PlagueWatch 2020-23 - Coronavirus

[richardjackson199]

Your mention of the emergency use authorization raises a question for me - when will adult usage be shifted from "emergency use" to "standard?" I have been told that a major reason why there are limitations on vaccine mandates is that the vaccine is only "emergency use" so it is hard to require people to get vaccinated (i.e. in many places schools require certain vaccinations in order to attend, but you can't require the covid vaccine since it is only emergency use right now).

Dr. Ohl does a good job answering your question. Emergency Use Authorization from the FDA requires evidence that the benefits clearly, clearly outweigh the risks.

Scroll this link to about 40:06 and he gives a full answer to your question:

https://www.facebook.com/watch/live/...546&ref=search

He expects full FDA approval possibly by the end of the year, but benefits clearly outweigh the risks are the magic words for a doctor recommending something.

[CrazyNotCrazie]

Dr. Ohl does a good job answering your question. Emergency Use Authorization from the FDA requires evidence that the benefits clearly, clearly outweigh the risks.

Scroll this link to about 40:06 and he gives a full answer to your question:

https://www.facebook.com/watch/live/...546&ref=search

He expects full FDA approval possibly by the end of the year, but benefits clearly outweigh the risks are the magic words for a doctor recommending something.

Thanks for sharing. Very helpful.

[rsvman]

We got a note from our school district this week that individuals who have an exposure to a close contact are no longer required to quarantine if: (1) they received the full course of a vaccine more than two weeks ago; and (2) not more than three months ago. It doesn't apply to kids, since none have been vaccinated, but I thought the timeline (for teachers and staff, I guess) seemed strange. This suggests a pretty small effective window between 2 weeks after final shot to 3 months after shot. Any thoughts on the rationale for the three month endpoint?

The three months comes from a CDC recommendation that they, um, pulled out of their nether regions, to be frank.

We don't know how long protection will last, but, as mentioned upthread, we already have data that it ls still going strong at six months. Time will tell the whole story.

[tbyers11]

Your mention of the emergency use authorization raises a question for me - when will adult usage be shifted from "emergency use" to "standard?" I have been told that a major reason why there are limitations on vaccine mandates is that the vaccine is only "emergency use" so it is hard to require people to get vaccinated (i.e. in many places schools require certain vaccinations in order to attend, but you can't require the covid vaccine since it is only emergency use right now).

In the article I read Pfizer says their 6 month efficacy data will lead them to apply for a BLA (biologics license application) that is required for full licensure for adults. There are really no differences in the data required for EUA v BLA. It is just that the vaccine vs placebo group is followed for a longer period of time to see if efficacy is maintained and no adverse safety effects pop up. Pfizer seems to check both these boxes.

Here is a recent article discussing this with 2 experts in the field Dr. William Schaffner and Dr. Arnold Monto
https://www.wusa9.com/amp/article/ne...8-194a6e0a21a4

[richardjackson199]

Encouraging, but 90 isn’t 100.

The university my wife works at does their own covid testing. They found 2 fully immunized employees that were covid positive. One of which had a high viral load and was presumably contagious.

I’m hopeful we are in the final stretch, but I am saddened at the thought that we are going to lose thousands more because restrictions are being loosened too much too fast.

Fortunately data is showing more and more that fully vaccinated folks are not transmitting much Covid.

This update yesterday from Dr. Ohl is definitely worth a watch. For the first 15 minutes he gives a high-yield update of recent evidence and studies including studies you probably haven't read about because they haven't been released or peer-reviewed yet. But the news and the evidence is good.
The last 5 minutes he just talks about international travel which is important for any who are contemplating that. So OPK watch that last 5 minutes.

https://www.facebook.com/watch/live/...146&ref=search

I'll try to remember a few other highlights:
-- The vaccines do protect quite well against variants so far, including the South African variant (which previous wild-type Covid infection does not protect as well against)
-- Data shows that pregnant women are protected by the vaccine, their antibodies from the vaccine protect their baby, and the antibodies from their breastmilk protect their newborn from Covid too. So pregnant women should get vaccinated.
--He talks about the Pfizer study in adolescents 12-15 that we talked about earlier in the thread and what it means. He talks about kids younger than 12 probably needing to wait until Christmas for their jab. But he really expects it to be safe and effective for them too.
--USA is #3 in the world in getting our population vaccinated, pretty good but meaning that other countries are not so far along.
--International travel will require lots of hoops to jump through, some of them weird like needing to get tested both before and right after an 8 hour flight among other things. Traveling domestically to Hawaii is also a pain in the arse and will need careful planning. NY State is working on having a vaccine passport to enter, especially if traveling by air. CA state and others are more restrictive to travel to with quarantines and testing requirements.
--He talks about how getting a vaccine appointment works now that we're entering a phase where supply is getting quite good, and literally everyone in NC age 16 and above will be eligible starting April 7. Thus convincing the vaccine hesitancy crowd to take the shot will be key. He takes a stab at this.
-- Things are on track to really get better by this summer IF we can follow safety guidelines for about 2 more months and keep getting shots in arms.

