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

[RShea]

Woot! I've been jabbed!

Good news for sure- which of the 3 were they doing and did you get Pfizer or Moderna that will require a second jab?

[old goat]

The CDC has a central database on all vaccines. If it comes to that, you can direct all inquiries to them. Also, I can go to their site and download a PDF that is maybe a bit more authentic than that easily forged card they gave me.

And Bill Gates doesnt have to implant a chip in us all. Steve Jobs sold you one for a thousand bucks, and you're addicted to it.

According to the link Riser posted, the states have the information on who's been vaccinated, not the cdc. "While the CDC itself doesn't have vaccination record information, providers are required to report vaccinations to their state's respective IIS or registry. Contact your state's listed phone number or email address to access your record and get your new card."

And I have the cheapest Samsung phone money can buy.

As far as strategy--a hybrid strategy would have made the most sense IMO--hcw's caring for covid patients, nursing home residents and the very elderly--the people at highest risk of exposure to the highest viral loads and people at the highest risk of hospitalization and death--get two shots, then everyone else gets one until everyone has had one. But the emergence of variants, the possibility that 2 doses might be necessary for significant protection against them, problems of equity, J and J coming on line all complicate any strategy. It is still too soon to know if the UK's strategy is the best.

I would have favored a less rigid adherence to the science but as it is there are still a lot of Americans who think the process was rushed--and not for political reasons--and Fauci et al have felt that sticking to the science was necessary to get people to accept vaccination.

[KQ]

Good news for sure- which of the 3 were they doing and did you get Pfizer or Moderna that will require a second jab?

W2 is giving out Pfizer jabs. 2nd appt is scheduled for the 24th.

[RShea]

Funny thing about the SS#s - I didn't have to give mine. Maybe because I have private insurance? Didn't ask for that info either beyond me acknowledging that I had it.

I had to show drivers license- asked about insurance but was not a required. They said to get their reimbursement billed out (Pharmacy) they needed to have just the license, not sure if any insurance payments are needed since the Feds paid for the doses.

[glademaster]

All I needed to provide was first/last name, email address and cell phone number. No ID checks at the vax site (ID checks are discriminatory), they just asked me my name and verified it off a list they had.

[RShea]

US hits 4 million Covid-19 vaccine doses in a day for a new record

As I mentioned earlier everyone walking through the doors of the fairground pavillion was pretty psyched to be getting jabbed and that gave me hope. You could tell there were a some that were nervous/anxious and I talked to one poor lady who was almost in tears because her husband refused to come with her. She said he is refusing the jab on the grounds that it's not FDA approved. I'm sure he's just a scared little man unfortunately his fear is making his wife quite distressed.

My Father got called in January asking to set an appointment. He told them he was not interested. 60 some years ago when in the Army he had a bad reaction to one of their vaccines- flu or one of them. He found out he has an egg allergy. So he pretty much is anti-vaccine for flu and some other things that are pretty much trying to be proactive protection since then. However my Mother got hers last month and he finally after that and probably reading and hearing that few severe effects decided to go to the VA and get his first shot. Scheduled for 2nd later in April... So there is some trepidation and even anti-vax reasons, but there is a chance some will come around.

[RShea]

W2 is giving out Pfizer jabs. 2nd appt is scheduled for the 24th.

You going to volunteer again? (Glad you did I am sure and ended up with the short lull so you could get in line...)

[KQ]

You going to volunteer again? (Glad you did I am sure and ended up with the short lull so you could get in line...)

Yeah I think so. It was nice to get out and be around people again other than the grocery store plus they are really worried about having a shortage of volunteers once things open up on the 14th due to a lack of incentive. Evidently the Whitman students and staff had been grabbing the majority of spots prior to this.

[jono]

As far as strategy--a hybrid strategy would have made the most sense IMO--hcw's caring for covid patients, nursing home residents and the very elderly--the people at highest risk of exposure to the highest viral loads and people at the highest risk of hospitalization and death--get two shots, then everyone else gets one until everyone has had one. But the emergence of variants, the possibility that 2 doses might be necessary for significant protection against them, problems of equity, J and J coming on line all complicate any strategy. It is still too soon to know if the UK's strategy is the best.

