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Coronavirus
- Thread starter Wenche
- Start date
scottf200
Well-Known Member
Related. [Aside: The person I know with Lupus talked to their yesterday doctor and is getting the booster shot tomorrow.]
Andy Slavitt
COVID Update: The debate on whether Americans should be offered 3rd shots as boosters in not a simple one.
But it does present a very clear choice. 1/
Our best understanding of the immune response to an m-RNA vaccine is important to this question. 2/
How:
1- 1st dose creates a big antibody response, made bigger by a 2nd
2- That response allows the immune system to act fast in the face of an invasion of the virus.
3- That quick response is key to preventing symptoms particularly when there’s a high viral load like Delta 3/
4- That antibody response wanes over time so in the case of Delta it provides less punch. The 2 factors together create more symptomatic infections for vaxxed ppl
5- But even as it wanes, our body remembers w memory B cells & T cells 4/
6- Memory B cells & T cells are how we remember to fight off measles even though we have a shot as a kid
7- But this response is slower than when you have high antibodies already
8- Therefore over time we are able to still blunt infections before they get serious w memory B & T /5
9- All of this means that over time, without a booster we have string protection against hospitalization & death but are more able to get colds & other effects
10- Some of these effects are mild and pass but occasionally we know they can be long lasting 6/
You can hear all about what happens when symptoms last here if you want. 7/
In the Bubble with Andy Slavitt: Our Shot: Channeling COVID Outrage (with Diana Berrent) on Apple PodcastsShow In the Bubble with Andy Slavitt: Our Shot, Ep Channeling COVID Outrage (with Diana Berrent) - Aug 16, 2021https://podcasts.apple.com/us/podcast/in-the-bubble-with-andy-slavitt/id1504128553?i=1000532125052
So (choice A) if you think the purpose of a vaccine is to prevent hospitalization & death, that may happen quite well without a boost.
(Best to speak with humbly by saying “may” of “may for now”) 8/
Now if instead you prefer a vaccine to prevent symptoms & also significantly reduce transmission (choice B), that’s what a boost would do. 9/
So who wouldn’t prefer choice B? It’s obviously better. And certainly better for people with lower immune protection or more exposure to the virus (nursing home, health care workers, immunosuppressed).
But before you say “Choice B!”, there’s a catch. 10/
The catch is that if we choose Choice B, we increase the odds of future variants.
Here’s how: variants are threatened by the vaccine & will mutate the more unvaccinated people exist. And if we keep giving the same people the vaccine we won’t get there. 11/
Right now 10 countries are using 90% of the vaccines. If those (rich) countries kept reusing new vaccine supply every 6 months, we will perpetuate this issue.
With many countries at 1-2% vax.
And the moral challenge of saying us first. And second. And third. Then you.12/
One expert tells me that if we can accelerate global vaccination by 9 months from the current G7 target we can dramatically reduce the potential for the more deadly variants. 13/
The other reality is the US needs to lead on this decision to get other wealthy countries to follow. 14/
So the way it all shakes down for me is: if we think the job of the vaccines should be to protect against severe illness & the development of more dangerous mutations, then we would boost only most at risk people. 14/
If we want the vaccine to protect us against symptoms and transmissions (in the first world), then we do so at the cost of others around the globe & the cost of future variants. 15/
The political realities favor the kind of choice we’ve been seeing made all pandemic. Protect well off first to the nth degree before we consider others (see: essential workers) 16/
The WHO calls on us morally not to boost. Many epis are in that camp when it comes to fighting the pandemic.
But neither of them call the shots. 17/
Money equals lives here. And the same country is writing the check for the vaccines that would be used here & in Africa.
The US. 18/
Only tough choices exist in a world of scarcity.
The public should understand the policy choices here & the implications of what we decide not just on us, not just in the pandemic, but on everyone. /end
• • •
Andy just summarized everything we've been talking about in this thread.
