COVID-19 vaccine discussion

1 hour ago, C-Man said:

Not sure if this has been posted or not but this seems like positive news.

https://www.cnn.com/2021/09/27/health/covid-treatment-pill-khn-partner/index.html

 

I’ve been getting targeted ads about a study for this in CenTex. I hope I don’t ever qualify for the study though. 

Not sure if this has been posted or not but this seems like positive news.
https://www.cnn.com/2021/09/27/health/covid-treatment-pill-khn-partner/index.html

Within a day of testing positive for covid-19 in June, Miranda Kelly was sick enough to be scared. At 44, with diabetes and high blood pressure, Kelly, a certified nursing assistant, was having trouble breathing, symptoms serious enough to send her to the emergency room.
When her husband, Joe, 46, fell ill with the virus, too, she really got worried, especially about their five teenagers at home: "I thought, 'I hope to God we don't wind up on ventilators. We have children. Who's going to raise these kids?"
But the Kellys, who live in Seattle, had agreed just after their diagnoses to join a clinical trial at the nearby Fred Hutch cancer research center that's part of an international effort to test an antiviral treatment that could halt covid early in its course.
By the next day, the couple were taking four pills, twice a day. Though they weren't told whether they had received an active medication or placebo, within a week, they said, their symptoms were better. Within two weeks, they had recovered.
"I don't know if we got the treatment, but I kind of feel like we did," Miranda Kelly said. "To have all these underlying conditions, I felt like the recovery was very quick."
In a matter of days, Pfizer CEO says they'll be ready to ask for approval of a Covid-19 vaccine for kids
The Kellys have a role in developing what could be the world's next chance to thwart covid: a short-term regimen of daily pills that can fight the virus early after diagnosis and conceivably prevent symptoms from developing after exposure.
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"Oral antivirals have the potential to not only curtail the duration of one's covid-19 syndrome, but also have the potential to limit transmission to people in your household if you are sick," said Timothy Sheahan, a virologist at the University of North Carolina-Chapel Hill who has helped pioneer these therapies.
Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of influenza and reduce the risk of hospitalization if given quickly.
The medications, developed to treat and prevent viral infections in people and animals, work differently depending on the type. But they can be engineered to boost the immune system to fight infection, block receptors so viruses can't enter healthy cells, or lower the amount of active virus in the body.
At least three promising antivirals for covid are being tested in clinical trials, with results expected as soon as late fall or winter, said Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, who is overseeing antiviral development.
"I think that we will have answers as to what these pills are capable of within the next several months," Dieffenbach said.
Covid-19 vaccine boosters can begin for some US adults as CDC partially diverges from its advisers' recommendations
The top contender is a medication from Merck & Co. and Ridgeback Biotherapeutics called molnupiravir, Dieffenbach said. This is the product being tested in the Kellys' Seattle trial. Two others include a candidate from Pfizer, known as PF-07321332, and AT-527, an antiviral produced by Roche and Atea Pharmaceuticals.
They work by interfering with the virus's ability to replicate in human cells. In the case of molnupiravir, the enzyme that copies the viral genetic material is forced to make so many mistakes that the virus can't reproduce. That, in turn, reduces the patient's viral load, shortening infection time and preventing the kind of dangerous immune response that can cause serious illness or death.
So far, only one antiviral drug, remdesivir, has been approved to treat covid. But it is given intravenously to patients ill enough to be hospitalized, and is not intended for early, widespread use. By contrast, the top contenders under study can be packaged as pills.
Sheahan, who also performed preclinical work on remdesivir, led an early study in mice that showed that molnupiravir could prevent early disease caused by SARS-CoV-2, the virus that causes covid. The formula was discovered at Emory University and later acquired by Ridgeback and Merck.
Clinical trials have followed, including an early trial of 202 participants last spring that showed that molnupiravir rapidly reduced the levels of infectious virus. Merck chief executive Robert Davis said this month that the company expects data from its larger phase 3 trials in the coming weeks, with the potential to seek emergency use authorization from the Food and Drug Administration "before year-end."
Pfizer launched a combined phase 2 and 3 trial of its product Sept. 1, and Atea officials said they expect results from phase 2 and phase 3 trials later this year.
If the results are positive and emergency use is granted for any product, Dieffenbach said, "distribution could begin quickly."
That would mean millions of Americans soon could have access to a daily orally administered medication, ideally a single pill, that could be taken for five to 10 days at the first confirmation of covid infection.
"When we get there, that's the idea," said Dr. Daniel Griffin, an infectious diseases and immunology expert at Columbia University. "To have this all around the country, so that people get it the same day they get diagnosed."
5 things to know about coronavirus booster shots
Once sidelined for lack of interest, oral antivirals to treat coronavirus infections are now a subject of fierce competition and funding. In June, the Biden administration announced it had agreed to obtain about 1.7 million treatment courses of Merck's molnupiravir, at a cost of $1.2 billion, if the product receives emergency authorization or full approval. The same month, the administration said it would invest $3.2 billion in the Antiviral Program for Pandemics, which aims to develop antivirals for the covid crisis and beyond, Dieffenbach said.
The pandemic kick-started a long-neglected effort to develop potent antiviral treatments for coronaviruses, said Sheahan. Though the original SARS virus in 2003 gave scientists a scare — followed by Middle East respiratory syndrome, or MERS, in 2012 — research efforts slowed when those outbreaks did not persist.
"The commercial drive to develop any products just went down the tubes," said Sheahan.
Widely available antiviral drugs would join the monoclonal antibody therapies already used to treat and prevent serious illness and hospitalizations caused by covid. The lab-produced monoclonal antibodies, which mimic the body's natural response to infection, were easier to develop but must be given primarily through intravenous infusions.
The federal government is covering the cost of most monoclonal products at $2,000 a dose. It's still too early to know how the price of antivirals might compare.
Like the monoclonal antibodies, antiviral pills would be no substitute for vaccination, said Griffin. They would be another tool to fight covid. "It's nice to have another option," he said.
One challenge in developing antiviral drugs quickly has been recruiting enough participants for the clinical trials, each of which needs to enroll many hundreds of people, said Dr. Elizabeth Duke, a Fred Hutch research associate overseeing its molnupiravir trial.
Participants must be unvaccinated and enrolled in the trial within five days of a positive covid test. Any given day, interns make 100 calls to newly covid-positive people in the Seattle area — and most say no.
"Just generally speaking, there's a lot of mistrust about the scientific process," Duke said. "And some of the people are saying kind of nasty things to the interns."
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If the antiviral pills prove effective, the next challenge will be ramping up a distribution system that can rush them to people as soon as they test positive. Griffin said it will take something akin to the program set up last year by UnitedHealthcare, which sped Tamiflu kits to 200,000 at-risk patients enrolled in the insurer's Medicare Advantage plans.
Merck officials predicted the company could produce more than 10 million courses of therapy by the end of the year. Atea and Pfizer have not released similar estimates.
Even more promising? Studies evaluating whether antivirals can prevent infection after exposure.
"Think about that," said Duke, who is also overseeing a prophylactic trial. "You could give it to everyone in a household, or everyone in a school. Then we're talking about a return to, maybe, normal life."