I would have favored a less rigid adherence to the science but as it is there are still a lot of Americans who think the process was rushed--and not for political reasons--and Fauci et al have felt that sticking to the science was necessary to get people to accept vaccination.

Agreed that hybrid would have been the best. Ideally HCWs' (and then others') second shots would have filled no-waste lists, especially since their proximity makes that easy.

I would characterize this a little differently, though. I'm saying I don't expect that science really won out. Risk management should be approached scientifically, and it probably wasn't. Throwing out all evidence that doesn't provide an arbitrary CI is a shortcut to simplify the math instead of being rigorous. That isn't good science.

There's certainly an argument that the PR and political concerns have a role to play, but if getting people to accept vaccination is the issue then the adherence to "only what we believe with 95% confidence" has gotten in the way there, too. For example, the narrative that we shouldn't expect vaccines to be as effective as we actually expect (51%+) them to be is reducing uptake.

Perhaps selfishly, my reason for hoping that quantitative risk management gets traction along researchers is that I think it should also adjust the way we approach cancer research and treatment.

[old goat]

Agreed that hybrid would have been the best. Ideally HCWs' (and then others') second shots would have filled no-waste lists, especially since their proximity makes that easy.

I would characterize this a little differently, though. I'm saying I don't expect that science really won out. Risk management should be approached scientifically, and it probably wasn't. Throwing out all evidence that doesn't provide an arbitrary CI is a shortcut to simplify the math instead of being rigorous. That isn't good science.

There's certainly an argument that the PR and political concerns have a role to play, but if getting people to accept vaccination is the issue then the adherence to "only what we believe with 95% confidence" has gotten in the way there, too. For example, the narrative that we shouldn't expect vaccines to be as effective as we actually expect (51%+) them to be is reducing uptake.

Perhaps selfishly, my reason for hoping that quantitative risk management gets traction along researchers is that I think it should also adjust the way we approach cancer research and treatment.

What I mean by science is--if you run a double blind prospective clinical trial under certain conditions then when you release the drug to the public you duplicate the conditions. In the case of mRNA vaccines that means two doses because that's how the Phase 3 trials were run. But of course lots of drugs are used off label in the US--in different ways and for different conditions than in the trials. Perfectly legal, as long as the drug company doesn't advertise or promote it.

Drug and vaccine trials are not run with epidemiology in mind, only with the benefit of individual patients in mind. For better or worse, that's how the folks who decided to stick with two doses approached it. Covid requires a different kind of thinking but we don't have a good model for running trials in a pandemic.

Normally, dosing schedules are optimized in Phase 2 trials before the Phase 3 trials and Phase 3 trials can be run with multiple dosing arms but that takes more time. With Covid the urgency meant that once they had a regimen that worked in Phase 2 they went right to Phase 3 without trying to figure out if different dosing would work as well or better. I believe people are going back and looking at that now but I think it will be hard work to do--hard to get volunteers and hopefully increasingly difficult to get enough controls sick to get meaningful results.

The big concern would be if the one dose people start losing immunity before they can get the second dose. I guess the Brits will tell us if that happens.

[jono]

What I mean by science is--if you run a double blind prospective clinical trial under certain conditions then when you release the drug to the public you duplicate the conditions. In the case of mRNA vaccines that means two doses because that's how the Phase 3 trials were run. But of course lots of drugs are used off label in the US--in different ways and for different conditions than in the trials. Perfectly legal, as long as the drug company doesn't advertise or promote it.

Drug and vaccine trials are not run with epidemiology in mind, only with the benefit of individual patients in mind. For better or worse, that's how the folks who decided to stick with two doses approached it. Covid requires a different kind of thinking but we don't have a good model for running trials in a pandemic.

