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  1. #581
    Join Date
    Feb 2007
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    Raleigh, NC
    Quote Originally Posted by dudog84 View Post
    I want some antibody tigers!!! Where do I get them?
    With apologies to Dave Barry, what a great name for a rock group.

    The Antibody Tigers.

  2. #582
    Join Date
    Feb 2007
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    Watching carolina Go To HELL!
    Quote Originally Posted by rsvman View Post
    If the companies know from their earlier trials what level of antibodies equates with protection, they could substitute immunogenicity for efficacy in their trials in children, as tbyers is saying.
    In other words, assume that if the vaccine engenders a robust antibody response, producing similar antibody tigers in tykes as it did in adults, then the FDA would likely accept that as a surrogate for protection, and give it the ok (providing the companies can also prove safety).
    I saw a push on my phone today that Duke is starting an under 12 trial. Should I encourage my daughter to enroll my grandkids (almost 11, 7 and 4)?
    Ozzie, your paradigm of optimism!

    Go To Hell carolina, Go To Hell!
    9F 9F 9F
    http://www.EGLEW.com


  3. #583
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by OZZIE4DUKE View Post
    I saw a push on my phone today that Duke is starting an under 12 trial. Should I encourage my daughter to enroll my grandkids (almost 11, 7 and 4)?
    I think it would be a fine thing to ENCOURAGE her to do just that. I would not PUSH it on her, though.
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  4. #584
    Join Date
    Feb 2007
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    Durham, NC
    Quote Originally Posted by OZZIE4DUKE View Post
    I saw a push on my phone today that Duke is starting an under 12 trial. Should I encourage my daughter to enroll my grandkids (almost 11, 7 and 4)?
    WTVD just reported on this. Dr. Susanna Naggie has enrolled her twin daughters in this trial. She is a well-known infectious disease specialist at Duke. If she trusts its safety . . .

    https://medicine.duke.edu/faculty/susanna-naggie-md

  5. #585
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    Sep 2007
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    Undisclosed

  6. #586
    Join Date
    Feb 2007
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    Raleigh, NC
    Quote Originally Posted by OldPhiKap View Post
    Two thumbs up because I only have two thumbs.

  7. #587
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    Feb 2007
    Location
    Greenville, SC
    Quote Originally Posted by OldPhiKap View Post
    This was on its way to my sister-in-law within 2 seconds.

    She’s British.

    It took her almost 5 seconds to respond.

  8. #588
    So can I ask a possibly silly question...

    When they look at efficacy, is the idea that an individual has, say, a 90% chance of being basically immune to covid overall?

    Or is the idea that, with each exposure to covid, there is a 90% chance of that particular exposure not resulting in sickness?

    Does that make sense? It makes sense to me, but that doesnt mean much right now

  9. #589
    Join Date
    Feb 2007
    Location
    Orlando, FL
    Quote Originally Posted by Lord Ash View Post
    So can I ask a possibly silly question...

    When they look at efficacy, is the idea that an individual has, say, a 90% chance of being basically immune to covid overall?

    Or is the idea that, with each exposure to covid, there is a 90% chance of that particular exposure not resulting in sickness?

    Does that make sense? It makes sense to me, but that doesnt mean much right now
    Efficacy numbers are determined by how often a vaccinated person has an event (in this case a symptomatic COVID case confirmed by PCR) compared to the placebo group in a controlled trial. It is an odds ratio calculation. So it is roughly you are 90% less likely than an unvaccinated person to get a case of COVID if faced with the same exposure situation. The 92.1% efficacy in the Moderna results below actually had 0.2% infection rate in vaccinated group and 2.6% infection rate in the placebo group over the same time period (>14 days after dose 1)

    Moderna EUA.jpg
    Coach K on Kyle Singler - "What position does he play? ... He plays winner."

    "Duke is never the underdog" - Quinn Cook

  10. #590
    Join Date
    Nov 2007
    Location
    Vermont
    Quote Originally Posted by aimo View Post
    WTVD just reported on this. Dr. Susanna Naggie has enrolled her twin daughters in this trial. She is a well-known infectious disease specialist at Duke. If she trusts its safety . . .

    https://medicine.duke.edu/faculty/susanna-naggie-md
    It was featured on the NBC evening news last night

  11. #591
    Quote Originally Posted by tbyers11 View Post
    Efficacy numbers are determined by how often a vaccinated person has an event (in this case a symptomatic COVID case confirmed by PCR) compared to the placebo group in a controlled trial. It is an odds ratio calculation. So it is roughly you are 90% less likely than an unvaccinated person to get a case of COVID if faced with the same exposure situation. The 92.1% efficacy in the Moderna results below actually had 0.2% infection rate in vaccinated group and 2.6% infection rate in the placebo group over the same time period (>14 days after dose 1)

    Moderna EUA.jpg

    Hm, yeah, I guess what I am wondering is more about how vaccines work, as opposed to how they establish efficacy numbers... like, if I have gotten a vaccine, but I am one of those people who is going to end up getting it, am I likely to get it any time I am exposed? Or am I basically immune, but if I get an "unlucky" exposure (or am exposed enough often) I might get it?

