Coronavirus

[rxlawdude]

I find this whole thing about the vaccine card to be silly. Some places across the country aren’t even giving out those cards according to friends and family. I know for a fact a few county vaccination sites and pharmacies around me that are not handing them out.
Plus, one can easily just call up their PCP to update their office saying they received the vaccine with no proof required. So, those vaccine cards, and any situation that requires proof of vaccination to participate in something, hold zero meaning IMO.

If they are not handing out those cards, they are not in compliance with the protocol.

 

[TespaceX]

If they are not handing out those cards, they are not in compliance with the protocol.

tldr: Right now, this pandemic doesn’t matter whether someone can prove they got a vaccine or not. What matters is that people do get vaccines.

Just like how all these places are supposed to be checking ID and verifying information before getting the shot? Which most places up and down the West Coast aren’t doing? All you need at many (most?) places is just to state your name and birthdate. Even UCSF has emailed members saying the state and their own system is all based on an honors system and no identification information will be verified. And, I know for a fact that some low-income clinics are not asking for any verification because of the demographics they serve.
Shutting down all these “non-compliant” sites, or not providing them supplies, because they’re not strictly following SOP would be the most ridiculous thing.
As many noted here, we just need more shots in arms as fast as we can.

Also, the lack of vaccine cards still does not negate the fact that one can just easily call their medical provider’s office to tell them you received the vaccine with no proof. Then your medical records can be shown as proof instead of the vaccine card. As someone verifying records, I would be multiples more inclined to believe a personal medical record than a piece of paper that can be easily forged.

 

[rxlawdude]

Also, the lack of vaccine cards still does not negate the fact that one can just easily call their medical provider’s office to tell them you received the vaccine with no proof. Then your medical records can be shown as proof instead of the vaccine card. As someone verifying records, I would be multiples more inclined to believe a personal medical record than a piece of paper that can be easily forged.

Um, no. Please don't make up crap, especially specific to California as I practice in this very area and also know the laws. Every vaccination is entered into the California Immunization Registry. Until about four years ago, each locality or county had their own vaccine registries, which led to predicable gaps and resulting in duplicated vaccinations.

Checking CAIR would be the gold standard for verifying someone's vaccine status. See CAIR .. [Portal Main Page].

You can't just make up stuff to tell your doctor. Wow.

 

[bkp_duke]

Um, no. Please don't make up crap, especially specific to California as I practice in this very area and also know the laws. Every vaccination is entered into the California Immunization Registry.

Checking CAIR would be the gold standard for verifying someone's vaccine status. See CAIR .. [Portal Main Page].

You can't just make up stuff to tell your doctor. Wow.

I was under the impression that the primary purpose for CAIR was for tracking pediatric immunizations. Given some of the things I've seen with the COVID vaccine, I'm not sure how up-to-date that would be for adults (I haven't looked up my record, but might do it if time permits soon).

 

[rxlawdude]

I was under the impression that the primary purpose for CAIR was for tracking pediatric immunizations. Given some of the things I've seen with the COVID vaccine, I'm not sure how up-to-date that would be for adults (I haven't looked up my record, but might do it if time permits soon).

All vaccinations in California must be reported, regardless of patient age. It is the law, and regardless of the locus of immunization (e.g., mega vaccination center vs community vaccination center vs hospital system). See California Immunization Registry » COVID-19 Vaccine Reporting Information and Resources and https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH Document Library/Immunization/IMM-1300.pdf

And to actually receive any supply of COVID vaccine, registration with CAIR is a predicate.

And if CAIR does not have your full record, it's most likely because whoever adminstered the vaccination didn't report it as required by law.

 

[Mark57]

I find this whole thing about the vaccine card to be silly. Some places across the country aren’t even giving out those cards according to friends and family.

I have a feeling it's borders at other countries where they may have some future value. Not locally.

 

[winfield100]

I have a feeling it's borders at other countries where they may have some future value. Not locally.

yes locally
have you been to Krispy Kreme donut shoppes yet for your _free_ glazed donut,

show your vaccination card

Krispy Kreme - Promotions

Learn more about our sweet deals and seasonal promotions!

www.krispykreme.com

(your cardiologist will know for sure)

 

[madodel]

As I see it the card is also a receipt that denotes when, where and from who one got the vaccine so if later when/if there is a federal registry to help with travel/work requirements you have some documentation of it happening in case the Feds have no record of it happening. My wife got hers at her hospital so it should be in her chart there but she also still has the CDC card. I assume pharmacies record it in their systems as well so maybe it won't matter if you have the card.

 

[AlanSubie4Life]

Even more galling are the Florida statistics that ignore every spreader who contracts the virus but then return to their home state to spread it and get counted there. So the actual rate of infections in the Sunshine State is obfuscated.

