To Vaccinate or Not---The Rat Flu Odyssey Continues

[::: :::]

Today on NPR, I heard an interesting metaphorical explanation comparing natural immunity to vaccination by an epidemiologist for a local county here in OR

Imagine covid is skittles. Skittles come in a 24 colors/flavors.

Natural immunity basically provides protection for one of those skittles colors, one of the varieties of covid’s manifestations. The person was exposed to it and got one version of the virus.

If you get covid, you may have gotten protection for the green variety, but not the remaining 23 varieties.

Vaccination on the other hand provides protection for 90% of the colors.

And if you’ve had the virus and vaccination, you have the 90% protection plus the verified protection against green variety.

Obviously, there’s a bunch of science that’s not discussed in that example but it seemed fairly illustrative

[summit]

That's a really really really bad analogy.

I don't think there is evidence that immunity acquired from natural infection is not cross-variant protective. Reinfections remain uncommon as far as we can tell. If someone knows otherwise please post the study.

The problem with immunity from natural infection is the variation in immune response with the least sick folks having lower response while the sickest folks have the best immunity... assuming they live.

Vaccine is more predictable and safer.

[funkendrenchman]

I am shocked at the number of people in this thread in favor of shunning those from society (and the ski hill) who choose not to be vaccinated. Really didn't expect that.

I don’t know about you, but I like hospitals to be available when/if I need them.

[AK47bp]

That's a really really really bad analogy.

I don't think there is evidence that immunity acquired from natural infection is not cross-variant protective. Reinfections remain uncommon as far as we can tell. If someone knows otherwise please post the study.

The problem with immunity from natural infection is the variation in immune response with the least sick folks having lower response while the sickest folks have the best immunity... assuming they live.

Vaccine is more predictable and safer.

Dammit man!!

The skittles analogy was really working for me, I was like “hey, now I’m understanding this shit!”




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[altacoup]

That is NOT correct. We actually have evidence that mAB don't do much by the time someone is that sick. The point is to give mAB *early* to people who are high risk but who have mild/moderate illness BEFORE it might progress to hospitalization/death.

Being vaccinated is NOT a contraindication for mAB. You absolutely can get mAB if you are vaccinated, get a breakthrough case, and meet the criteria (risk factors/timing/age).

You can also use 1 mAB (Regen-COV) for post exposure prophylaxis in high risk not-fully vaccinated individuals, or those who are fully vaccinated but not expected to mount a full response (eg immunocompromised, but there is insufficient supply and resources for this.

All that being said, mAB is expensive, resource intensive, and limited in supply. Vaccination is better, and if the Pfizer oral antiviral combo works as they claim, it will be superior to mAB.

Well guess I was wrong. Thanks for posting the relevant info. Really wish that Pfizer pill would hit the market. Seems like it could really alleviate pressure on hospitals. I’m currently 3 weeks out of booster. Still masking around strangers indoors and what not. Have basically no worries for my self but I’d hate to give it to someone I love who’s potentially higher risk.


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[summit]

^all good

Dammit man!!

The skittles analogy was really working for me, I was like “hey, now I’m understanding this shit!”

Skittles analogy is a good analogy for the Pneumococcal 23 valent vaccine...

[LeeLau]

I am shocked at the number of people in this thread in favor of shunning those from society (and the ski hill) who choose not to be vaccinated. Really didn't expect that.

Fuck those people.

[SumJongGuy]

The pills are not yet in play. They don't have EUA.

They may prove useful to give post-exposure as well as early-disease course much like Oseltamivir (Tamiflu).

The fact that they are easy, low resource, and cheap (compared to mAB) while being effective is very promising.

And you can put them in farm store equine product bottles for effective targeted marketing..

[ghosthop]

I don’t know about you, but I like hospitals to be available when/if I need them.

32 y/o cousin had a seizure last night and a second once they got him to the hospital. He still hasn't had an MRI because the community hospital he went to doesn't have a working machine right now and the tertiary center doesn't have the available beds to accept the transfer. He has a daughter at home, our grandmother used to sit on their porch and wave to her through the window because she was born March 2020.

How are y'all dealing with unvaccinated family/friends over the holidays? I have a strong feeling we are going to skip my Mom's 30+ person event next Wednesday, not sure we'll get off so easy for Christmas.

[Tri-Ungulate]

@summit and other medical folks- is monoclonal antibody therapy approved/recommended for breakthrough infection?

I'm not Summit, but I stayed at a Holiday Inn Express.

Answer is yes, but primarily for individuals at risk for complications for either age- or comorbidity-related reasons.

Edit to add: I see Summit already addressed this much more thoroughly than I would have.

I am shocked at the number of people in this thread in favor of shunning those from society (and the ski hill) who choose not to be vaccinated. Really didn't expect that.

I am shocked at the number of people in this country in favor of putting other members of society (and the ski hill) at risk by choosing to not be vaccinated. Really, it's not that unexpected with the prevalence of stoopid selfish shitstains.

[Mazderati]

How are y'all dealing with unvaccinated family/friends over the holidays?

[AK47bp]

I am shocked at the number of people in this thread in favor of shunning those from society (and the ski hill) who choose not to be vaccinated. Really didn't expect that.

Unvaccinated in the US are one or more of these;

1. Selfish dicks who only care about themselves
2. Scared of needles and therefore giant pussies
3. Really dumb, Covid denier, conspiracy theorists
4. Medically advised to not get the vaccine for health reasons.
5. Follow a stupid rare religion and legitimately have never had a vaccine and their religion doesn’t allow it.

