COVID VACCINE - The Megathread

Would you get the Pfizer vaccine if it were available to you?


  • Total voters
    66

Summit

Critical Crazy
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Good studies but the 1:20k CYP deaths appears to be incorrectly interpreted
“The mortality rate in CYP who died of SARS-CoV-2 was 0·2 per 100,000”

It does also say 5:100k (or 1:20k as you said) but that was people dying with C19 as opposed to of C19
The 0.2 per 100K is deaths (due TO COVID) vs total population (1 in 2M) the numerator (25) is the exact as the 5 per 100K stat. The denominator for 5 per 100K is dead d/t (not with) COVID over diagnosed. The 0.2 per 100K is dead over total population. That is the number I was calling out as meaningless at best because most people haven't had COVID-19 and their study time was Mar 2020-Feb 2021.

ETA That being said, COVID prevalence in CYP mortality appears undersized vs total seroprevelenence by a factor of 2-3 to 1 which of course tracks our knowledge of COVID being less severe in CYP but also here that it is relatively less severe than other causes and you actually do need to wonder about "of vs with," which is why the authors examined this exact thing (there's an algorithm in the study that explains how they did this) and they came up with at least 41% of those who died with COVID (61), died of COVID (25), with the rate being higher the older the patient was.

That metric is how you would examine an endemic disease for comparison across time to determine risk. That works pretty well for disease (infectious or not) with minimally/slowly changing incidence, morbidity and mortality.

It is nonsense for a pandemic with a dynamic novel virus in a largely naïve population when the virus is changing its virulence and R0 over timeframes of months and thus frequently goes exponential with curves that look like any Reed Frost until mitigating factors kick in.

Knowing when to use what method of analysis is basic epidemiology which gives me pause in examining this preprint, although I shouldn't impart intent on the investigators as it may merely be a statistic of interest, but really relevance of statistical points is something of great importance.

With the high R0 of Delta the vast majority, probably 70% or much higher, of unvaccinated folks will get COVID if they have not already had it. Given the discussion about vaccine these days revolves almost entirely around the individual's personal decision of whether or not they should get vaccinated, the question is most obviously NOT what is my risk based on a retrospective snapshot of the whole population, but what is my personal risk going forward: risk from vaccine and risk from disease.

Let me put it a different way: if there was incredibly rare brain cancer with 100% mortality for those who got it but it only killed 330 people a year in the US, the rate is 1 in 1 million because it is rare in incidence. Both numbers are interesting. But COVID-19 is something that almost everyone who isn't vaccinate or already recovered is going to get. So for those people, looking at the mortality rate across the whole population in a given timeframe is not useful to inform risk decisions for an individual or subpopulation looking forward.

Nobody is giving vaccine AE rates based on total population
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They give those rates for the vaccinated population only. AE rates are lower than COVID complication rates, even in low risk groups like CYP.

Also, you are set in “camp mandatory vaccine” for all, apparently including children once the gov gives the green light. That’s okay. You can have whatever opinion you want, I do not expect you to change your mind.
That is NOT what I said at all in my post. I made a risk-benefit argument that an individual could use to make a voluntary decision for themselves or their child who is low risk because the vaccine is low risk because the available data shows disease to be both inevitable and higher risk than vaccine. You counter that you don't think there is enough data to back my position. Thus I ask you what would be sufficient?
 
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EpiEMS

Forum Deputy Chief
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Still, with data like this, I would be hesitant giving my child the vaccine. Lucky for me I don’t have to.
Is death the only outcome metric of relevance?
Hospitalization? Avoidance of morbidity?
 

SandpitMedic

Crowd pleaser
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Great analysis @Summit. You are correct about the shifting dynamics and data capturing and aggregation.

As to what would be sufficient… I can’t answer that at this time. I just know that I wouldn’t vaccinate my toddler, even if the FDA said go ahead. So long as the CFR remains minuscule in CYP, and the vaccine does not prevent infection I just can’t see myself or many other parents I know going forward with it.

Just for perspective, if we all thought the vaccine/no-vaccine debates were hot with regard to adults… just wait until they try to start mandating the kids. Fauci is already starting to say it.