 

It may be. I think that’s our ultimate path through this: 1) widespread vaccinations, 2) updates/boosters to same as Covid evolved over time, and 3) effective and easy to access therapeutics.

Would be nice for piece 3 to start to gel. Or paste. Paste is nice I hear.

8 hours ago, Buzzrock said:

Well fuck. My work buddy’s mom caught a breakthrough case a couple weeks ago and has been on a vent. She passed this morning. He closed the biggest deal of his career last week. What a fucking roller coaster.

That's terrible.  I'm sorry for your friend.

That's terrible.  I'm sorry for your friend.

Thanks dcbc. He’s an aggy but still. It really sucks that she did the right thing and got vaxxed and it got her anyway.

Kareem says NBA players should get vaxxed or be removed from their teams.

https://www.cnn.com/2021/09/27/us/kareem-abdul-jabbar-nba-vaccines-spt-trnd/index.html

Quote

(CNN)If NBA players are not vaccinated, they shouldn't be on the team, basketball Hall of Famer Kareem Abdul-Jabbar told Rolling Stone.

"The NBA should insist that all players and staff are vaccinated or remove them from the team," said Abdul-Jabbar.

"There is no room for players who are willing to risk the health and lives of their teammates, the staff and the fans simply because they are unable to grasp the seriousness of the situation or do the necessary research."

Abdul-Jabbar has been a vocal advocate for getting the Covid-19 vaccine. The NBA great received his vaccine on camera and appeared in an NBA public service announcement encouraging others to get vaccinated.

The NBA does not require players to be vaccinated against Covid-19 to play. However, referees and other staff who work closely with players are required to be fully vaccinated.

NBA requiring Covid-19 vaccinations for referees and others who work with players

New York City and San Francisco changed the game in August when they required that NBA players on their home teams be vaccinated. That could mean that stars of NBA teams in those cities would not be able to play, unless they are medically or religiously exempted.

Brooklyn Nets point guard Kyrie Irving wasn't physically present with his teammates at the Nets annual media day on Monday. But Irving took a question on the issue remotely.

Irving did not disclose his vaccination status -- nor did he say if he expected to be vaccinated or compliant by the time the Nets return home following their preseason game against the Los Angeles Lakers on Sunday. He said he wants "to keep that stuff private."

"I'm a human being first," Irving said. "Obviously living in this public sphere, it's just a lot of questions about what's going on in the world of Kyrie and I think I just would love to just keep that private and handle it the right way, with my team and go forward together with the plan."

Abdul-Jabbar called out vaccine deniers in the Rolling Stone article.

"What I find especially disingenuous about the vaccine deniers is their arrogance at disbelieving immunology and other medical experts," he told Rolling Stone. "Yet, if their child was sick or they themselves needed emergency medical treatment, how quickly would they do exactly what those same experts told them to do?"

While vaccine hesitancy is shrinking, there are parts of the population who are still more hesitant than others.

Black Americans are the least vaccinated demographic group, according to the US Centers for Disease Control and Prevention, which estimated in August that 25% of the Black population in the US was fully vaccinated. Of the US population that is fully vaccinated, only 9% are Black. However, this data is incomplete -- the CDC reports that race and ethnicity data is available for only 68% of people who are fully vaccinated.

Abdul-Jabbar has spoken about the importance of reaching out to those who are vaccine hesitant, especially those in the minority community.

Basketball star explains why he wants NBA players vaccinated now 02:41

"We have to gain the trust of minority communities by showing them that the vaccine is effective and that it's in their best interest to take the vaccine," Abdul-Jabbar told CNN's Chris Cuomo in March. "The problem in times past was that no one wanted to give them the latest treatment."

He referred to the Tuskegee experiment, when researchers unethically withheld treatment for Black men who had syphilis between 1932 and 1972, letting the disease progress.

Abdul-Jabbar said athletes and celebrities may be able to help those who are vaccine hesitant.

"A lot of people in minority communities respect athletes that go out there and take their word on things of this nature," he told CNN in March. "Anytime that that happens it's making it possible for more people to get the vaccination that they need and help us beat this Covid-19 thing down."

CNN's Nicquel Terry Ellis contributed to this report.