Seriously, read the last couple pages and you'll get the exact same info. Good job, TMC!
if you missed it, this might be a good time to listen to Andy Slavitt’s interview with the CEO of Pfizer where he talks about the case for 3rd shots and the data about blood antibodies waning after 8 months.
My recent post has links to the two podcast episodes:
teslamotorsclub.com
My recent post has links to the two podcast episodes:
Coronavirus
https://www.msn.com/en-us/health/medical/mayo-clinic-covid-breakthrough-risk-may-be-much-lower-with-moderna-than-pfizer/ar-AANeSmO
teslamotorsclub.com
dhanson865
Well-Known Member
Here is a off the wall visualization of covid deaths you probably haven't seen, poorly labeled and a few issues with presentation but look at it a second and it might hit you.
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Here is a off the wall visualization of covid deaths you probably haven't seen, poorly labeled and a few issues with presentation but look at it a second and it might hit you.
So instead of mask, we should be mandating bullet proof vest?
AlanSubie4Life
Efficiency Obsessed Member
They wane starting shortly after full vaccination becomes fully effective. It’s kind of a continuum.
Nothing magical about 8 months, of course. Just perhaps happens to be the point where maybe x % of people fall below a threshold where Delta will have a good chance of taking hold.
But that time period where that crossover happens can probably be extended by wearing a mask in high risk situations (lower dose when exposed).
In plenty of people, the antibody levels are never really high - look at all the various papers measuring titers. Those people would probably benefit most from boosters. But high titer isn’t a guarantee - it probably depends on the viral dose received as well.
Boosters are fine and they’ll probably help a bit, but as linked above, not without downsides. These vaccines could be used better elsewhere, but such is the way of things. What we really need is way more vaccine production everywhere then we can have boosters and vaccinate everyone too.
It’ll be interesting to see the data they used to drive this decision. It’s been tough to obtain solid data on what is happening.
In the end boosters aren’t going to stop a winter wave, unfortunately. Something like 1 in 10 vaccinated people with boosters will likely be at risk of infection, as long as there is viral pressure around. And we all know why that would be…
Hopefully Delta really does scour out most of the vulnerable population but it doesn’t look like it will this wave, and that’s never the way viruses work anyway. So we’ll have plenty of dry tinder for the fall in some places. Hooray! Hooray for full hospitals! Just don’t break an arm or have a heart attack or anything.
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JRP3
Hyperactive Member
You didn't read the graph properly.So instead of mask, we should be mandating bullet proof vest?
Every cop knows that this COVID has been around since the 1929 crash. The spike is what started it all and it peaked in the beginning of the great depression.Here is a off the wall visualization of covid deaths you probably haven't seen, poorly labeled and a few issues with presentation but look at it a second and it might hit you.
Texas requests 5 FEMA morgue trailers in anticipation of COVID-19 fatality surge
At least they are preparing already.
If anybody could have just predicted that...
At least they are preparing already.
If anybody could have just predicted that...
Emails are being sent by Walgreens (and maybe others) that you can get a third shot. My assumption is that this is the same vaccine and not the booster. Pros, Cons? Is it best to wait the full eight months?
EVNow
Well-Known Member
Well - whether the reason is immune escape or something else - the efficacy of mRNA reduces from ~90% to ~60% against delta (IIRC). To me the question is - will the booster bring the efficacy back to 90%.
EVNow
Well-Known Member
Those are good points - but if there is one thingthat defines and binds wealthy countries - it is "short sighted selfishness", unfortunately.
AlanSubie4Life
Efficiency Obsessed Member
The thing is, we actually don’t have evidence of that. We have observational data showing VE between 40% and 60% in specific populations, and that is it.
The very solid evidence (very large dataset, and peer-reviewed methods to deal with observational bias) we have is 88% (symptomatic) efficacy against Delta from PHE (no vaccine-type breakout of their recent 79% number). However, that was with a longer dosing interval. (This may matter - but we don’t even know that since we have no similar quality evidence from other places.)