I agree the numbers are probably obfuscated, but I think the emphasis and focus on Florida as the source of all things evil Spring Break related is a bit overblown. And if this were happening to a large degree, it would show up in case numbers in Florida too - it's not like the virus selectively targets tourists & Spring Breakers. It's really the millions of other people conducting Spring Break activities nationwide (even traveling to Mexico and other countries) which matter. Florida is a small but significant piece of this, but it's not the only piece. The local rises in Michigan and other states are unlikely to be related to Florida, for example.

And if you look at Florida, infection rates are starting to rise, mildly. I hope they can keep things under control as the weather heats up.

It really does look like we're starting to get a confirmed rise in cases now. Guess we'll see how it goes. It really is interesting (and completely mysterious) how places like California and (to a lesser extent) Texas are doing great, while New York, New Jersey, Pennsylvania and Michigan are doing terribly. Florida isn't doing great either, but they're kind of middle of the pack. It is just so hard to understand the reason for local patterns. It seems pretty clear that you cannot look at state-level mandates and expect to learn anything.

I guess they should start harvesting plasma from people who have had both doses of the Pfizer vaccine, since that serum is likely to be more effective than the inconclusive results from convalescent plasma (it has much higher antibody levels). They can also get plasma from people who were previously infected who are coming in for their second (probably unnecessary) vaccine - can combine the visit! Seems like we're going to need this plasma for the young people! Seems like it has to be used early though.

 

[rxlawdude]

I agree the numbers are probably obfuscated, but I think the emphasis and focus on Florida as the source of all things evil Spring Break related is a bit overblown. And if this were happening to a large degree, it would show up in case numbers in Florida too - it's not like the virus selectively targets tourists & Spring Breakers. It's really the millions of other people conducting Spring Break activities nationwide (even traveling to Mexico and other countries) which matter. Florida is a small but significant piece of this, but it's not the only piece. The local rises in Michigan and other states are unlikely to be related to Florida, for example.

And if you look at Florida, infection rates are starting to rise, mildly. I hope they can keep things under control as the weather heats up.

It really does look like we're starting to get a confirmed rise in cases now. Guess we'll see how it goes. It really is interesting (and completely mysterious) how places like California and (to a lesser extent) Texas are doing great, while New York, New Jersey, Pennsylvania and Michigan are doing terribly. Florida isn't doing great either, but they're kind of middle of the pack. It is just so hard to understand the reason for local patterns. It seems pretty clear that you cannot look at state-level mandates and expect to learn anything.

I guess they should start harvesting plasma from people who have had both doses of the Pfizer vaccine, since that serum is likely to be more effective than the inconclusive results from convalescent plasma (it has much higher antibody levels). They can also get plasma from people who were previously infected who are coming in for their second (probably unnecessary) vaccine - can combine the visit! Seems like we're going to need this plasma for the young people! Seems like it has to be used early though.

Convalescent plasma has a rather iffy record. For the latest on the US FDA EUA, see FDA Updates EUA for COVID-19 Convalescent Plasma

 

[AlanSubie4Life]

Convalescent plasma has a rather iffy record. For the latest on the US FDA EUA, see FDA Updates EUA for COVID-19 Convalescent Plasma

Yes, the results of convalescent plasma were not great (I suspect partially because not used early enough and I could see that being a difficult decision as it's probably not without risks - looks like that's how the FDA tweaked their guidance, too). That's why getting vaccinated plasma might well do better, theoretically. Since it's 10-100x more potent than convalescent plasma (and all the antibodies are likely effective). But I have no idea. It does appear that people are starting to look at this. It's thought that plasma from a convalescent who has been vaccinated might actually be the best, perhaps?

So maybe vaccinated plasma used early (should be ample supply now!) would have notably improved results?

Lancet Journal Link (a letter): Convalescent plasma from people vaccinated after COVID-19 infection

 

[rxlawdude]

Yes, the results of convalescent plasma were not great (I suspect partially because not used early enough and I could see that being a difficult decision as it's probably not without risks - looks like that's how the FDA tweaked their guidance, too). That's why getting vaccinated plasma might well do better, theoretically. Since it's 10-100x more potent than convalescent plasma (and all the antibodies are likely effective). But I have no idea. It does appear that people are starting to look at this. It's thought that plasma from a convalescent who has been vaccinated might actually be the best, perhaps?

So maybe vaccinated plasma used early (should be ample supply now!) would have notably improved results?

Lancet Journal Link (a letter): Convalescent plasma from people vaccinated after COVID-19 infection

Interesting concept proposed, but of course at this time there are no data to back up its use. In theory, convalescent plasma should work, but results (as mentioned) overall are not that impressive. In theory, fluvoxamine may work to reduce intensity of COVID-19, but with less than a couple of hundred subjects, too early to get excited. I guess the side effects of that result in less OCD behavior and depression.