Even school mask mandates are creating a subculture of like minded folks hiring teachers who quit or disagree with mandates to teach neighboring kids in homes, with parents pooling money to pay their salary. Force vaccines for school, which is hypothetical at this point but definitely probable down the line, and you’re gonna see some fierce blowback.
 
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SandpitMedic

Crowd pleaser
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Is death the only outcome metric of relevance?
Hospitalization? Avoidance of morbidity?
Yes. Nearly 100% of young children do just fine to date.
If we see a variant that changes that I would reconsider. Exactly as I did wrt my own vaccination.
 

SandpitMedic

Crowd pleaser
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We have not touched on natural immunity. Should one be mandated who has had natural COVID?
 

Summit

Critical Crazy
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We have not touched on natural immunity. Should one be mandated who has had natural COVID?
I don't think I'd agree with the article titular claim of "much greater" because it depends on a lot of variables (what vaccines on what schedule when) and seems to vary with variants (in play and original exposure).

But I definitely think that the evidence is strong enough to consider documented previous infection as equal to being fully vaccinated. How could you not and still consider J&Jx1 fully vaccinated.

I think there is good evidence to support 1 dose of mRNA vaccine as a good booster for previous infections that are at least 90 days past.

We should never test people who have had a documented infection in the last 90 days, not even for screening, unless there is a very good reason to suspect reinfection like diagnostic symptoms and/or immunocompromise. Otherwise you are more likely to pick up remaining RNA fragments of the previous infection than a true reinfection.
 

SandpitMedic

Crowd pleaser
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I don't think I'd agree with the article titular claim of "much greater" because it depends on a lot of variables (what vaccines on what schedule when) and seems to vary with variants (in play and original exposure).

But I definitely think that the evidence is strong enough to consider documented previous infection as equal to being fully vaccinated. How could you not and still consider J&Jx1 fully vaccinated.

I think there is good evidence to support 1 dose of mRNA vaccine as a good booster for previous infections that are at least 90 days past.

We should never test people who have had a documented infection in the last 90 days, not even for screening, unless there is a very good reason to suspect reinfection like diagnostic symptoms and/or immunocompromise. Otherwise you are more likely to pick up remaining RNA fragments of the previous infection than a true reinfection.
We do not retest within 90 days per CDC. People will test positive up to that (and possibly over) due to viral particle remnants.

If I suspect reinfection within that window I am to consult with ID, especially in high risk patients.

I know you know that, but others reading may not be familiar with the guidelines.

I believe that natural immunity is far superior to vaccination. There are outliers among us, but for most wild type viral pathogens this is the case. For how long, well, there are in going studies to figure that out.
 

EpiEMS

Forum Deputy Chief
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Yes. Nearly 100% of young children do just fine to date.
If we see a variant that changes that I would reconsider. Exactly as I did wrt my own vaccination.

With appreciation for that as a fact, I do worry about long COVID & probably more importantly that children can spread / contribute to variant generation.

Shouldn’t children be vaccinated for broader public health benefits?
 

VentMonkey

Family Guy
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Our entire family had Covid last November. All but our two youngest have been vaccinated.

Our oldest (14) had her vaxx in July, her reaction was mild to moderate compared with her lack of symptoms from the actual virus last year.

If approved, and my wife and receive a blessing from the good doc (i.e., their pediatrician), we’re all in favor of vaccines for the little’s as well.

I do not disagree that natural immunity is absolutely important, however, far superior having seen 3 children suffer through multiple infections over the years?…well, I’d beg to differ.

I think what it boils down to for my wife and I, is why have them needlessly unvaccinated if proven equally effective and safe. It seems kind of selfish, IMHO.
 

DrParasite

The fire extinguisher is not just for show
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Are we to the point that your vaccination status determines if you can visit your child?
As much as I support the Judge attempting to protect the child, I think this is a massive overreach of the judge's authority, especially since the mothers doctor recommended that she not get the shot. And it looks like the judge saw the error of his ways, and vacated his previous order... and I am very glad to see that he did

 

ffemt8978

Forum Vice-Principal
Community Leader
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As much as I support the Judge attempting to protect the child, I think this is a massive overreach of the judge's authority, especially since the mothers doctor recommended that she not get the shot. And it looks like the judge saw the error of his ways, and vacated his previous order... and I am very glad to see that he did

Still concerns me that a judge decided to make vaccination status an issue all on his own, since the father did not bring up the issue first.
 