 

11 hours ago, Brisketexan said:

 

It may be. I think that’s our ultimate path through this: 1) widespread vaccinations, 2) updates/boosters to same as Covid evolved over time, and 3) effective and easy to access therapeutics.

Would be nice for piece 3 to start to gel. Or paste. Paste is nice I hear.

My initial reaction was almost the opposite. When I saw that it could be treated, i felt like it would only solidify people’s insistence not to get the vaccine. Easier to have the courage of your convictions when there’s no risk to self.  Because self interest is the only real motivator for the unvaccinated.  

 

14 minutes ago, OneOfTheOutOfFocusGuys said:

My initial reaction was almost the opposite. When I saw that it could be treated, i felt like it would only solidify people’s insistence not to get the vaccine. Easier to have the courage of your convictions when there’s no risk to self.  Because self interest is the only real motivator for the unvaccinated.  

Depends, is it available in Apple-flavored paste form?  What if it’s made from equine aborted fetuses?  Did Hunter Biden somehow sponsor it?  Is it manufactured in China?

Plenty of questions need to be answered first.  

5 minutes ago, Homercles said:

 

Depends, is it available in Apple-flavored paste form?  What if it’s made from equine aborted fetuses?  Did Hunter Biden somehow sponsor it?  Is it manufactured in China?

Plenty of questions need to be answered first.  

CR

22 minutes ago, OneOfTheOutOfFocusGuys said:

My initial reaction was almost the opposite. When I saw that it could be treated, i felt like it would only solidify people’s insistence not to get the vaccine. Easier to have the courage of your convictions when there’s no risk to self.  Because self interest is the only real motivator for the unvaccinated.  

This is short sighted. You still want treatments for people like Buzzrock’s friend’s mom, or people that had reactions to the shot like Troph that may not be getting boosters. 

If the vaccine has tracking chips and/or intentionally causes sterility because deep state, why wouldn’t the therapeutics also have those things?

why is regeneron ok but vaccine is not?  Why would this pill be deep state free?  Isn’t this all big pharma?

 

kust remembered this isn’t the cr thread, but rereading that I think it can stay. Overreaching point being a snarky way of asking why people that don’t trust the vaccine would trust the therapeutics. 

Edited September 28, 2021 by Pato del Muerto

Pfizer submitted their data on 5-11 years olds to the FDA this morning. Hopefully approval comes in the next couple of weeks.

1 hour ago, Pato del Muerto said:

Overreaching point being a snarky way of asking why people that don’t trust the vaccine would trust the therapeutics. 

Because it's not about genuinely held beliefs or a religious opposition, it's about being a mental toddler that doesn't want to be told they're wrong and are protecting their ego over their own and other's health

3 hours ago, Pato del Muerto said:

If the vaccine has tracking chips and/or intentionally causes sterility because deep state, why wouldn’t the therapeutics also have those things?

why is regeneron ok but vaccine is not?  Why would this pill be deep state free?  Isn’t this all big pharma?

 

kust remembered this isn’t the cr thread, but rereading that I think it can stay. Overreaching point being a snarky way of asking why people that don’t trust the vaccine would trust the therapeutics. 

It has to be a lack of understanding and/or a lack of trying to understand. There isn't a whole lot of difference between injecting a recombinant protein to create antibodies, mRNA to create antibodies or delivering monoclonal antibodies through infusion. The first two are called vaccines while the last is called a therapeutic. Interestingly, there is an RSV monoclonal that is given prophylactically but I think they call it a therapy. I

I can tell you though that if I wanted to inject a chip, it would be much easier through monoclonal infusion than by a shot. With that said, most people who are against the vaccine are not against getting treated for the disease. It is obviously different for people to take something to lessen the risk of disease than taking something to help cure disease.

Edited September 28, 2021 by Bevo

On 9/27/2021 at 8:06 AM, Pato del Muerto said:

Anyone else given a minute of thought as to where we’d be right now if delta had happened and there was no vaccine prophylaxis?  Pretty grim, I’d say. 

India ran out of wood to burn the bodies.

This is short sighted. You still want treatments for people like Buzzrock’s friend’s mom, or people that had reactions to the shot like Troph that may not be getting boosters. 

South Carolina is starting clinical trials for three potential therapeutics including ivermectin:

https://www.wspa.com/news/ivermectin-clinical-trials-now-open-to-all-south-carolinians-heres-how-to-sign-up/

13 hours ago, Pato del Muerto said:

If the vaccine has tracking chips and/or intentionally causes sterility because deep state, why wouldn’t the therapeutics also have those things?

why is regeneron ok but vaccine is not?  Why would this pill be deep state free?  Isn’t this all big pharma?

 

kust remembered this isn’t the cr thread, but rereading that I think it can stay. Overreaching point being a snarky way of asking why people that don’t trust the vaccine would trust the therapeutics. 

Because anti vaxxers are total morons? 
 

Not much more dangerous than idiots who think they are much smarter than they are. 

The latest I saw showed 51% of Texas fully vaccinated. A few percent more have had the first shot and not yet the seconds. Another few percent have had the first shot but are declining the second. 
  
28% of the state is under the age of 20. From extrapolating some stats, about 6% of the population is under 20 and has also been vaccinated. 
 
About 14% of the state population, per Worldometer, has had Covid officially, meaning some larger number (twice to three times?) has had it with no or few symptoms and was undiagnosed. 
  
So, given that there is some overlap of vaccinated, had Covid and the young with robust immunities, what is the end game? I hate to focus on “hers immunity”, as it seems to be poorly defined (and probably is more significant in year 5 than year 2?), but is there a target for when we’re over the hump?

There's no reason to, but I'm hoping that the vaccine approval for 5-11 gets us close to over the hump.  The vaccination rates for 12-18 is abysmal, so this is probably wishful thinking.  My kids will be in line day one.  We've got hockey games to attend, by god.