    Again, not sure if this is making sense

  12. #592
    Join Date
    Feb 2007
    Location
    NC
    Quote Originally Posted by Lord Ash View Post
    Hm, yeah, I guess what I am wondering is more about how vaccines work, as opposed to how they establish efficacy numbers... like, if I have gotten a vaccine, but I am one of those people who is going to end up getting it, am I likely to get it any time I am exposed? Or am I basically immune, but if I get an "unlucky" exposure (or am exposed enough often) I might get it?

    Again, not sure if this is making sense
    I think you are more likely to get it closer to when you got vaccinated (as your body is still building up the antibodies) or WAY further from when you got vaccinated (as the efficacy wanes). I suspect that's more or less true across the effectiveness spectrum of vaccine recipients.

  13. #593
    Join Date
    Feb 2007
    Location
    Orlando, FL
    Quote Originally Posted by Lord Ash View Post
    Hm, yeah, I guess what I am wondering is more about how vaccines work, as opposed to how they establish efficacy numbers... like, if I have gotten a vaccine, but I am one of those people who is going to end up getting it, am I likely to get it any time I am exposed? Or am I basically immune, but if I get an "unlucky" exposure (or am exposed enough often) I might get it?

    Again, not sure if this is making sense
    I guess I don't understand what you mean by "but I am one of those people who is going to end up getting it". Short answer is you are basically immune once the vaccine has had time to work (2-3 weeks), especially to getting a severe case, for a period of time. Caveats regarding exactly how long that period is and "unlucky" exposure below.

    These vaccines, and vaccines in general, provide a sufficient level of immunity over a period of time (exactly how long and how strong varies) so that if you have multiple "normal" exposures (an exposure every few weeks for example) you should be protected each time for an extended period of time. "Protection" may vary from no case at all or very mild symptoms depending on person and exposure but it definitely appears that the COVID vaccines keep you from getting really sick. An initial exposure to COVID should not lessen the vaccines ability to "protect" you from the next exposure. That protection is not indefinite (which is why we may need a booster or we need booster for other vaccines) but it looks it will be good for at least 6-12 months.

    As for "unlucky" exposure I would consider that something like a high dose exposure (say a healthcare setting with an actively ill patient). Vaccine immunity, or any immunity, is rarely perfectly sterilizing and a high dose exposure could be more likely to cause an infection, even in a vaccinated individual. But the vaccine decreases that likelihood by a large amount as well.

    Does that help answer your question a bit more?
    Coach K on Kyle Singler - "What position does he play? ... He plays winner."

    "Duke is never the underdog" - Quinn Cook

  14. #594
    Quote Originally Posted by Lord Ash View Post
    Hm, yeah, I guess what I am wondering is more about how vaccines work, as opposed to how they establish efficacy numbers... like, if I have gotten a vaccine, but I am one of those people who is going to end up getting it, am I likely to get it any time I am exposed? Or am I basically immune, but if I get an "unlucky" exposure (or am exposed enough often) I might get it?

    Again, not sure if this is making sense
    Quote Originally Posted by CDu View Post
    I think you are more likely to get it closer to when you got vaccinated (as your body is still building up the antibodies) or WAY further from when you got vaccinated (as the efficacy wanes). I suspect that's more or less true across the effectiveness spectrum of vaccine recipients.
    I think what Lord Ash is asking is if a vaccinated person is hanging out with someone indoors unmasked who has COVID and IS currently "transmitting" it, what are the odds of getting COVID? I don't think anybody knows the answer to that question, but I could be wrong. Even an unvaccinated person would be less than 100%. Does a vaccinated person have like a 1 in 10 chance of getting it after an exposure, so if someone has 10 exposures they are still likely to get it, etc. Isn't that what you're asking Lord Ash. I would say that even if you "get it" as a vaccinated person, the likelihood of it actually causing severe symptoms is GREATLY reduced, so you're basically safe from the most adverse effects of COVID even if you're not 100% protected from "testing positive." You also have a greatly reduced chance of transmitting it to others while being fully vaccinated.

