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GRHorn

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Posts posted by GRHorn

  1. 45 minutes ago, JimmyJames said:

    Just being honest in my interactions with trump supporters who I don’t know who get invited to things I also get invited to. Sorry if the truth about them bothers you so much. I’m sure everyone you meet who supports trump isn’t racist though. They probably respect Obama too and talk well of him and his Kenyan heritage.

    I can’t decide if you’re more Jimmy Northam or Jimmy Smollett.
     

    Were the Trump supporters in question wearing their MAGA hats while telling racist Jokes and discussing Obama’s Kenyan heritage? Because that’s totally Trumper stuff! Hoo-ey! I bet they only stopped talking racist shit to go off about QAnon!

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  2. 2 minutes ago, fattyflattie said:

    But it's not.  There's a large section of our country that is refusing to get the vaccine that is not talked about much on this board.  I assure that they are not Trumpers, and I fail to see anyone calling them "stupid", "ignorant", or that they are ruining our chances of beating this thing. It just isn't discussed.  Wonder why?

    Vax that thing up

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  3. 3 minutes ago, PenelopeWitherspoon said:

    I am fine with insurance rates going sky high for the unvaccinated.  The problem is, I think a lot of these folks are probably on Medicaid, so there needs to be a consequence there.  Sorry, but I have zero tolerance for people that can get the vaccine and choose not to.  Fuck them.

    It seems you have a lot of unresolved anger issues. Your Twitter account you linked to before was the most basic bitch Mad Liberal account around.

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  4. 4 hours ago, landman said:

    I'm thinking this is a reflection of who you are spending time with/around.  I have family in Midland and have spent a lot of time there over the years and never heard it.  And as for the coast, multiple trips a year to Port Aransas for the last 30+ years and never hear the word.

    Lol Jimmy Northam can’t help it. He keeps selling himself out. The poor guy can’t stop hanging out with racists. The current Vegas over/under line on parties he’s attended wearing black face sits at 6.5. 
     

    3 hours ago, fattyflattie said:

    lol.  You’re first sentence has more to do with it than any location. I heard it as much or more when I was working in Boston, and hanging out in bars with cops who couldn’t imagine why we voted R, but would then drop an N bomb, and then praise Obama for the job he was doing.   I still hear the work >1x weekly from someone on a crew of 20 (mostly) Hispanics that I am managing in Va.  I’m on the coast a lot and I can’t recall hearing it anywhere, but I know of people that use the word that fish down there every other week or so.  It’s the people, not the place (mostly).    

    There does seem to be an interesting phenomenon where some of the most conspicuous racist behavior occurs in traditionally “liberal” areas or amongst “liberal” populations. Then people project these behaviors onto other people when they just aren’t there. I guess it’s just a defense mechanism, but frustrating to see it applied repeatedly. 

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  5. 2 hours ago, shadow_operative said:

    the diversity stuff was so on the nose last night, it was off putting. i mean literally, "im derek, and im fat, black, and gay!" classic CBS. same network whose no.1 show for the last 3-4 years revolves around the absolutely ZANY antics that occur when black people and white people live in the same neighborhood.

    we've watched the last few years with our kids  my 12 year old son last night even realized 'they're checking all the boxes'. lol

    • Like 1
  6. 2 minutes ago, DigglerontheHoof said:

    If this motherfucker mutates and makes my vaccine useless, I'm gonna be pissed off beyond belief.  

    Scientists did the damn near impossible and got a fantastic vaccine out in less than a year from the original lockdown and the stupid among us are going to fuck it up.

    God damn them. 

    the variants are coming from other parts of the world where there's limited vaccine availability. it's not from hesitancy, numbnuts.

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  7. 47 minutes ago, jimmyjazz said:

    You need to show that young peoples' risk of heart issues from the vaccine is greater than the risk of heart issues from Covid.  So far, you've completely ignored that point.  Now throw in all the other bad shit that can happen with Covid.

    One example is in the article I linked. It doesn’t specifically compare heart issues from covid, but I’d say hospitalizations roughly equal “all the other bad shit that can happen with covid.”
     

    At the June 23 FDA meeting, Tom Shimabukuro, MD, gave a vaccine safety update, and two CDC doctors (Megan Wallace, DrPh, and Sara Oliver, MD) gave a benefit-risk discussion of mRNA vaccines in young people.

     

    They both used many slides. Yet I need only two data points to support my argument that parents and adolescents should be allowed to make judgments based on their unique situation.