[richardjackson199]

I see my patients more often than their PCP, and I see a lot of the vaccine hesitancy crowd. So in my field we have been encouraged to try to answer families' questions about vaccines to fight vaccine hesitancy. I try to do it when I have extra time in a visit. I was happy to change a parent's mind about it yesterday.

I've heard different misunderstandings, but the most common one I'm hearing from the vaccine hesitancy crowd is that vaccines kill people. They'll say that they don't want the vaccine because they've heard about the severe side effects including people dying from getting the vaccines. I've also heard separately the concern that vaccines were developed and released to the public too quickly.

My understanding of the people dying thing or where that came from is that has been pretty rare, but has happened with some very old (80's/90's) and/or very frail people (with weak hearts, severe medical conditions). I try to point out that many, many more people have been dying from Covid, including these same higher risk older frail population. I try to clarify exactly who has been dying, why, how the vaccine causes mild, harmless expected side effects in 15-18%, and exactly why the benefits far outweigh the risks. I point out the risk of anaphylaxis is about 3 per 1 million people, and that is treatable with epinephrine on hand even if you lose that lottery.

If anyone has any good advice to answer these misunderstandings, I'll put it to good use one person at a time.

Folks seem to respond to me telling them that this is one of the most effective vaccines ever made, comparable to the one for measles. I also discuss immediate post-vaccine anxiety reactions (like wooziness) which I believe are quite common for the anxious type. And there are a lot of anxious types.

[TruBlu]

I see my patients more often than their PCP, and I see a lot of the vaccine hesitancy crowd. So in my field we have been encouraged to try to answer families' questions about vaccines to fight vaccine hesitancy. I try to do it when I have extra time in a visit. I was happy to change a parent's mind about it yesterday.

I've heard different misunderstandings, but the most common one I'm hearing from the vaccine hesitancy crowd is that vaccines kill people. They'll say that they don't want the vaccine because they've heard about the severe side effects including people dying from getting the vaccines. I've also heard separately the concern that vaccines were developed and released to the public too quickly.

My understanding of the people dying thing or where that came from is that has been pretty rare, but has happened with some very old (80's/90's) and/or very frail people (with weak hearts, severe medical conditions). I try to point out that many, many more people have been dying from Covid, including these same higher risk older frail population. I try to clarify exactly who has been dying, why, how the vaccine causes mild, harmless expected side effects in 15-18%, and exactly why the benefits far outweigh the risks. I point out the risk of anaphylaxis is about 3 per 1 million people, and that is treatable with epinephrine on hand even if you lose that lottery.

If anyone has any good advice to answer these misunderstandings, I'll put it to good use one person at a time.

Folks seem to respond to me telling them that this is one of the most effective vaccines ever made, comparable to the one for measles. I also discuss immediate post-vaccine anxiety reactions which I believe are quite common for the anxious type. And there are a lot of anxious types.

The most common argument that I hear from the “Hesitants” is that getting the Covid vaccine gives you Covid. Facts do not change their mind. SMDH.

[richardjackson199]

Fortunately data is showing more and more that fully vaccinated folks are not transmitting much Covid.

This update yesterday from Dr. Ohl is definitely worth a watch. For the first 15 minutes he gives a high-yield update of recent evidence and studies including studies you probably haven't read about because they haven't been released or peer-reviewed yet. But the news and the evidence is good.
The last 5 minutes he just talks about international travel which is important for any who are contemplating that. So OPK watch that last 5 minutes.

https://www.facebook.com/watch/live/...146&ref=search

I'll try to remember a few other highlights:
-- The vaccines do protect quite well against variants so far, including the South African variant (which previous wild-type Covid infection does not protect as well against)
-- Data shows that pregnant women are protected by the vaccine, their antibodies from the vaccine protect their baby, and the antibodies from their breastmilk protect their newborn from Covid too. So pregnant women should get vaccinated.
--He talks about the Pfizer study in adolescents 12-15 that we talked about earlier in the thread and what it means. He talks about kids younger than 12 probably needing to wait until Christmas for their jab. But he really expects it to be safe and effective for them too.
--USA is #3 in the world in getting our population vaccinated, pretty good but meaning that other countries are not so far along.
--International travel will require lots of hoops to jump through, some of them weird like needing to get tested both before and right after an 8 hour flight among other things. Traveling domestically to Hawaii is also a pain in the arse and will need careful planning. NY State is working on having a vaccine passport to enter, especially if traveling by air. CA state and others are more restrictive to travel to with quarantines and testing requirements.
--He talks about how getting a vaccine appointment works now that we're entering a phase where supply is getting quite good, and literally everyone in NC age 16 and above will be eligible starting April 7. Thus convincing the vaccine hesitancy crowd to take the shot will be key. He takes a stab at this.
-- Things are on track to really get better by this summer IF we can follow safety guidelines for about 2 more months and keep getting shots in arms.