Normally, dosing schedules are optimized in Phase 2 trials before the Phase 3 trials and Phase 3 trials can be run with multiple dosing arms but that takes more time. With Covid the urgency meant that once they had a regimen that worked in Phase 2 they went right to Phase 3 without trying to figure out if different dosing would work as well or better. I believe people are going back and looking at that now but I think it will be hard work to do--hard to get volunteers and hopefully increasingly difficult to get enough controls sick to get meaningful results.

The big concern would be if the one dose people start losing immunity before they can get the second dose. I guess the Brits will tell us if that happens.

I understand, and I take Dr. Fauci as using the same terminology which is where my beef lies--I hope it hasn't come off as an attack on you. (Maybe the entire medical establishment, IDK.) In the broader sense science means the application of the scientific method to test hypotheses (experimentally or otherwise). Agreed? What is being described as science by the medical community here is really a rigid adherence to a standard procedure. Standard procedures are comforting, but saying we're relying on science by sticking close to the comfortable and familiar reveals a human weakness in our processes (and I include my own field in this--it's common, perhaps universal).

The intent of an experiment doesn't limit the range of hypotheses it might examine, of course. One example in this case, as published in a letter to the NEJM a couple months ago, was evidence revealed by the Phase III trials' data that the first dose was almost as protective (as of the time of the second dose) as the two doses were together (two weeks later).

https://www.huffingtonpost.ca/entry/...b66da5dba03800

The evidence for the optimistic scenario is weaker because the sample size was small. So the confidence interval over which the hypothesis is upheld is smaller, and thus the probability of being wrong is greater. But the value of such a risk is that probability times the cost if it occurs. The values of various risks can be useful when there are two or three scenarios to compare. In that way the lower levels of certainty for weaker evidence can be accounted for rather than just neglecting them.

This is largely moot for the US at this point, but it's applicable in other fields--and maybe other places.

[Hopeless Sinner]

Another wrinkle I've read about is 2 shots each from different manufacturers. I've had 2 from Pfizer but I wouldn't hesitate to add a 3rd shot from either JJ or Moderna if given the opportunity, although the I don't think I'd get the Astra-Zeneca at this point.

[old goat]

I don't see what you're saying as an attack on me; I may have not made it clear but I agree with you.
You say "What is being described as science by the medical community here is really a rigid adherence to a standard procedure." I would agree, and I would say it's a good thing. Rigid adherence to a standard procedure is how scientific knowledge is accumulated. The problem comes when trying to put the knowledge gained into practice in the same rigid way. The scientific method is slow and tedious and not well suited to dealing with the crisis of a pandemic.

All of the top advisors and spokespeople in both administrations are physicians, mostly academics (I consider the NIH to be part of academia) . Physicians are trained to focus on what's best for individual patients. Academics are trained in the supremacy of the scientific method, culminating in the controlled clinical trial. The most prominent epidemiologist on Biden's task force is Dr. Osterholm, who was commenting from the outside during the Trump administration. IMO the response should have been guided by both physicians and other infectious disease specialists, and by epidemiologists like Dr. Osterholm.

The place where we disagree is in defining the term "science". It would be more accurate for me to say that there is medical science and epidemiology science and so far the medical science has ruled when it comes to the vaccine schedules.

To the extent that your remarks are a criticism of the medical profession they are justified, with the caveat that it is academic physicians you're talking about. Practicing non-academics are the ones using drugs off label, inventing and performing new operations with little oversight, and otherwise eschewing the limitations of strict science. (The biggest advance in surgery in many decades--laparoscopic surgery--was largely developed by nonacademic surgeons without any government oversight--the FDA has to approve surgical devices but to this day no one has to approve new operations, except the Institutional Review Board of the hospital where the operation is carried out, at least in the US. Practicing docs are also known for going completely off the rails--Jack Kevorkian being an example, for good or ill.)

[jono]

The place where we disagree is in defining the term "science". It would be more accurate for me to say that there is medical science and epidemiology science and so far the medical science has ruled when it comes to the vaccine schedules.