Summit

Critical Crazy
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I believe that natural immunity is far superior to vaccination. There are outliers among us, but for most wild type viral pathogens this is the case. For how long, well, there are in going studies to figure that out.
Immunity from infection is not "far superior" to mRNA vaccination and there is ample evidence to show that natural infection is generally nonsuperior and likely inferior, and there are even studies demonstrating why (immune overfocus on poor epitopes like overgeneration of anti-N antibodies and undergeneration of anti-S over time). I believe that infection and recovery should be recognized as fully vaccinated immunity so long as we are continuing to counting non-mRNA and non-boostered individuals as fully vaccinated.

A new very large UK study with over 300K people including a randomization component involving regular testing to determine both vaccine immunity and natural immunity during Delta indicates vaccine immunity performs better than natural immunity. While this and other studies show a small reduction in vaccine efficacy against Delta compared to Alpha, the overall numbers are still good.

Note BNT162b2 is mRNA Pfizer. ChAdOx1 is Astrazeneca viral vector vaccine which is known to be less effective and not used in the US and many other countries.


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Seirende

Washed Up Paramedic/ EMT Dropout
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On a positive note, my pretend grandma, who is very conservative and adamantly was not going to get the shot, just told me that tomorrow is two weeks since she had the J&J. Apparently her family was concerned so she finally gave in and did it for them. We're having coffee on Saturday and I'm finally going to be able to give her a big hug
 

Fezman92

NJ and PA EMT
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So the guy I’m working with today is on the fence about the vaccine because of the mRNA stuff and he’s one of those always question everything guys. He does plan on getting it down the road. Also he thinks that everyone is mandating it which is taking away personal choice. He also claims that he’s had COVID twice and didn’t need to go to the hospital.
 

mgr22

Forum Deputy Chief
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So the guy I’m working with today is on the fence about the vaccine because of the mRNA stuff and he’s one of those always question everything guys. He does plan on getting it down the road. Also he thinks that everyone is mandating it which is taking away personal choice. He also claims that he’s had COVID twice and didn’t need to go to the hospital.
I've noticed two broad categories of people who haven't been vaccinated: those concerned with dangers or inadequate potency of the vaccine, and those who wish to emphasize their right not to be vaccinated. Of course, I don't know the guy you're working with, but from what you've said, it sounds to me like he's in the latter group. If I were riding with him and we had nothing better to talk about, I'd probably tell him that I think choosing when to exercise my rights is more important than having them.
 

E tank

Caution: Paralyzing Agent
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The time is approaching very quickly when the only folks sick enough to be hospitalized will be the unvaccinated. Then that's on them. I'll take care of them and I won't lay some trip on them either. But they'll be the only ones.

And if where I am is any indication, we won't need to open any temporary ICU's for them either 'cause they won't need them or enough of them will die before we come too close to needing more CC beds. We do now, but we won't then.

I really don't care if some healthy adult doesn't want the vaccine. They'll get sick or they won't. If they don't want to get sick, they'll get it. Just wildcatting here but the resolution is relatively near IMHO...
 

CCCSD

Forum Deputy Chief
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Still concerns me that a judge decided to make vaccination status an issue all on his own, since the father did not bring up the issue first.
The Family Court Judge must decide on the safety of the Child.
 

cruiseforever

Forum Asst. Chief
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Tested positive today. 8 months to the date from my second shot. Been having body aches, low grade temp, runny nose. Hoping this is as bad as it gets.
 

mgr22

Forum Deputy Chief
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Tested positive today. 8 months to the date from my second shot. Been having body aches, low grade temp, runny nose. Hoping this is as bad as it gets.
I'm still seeing lots of debate among docs about the need for a booster. I wonder what the protocols will be for folks like you who had breakthrough infections. Booster or not, you could be one of the most immune people on the planet by the time you're feeling better.
 

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