So, it’s definitely not clear at all that efficacy has dropped to 60% on average.
As I said, I wouldn’t be shocked at a drop of efficacy from 80% to 60% in older people who are 8 months out, but as an average efficacy, I would be pretty surprised actually, based on the evidence so far.
The thing that is lacking, really, is evidence.
And I have no concerns that the booster will restore efficacy to good levels close to (but lower than) the trials. It has to be lower than the trials, not because it is delta immune escape, but because people are being exposed to higher viral loads. That lowers actual efficacy (vaccinated people are more likely to become infected, while the risk to unvaccinated people is much less dependent on the viral dose, since they have no barrier to infection). The higher viral loads are both because of delta, maybe, and because of reduced mask use, etc, quite likely.
If the vaccine had been tested against alpha with no NPIs in place, the efficacy would have almost certainly been lower.
On average, how much will it increase efficacy? I don't know! It depends who gets the boosters. If they're reserved for people with low titers (or likely low titers since no one will be measuring), then it might actually be a pretty effective boost. But for people with little waning (yet), it might only marginally increase efficacy. It's going to be very different across the population, I believe.
At 90% symptomatic efficacy, breakthrough infections with people with three doses will continue to be a “story” - because they will still be so common! Clicks! And that’s probably closer to 80% efficacy against any infection (likely very close to the original efficacy, but of course lower for the reasons above).
As I have said before on this, I could be wrong on the efficacy - but I’ll wait for actual strong evidence before changing my mind. The limited statistics so far on hospitalizations AND cases lead me to believe efficacy is still quite good indeed (I would guess 70-80% against infection, including asymptomatic.)
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AlanSubie4Life
Efficiency Obsessed Member
Good question! Depends on your personal risks and preferences. Personally I think I might wait another couple months (I am not eligible anyway), just to see if more information becomes available (only 4 months out but had no reaction so no idea what my titer would look like). The advantage of not getting vaccinated again right now is that you have the possibility of getting a dose that is somehow shown to be more effective in the coming months (for example, maybe there will be good evidence that Moderna does better than Pfizer). Of course, right now they are requiring you to get the same shot…but…maybe they will “follow the science”…eventually…
Yet another surprise to Abbot.
:watermark(cdn.texastribune.org/media/watermarks/2021.png,-0,30,0)/static.texastribune.org/media/files/d21936436926a917334291574b57ee91/Abbott%20Border%20Announcement%20SP%20TT%2010)
Texas Gov. Greg Abbott tests positive for COVID-19
The governor spoke Monday night at a GOP event in Collin County, later tweeting photos of him addressing a maskless crowd. Less than three hours before his diagnosis was announced Tuesday afternoon, he tweeted pictures of a meeting with guitarist Jimmie Vaughan.
www.texastribune.org
AlanSubie4Life
Efficiency Obsessed Member
Great (for him) that he was being tested daily for COVID! It's almost like he takes COVID (personally) seriously and the rest of this nonsense is for show (and unfortunately costs lives). On the other hand, he was doing large unmasked indoor events so clearly he has no clue (though of course you have to keep up the show). Anyway, get some quick Regeneron (when it is most effective), and knock it out. It's good to be Governor I guess.Yet another surprise to Abbot.
Texas Gov. Greg Abbott tests positive for COVID-19
The governor spoke Monday night at a GOP event in Collin County, later tweeting photos of him addressing a maskless crowd. Less than three hours before his diagnosis was announced Tuesday afternoon, he tweeted pictures of a meeting with guitarist Jimmie Vaughan.
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AlanSubie4Life
Efficiency Obsessed Member
Cool animation showing the dynamics of the Israel outbreak. Important to keep in mind when assessing efficacy data - the outbreak started in highly vaccinated populations (not too surprising since that is where delta would be most likely to be introduced).
JRP3
Hyperactive Member
Or even an updated version more effective against the latest variant.
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