Can someone with a NYT sub please post this article?

 

https://www.nytimes.com/2021/09/22/health/covid-moderna-pfizer-vaccines.html?campaign_id=190&emc=edit_ufn_20210929&instance_id=41574&nl=updates-from-the-newsroom&regi_id=135361148&segment_id=70175&te=1&user_id=2dc19957a08ac80e2324537a278a9160

1 hour ago, Gatorubet said:

It’s about team identity - and not wanting to appear as being a liberal who thinks Covid might be worse than the flu. Better to die than be seen as a Democrat thinker by your family and friends.

Wrong forum 

59 minutes ago, Baboontyme said:

Can someone with a NYT sub please post this article?

 

https://www.nytimes.com/2021/09/22/health/covid-moderna-pfizer-vaccines.html?campaign_id=190&emc=edit_ufn_20210929&instance_id=41574&nl=updates-from-the-newsroom&regi_id=135361148&segment_id=70175&te=1&user_id=2dc19957a08ac80e2324537a278a9160

Here ya go

Spoiler

Moderna vs. Pfizer: Both Knockouts, but One Seems to Have the Edge
A series of studies found that the Moderna vaccine seemed to be more protective as the months passed than the Pfizer-BioNTech vaccine. Here’s why.

It was a constant refrain from federal health officials after the coronavirus vaccines were authorized: These shots are all equally effective.

That has turned out not to be true.

Roughly 221 million doses of the Pfizer-BioNTech vaccine have been dispensed thus far in the United States, compared with about 150 million doses of Moderna’s vaccine. In a half-dozen studies published over the past few weeks, Moderna’s vaccine appeared to be more protective than the Pfizer-BioNTech vaccine in the months after immunization.

The latest such study, published on Wednesday in The New England Journal of Medicine, evaluated the real-world effectiveness of the vaccines at preventing symptomatic illness in about 5,000 health care workers in 25 states. The study found that the Pfizer-BioNTech vaccine had an effectiveness of 88.8 percent, compared with Moderna’s 96.3 percent.

Research published on Friday by the Centers for Disease Control and Prevention found that the efficacy of the Pfizer-BioNTech vaccine against hospitalization fell from 91 percent to 77 percent after a four-month period following the second shot. The Moderna vaccine showed no decline over the same period.

If the efficacy gap continues to widen, it may have implications for the debate on booster shots. Federal agencies this week are evaluating the need for a third shot of the Pfizer-BioNTech vaccine for some high-risk groups, including older adults.

Scientists who were initially skeptical of the reported differences between the Moderna and Pfizer-BioNTech vaccines have slowly become convinced that the disparity is small but real.

“Our baseline assumption is that the mRNA vaccines are functioning similarly, but then you start to see a separation,” said Natalie Dean, a biostatistician at Emory University in Atlanta. “It’s not a huge difference, but at least it’s consistent.”

But the discrepancy is small and the real-world consequences uncertain, because both vaccines are still highly effective at preventing severe illness and hospitalization, she and others cautioned.

“Yes, likely a real difference, probably reflecting what’s in the two vials,” said John Moore, a virologist at Weill Cornell Medicine in New York. “But truly, how much does this difference matter in the real world?”

“It’s not appropriate for people who took Pfizer to be freaking out that they got an inferior vaccine.”

Even in the original clinical trials of the three vaccines eventually authorized in the United States — made by Pfizer-BioNTech, Moderna and Johnson & Johnson — it was clear that the J.&J. vaccine had a lower efficacy than the other two. Research since then has borne out that trend, although J.&J. announced this week that a second dose of its vaccine boosts its efficacy to levels comparable to the others.

The Pfizer-BioNTech and Moderna vaccines rely on the same mRNA platform, and in the initial clinical trials, they had remarkably similar efficacy against symptomatic infection: 95 percent for Pfizer-BioNTech and 94 percent for Moderna. This was in part why they were described as more or less equivalent.

The subtleties emerged over time. The vaccines have never been directly compared in a carefully designed study, so the data indicating that effects vary are based mostly on observations.

Results from those studies can be skewed by any number of factors, including the location, the age of the population vaccinated, when they were immunized and the timing between the doses, Dr. Dean said.

For example, the Pfizer-BioNTech vaccine was rolled out weeks before Moderna’s to priority groups — older adults and health care workers. Immunity wanes more quickly in older adults, so a decline observed in a group consisting mostly of older adults may give the false impression that the protection from the Pfizer-BioNTech vaccine falls off quickly.

Given those caveats, “I’m not convinced that there truly is a difference,” said Dr. Bill Gruber, a senior vice president at Pfizer. “I don’t think there’s sufficient data out there to make that claim.”

But by now, the observational studies have delivered results from a number of locations — Qatar, the Mayo Clinic in Minnesota, several other states in the United States — and in health care workers, hospitalized veterans or the general population.

Moderna’s efficacy against severe illness in those studies ranged from 92 to 100 percent. Pfizer-BioNTech’s numbers trailed by 10 to 15 percentage points.

The two vaccines have diverged more sharply in their efficacy against infection. Protection from both waned over time, particularly after the arrival of the Delta variant, but the Pfizer-BioNTech vaccine’s values fell lower. In two of the recent studies, the Moderna vaccine did better at preventing illness by more than 30 percentage points.

A few studies found that the levels of antibodies produced by the Pfizer-BioNTech vaccine were one-third to one-half those produced by the Moderna vaccine. Yet that decrease is trivial, Dr. Moore said: For comparison, there is a more than 100-fold difference in the antibody levels among healthy individuals.

Still, other experts said that the corpus of evidence pointed to a disparity that would be worth exploring, at least in people who respond weakly to vaccines, including older adults and immunocompromised people.

