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COVID-19 vaccine discussion


Texas Jeff

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1 hour ago, Heme Doc said:

Similarly, there’s only two things that scare me.  The risk of transverse myelitis or Guillan Barre after vaccination with an adenovirus vector.  

That, and carnies.  Small hands.  Smell like cabbage.

I know you specialize in leukemia and lymphoma, and you aren't worried, and adenovirus is epichromosal, but I'm more worried about long-term effects from adenovirus products. mRNA or recombinant proteins for me. 

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23 minutes ago, Bevo said:

I know you specialize in leukemia and lymphoma, and you aren't worried, and adenovirus is epichromosal, but I'm more worried about long-term effects from adenovirus products. mRNA or recombinant proteins for me. 

I tend to be more nervous about adenoviral vaccines than mRNA vaccines also.  Fortunately, it seems serious side effects with each have been quite rare.  I believe that the AstraZeneca trial (adenovirus vector) was halted because of a case of transverse myelitis a few months ago.  I don’t believe Pfizer or Moderna saw any issues like that.   But if a serious side effect (say Guillan Barre) only occurs in 1:500,000 patients, then a clinical trial of 40,000 people might not pick it up.  But you’ll damn sure see it once you start vaccinating millions of people.  Hell, we still see cases of Guillan Barre each year with the flu vaccine.  

Each person will need to make their own calculated decision about their risk of getting COVID and falling seriously ill or dying vs risks of the vaccine.  From my look at the data, getting the vaccine (any of them) would be of significantly less risk for most.  

I’m hopeful that messaging from the new Biden administration and other mouthpieces in the government/medical community can clearly communicate to the public about some of these issues related to COVID vaccines including their effectiveness, safety, and expected side effects. I’d love to see Fauci go on 60 Minutes and lay out this stuff in an interview and at the end stand up and take the vaccine on TV.  

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15 minutes ago, Hagbard Celine said:

astrazeneca/oxford nanotech.

yes or no.

See reply to Bevo above.

But one interesting difference in the AZ/Oxford trial compared to Moderna and Pfizer trials is that in AZ/Oxford they actually did weekly nasal swabs in all participants (as opposed to only testing with PCR if participants had symptoms).  And they found that the vaccinees had lower rates of asymptomatic infection, suggesting that the vaccine could stop transmission/block infection entirely (not just make you infected but asymptomatic).  Moderna/Pfizer vaccines may do the same thing, but we don’t know that.  I can’t wait to see this data, as we won’t have anything like this for Pfizer/Moderna.  

 

 

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On 11/20/2020 at 7:55 PM, bschoolprof said:

I'm pro-vaccine, obviously, but the fact that mRNA vaccines are brand new (they've never been given before) and we have no evidence on their long term safety, I'm a bit nervous.  I know the whitecoats tell me that, theoretically, the long run risks are small because the mRNA breaks down quickly, and efficacy is the real concern. However, jiggering around with our cells to produce virus spikes they weren't designed to produce gives me the heeby jeebies.  What could possibly go wrong?  

Anyway, I expect this will be the next great politicized nonsense that further tears away at the national fabric.  Personally, I'd rather wait for the traditional vaccines that are in the works. 

If I'm 80+ though, sign me up now bitches.  

God dammit. I wasn't worried at all until reading this shit. Hell, i was planning on waiting in line the first day i was able. 
 

should i be worried?  I don't want to be riddled with cancer due to shit 40 years from now. 

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5 hours ago, Heme Doc said:

I’d love to see Fauci go on 60 Minutes and lay out this stuff in an interview and at the end stand up and take the vaccine on TV.  

Not me. The guy’s a scientist first and foremost and respected at that. He’s not a good PR person especially off the cuff. He makes scientific statements sometimes without qualifications that a vast majority of Americans cannot process and he would end up scaring the shit out of half the country.

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25 minutes ago, Pato del Muerto said:

Doctors: are you or will you be advising for or against pediatric vax?

I would need to see a lot more data for the under 10 crowd. They are low risk for catching and being vectors of this disease. Their complications and death rates are next to nothing.