Which are you?

I’m okay with #4.

You can’t cure stupid so #3 and #5 are here to stay.

#1 and #2 are well aware of what’s going on and suck the most.


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[Buster Highmen]

I'm not Summit, but I stayed at a Holiday Inn.

Answer is yes, but primarily for individuals at risk for complications for either age- or comorbidity-related reasons..

Does stupidity count as a comorbidity-related reason?

[::: :::]

That's a really really really bad analogy.

I don't think there is evidence that immunity acquired from natural infection is not cross-variant protective. Reinfections remain uncommon as far as we can tell. If someone knows otherwise please post the study.

The problem with immunity from natural infection is the variation in immune response with the least sick folks having lower response while the sickest folks have the best immunity... assuming they live.

Vaccine is more predictable and safer.

perhaps I’ve misrepresented it?
Here’s the link
https://player.fm/series/opb-audio/w...-with-skittles

[CarlMega]

perhaps I’ve misrepresented it?

Huh. I'd have represented that the same as you. Being a dumb-dumb, I don't know what the data implies about past infection in relation to cross-variant protection (as Summit put it). She's certainly bullish on vaccines. I wonder if she was asking a lot out of this analogy whilst trying to dumb it down and kinda got lost in the proportions (just 1 out of 24)? The piece was a little too light on information to be useful - packaged to influence.

I would like to know more about natural infection protection as it applies to emerging strains - she leaned hard on the vaccines having a more generic protection that infers protection across the variants.

I'll wait for the smart folks.

[summit]

perhaps I’ve misrepresented it?
Here’s the link
https://player.fm/series/opb-audio/w...-with-skittles

No. You got it right. That doctor (PhD MPH) is wrong in a way she should know better... to the point where I uncharitably assume she is giving misleading commentary to combat the myth that natural immunity is "better" in order to get people to do what is already in their best interest, and the right thing is to get vaccinated.

Yes, Delta has a higher reinfection risk vs Alpha or Wuhan Classic, and yes the risk rises at 6mo, but to imply there is no real protection from previous infection to any other strain is incorrect and/or misleading.

I'm as pro-vaccine as they come. I'm tired as hell of anti-vaxxers. But what do you do about them?

You can tell a person why they should do the right thing. In certain circumstances, you can limit or mandate a person to do the right thing if they won't. But if you lie to a person to get them to do something, you are fucking up.

[Tri-Ungulate]

Does stupidity count as a comorbidity-related reason?

Stupid is as stupid does, and sadly our ICU is currently filled with science-denying stupidity (insofar as they deny the science behind vaccinations but somehow accept the science behind monoclonal antibodies, which I am certain they have zero understanding).

But hey, there's always duh siunce supporting the use of horse dewormer cuz' dey dun dere reesurch.

[Buster Highmen]

Stupid is as stupid does, and sadly our ICU is filled with science-denying stupidity (insofar as they deny the science behind vaccinations but somehow accept the science behind monoclonal antibodies, which I am certain they have zero understanding).

I'll take that as a "yes".

But hey, there's always duh siunce supporting the use of horse dewormer cuz' dey dun dere reesurch.

More comorbidity evidence?

[The AD]

If by "shunning" you mean not being a childish fool, needlessly risking the health of yourself and those around you, then ....... yeah.

Shocking.

These have got to be the same people who were opposed to banning indoor smoking. Their right to do whatever the fuck they want is definitely more important than anyone else's health.

[Tri-Ungulate]

I'll take that as a "yes".

TBH it's actually a "no" though you doubtless already know that.

Once they're in the ICU, it's too late to administer monoclonal antibodies, at least to salutary effect.

[Buster Highmen]

So stupidity doesn't count as a comorbidity-related reason?
Hmmm. It sure seems to lead to morbidity of themselves and others since they jam the health care resources.
Stupidity is how they got there.

[Tri-Ungulate]

well, at least not for mAb administration. As a risk factor, definitely.

[Buster Highmen]

Aw c'mon there doc. It's like a preexisting condition, right? Right?

[LongShortLong]

How are y'all dealing with unvaccinated family/friends over the holidays? I have a strong feeling we are going to skip my Mom's 30+ person event next Wednesday, not sure we'll get off so easy for Christmas.

First we vaccinated them all and boosted a few too. Second, scheduled mid-day so we can meet/eat outdoors if the weather allows. Third, if indoors we'll wear masks when not eating, open windows, run the house fan, seating by family/pod. We're all skiers so we can dress for the cold. Tahoe mags can thank us now for the Thanksgiving powder-pocalypse. (I hear some families are testing.)

For 30 people, 25 cases/100k/day, 2x undercount, 5 days infectiousness before symptoms noticeable enough to stay home... equals 7.5% chance someone bring infectious covid to mom's party. (US avg is currently above 25cases/100k/day)

And for the mSeries shocked that people get shunned, try being a drunk driver, embezzler, murderer, smoker, etc. Those types are also unpopular.

[bennymac]

I am shocked at the number of people in this thread in favor of shunning those from society (and the ski hill) who choose not to be vaccinated. Really didn't expect that.

WTF? Are you serious? Are you new to this contagious disease? New to society? Get a grip man. There is a social contract. Been there since long before your ignorant naive ass was born. Feel free to check out to a failed state if you don’t agree. Your absence will strengthen society and raise its average IQ.