“At the end of the day, I do think there are subtle but real differences between Moderna and Pfizer,” Dr. Jeffrey Wilson, an immunologist and physician at the University of Virginia in Charlottesville who was a co-author of one such study, published in JAMA Network Open this month. “In high-risk populations, it might be relevant. It’d be good if people took a close look.”

“Pfizer is a big hammer,” Dr. Wilson added, but “Moderna is a sledgehammer.”

Several factors might underlie the divergence. The vaccines differ in their dosing and in the time between the first and second doses.

Vaccine manufacturers would typically have enough time to test a range of doses before choosing one — and they have done such testing for their trials of the coronavirus vaccine in children.

But in the midst of a pandemic last year, the companies had to guess at the optimal dose. Pfizer went with 30 micrograms, Moderna with 100.

Moderna’s vaccine relies on a lipid nanoparticle that can deliver the larger dose. And the first and second shots of that vaccine are staggered by four weeks, compared with three for the Pfizer-BioNTech vaccine.

The extra week may give immune cells more time to proliferate before the second dose, said Dr. Paul Burton, Moderna’s chief medical officer. “We need to keep studying this and to do more research, but I think it’s plausible.”

Moderna’s team recently showed that a half dose of the vaccine still sent antibody levels soaring. Based on those data, the company asked the F.D.A. this month to authorize 50 micrograms, the half dose, as a booster shot.

There is limited evidence showing the effect of that dose, and none on how long the higher antibody levels might last. Federal regulators are reviewing Moderna’s data to determine whether the available data are sufficient to authorize a booster shot of the half dose.

Ultimately, both vaccines are still holding steady against severe illness and hospitalization, especially in people under 65, Dr. Moore said.

Scientists had initially hoped that the vaccines would have an efficacy of 50 or 60 percent. “We would have all seen that as great result and been happy with it,” he said. “Fast forward to now, and we’re debating whether 96.3 percent vaccine efficacy for Moderna versus 88.8 percent for Pfizer is a big deal.”

 

maybe i'm spoiled from all the high numbers on the efficacy of the vaccines until now, but 77% at preventing hospitalization seems like a pretty shitty vaccine.

...and not to sound too skeptical, because I'm extremely pro vaccine (mentioned elsewhere I'm in the Moderna trial), but I suspect that when all is said and done and we look back on Delta, those numbers are going to be lower than that. Or maybe it's just the early adopters immunity waning. The way Delta tore through everyone in my wife's vaccinated circle is a little concerning. 

Also re: Delta, take a listen to Andy Slavitt's On the Bubble pod with Fauci a few weeks back. They make an interesting assertion that we are somewhat fortunate with Delta because it's mild but it's so overwhelming that it is knocking out the other variants by taking them over. Nightmare fuel is if we get a variant that is just as transmissible but more severe. 

30 minutes ago, OneOfTheOutOfFocusGuys said:

maybe i'm spoiled from all the high numbers on the efficacy of the vaccines until now, but 77% at preventing hospitalization seems like a pretty shitty vaccine.

I don't follow what that 77% number means.  Surely it doesn't mean if you are vaccinated you have a 23% of hospitalization if infected.  Because if so we would be seeing a lot more vaccinated hospitalizations.  I mean hospitalization for non-vaccinated is only estimated at like 20 or 25% I believe.

I mean hospitalization for non-vaccinated is only estimated at like 20 or 25% I believe.

Pre vaccine and pre Delta, hospitalization rate was between 1 and 5%

On 9/27/2021 at 11:18 AM, Buzzrock said:

Well fuck. My work buddy’s mom caught a breakthrough case a couple weeks ago and has been on a vent. She passed this morning.

Do you have any idea if she was in a higher risk group (75+ or severely immunocompromised, etc.)

Sorry to hear it regardless.

16 minutes ago, smoky said:

 

 

Pre vaccine and pre Delta, hospitalization rate was between 1 and 5%

 

Yeah, I think I was thinking of the 65+ population that had the higher rate pre vaccine.

More thoughts on “herd immunity”. I don’t think it means the disease is a non-problem. I think it means a disease is a tolerable/manageable problem. For example- I guess we have “herd immunity” on the flu, meaning it’s not a new virus to our immune systems and we all have some resistance to it. Despite herd immunity, the flu still kills tens of thousands of American infants and elderly per year. (Also- the flu can be contracted through food and drink, and a little googling shows that most cities in the US started purifying their water systems about 100 years ago, after the onset of the Spanish Flu…hmmm). 
  
So, herd immunity to Covid will be good, but only to the extent that it makes it manageable, and Covid may still affect our lives in fundamental ways. 

Edited September 29, 2021 by statsman

2 minutes ago, statsman said:

More thoughts on “herd immunity”. I don’t think it means the disease is a non-problem. I think it means a disease is a tolerable/manageable problem. For example- I guess we have “herd immunity” on the fly, meaning it’s not a new virus to our immune systems and we all have some resistance to it. Despite herd immunity, the flu still kills tens of thousands of American infants and elderly per year. (Also- the flu can be contracted through food and drink, and a little googling shows that most cities in the US started purifying their water systems about 100 years ago, after the onset of the Spanish Flu…hmmm). 
  
So, herd immunity to Covid will be good, but only to the extent that it makes it manageable, and Covid may still affect our lives in fundamental ways. 

I think that's generally right, which is why developing better therapeutics is also important.

I have said it before, but will repeat: I think our global health goal should be to reduce the health impacts of COVID to where they are roughly on par with the flu.  That is, SOME people will still get sick with it in a given year, and SOME of them will have a severe case and even die.  But in comparison, the US will see maybe 50,000 annual COVID deaths instead of 500,000.  That will be a public health win in the near term (the next 10 years or so....maybe after that time, we can develop more effective vaccines etc., and really make it a marginal illness, we'll see).