To update one change from the end of Dr. Ohl's Thursday update. He said the CDC still did not recommend travel. They didn't, but that changed today for the fully vaccinated. Today, Friday, the CDC announced that fully vaccinated people may travel. But as Dr. Ohl said, that will be easier domestically. Internationally it will still also depend on the rules of the country your are entering.

https://www.msn.com/en-us/news/us/fu...dT1?li=BBnb7Kz

[Kdogg]

If anyone has any good advice to answer these misunderstandings, I'll put it to good use one person at a time.

Folks seem to respond to me telling them that this is one of the most effective vaccines ever made, comparable to the one for measles. I also discuss immediate post-vaccine anxiety reactions (like wooziness) which I believe are quite common for the anxious type. And there are a lot of anxious types.

Can you write a prescription to get them off social media? I’ve found that much of the hesitancy is fueled by Facebook and YouTube.

[rsvman]

The argument I keep hearing is that the mRNA vaccines 'alter' your DNA. Not sure how they expect that to work, but don't let science and reason get in the way of a good anti-vax argumemt.

[jimsumner]

The argument I keep hearing is that the mRNA vaccines 'alter' your DNA. Not sure how they expect that to work, but don't let science and reason get in the way of a good anti-vax argumemt.

Don't forget the chip that allows folks with bad intentions to monitor your every movement.

[richardjackson199]

The argument I keep hearing is that the mRNA vaccines 'alter' your DNA. Not sure how they expect that to work, but don't let science and reason get in the way of a good anti-vax argumemt.

I had Cell Bio with Dr. Bruce Kohorn, so I know that is garbage. Our body already has mechanisms to quickly break down that mRNA just as it breaks down all the mRNA our own body makes.

Stupid question, but I'm actually more worried about this concept with the J & J adenovirus-vectored DNA vaccine. DNA viruses like EBV do integrate their DNA into our DNA and can thus be associated with cancers like Hodgkins Lymphoma. Is this a concern at all with the DNA vaccines? I'm pretty sure there is zero evidence of that, just asking from a biological plausibility standpoint? rsvman or tbyers or any of the extreme experts on this thread?

I would have taken the J & J vax in a second if that is what I was given. But if I had a choice of all 3, I would have preferred either of the 2 mRNA vaccines because I believe the 2 shot series should boost immunity to maybe last longer and be more robust. Doesn't that make sense? I know it shouldn't matter as there will be boosters as soon as we know when they are needed. I'm just saying I'd have picked an mRNA vax if I had a choice, and I feel like I'm in the minority from folks I've talked to.

[rsvman]

First of all, EBV does not integrate into host DNA, although it does take up permanent residency inside infected cells, where it resides in a latent state, for the most part. Retroviruses like HIV actually integrate into the host cell.

Adenoviruses do not integrate, nor do they have a true latent state, although they can last in the body for quite some time. They got the name because they were found in adenoid tissue that was removed surgically (the adenoids are like smaller versions of your tonsils that reside in your nasopharynx; these are often removed, along with the tonsils, in people with sleep apnea or in children with frequent ear infections).

As for the adenoviruses used in these vaccines, they are altered or chosen from a different species in order to make it hard for them to replicate in your cells. So, in theory, they serve essentially as a delivery truck that drops off the material you need to mount a protective response. There is no reason to expect these viruses to integrate or even to survive very long inside your cells.

[richardjackson199]

First of all, EBV does not integrate into host DNA, although it does take up permanent residency inside infected cells, where it resides in a latent state, for the most part. Retroviruses like HIV actually integrate into the host cell.

Adenoviruses do not integrate, nor do they have a true latent state, although they can last in the body for quite some time. They got the name because they were found in adenoid tissue that was removed surgically (the adenoids are like smaller versions of your tonsils that reside in your nasopharynx; these are often removed, along with the tonsils, in people with sleep apnea or in children with frequent ear infections).

