at that question, but did look into adjuvant content and the indication was that the lipid nanoparticles stimulate the immune system like an adjuvant would, but nothing about mounting an immune response specific to the delivery vehicles.  Seems like that would have been brought out fairly early on in development. Besides all that, PFE and MRNA are using different vehicles, and if the LNPs became neutralized the formulations could be modified further. Three shot regimens are fairly standard.  You make good points to consider, but I think it overstates the risk of marginalizing the technology in the future.

     

     

    I'm not sure the delivery systems used by Pfizer and Moderna differ all that much.  There are very few people in the world that really understand that lipid capsule technology and I would imagine they have reached similar conclusions.  This is speculation on my part so maybe you have more knowledge than I do?  And I wouldn't bank on them being easily modifiable.  The current construction seems to be doing a good job stimulating the immune system which negates the need for an adjuvant to the vaccine, but that is exactly what has me concerned that we could see a cumulative effect that would reduce the effectiveness of the vaccines with every shot.  Adjuvants in traditional vaccines are not carrying the actual target, so they can stimulate the immune system without the worry of reduced efficacy. 

    These are so new we have no data to know definitively either way, which is why I caution people to not rush out and get them when the risk of what you are vaccinating for is incredibly low.  Without more data it just isn't worth it.  

  13. 25 minutes ago, Armybrat said:

    Thanks, will do so. My PCP is always on top of things.

    in my case I am at the stage where I don’t buy green bananas.

    The vaccine mixing studies will be important for you too.  Data out of the UK suggests that combining the Astrazeneca vaccine with the Pfizer vaccine results in a better immune response compared to sticking with the same vaccine.  You might be better served getting a J&J shot if you got an mRNA vaccine initially.   

    It will be interesting to see what the vaccine recommendations and schedule looks like once we have all that data.  

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  14. 1 minute ago, Armybrat said:

    I’m 76, obese, 4 heart stents, mild heart attack 3 years ago, aorta stenosis (not severe yet).

    Second Moderna shot was March 10.

    my annual physical is Sept. 30th. I was planning to ask my PCP for the booster.

    What do you think?

     

    You are in the category where the risk/reward ratio begins to make sense.  Talk to your doctor to confirm. 

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