42 minutes ago, Skipper said:

Yeah, I think I was thinking of the 65+ population that had the higher rate pre vaccine.

~30-35% for 65+, ~6-7% for 18-64 is what I have seen.  

Doing some more reading- I saw another definition for herd immunity- where, due to vaccinations (like with measles), the percent of the population that can’t get it is so high that there can’t practically be an actual outbreak. 
 
I don’t know if there are two definitions, or some combination. I know that our current vaccines are effective, but they aren’t effective enough to get us to herd immunity at 100% vaccinated by this definition, because a variant can always come in and effect an outbreak. I guess they can keep the outbreak from being a disaster. 

1 minute ago, statsman said:

Doing some more reading- I saw another definition for herd immunity- where, due to vaccinations (like with measles), the percent of the population that can’t get it is so high that there can’t practically be an actual outbreak. 
 
I don’t know if there are two definitions, or some combination. I know that our current vaccines are effective, but they aren’t effective enough to get us to herd immunity at 100% vaccinated by this definition, because a variant can always come in and effect an outbreak. I guess they can keep the outbreak from being a disaster. 

That also seems right.  You may well see outbreaks in certain communities that have low/no vaccinations, just like we have with measles.  But hopefully, it will stay like those - isolated outbreaks, that don't spread very far into the population at large.

2 minutes ago, statsman said:

Doing some more reading- I saw another definition for herd immunity- where, due to vaccinations (like with measles), the percent of the population that can’t get it is so high that there can’t practically be an actual outbreak. 
 
I don’t know if there are two definitions, or some combination. I know that our current vaccines are effective, but they aren’t effective enough to get us to herd immunity at 100% vaccinated by this definition, because a variant can always come in and effect an outbreak. I guess they can keep the outbreak from being a disaster. 

Here immunity is strictly speaking, a function of R0 and Vaccine Effectiveness.  If R0 is high or VE is low, you need a high proportion of individuals vaccinated to achieve herd immunity. If you have a variant break out that is strongly evasive of the vaccines, all bets off until you reformulate the vaccine and you start over.  I hope that we didn't see that kind of breakout.  That would really suck. 

5 hours ago, orange dream said:

Do you have any idea if she was in a higher risk group (75+ or severely immunocompromised, etc.)

Sorry to hear it regardless.

She was definitely in the at-risk age range.

Don’t you get three draws with the UT Cares thing?  Anyone know how you do the second draw?  Do I just show up at CPL with the original code or do I need to do something to tell them I’m coming?

Don’t you get three draws with the UT Cares thing?  Anyone know how you do the second draw?  Do I just show up at CPL with the original code or do I need to do something to tell them I’m coming?

I think I read somewhere that they text you another code to give CPL. I’ve only done the first draw so not speaking from direct experience here.

13 minutes ago, Liquor and Poker said:

Don’t you get three draws with the UT Cares thing?  Anyone know how you do the second draw?  Do I just show up at CPL with the original code or do I need to do something to tell them I’m coming?

They text you three months after your first draw, then again three months after your second.

Update on breakthrough case (Moderna/mid-April/1600 antibodies as of last month) -- kid brought it home and gave it to me.

From Saturday-Tuesday felt pretty rough. Lots of chills, fatigue, etc. All the classic symptoms. Starting last Wednesday I've felt fine, but even a week later have a lingering cough and after I felt better, sense of smell vanished. It's about 20% of normal now and still have a cough. Wife who also did Texas Cares study and had around 1200 on antibodies never got it.

Also, I've been testing occasionally with at-home tests and still show as positive. I've read that can be the case for weeks/months. Blech.

I do feel a bit like Vince McMahon walking around now having the virus and the vaccine. I gotta be bulletproof now, right?

 

Edited September 30, 2021 by FirstTimeCaller

37 minutes ago, FirstTimeCaller said:

I gotta be bulletproof now, right?

Fuck around and find out. 

43 minutes ago, FirstTimeCaller said:

I gotta be bulletproof now, right?

Feel free to condomless in Haiti 

As to comments about vaccine efficacy- the vaccines were developed for the ur-variant, and testing showed they were great for that, around 90% and better. If that were the only strain out there, we’d be in a whole ‘nuther place right now. Then the delta variant came along, and the vaccines are less effective on it. Of course, because natural selection supports the strains most resistant to the vaccines. So now we are more like 60% effective, like a good flu shot, in a year where they did a good job of selecting the flu strains to target. 
  
I was inventorying the facets of the pandemic, and this is how I understand Covid-

The disease is contagious through airborne particles that survive for hours in the air. That means, sharing a closed ventilation system (“being inside”) with someone that has it means you getting infected is just a function of proximity and time. The closer you are to them, the sooner you get infected. The longer you are inside with them, the more likely you are to get infected. 
 

Young people do better. Your body produces fewer T cells as you age. Older people’s immune systems just have less ammo. 
  
The CDC did a study on BMI and Covid results. Basically, the fatter you are, the more likely you are to have a bad outcome. Frankly, I don’t understand all the jargon about how the respiratory system of fat people is under increased load, but the empirical data is enough. This report inspired me to diet, and get my BMI under 30 (5’10”, 198#). I don’t like that BMI doesn’t differentiate between men and women, but maybe it doesn’t matter for this study. I really think our government has dropped the ball on this facet- it seems to me that having a healthy weight nears vaccination in importance, and is more important than wearing a mask. 
  