    But maybe I'm also off with what you're asking. And I'm not the expert.

  15. #595
    Join Date
    Feb 2018
    Location
    Durham, NC
    Quote Originally Posted by tbyers11 View Post
    An initial exposure to COVID should not lessen the vaccines ability to "protect" you from the next exposure. That protection is not indefinite (which is why we may need a booster or we need booster for other vaccines) but it looks it will be good for at least 6-12 months.
    An exposure that prompts an effective immune response may actually increase protection from the next exposure, correct? Effectively, it may act as a booster, which is why people who have already had COVID are experiencing worse reactions to the first dose, while people who have not generally experience worse reactions to the second shot.

    I emphasize separately emphasize "may", as I doubt that has been studied directly, but that would be the usual expectation, would it not?

  16. #596
    Join Date
    Feb 2007
    Location
    NC
    Quote Originally Posted by Bluedog View Post
    I think what Lord Ash is asking is if a vaccinated person is hanging out with someone indoors unmasked who has COVID and IS currently "transmitting" it, what are the odds of getting COVID? I don't think anybody knows the answer to that question, but I could be wrong. Even an unvaccinated person would be less than 100%. Does a vaccinated person have like a 1 in 10 chance of getting it after an exposure, so if someone has 10 exposures they are still likely to get it, etc. Isn't that what you're asking Lord Ash. I would say that even if you "get it" as a vaccinated person, the likelihood of it actually causing severe symptoms is GREATLY reduced, so you're basically safe from the most adverse effects of COVID even if you're not 100% protected from "testing positive." You also have a greatly reduced chance of transmitting it to others while being fully vaccinated.

    But maybe I'm also off with what you're asking. And I'm not the expert.
    If that is the question, then I'd say that vaccination probably reduces the likelihood of getting it at all (even with exposure), but exactly how much is not necessarily clear. But it does seem to suggest (as Bluedog states) that if you get it the risk of truly severe outcomes (not "severe" as it is defined for trial purposes, which is much less severe than what we think of as severe) is REALLY low. Probably not 0% low, but close enough.

    What isn't clear as far as I can tell is whether or not vaccination prevents the ability to transmit, although the suspicion is that it does. But once vaccinated, that'd be the big concern I'd have: potentially serving as essentially a carrier to others despite it not being that dangerous to you anymore.

  17. #597
    Join Date
    Feb 2018
    Location
    Durham, NC

    Vaccines and Flu

    I'm not sure where to post this question, but this seems as good a spot as any, so here goes:

    As the pace of vaccinations increases and it looks more and more like all who want one in the U.S. (except children) will be able to get one by summer, how are we planning to manage next year and beyond? Europe is on an indefinite vaccine hold with the AstraZeneca problem, and the third world has largely not even started. We've seen a bunch of variants already appear, and although our vaccines appear to be keeping up for now, there's a pretty good chance that the virus will gradually mutate away from the vaccine's umbrella long before the virus is contained worldwide. It therefore seems very likely that we will need annual boosters for this disease in much the same way as we need them for the flu.

    Is there any plan being worked on to incorporate COVID-19 into regular the regular flu vaccine pipeline? It seems wasteful to me to manage COVID as a separate vaccine, if we don't absolutely need to. Is it too early to be asking this kind of question, given that we are still a ways away from containment and haven't accumulated a lot of relevant data, or is this the kind of question we really should be actively processing now, so we can stay ahead of things once we do get an acceptable amount of containment? Pipelines for the flu vaccine are usually fairly lengthy, aren't they? How far ahead should this kind of thing be looked at, assuming that it really does behave from a mutation point of view much like the flu?

    Once we get this disease at least somewhat limited, it would be nice to keep our proverbial foot down on it's proverbial neck.



    Mods: If this is better in its own thread or the general PlagueWatch thread, feel free to move.

  18. #598
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    I think I understand what Lord Ash is asking, and he can correct me if I am wrong.

    It is known that no vaccine is 100% protective. It follows, therefore, that at least some people will get the disease even though they got vaccinated. What if he is one of those people? If he is, would he get it right away, with the first exposure, or would he get it only if he has a severe exposure, or multiple exposures?

    At least that's what I THINK he is asking.


    Nobody can answer the question for you. tbyers has done a pretty good job. I guess I don't think of it in the way that you are thinking of it; that is to say, I imagine that you are thinking that some people just don't respond to the vaccine and are therefore unprotected. This certainly has been documented for other vaccines, such as MMR, which, similarly is 95% protective after a single dose.