Yep. I'm curious whether epidemiology normally deals with this level of policy or not? There is obviously plenty to know in that field without delving into risk management. Especially if the math is being done by non-epidemiologist specialists, in which case maybe those people are the ones who need a broader mandate in this case. Some of the political people might prefer no advice anyway, but those people are wrong. As with avalanches, I'd argue that the "right" answer should be the best one given all the information known at the time, not what we see in hindsight.

To the extent that your remarks are a criticism of the medical profession they are justified, with the caveat that it is academic physicians you're talking about. Practicing non-academics are the ones using drugs off label, inventing and performing new operations with little oversight, and otherwise eschewing the limitations of strict science.

For sure. But of course most practitioners are aware of the risks of leaving evidence-based medicine to one degree or another, so that has to be quite personal.

Ironically, when I had a choice between one who was "very open" to non-conventional adjuvant therapies and one who absolutely wasn't I chose the latter for his perspective and confidence. Then I kept what he didn't want to hear to myself. Obviously the antithesis of scientific. They're partners now so I figure it worked out on their end and I kinda hope I never get a chance to come clean.

[splat]

.

[RootSkier]

Missoula is now at just under 50% of eligible residents with their first shot. Pretty good, and I suspect this seriously underestimates because lots of people (like mrs. rootskier and I, along with a bunch of people I work with) got our shots in neighboring counties.

Missoula County
Total Doses Administered: 73,201
Dose #1 Administered: 47,964
Fully Immunized: 26,898
Doses per 1,000 people: 733.4
Eligible Population to be Vaccinated: 99,813

[KQ]

Missoula is now at just under 50% of eligible residents with their first shot. Pretty good, and I suspect this seriously underestimates because lots of people (like mrs. rootskier and I, along with a bunch of people I work with) got our shots in neighboring counties.

Missoula County
Total Doses Administered: 73,201
Dose #1 Administered: 47,964
Fully Immunized: 26,898
Doses per 1,000 people: 733.4
Eligible Population to be Vaccinated: 99,813

We've got 35K jabs (13K fully vaxxed) out of a county population of 60K (7 cities/towns)

[nickwm21]

One of my coworkers is spouting out the latest Facebook conspiracies daily... the current one is that life insurance will not pay out if you have had the vaccine. I asked him if he actually picked up the phone and called his insurance company and asked. That shut him up.


Sent from my iPhone using TGR Forums

[rod9301]

There's talk that the second dose isn't necessary for people who've had Covid--that antibody levels after the first shot are comparable to levels after shot 2 in people who haven't had the disease. That's nobody's official policy though.
This is all based on antibody levels, not on following people who got Covid and one shot to see if they get Covid again. The latter would be the gold standard.
https://www.ny1.com/nyc/all-boroughs...e-second-doses

When you got the vaccine, could you request moderna? And was it in Truckee? Coming back in may and i would like to get vaccinated.

Sent from my Redmi Note 8 Pro using Tapatalk

[The AD]

One of my coworkers is spouting out the latest Facebook conspiracies daily... the current one is that life insurance will not pay out if you have had the vaccine. I asked him if he actually picked up the phone and called his insurance company and asked. That shut him up.

Social media has certainly lowered my perception of what constitutes average intelligence.

[uglymoney]

We've got 35K jabs (13K fully vaxxed) out of a county population of 60K (7 cities/towns)

Found KQ's vax selfie.

Sent from my SM-G981U using Tapatalk

[concretejungle]

Got signed up today for my first shot next Monday. Way quicker than I thought and I don’t have to day trip to Billings.

[Danno]

Social media has certainly lowered my perception of what constitutes average intelligence.

Then imagine that half the people are dumber than that.

(hat tip to George Carlin)

[bodywhomper]

When you got the vaccine, could you request moderna? And was it in Truckee? Coming back in may and i would like to get vaccinated.

Sent from my Redmi Note 8 Pro using Tapatalk

I know you’re a different demographic. I had a coworker in truckee that has to go to grass valley/Nevada city to get poked both times, and a coworker in Nevada city that had to go to truckee to get poked. Both received Pfizer.

[dan_pdx]

Oregon just opened it up to BMI of 25 or greater, and I'm close but not quite there. Guess I need to get busy eating more junk.