Heme Doc

This is a great question that’s complex and which we have zero data. We know COVID is less serious for kids than seasonal flu. The main argument to vaccinating kids would be to help end the pandemic quicker so kids aren’t spreading it to adults/others who are more likely to have severe disease. But those higher risk adults will have already been vaccinated by the time kids are up for vaccinations.

Legit lol. Well done. As a cancer doctor, my sense of humor is darker than just about anyone.

If you had really high titers of antibodies to Spike already, that would be consistent with you already having COVID (prob around Thanksgiving) and you wouldn’t need the 2nd dose

Have you already had COVID?

Lots of confusion/concern out there about the AZ vaccine effectiveness against South African variant. So I’ll try to help explain... The AZ trial in question looked at healthy adults age 18-65 in South Africa. AZ vaccine is super cheap ($3/dose) so it’s the one a lot of poor countries are betting on. They designed the trial to show 60% effectiveness against getting symptomatic COVID. They only enrolled 1789 participants and only had 42 cases of COVID in the trial (19 in vaccine and 23 in placebo). So it was quite under powered to show what they wanted it to. Of those 42 cases, all were mild. Nobody needed the hospital or oxygen. But that’s what you might expect in a younger healthier study population. So this was a small study but protection against SEVERE disease with AZ is unknown but probable. J&J vaccine shows excellent protection (89%) against severe disease due to the SA variant. Thanks for reading. I will bill the surly fund for $1,000.

I think a correct answer would be “we don’t know yet, but probably not that big a deal” The AZ study in South Africa showed no difference between placebo and vaccine in protecting against mild or moderate infections. So, I’m sure your next question is how it did against things we REALLY care about like severe infections, hospitalizations, and death. But the problem is the study wasn’t looking at that. They only enrolled younger people and didn’t have any hospitalizations or death.

Agree that it’s totally stupid. As a vaccinated person who had to cancel international travel because of this, you’re absolutely preaching to the choir here.

You want a positive test? I can get ya a positive test dude. Believe me there are ways dude. I can get ya a positive test result by 3 o’clock this afternoon. With nail polish.

You are interpreting things correctly. And I don’t think you can just have a doc state that you’ve recovered from COVID. You need to provide a positive COVID test result within 90 days of travel.

I think it’s actually Initrode

https://www.labcorp.com/tests/164090/sars-cov-2-semi-quantitative-total-antibody-spike This is the test I’d want after vaccination to see my Spike antibody titers. The problem is that we don’t yet know what titers correlate with protection...

My read on the various vaccine data and trials is that all these vaccines kick serious ass. Do some kick a little more ass than others? Perhaps. But you’re probably splitting hairs and they’re all much more similar than different.

That’s all correct Based on 2 large trials, mRNA vaccines are both: 95% effective at keeping you from getting symptomatic COVID and pretty much 100% effective at keeping you from getting severe COVID, being hospitalized, or dying The antibody test situation is evolving and I believe LabCorp is offering antibody tests and titers against Spike. Plus vaccines do induce other vaccine fighting goodies like T cells which help protect you but are much harder to measure

https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1.full.pdf Here’s some solid data in pre-print form from a very reputable lab. It shows what we suspected. 1. If you already had COVID, you’re more likely to react to first dose of mRNA vaccine 2. If you already had COVID, you probably just need one vaccine dose to achieve the same level of immunity as those who never had COVID that received 2 doses

My hospital has gone from around 186 confirmed COVID positive in house about 10 days ago to around 120 as of Friday.

THIS!

Great news overall. Will have J&J approved (hopefully) very soon. Novavax perhaps as well. Get as many shots in arms as quick as possible.

Anecdotally, people who’ve had COVID seem to react more strongly to the vaccine. Likely due to the immune system already being primed against the virus and when the immune system sees virus again, it’s super pissed off about it

“Y’all got any of that phase 3 J&J data?”

Lol. Yeah. I’m sure the Pfizer study tech knows all about it. I’m vaccinated. I’m ok wearing a mask until a critical mass is reached and once we have good data showing that vaccines do in fact prevent infection (likely), and not just asymptomatic infection. I’d also like to see cases and hospitalizations go WAY down. But once all those things occur, which I suspect will be May/June ish, there is no fucking point in wearing a mask past that. None. Back to normal. If you want to wear a mask because it makes you feel safer...go for it. If you want to wear a mask if you’re feeling a little sick...that’s probably a great thing to do.

As a physician that was vaccinated in August with the Pfizer vaccine on trial, I’m fucking PISSED about this. Having to cancel several international trips for 2021

https://www.reuters.com/article/us-health-coronavirus-pfizer-vaccine/pfizer-biontech-vaccine-appears-effective-against-mutation-in-new-coronavirus-variants-study-idUSKBN29D0DX Eat shit, COVID variant

Yes. Similar. Reactions seem to be more pronounced if you’ve already had COVID

I agree. Vaccines likely prevent infection (not just symptoms), although not much data on this yet. There’s good data that this is the case with immunity from natural infection (prevents infection - not just symptomatic infection), and hopefully we will have data from the vaccines soon. So if you can’t get it, you can’t spread it. Interestingly, my mom in her 70s got COVID about 3 weeks ago. Fortunately, she had a mild case, but my dad (in his 70s) tested negative and never got symptoms. My dad was in the Pfizer trial and found out today that he got vaccine and not placebo. So, I guess the vaccine may have prevented him from getting it from my mom.

https://www.nejm.org/doi/full/10.1056/NEJMoa2034545?query=featured_home Not sure where else to post this so I’m putting it here since I think it has important implications for vaccine efficacy. Here’s the short version of this study out yesterday in the NEJM... The folks at Oxford teaching hospitals in England checked about 12,000 hospital staff for antibodies to COVID starting in March. They found about 1200 people who had COVID antibodies, and the rest (about 11,000) didn’t. Then, they did PCR nose swabs if anyone had symptoms of COVID AND every 2 weeks on everybody (even asymptomatic). They did this for about 8 months. So of those 11,000 people who didn’t have antibodies, 223 tested positive for COVID during the 6-8 months of follow up. (100 were asymptomatic and 123 had symptoms) And those 1200 who had antibodies...2 documented PCR positive tests. Both asymptomatic. So this is strong evidence, in my eyes, that antibodies to COVID (whether through prior infection in this study or vaccination) are protective against getting COVID at all and not just SYMPTOMATIC COVID. So, if you are immune, you hopefully don’t need to worry as much about potentially having an asymptomatic COVID infection and then spread it to a non-immune person