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Just now, Newdoc said:

Not me. The guy’s a scientist first and foremost and respected at that. He’s not a good PR person especially off the cuff. He makes scientific statements sometimes without qualifications that a vast majority of Americans cannot process and he would end up scaring the shit out of half the country.

A good portion of the country is very skeptical of the government. I am confident that it would not go over as well as some think it would.

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16 minutes ago, Newdoc said:

Not me. The guy’s a scientist first and foremost and respected at that. He’s not a good PR person especially off the cuff. He makes scientific statements sometimes without qualifications that a vast majority of Americans cannot process and he would end up scaring the shit out of half the country.

Good point

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19 minutes ago, Xian said:

God dammit. I wasn't worried at all until reading this shit. Hell, i was planning on waiting in line the first day i was able. 
 

should i be worried?  I don't want to be riddled with cancer due to shit 40 years from now. 

You shouldn’t be worried.  

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So, I’ve been refining my math. Hadn’t thought about the fact that young kids will be in the last group to get the vaccine. Around 40 million people here are under 10, out of a population of 330 million. So, around 290 million in the pool to get vaccines in the near term.

Presume that 20% of that group will be resistant/apathetic, which takes the near term “to be vaccinated” group down to around 230 million.

(Here’s where my numbers may be off, because I’m not sure if it’s just for the Pfizer vaccine or all three). I saw that Pfizer estimated that they’d administer 20 million doses this year, then 30 million a month after that. If that’s just the Pfizer vaccine, that’s great, as we could have additional doses of others in the same timeframe? Anyway, by the end of June, we’d hit 200 million, and the 230 million by the end of July.

That’s pretty good. Hopeful, even. And if there are even more doses available of other options, it could happen even faster - does anyone know the story there?

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24 minutes ago, Brisketexan said:

So, I’ve been refining my math. Hadn’t thought about the fact that young kids will be in the last group to get the vaccine. Around 40 million people here are under 10, out of a population of 330 million. So, around 290 million in the pool to get vaccines in the near term.

Presume that 20% of that group will be resistant/apathetic, which takes the near term “to be vaccinated” group down to around 230 million.

(Here’s where my numbers may be off, because I’m not sure if it’s just for the Pfizer vaccine or all three). I saw that Pfizer estimated that they’d administer 20 million doses this year, then 30 million a month after that. If that’s just the Pfizer vaccine, that’s great, as we could have additional doses of others in the same timeframe? Anyway, by the end of June, we’d hit 200 million, and the 230 million by the end of July.

That’s pretty good. Hopeful, even. And if there are even more doses available of other options, it could happen even faster - does anyone know the story there?

I’m thinking the recently recovered (or maybe even longer ago than recently) wouldn’t need to be vaxed early and would have some level of resistance. So 20 millionish less needed?

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A question for the docs. I have had Bell’s Palsy 3 times, the last case was about 5 years ago and the last two cases were mild. I got both of the Shingrix vaccines this past year, and had pretty strong reactions to both. Felt like the flu for a couple of days.

Is that because my immune system’s response was very aggressive since it had already fought Bell’s Palsy (both are herpes zoster viruses) several times?

I’ve never had any reaction to the flu shot. Just curious if I should expect a really strong reaction to a COVID vaccine, which I will get. Or if my previous experiences don’t mean anything about how I will react to a COVID vax.

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46 minutes ago, Brisketexan said:

So, I’ve been refining my math. Hadn’t thought about the fact that young kids will be in the last group to get the vaccine. Around 40 million people here are under 10, out of a population of 330 million. So, around 290 million in the pool to get vaccines in the near term.

Presume that 20% of that group will be resistant/apathetic, which takes the near term “to be vaccinated” group down to around 230 million.

(Here’s where my numbers may be off, because I’m not sure if it’s just for the Pfizer vaccine or all three). I saw that Pfizer estimated that they’d administer 20 million doses this year, then 30 million a month after that. If that’s just the Pfizer vaccine, that’s great, as we could have additional doses of others in the same timeframe? Anyway, by the end of June, we’d hit 200 million, and the 230 million by the end of July.

That’s pretty good. Hopeful, even. And if there are even more doses available of other options, it could happen even faster - does anyone know the story there?