So here is where I come down to on the vaccine- there are three things available to protect you from a bad outcome (ranging from hospitalization to death): be young, be trim and be vaccinated. I think everyone should have at least two of the three to feel good about re-entering normal life. Age is not discretionary, but the other two are. I’m 57, so I’m vaccinated and I’m losing weight. 
  
Three out of three (young, healthy and vaccinated) is better. I think that one out of three (young, fat and unvaccinated, or old, fat and vaccinated, or old, trim and unvaccinated) are inadequate. If you only have one of the three, you probably still need to be wary of rejoining all activities. 
 
I think that as a nation, we screwed up with children last year. Between curtailing of activities and increases in junk food, childhood obesity went up, and that was the worst thing we could let happen. 

Edited September 30, 2021 by statsman

I wasn’t able to edit in time, but my post above ignores “long Covid”, which may not require hospitalization, but is plenty of reason to manage your life activities so as to avoid infection altogether, if possible. I have no idea if age and weight affect getting long Covid. I guess that’s a great reason for all to get vaccinated, no matter the other conditions, to reduce odds of getting it. 

2 hours ago, Deej said:

They text you three months after your first draw, then again three months after your second.

So it’s not “whenever you feel like it” after the first one. Oh well. 

Interesting

1 hour ago, statsman said:

So here is where I come down to on the vaccine- there are three things available to protect you from a bad outcome (ranging from hospitalization to death): be young, be trim and be vaccinated. I think everyone should have at least two of the three to feel good about re-entering normal life. Age is not discretionary, but the other two are. I’m 57, so I’m vaccinated and I’m losing weight. 

If you gigavax and take a third shot, can vaccination count as two?

Here ya go
Spoiler

Moderna vs. Pfizer: Both Knockouts, but One Seems to Have the Edge
A series of studies found that the Moderna vaccine seemed to be more protective as the months passed than the Pfizer-BioNTech vaccine. Here’s why.
It was a constant refrain from federal health officials after the coronavirus vaccines were authorized: These shots are all equally effective.
That has turned out not to be true.
Roughly 221 million doses of the Pfizer-BioNTech vaccine have been dispensed thus far in the United States, compared with about 150 million doses of Moderna’s vaccine. In a half-dozen studies published over the past few weeks, Moderna’s vaccine appeared to be more protective than the Pfizer-BioNTech vaccine in the months after immunization.
The latest such study, published on Wednesday in The New England Journal of Medicine, evaluated the real-world effectiveness of the vaccines at preventing symptomatic illness in about 5,000 health care workers in 25 states. The study found that the Pfizer-BioNTech vaccine had an effectiveness of 88.8 percent, compared with Moderna’s 96.3 percent.
Research published on Friday by the Centers for Disease Control and Prevention found that the efficacy of the Pfizer-BioNTech vaccine against hospitalization fell from 91 percent to 77 percent after a four-month period following the second shot. The Moderna vaccine showed no decline over the same period.
If the efficacy gap continues to widen, it may have implications for the debate on booster shots. Federal agencies this week are evaluating the need for a third shot of the Pfizer-BioNTech vaccine for some high-risk groups, including older adults.
Scientists who were initially skeptical of the reported differences between the Moderna and Pfizer-BioNTech vaccines have slowly become convinced that the disparity is small but real.
“Our baseline assumption is that the mRNA vaccines are functioning similarly, but then you start to see a separation,” said Natalie Dean, a biostatistician at Emory University in Atlanta. “It’s not a huge difference, but at least it’s consistent.”
But the discrepancy is small and the real-world consequences uncertain, because both vaccines are still highly effective at preventing severe illness and hospitalization, she and others cautioned.
“Yes, likely a real difference, probably reflecting what’s in the two vials,” said John Moore, a virologist at Weill Cornell Medicine in New York. “But truly, how much does this difference matter in the real world?”
“It’s not appropriate for people who took Pfizer to be freaking out that they got an inferior vaccine.”
Even in the original clinical trials of the three vaccines eventually authorized in the United States — made by Pfizer-BioNTech, Moderna and Johnson & Johnson — it was clear that the J.&J. vaccine had a lower efficacy than the other two. Research since then has borne out that trend, although J.&J. announced this week that a second dose of its vaccine boosts its efficacy to levels comparable to the others.
The Pfizer-BioNTech and Moderna vaccines rely on the same mRNA platform, and in the initial clinical trials, they had remarkably similar efficacy against symptomatic infection: 95 percent for Pfizer-BioNTech and 94 percent for Moderna. This was in part why they were described as more or less equivalent.
The subtleties emerged over time. The vaccines have never been directly compared in a carefully designed study, so the data indicating that effects vary are based mostly on observations.
Results from those studies can be skewed by any number of factors, including the location, the age of the population vaccinated, when they were immunized and the timing between the doses, Dr. Dean said.
For example, the Pfizer-BioNTech vaccine was rolled out weeks before Moderna’s to priority groups — older adults and health care workers. Immunity wanes more quickly in older adults, so a decline observed in a group consisting mostly of older adults may give the false impression that the protection from the Pfizer-BioNTech vaccine falls off quickly.
Given those caveats, “I’m not convinced that there truly is a difference,” said Dr. Bill Gruber, a senior vice president at Pfizer. “I don’t think there’s sufficient data out there to make that claim.”
But by now, the observational studies have delivered results from a number of locations — Qatar, the Mayo Clinic in Minnesota, several other states in the United States — and in health care workers, hospitalized veterans or the general population.
Moderna’s efficacy against severe illness in those studies ranged from 92 to 100 percent. Pfizer-BioNTech’s numbers trailed by 10 to 15 percentage points.
The two vaccines have diverged more sharply in their efficacy against infection. Protection from both waned over time, particularly after the arrival of the Delta variant, but the Pfizer-BioNTech vaccine’s values fell lower. In two of the recent studies, the Moderna vaccine did better at preventing illness by more than 30 percentage points.
A few studies found that the levels of antibodies produced by the Pfizer-BioNTech vaccine were one-third to one-half those produced by the Moderna vaccine. Yet that decrease is trivial, Dr. Moore said: For comparison, there is a more than 100-fold difference in the antibody levels among healthy individuals.
Still, other experts said that the corpus of evidence pointed to a disparity that would be worth exploring, at least in people who respond weakly to vaccines, including older adults and immunocompromised people.
“At the end of the day, I do think there are subtle but real differences between Moderna and Pfizer,” Dr. Jeffrey Wilson, an immunologist and physician at the University of Virginia in Charlottesville who was a co-author of one such study, published in JAMA Network Open this month. “In high-risk populations, it might be relevant. It’d be good if people took a close look.”
“Pfizer is a big hammer,” Dr. Wilson added, but “Moderna is a sledgehammer.”
Several factors might underlie the divergence. The vaccines differ in their dosing and in the time between the first and second doses.
Vaccine manufacturers would typically have enough time to test a range of doses before choosing one — and they have done such testing for their trials of the coronavirus vaccine in children.
But in the midst of a pandemic last year, the companies had to guess at the optimal dose. Pfizer went with 30 micrograms, Moderna with 100.
Moderna’s vaccine relies on a lipid nanoparticle that can deliver the larger dose. And the first and second shots of that vaccine are staggered by four weeks, compared with three for the Pfizer-BioNTech vaccine.
The extra week may give immune cells more time to proliferate before the second dose, said Dr. Paul Burton, Moderna’s chief medical officer. “We need to keep studying this and to do more research, but I think it’s plausible.”
Moderna’s team recently showed that a half dose of the vaccine still sent antibody levels soaring. Based on those data, the company asked the F.D.A. this month to authorize 50 micrograms, the half dose, as a booster shot.
There is limited evidence showing the effect of that dose, and none on how long the higher antibody levels might last. Federal regulators are reviewing Moderna’s data to determine whether the available data are sufficient to authorize a booster shot of the half dose.
Ultimately, both vaccines are still holding steady against severe illness and hospitalization, especially in people under 65, Dr. Moore said.
Scientists had initially hoped that the vaccines would have an efficacy of 50 or 60 percent. “We would have all seen that as great result and been happy with it,” he said. “Fast forward to now, and we’re debating whether 96.3 percent vaccine efficacy for Moderna versus 88.8 percent for Pfizer is a big deal.”