 

[JRP3]

The total crap show in Brazil is leaking out to the rest of the world

 

[AlanSubie4Life]

results (as mentioned) overall are not that impressive.

For sure, but as they say, there are a few factors that make that result make sense:

1) Getting good antibody titers in plasma has been tough since natural infection leads to a sub-optimal response. And the timing has to be right.
2) Early use is key. (FDA has adjusted their guidance.) After damage to the body and the systems has occurred, which takes some time, it's probably of limited utility. (The virus multiplies quickly in the nose which is why presymptomatic/asymptomatic spread is such an issue, but it takes a good long time to damage the rest of the body.)
3) Fully vaccinated sera is way, way more neutralizing than natural infection. The really high titers probably make timing of collection less of an issue.

I guess we'll see. I assume someone will try this soon - I don't know whether it requires FDA approval to explore, especially if you take it from previously infected vaccinated folks.

 

[rxlawdude]

For sure, but as they say, there are a few factors that make that result make sense:

1) Getting good antibody titers in plasma has been tough since natural infection leads to a sub-optimal response. And the timing has to be right.
2) Early use is key. (FDA has adjusted their guidance.) After damage to the body and the systems has occurred, which takes some time, it's probably of limited utility. (The virus multiplies quickly in the nose which is why presymptomatic/asymptomatic spread is such an issue, but it takes a good long time to damage the rest of the body.)
3) Fully vaccinated sera is way, way more neutralizing than natural infection. The really high titers probably make timing of collection less of an issue.

I guess we'll see. I assume someone will try this soon - I don't know whether it requires FDA approval to explore, especially if you take it from previously infected vaccinated folks.

I can just see those plasma centers downtown getting a bunch of (vaccinated) donors wanting cash to buy that next bottle or ounce.

 

[EVNow]

Florida is a small but significant piece of this, but it's not the only piece. The local rises in Michigan and other states are unlikely to be related to Florida, for example.

It’s because of the bird brained governors relaxing rules as soon as the last wave recedes.

It’s like celebrating every weight loss milestone by pigging out for weeks.

 

[AlanSubie4Life]

It’s because of the bird brained governors relaxing rules as soon as the last wave recedes.

It’s like celebrating every weight loss milestone by pigging out for weeks.

But, it’s not quite so simple...why is Texas doing so relatively well? Whitmer isn’t exactly an anti-masker either. Why is everything blowing up there? Weather? Variants? Luck? Local Restrictions? Why is B.1.1.7 growing faster in some states than others? Differing vaccination strategy or acceptance in critics populations?

I honestly have no idea. My understanding is that mask compliance in Texas hasn’t actually changed much after lifting of the statewide order but I can’t actually find any data.

My general feeling is that there are so many inputs to the situation in each state that differ so much that it is difficult to disentangle them all. And I have no explanation for the results. No idea.

I do agree that maintaining restrictions through March would have been helpful, probably. I think we’d see much lower case numbers now if we had, and I do think NPIs work in general. But sometimes it feels like pushing on the end of a string since they are not always sufficient.

 

[nwdiver]

I honestly have no idea. My understanding is that mask compliance in Texas hasn’t actually changed much after lifting of the statewide order but I can’t actually find any data.

Anecdotal but when I was in Andrews a few days after the gov lifted the mandate there wasn't a mask in site in any of the indoor places I stopped by.

 

[JRP3]

Starting Friday, New Yorkers will be able to pull up a code on their cell phone or a printout to prove they've been vaccinated against COVID-19 or recently tested negative for the virus that causes it.

The first-in-the-nation certification, called the Excelsior Pass, will be useful first at large-scale venues like Madison Square Garden, but next week will be accepted at dozens of event, arts and entertainment venues statewide. It already enables people to increase the size of a wedding party, or other catered event.

New York launches nation's first 'vaccine passports.' Others are working on similar ideas, but many details must be worked out.

New York's new Excelsior Pass is part of a growing but disjointed effort to provide vaccine 'passports' or certifications useful for safe gatherings.

www.usatoday.com

 

[jerry33]

I honestly have no idea. My understanding is that mask compliance in Texas hasn’t actually changed much after lifting of the statewide order but I can’t actually find any data.

From what I can tell, mask compliance is about the same. The weather pretty much shut everything down for a week, so no one left their homes unless they really, really had to. Even though I'm not in one of the areas that lost power, ice days are not the days you want to go driving or walking. One week of no one going anywhere probably did put a big dent in the spread. And it's been warm since, which is not particularly friendly to the virus (my understanding).