The NY Times has a great vaccine tracker.  Make sure you're figuring in second shots when you count doses vs people who are immune.  When Pfizer says they have 20 million doses I think they mean they can make 10 million people about 90-95% immune.

Hopefully Pfizer and Moderna can get the run rates up, at least for a year or two.  Pfizer and BioNTech have a partnership with a goal of producing 1.3 billion doses in 2021, which is just over 100 million/month.  Moderna is a much smaller company.  Not all of the production will go to the US.  The rest of the world wants this crap to end too.

So, yep there are likely to be other vaccines out in addition to the ones with results already announced and hopefully they all can scale.

 

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7 hours ago, sunset87 said:

A question for the docs. I have had Bell’s Palsy 3 times, the last case was about 5 years ago and the last two cases were mild. I got both of the Shingrix vaccines this past year, and had pretty strong reactions to both. Felt like the flu for a couple of days.

Is that because my immune system’s response was very aggressive since it had already fought Bell’s Palsy (both are herpes zoster viruses) several times?

I’ve never had any reaction to the flu shot. Just curious if I should expect a really strong reaction to a COVID vaccine, which I will get. Or if my previous experiences don’t mean anything about how I will react to a COVID vax.

With Moderna/Pfizer vaccines, I’d expect a reaction for 1-2 days of headache, fatigue, maybe fever/chills and some body aches after the 2nd dose especially.  Take some Tylenol and ibuprofen and be happy that your immune system is doing its job and you’re helping to kick this things ass.  Those flu-like reactions are pretty common after Shingrix and I don’t think that reaction or the Bell’s palsy can reliably predict how you’ll react to a COVID vaccine.  I know about 10 people on the Pfizer trial.  The 5 of us who got vaccine all had some side effects, usually after the 2nd dose but nothing too severe and that a little Tylenol couldn’t take care of

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6 hours ago, troph said:

How long do we expect immunity to last? MMR is years, flu is less than a year, what is this one expected to be? 

I don’t think we know the exact answer to that yet, but recent data suggests “years” for most folks.  I linked a nice twitter feed and recent article below that explain it a bit more.  
 

https://www.medrxiv.org/content/10.1101/2020.11.18.20234369v1

 

https://mobile.twitter.com/apoorva_nyc/status/1328751557719040001

 

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8 hours ago, Brisketexan said:

So, I’ve been refining my math. Hadn’t thought about the fact that young kids will be in the last group to get the vaccine. Around 40 million people here are under 10, out of a population of 330 million. So, around 290 million in the pool to get vaccines in the near term.

Presume that 20% of that group will be resistant/apathetic, which takes the near term “to be vaccinated” group down to around 230 million.

(Here’s where my numbers may be off, because I’m not sure if it’s just for the Pfizer vaccine or all three). I saw that Pfizer estimated that they’d administer 20 million doses this year, then 30 million a month after that. If that’s just the Pfizer vaccine, that’s great, as we could have additional doses of others in the same timeframe? Anyway, by the end of June, we’d hit 200 million, and the 230 million by the end of July.

That’s pretty good. Hopeful, even. And if there are even more doses available of other options, it could happen even faster - does anyone know the story there?

Even though I was told there would be no math, I think your numbers/timeframe are quite realistic, which is why I too am hopeful.  

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The question of how long the vaccine lasts is pretty important. If it takes us until next summer to get everyone vaccinated, are we looking at turning around and doing it all again before we finish? And how sustainable is this production? I'm assuming that they are having to scale back other stuff to do this, but at some point they will need to resume production on the other stuff. What kind of time frame would it take to permanently increase their capacity so that they aren't sacrificing one vaccine for another? What kind of capital projects would that require, because if it involves specialized equipment, it takes time to engineer and install that stuff.

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I don’t think we know the exact answer to that yet, but recent data suggests “years” for most folks.  I linked a nice twitter feed and recent article below that explain it a bit more.  
 
https://www.medrxiv.org/content/10.1101/2020.11.18.20234369v1
 
https://mobile.twitter.com/apoorva_nyc/status/1328751557719040001
 

Thank you that’s really great news!