     

    The first is slide 13 of the benefit-risk presentation, which shows the risk for hospitalization in a young person in the last 3 months fromCOVID-19 as less than 1 in 100,000. The other comes from slide 27 ofthe Shimabukuro talk, which shows the rate of myocarditis in 12- to 17-year-old boys after the seconddose of mRNA as 132/2,039,871, orabout 6/100,000.

    47 minutes ago, jimmyjazz said:

    Now throw in the greater good aspect concerning the community.

    Again from that article. Well stated IMO. 
     

    Some might argue that shared decisions don't apply to communicable disease prevention. Vaccination of an individual helps others by reducing transmission and promoting herd immunity.
     

    I see two problems with this argument in the case of SARS-CoV2.

     

    The mRNA vaccines are so effective at preventing severe COVID-19 disease that US citizens need not depend on others for protection. If someone wants to be protected, they can simply get the shots. Recent reports from Israel on the rise of cases due to the Delta variant support my point: these were cases , not hospitalizations.

     

    The second problem with the societal-good argument is that the signal of myocarditis from the vaccine is strong enough to be more than correlation. I am not an ethicist, but it seems dubious to force young people to expose themselves to a risk for an unknown benefit to society. Once again, data from Israel are instructive: cases and hospitalizations plummeted earlier in the year without mandating vaccinations in the young.

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  8. 57 minutes ago, Captainant said:

    This article makes good points about individuals, but the desired outcome from vaccinating children isn't to make them safer from the virus but rather to remove them as a transmission vector. Ultimately I agree with his thesis of "it's each parents decision", but it should be remembered that stopping a pandemic is heavily dependent on stopping its transmission vectors.

    Exactly. Using kids (specifically 12-17 year old boys) and putting them at risk to protect the elderly or non-immunized adults. 
     

    • Fuck You 3
  9. 8 hours ago, ChuckNorrisActionJeans said:

    The data showing risk/benefit vastly favors young people in that age group getting vaccinated.  Everything you say  beyond that is either troll-dom or ignorance.

    I’m afraid you’re the ignorant one. 

    Spoiler

    For the first half of 2021, the mRNA vaccines looked to be near perfect. The trials reported more than 90% efficacy for the Pfizer and Moderna vaccines. Both provided near 100% prevention of severe COVID-19 and after hundreds of millions of adults received the shots, no signal of harm emerged.

    I, like any rational person, see a positive benefit-harm ratio from the vaccines for adults.

    Younger People?

    After a "positive" trial in which just over 1100 kids aged 12 to 15 years received an mRNA vaccine, a movement arose to vaccinate young and old alike. I put "positive" in quotes for two reasons:  The first is that this trial measured noninferiority of the immune response, not clinical outcomes. That was necessary because so few kids get sick with COVID-19. The other reason is that the authors claimed a favorable safety profile, but 1100 kids is not enough to inform the safety of a vaccine that will be given to many millions.

     

    Then came a signal of myocarditis in young people, then another, and another, and now one in slightly older (median age, 25 years) military recruits. These reports complicate matters because young people have the lowest risk from COVID-19.

    A debate arose: some argued to slow the deployment of vaccines for children, while the CDC noted that the benefit-harm profile is favorable.

     

    The aim of this column is to argue that when it comes to vaccinating young people at low risk from the virus, parents and younger people should be allowed to weigh the vaccine decision with their clinicians without anyone being tarred as an antivaxxer.

     

    What About the Myocarditis?

    Medicine is full of euphemisms that hide reality: we say "cardioversion" instead of "shock"; "ablate" instead of "burn";  "fibrosis" instead of "scar." The term "myocarditis" sterilizes and obscures heart injury due to excess inflammation.

    Emergency medicine doctor and frequent contributor to the New York Times, Jeremy Faust, MD, called postvaccine myocarditis "self-limited troponinemia." CDC director Rochelle Walensky, MD, recently described postvaccine myocarditis in young people as "mild."

    I disagree; calling myocarditis mild reminds me of the saying about minor surgery. Minor surgery is surgery on someone else; mild myocarditis is something that happens to other folks' kids.

    Humans have only one heart; inflaming it at a young age is not a small thing.

    University of Michigan cardiologist Venk Murthy, MD, a specialist in imaging, rebutted the "mild" framing with comments on Twitter: "people with myocarditis are usually counseled to limit activity, placed on 1 or more meds and are at lifetime increased risk of cardiac complications. This can have profound consequences."

     

    As an electrophysiologist, I see the complications of myocarditis: heart failure and ventricular arrythmia due to scar. Availability bias notwithstanding, heart rhythm doctors feel the asymmetry of myocarditis risk. Although it is true that most myocarditis resolves without issue, it is also true that sometimes it does not.