As for the adenoviruses used in these vaccines, they are altered or chosen from a different species in order to make it hard for them to replicate in your cells. So, in theory, they serve essentially as a delivery truck that drops off the material you need to mount a protective response. There is no reason to expect these viruses to integrate or even to survive very long inside your cells.

Thanks so much for your response. I got quite sick with Mono in college for a long time and thus don't like EBV or any of the 8 or so HSV viruses. I think I've gotten sick as hell from an adenovirus too so I don't want to trust it either. I'd read the adenoviruses used as the vector were "beaten up" so that they can't replicate or cause problems. But I just liked the idea of mRNA vaccine better than an adenovirus and DNA for zero scientific reason. Just things I'd pondered.

But this from a true ID expert makes me feel better. Thanks again!

[Skydog]

This is off-topic (feel free to remove mod if inappropriate) but I thought possibly some participant in this thread could help me (especially someone currently at Duke, possibly in medicine). My great-niece was accepted to Duke a few days ago (yay!). She is interested in a career in biomedical engineering and is leaning Duke but will also hear from some Ivys in a few days and has to make her decision soon. To help inform her decision she is flying up here for a informal visit this Thursday, staying through the weekend. I'm a Duke grad school alum and live in Durham so she was asking me if I knew anyone on campus who could show her around, especially around Duke's biomedical facilities, since everything is likely to be locked up. However I don't have such a connection - any suggestions?

[Bluedog]

This is off-topic (feel free to remove mod if inappropriate) but I thought possibly some participant in this thread could help me (especially someone currently at Duke, possibly in medicine). My great-niece was accepted to Duke a few days ago (yay!). She is interested in a career in biomedical engineering and is leaning Duke but will also hear from some Ivys in a few days and has to make her decision soon. To help inform her decision she is flying up here for a informal visit this Thursday, staying through the weekend. I'm a Duke grad school alum and live in Durham so she was asking me if I knew anyone on campus who could show her around, especially around Duke's biomedical facilities, since everything is likely to be locked up. However I don't have such a connection - any suggestions?

Certainly not the same as an in person tour and I can’t help you there, but Pratt does offer “live hosted” virtual tours in addition to the virtual tours one can view anytime:
https://pratt.duke.edu/about/campus/tours

I studied BME at Duke. When the Fitzpatrick Center became the hot new building, and now it’s old news with a new engineering building. There is definitely nothing like a live visit to the campus and facilities. I feel like Duke sets itself apart in that regard and wonder if it will be hurt this year due to fewer in person events/visits compared to other schools.

Congrats to your grand niece! Quite an accomplishment.

[budwom]

I see Vermont just broke into the top ten in cases per capita! Uh oh, I guess that's a bad thing, not a good thing. Just an odd transition, the state government has been very careful, vaccinations are going great, people are staying out of the hospital and ICU...but younger people are passing the virus around like a joint at a concert. Does not make me want to venture forth into restaurants any time soon, despite having been jabbed... not sure if this will end well or not.

[Skydog]

Certainly not the same as an in person tour and I can’t help you there, but Pratt does offer “live hosted” virtual tours in addition to the virtual tours one can view anytime:
https://pratt.duke.edu/about/campus/tours

I studied BME at Duke. When the Fitzpatrick Center became the hot new building, and now it’s old news with a new engineering building. There is definitely nothing like a live visit to the campus and facilities. I feel like Duke sets itself apart in that regard and wonder if it will be hurt this year due to fewer in person events/visits compared to other schools.

Congrats to your grand niece! Quite an accomplishment.

Thank you, I will convey that information to her! Live hosted, even virtual, would be great. And yes 'quite an accomplishment' are exactly the words I used. I'm quite proud of her.

[YmoBeThere]

Alexander Nazaryan

Mon, April 5, 2021, 12:34 PM

It’s time to unplug the sanitizing robots and put away the bottles of Clorox that seem to line the entrances to every school, restaurant and supermarket wanting to advertise its safety protocols. While such protocols may be reassuring to an anxious populace, they are not necessary, says a revised guidance issued on Monday by the Centers for Disease Control and Prevention.

https://news.yahoo.com/end-the-hygie...173440864.html

Sigh, this is the one theater part I played well.

[aimo]

Alexander Nazaryan

Mon, April 5, 2021, 12:34 PM

It’s time to unplug the sanitizing robots and put away the bottles of Clorox that seem to line the entrances to every school, restaurant and supermarket wanting to advertise its safety protocols. While such protocols may be reassuring to an anxious populace, they are not necessary, says a revised guidance issued on Monday by the Centers for Disease Control and Prevention.

https://news.yahoo.com/end-the-hygie...173440864.html

Sigh, this is the one theater part I played well.

I just moved into a new office today and I Clorox-wiped everything.