    I would think of it more like this: Almost everybody will make some response to the vaccine. The amount of protective antibody that is formed after vaccination would likely form a bell-shaped curve if plotted out with data from multiple vaccinees. So there probably ARE some people who are more likely to get infected because their responses fall on the lower end of that curve.

    You would get sick if you got exposed to enough virus that it overcame the amount of protective antibody that you have. Therefore, a close, long-duration exposure to a person shedding a lot of virus is more likely to get you sick than smaller, shorter-duration exposures that happen over time. In fact, you could perhaps make a hypothetical argument that at least in some cases, a "light exposure" to the virus might actually BOOST up your immunity and make you less likely to get sick later on (although we don't have any data addressing this). This could happen because as the small amount of virus began to replicate, it would fire up your memory cells and get them to produce more antibody, which would ultimately boost your antibody titer and strengthen your immunity.

    I also agree that, in general, people are more likely to get infected right after their vaccination (before they have had enough time to build up a good immune response) and a long time after vaccination, at which time perhaps the antibody titer has waned a bit. It's a lot more complicated than that, and it is likely that there is more to protection than just antibodies, but for now this is a reasonable thought process.

    I hope this was helpful.
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  19. #599
    Join Date
    Feb 2007
    Location
    Chesapeake, VA.
    Quote Originally Posted by Phredd3 View Post
    I'm not sure where to post this question, but this seems as good a spot as any, so here goes:

    As the pace of vaccinations increases and it looks more and more like all who want one in the U.S. (except children) will be able to get one by summer, how are we planning to manage next year and beyond? Europe is on an indefinite vaccine hold with the AstraZeneca problem, and the third world has largely not even started. We've seen a bunch of variants already appear, and although our vaccines appear to be keeping up for now, there's a pretty good chance that the virus will gradually mutate away from the vaccine's umbrella long before the virus is contained worldwide. It therefore seems very likely that we will need annual boosters for this disease in much the same way as we need them for the flu.

    Is there any plan being worked on to incorporate COVID-19 into regular the regular flu vaccine pipeline? It seems wasteful to me to manage COVID as a separate vaccine, if we don't absolutely need to. Is it too early to be asking this kind of question, given that we are still a ways away from containment and haven't accumulated a lot of relevant data, or is this the kind of question we really should be actively processing now, so we can stay ahead of things once we do get an acceptable amount of containment? Pipelines for the flu vaccine are usually fairly lengthy, aren't they? How far ahead should this kind of thing be looked at, assuming that it really does behave from a mutation point of view much like the flu?

    Once we get this disease at least somewhat limited, it would be nice to keep our proverbial foot down on it's proverbial neck.



    Mods: If this is better in its own thread or the general PlagueWatch thread, feel free to move.
    The flu vaccine pipeline is a lot more straightforward because storage and transport conditions for standard injectable flu vaccine are not as complex. The way things stand right now it would be impossible to just plus SARS-CoV-2 vaccination into the flu vaccine pipeline.

    Given the high levels of protection engendered by the mRNA vaccines, I can forsee a possible future in which pharmaceutical companies also make an mRNA vaccine for the flu (maybe it would improve efficacy from 40-60% up to 60-80%?). If that happens, I can also imagine that they could potentially just put the mRNA for SARS-CoV-2 and the mRNA for influenza into the same vaccine, and you would get a combined "Covid-flu" vaccine. Who knows?
    "We are not provided with wisdom, we must discover it for ourselves, after a journey through the wilderness which no one else can take for us, an effort which no one can spare us, for our wisdom is the point of view from which we come at last to regard the world." --M. Proust

  20. #600
    Join Date
    Feb 2018
    Location
    Durham, NC
    Quote Originally Posted by rsvman View Post
    The flu vaccine pipeline is a lot more straightforward because storage and transport conditions for standard injectable flu vaccine are not as complex. The way things stand right now it would be impossible to just plus SARS-CoV-2 vaccination into the flu vaccine pipeline.

    Given the high levels of protection engendered by the mRNA vaccines, I can forsee a possible future in which pharmaceutical companies also make an mRNA vaccine for the flu (maybe it would improve efficacy from 40-60% up to 60-80%?). If that happens, I can also imagine that they could potentially just put the mRNA for SARS-CoV-2 and the mRNA for influenza into the same vaccine, and you would get a combined "Covid-flu" vaccine. Who knows?
    J&J and AstraZeneca are not an mRNA vaccines, though, right? Or are those still too different to be included in the same pipeline? On the other hand, mRNA vaccines are presumably faster to "tweak", so if that eventually works, it could actually be a big improvement. I does sound like we're in the "too speculative to be able to say much" range on this question, though.

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