     

    A radiologist who reads cardiac magnetic resonance scans might oppose this framing by saying myocarditis occurs on a spectrum and even patients with severe myocarditis mostly recover. Pediatricians might counter my framing by saying that most of the affected kids recovered and were discharged from the hospital. Public health experts could argue that 300-plus kids died of COVID-19 and no one as yet has died from the vaccine, so the benefit-harm ratio favors the vaccine.

     

    These are all true statements, but that's not how people make medical decisions. Regular people are not emotionless robots who decide using odds ratios. Most people do not calculate risk, they feel risk. People have special circumstances and make judgments relative to their benefit-harm situation. To persuade people with charts and statistics belies an understanding of clinical practice.

     

    For example, let's say the parents (or grandparents) of a teenager have pre-existing conditions. These special circumstances tip the balance, and the parents decide to vaccinate the adolescent. Contrast that with, say, young parents who have no risk factors. This family feels less risk from the virus, and they might feel more regret if their child developed myocarditis. They want to see more data before making the decision.

     

    Both scenarios depict rational decision-making. It's how medical decisions should be made: with judgment and benefit-harm balances and considerations of special circumstances.

     

    Stats and Data 

    At the June 23 FDA meeting, Tom Shimabukuro, MD, gave a vaccine safety update, and two CDC doctors (Megan Wallace, DrPh, and Sara Oliver, MD) gave a benefit-risk discussion of mRNA vaccines in young people.

     

    They both used many slides. Yet I need only two data points to support my argument that parents and adolescents should be allowed to make judgments based on their unique situation.

     

    The first is slide 13 of the benefit-risk presentation, which shows the risk for hospitalization in a young person in the last 3 months from COVID-19 as less than 1 in 100,000. The other comes from slide 27 of the Shimabukuro talk, which shows the rate of myocarditis in 12- to 17-year-old boys after the second dose of mRNA as 132/2,039,871, or about 6/100,000.

     

    Suffice it to say that rates that low allow for consideration of special circumstances and judgment. But that's not what has happened. The CDC concluded "the benefits still clearly outweigh the risks for COVID-19 vaccination in adolescents and young adults," and in a tweetwith 500 retweets, Faust listed the stats and concluded: "#vaccinate," with a peace sign emoji.

     

    What About Societal Good? 

    Some might argue that shared decisions don't apply to communicable disease prevention. Vaccination of an individual helps others by reducing transmission and promoting herd immunity. For example, human papillomavirusvaccine in boys reduces the future risk for cervical cancer in women.

     

    I see two problems with this argument in the case of SARS-CoV2.

     

    The mRNA vaccines are so effective at preventing severe COVID-19 disease that US citizens need not depend on others for protection. If someone wants to be protected, they can simply get the shots. Recent reports from Israel on the rise of cases due to the Delta variant support my point: these were cases , not hospitalizations.

     

    The second problem with the societal-good argument is that the signal of myocarditis from the vaccine is strong enough to be more than correlation. I am not an ethicist, but it seems dubious to force young people to expose themselves to a risk for an unknown benefit to society. Once again, data from Israel are instructive: cases and hospitalizations plummeted earlier in the year without mandating vaccinations in the young.

     

    Other countries see the need for nuance in vaccinating the young: advisors in the United Kingdom have decided not to support vaccination for kids under 18. In Germany, the Standing Vaccination Commission advised that only children with pre-existing conditions receive the vaccine. And the Dutch health counsel has invited kids with pre-existing conditions or those living in a household with a family member who cannot be vaccinated to receive the mRNA vaccine.

     

    Benefits of Waiting 

    The recent FDA presentation on myocarditis provided three clear signals. There were many more cases after the second shot; males were more often affected; and the age groups with the highest incidence were 16- to 24-year-olds.

     

    Given the extremely low levels of circulating SARS-CoV2 in the United States, public health experts have time to consider different options for young people: would one shot (especially in younger males) offer a better benefit-harm calculus? Should we study lower doses in children? Should we test young adults for signs of recovered infection and delay vaccination in those with natural immunity?

     

    Conclusion: The Danger of Absolutism 

    In the United States, rates of vaccine uptake among vulnerable adults remain less than ideal. This is not from lack of knowledge. Americans can now observe the vaccine efficacy directly from the evidence in the digital space but also in their communities where cases have plummeted.

     

    In my clinic, I occasionally see at-risk adults who refuse the vaccine. This makes me intensely curious. These are folks taking preventive cardiac medications with a fraction of the efficacy of the (free) mRNA vaccines.  