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1 hour ago, NotActuallyALonghorn said:

The question of how long the vaccine lasts is pretty important. If it takes us until next summer to get everyone vaccinated, are we looking at turning around and doing it all again before we finish? And how sustainable is this production? I'm assuming that they are having to scale back other stuff to do this, but at some point they will need to resume production on the other stuff. What kind of time frame would it take to permanently increase their capacity so that they aren't sacrificing one vaccine for another? What kind of capital projects would that require, because if it involves specialized equipment, it takes time to engineer and install that stuff.

The vaccine will probably work for a couple of years. Coronaviruses don't mutate rapidly like influenza. And research is showing that the immune response to the vaccines are robust.  Production of mRNA vaccines is a breeze. It doesn't require cell culture which is what causes high prices and scarcity of many biologics. And there are probably 25 vaccines in development so the vaccine used in a few years may be different than the one you use now.

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On 11/21/2020 at 9:51 AM, Armybrat said:

Then you should ask for a referral to Dr. Denson (Austin Urology)

She did a great job with my digital exam and very close junk inspection several years ago. Very gentle fingers with well-trimmed nails.. 🙂
 

 

8DACDD7E-B22D-4841-B91B-58DB3937164C.jpeg

Should we move this discussion to NSAA?  Any more pictures Brat?

On a serious note, thanks for this thread.  Keeps me from ducking the flying shit in the other thread.

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10 hours ago, sunset87 said:

A question for the docs. I have had Bell’s Palsy 3 times, the last case was about 5 years ago and the last two cases were mild. I got both of the Shingrix vaccines this past year, and had pretty strong reactions to both. Felt like the flu for a couple of days.

Is that because my immune system’s response was very aggressive since it had already fought Bell’s Palsy (both are herpes zoster viruses) several times?

I’ve never had any reaction to the flu shot. Just curious if I should expect a really strong reaction to a COVID vaccine, which I will get. Or if my previous experiences don’t mean anything about how I will react to a COVID vax.

I have yet to have a patient not get a reaction from shingrix whether it be mild injection site soreness or feeling like they had the flu. So I'm not sure if your shingrix experience will directly translate into what a covid vaccine will do to you 

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26 minutes ago, Parliament said:

So am I just being a Debbie Downer for thinking this is too good to be true? The worst Pandemic since the 50's, and we can get 90% efficacy with 9 months of work? Are we REALLY that good? Would be awesome of course.

early on, so about 13 years ago, the scientific community mentioned numerous times that a covid vaccination would be pretty simple. that notion, the digital and medicinal advances, the entire world working on a solution, and the fact that three separate vaccines (only up to now, mind you) have shown great promise is very, very good news.

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37 minutes ago, Parliament said:

So am I just being a Debbie Downer for thinking this is too good to be true? The worst Pandemic since the 50's, and we can get 90% efficacy with 9 months of work? Are we REALLY that good? Would be awesome of course.

we've never really had to do this before but as usual we rise to the occasion.  The H1N1 vax timeline was what I was hoping for and we are right about on that(maybe a month or 2 later).

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13 hours ago, Heme Doc said:

I don’t think we know the exact answer to that yet, but recent data suggests “years” for most folks.  I linked a nice twitter feed and recent article below that explain it a bit more.  
 

https://www.medrxiv.org/content/10.1101/2020.11.18.20234369v1

 

https://mobile.twitter.com/apoorva_nyc/status/1328751557719040001

 

well that is damn good to hear.

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Soooo this AstraZeneca news doesn’t sound promising to a dipshit such as myself. Anybody wanna shed some light on the situation given that most of the free world has hung its hat on it.

From what I understand Astrazeneca did not use the same stabilized S2P protein (UT Austin) which has resulted in much higher effectiveness in the other vaccines. The AstraZeneca vaccine uses a spike protein from the next closest chimpanzee coronavirus and triggers an immune response to fight other coronaviruses. It is not as effective as the stabilized SP2 which is a closer match. I say closer because multiple mutations have already been identified. The UT Austin lab has already developed a vaccine candidate for an already identified mutation which means the “next” vaccine may be rapidly tested, approved, and produced.

I am not a doctor and did not stay at a holiday inn express last night.
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