 

Our Germans are better than their Germans.

1 hour ago, statsman said:

I wasn’t able to edit in time, but my post above ignores “long Covid”, which may not require hospitalization, but is plenty of reason to manage your life activities so as to avoid infection altogether, if possible. I have no idea if age and weight affect getting long Covid. I guess that’s a great reason for all to get vaccinated, no matter the other conditions, to reduce odds of getting it. 

I am not convinced that long COVID is a unique entity, differentiable from long flu or long post-critical care syndrome. From a public health perspective, I think that the impact of "long COVID" is generally driven by the sheer number of C19 cases, rather than some unique clinical aspect associated with post acute covid.  

27 minutes ago, Anastasis said:

I am not convinced that long COVID is a unique entity, differentiable from long flu or long post-critical care syndrome. From a public health perspective, I think that the impact of "long COVID" is generally driven by the sheer number of C19 cases, rather than some unique clinical aspect associated with post acute covid.  

I am not convinced that long COVID is a unique entity, differentiable from long flu or long post-critical care syndrome. From a public health perspective, I think that the impact of "long COVID" is generally driven by the sheer number of C19 cases, rather than some unique clinical aspect associated with post acute covid.  

Makes total sense to me. However I do recall early on that at Cedar’a in NYC the vast majority of ling Covid stuff was being reported in the more mild cases that did not include any hospitalizations initially.

1 hour ago, Anastasis said:

I am not convinced that long COVID is a unique entity, differentiable from long flu or long post-critical care syndrome. From a public health perspective, I think that the impact of "long COVID" is generally driven by the sheer number of C19 cases, rather than some unique clinical aspect associated with post acute covid.  

I agree, but that's an incomplete statement -- long COVID is relevant, so we should discuss why it's relevant.

It's relevant because the "bad outcomes from COVID" aren't limited to deaths.  If we had a category of "number of people seriously fucked up by COVID, up to and including death," it would be VASTLY more than 670,000.  It may well be in the millions.  That's important, because the discussion of COVID as not being bad because the number of DEAD isn't so bad purposefully downplays the significant harm and suffering caused by COVID.

For an analogy, the number of American troops killed in Afghanistan was around 2,500.   But over 20,000 -- EIGHT TIMES AS MANY -- were wounded.  While some wounds were relatively minor, many were not -- we have thousands of amputees and people with TBIs walking around as a result of that war.

When we think of COVID in terms of serious casualties it has caused, it's pretty fucking horrible, and it vastly outpaces the numbers from other easily transmissible illnesses.  I don't want my family members to die of COVID.  I also don't want them to be debilitated for years because of it.  Shit, we went through this with a son who had a case of long mono, and it fucking SUCKED.  It was horrible for him, and had a huge negative effect on his life and well-being.  It's no joke.

So, considering the prevalence of long COVID is important in considering the significant negative health impacts of the disease.  Anything that utterly fucks up millions of Americans in a mere 18 months is some serious shit.

Looks like Moderna is better than Pfizer at producing antibodies and preventing breakthrough infections. Sorry Pfizer suckers. Us Modernites will rule the earth.

https://www.nbcchicago.com/news/coronavirus/moderna-vs-pfizer-is-one-vaccine-stronger-against-delta-variant/2603249/?amp