     

    I could be wrong, but I can't help thinking that absolutism about vaccine decisions in the young, or the minimization of harm from myocarditis, might reduce trust in messaging.

     

    Consider that earlier in the pandemic there was intense coverage of a flawed paper on myocarditis after SARS-CoV2 infection. Hundreds of news outlets wrote scary headlines, and college sports were almost canceled. Subsequent studies found no evidence that the virus had any special proclivity for heart inflammation.

    A neutral observer might wonder: well, if folks were that excited about myocarditis in young people after the infection, why are they not equally worried about this early signal of harm from the vaccine?

     

    As I write this column, many major universities will mandate vaccines for college-age kids. Some hospitals will require the mRNA vaccines for all employees—including the 18-year-old who works in engineering, has no patient contact, and who recovered from COVID-19 a few months ago.

     

    Maybe, just maybe, a more humble and nuanced approach to vaccination in low-risk young people would improve trust and vaccine uptake?

     

    • Fuck You 3
  10. 1 hour ago, gmr548 said:

    Maybe GRHorn is attempting to make a point in good faith, maybe he’s not. Unfortunately, if he is, he’s very much the boy who cried wolf. When you’re consistently trolling people start to treat you as such.

    I don’t have kids so I don’t have a dog in the fight and I do understand why parents would be more cautious with their children. Do find it interesting that cardiovascular issues associated with COVID for college athletes was generally dismissed as a nothing burger in the name of being able to watch football on Saturdays, but now that it’s personally real some folks are singing a different tune. It’s easy to read that as general dismissiveness of the vaccine or risks from COVID.

    1- it was a nothing burger, that had nothing to do with football. 
    2- those were also consenting adults. 

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  11. 14 minutes ago, ChuckNorrisActionJeans said:

    .....and what about transmission to others ... and serving as a host to potential variants. It's never just about the individual

    Exactly as my post said. 
     

    So we need to use kids to help protect old people? Under questionable risk/benefit breakdown? That’s just messed up. Listen to what you’re actually saying.  

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  12. 1 hour ago, Anastasis said:

     

     

    I know that certain people are just going to neg rep this post and do the CR thing, but this perspective in not unreasonable.  IMO, the tipping point is 15 yo generally, with slightly different considerations for males and females. All of the safety events being observed are exceedingly rare, but so are serious adverse outcomes related to COVID under that age.  One dose might be a sweet spot tbh, esp in that 12-15 male age band. My 12 yo daughter just got her second dose.  My sons are too young, but it will be a complicated decision because of some pre-existing CV issues with one of them.  We considered delaying the 2nd PFE dose for the daughter, but decided to pull the trigger and everything has been fine.

     

    Thank you sir, I appreciate that. 
     

    I will expand a little and you may not agree with this and that’s cool. Given the obvious risks and benefits for that cohort, I think the biggest reason that the CDC didn’t adjust the dosing regimen is that they see pursuing the “greater good” of vaccinating more people as being worth the risk to these young males. 
     

    I could not disagree more. Essentially we are pressing forward vaccinating these kids with an unaltered schedule, for a disease that doesn’t even really make them sick, to protect older people. That’s a warped thing to me. You protect kids first. Every other disease that kids are vaccinated for, except maybe chickenpox, can make you pretty sick. And chicken pox can give you shingles later in life.
     

    These teens most often have minimal symptoms. And don’t get me started on little kids. My 7 and 3 year olds had it and outside of one day of being tired they had not even a sniffle or other symptom.
     

    This is no longer an emergency. People should chill out.

     

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  13. 20 hours ago, immortal13 said:

    You didn't stand for such behavior, did you? Please tell me you stood up to these people!

    What a fucking shocker that Jimmer keeps finding himself around N bombs being dropped repeatedly.
     

    I think I’m gonna call bullshit though. I’m a conservative guy, from small town Texas and I can’t remember the last time I heard the N word dropped in conversation. But Jimmer, the guy that likes to drop the N word on CR can’t escape it. 🤔 I bet they were all wearing maga hats while they were being hardcore racist too!!!

    11 hours ago, Anastasis said:

    Goes on a post-vaccination vacation to Trump country to spend time with rando racists on July 4th?

    Get your shit together Jimmy.  

    He’s completely full of shit or his posting history here is projection. Those are the options. Pretty simple. What a joke. But he’ll get a pass here. Thanks Jimmy for telling us how racist all those yokels are that you hang out with? Wtf. 

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