The Vaccine Discussion Thread

[brentm77]

As I had cautioned previously, the South African variant was able to get through Pfizer's two doses as well:

https://www.cnbc.com/2021/04/11/cov...-through-pfizer-vaccine-in-israeli-study.html
Here is a link to the study itself:
https://www.medrxiv.org/content/10.1101/2021.04.06.21254882v1
The highlights:
* This study is sourced from the real-life data in Israel.
* The researchers were expecting to see just one (1) case of the South African variant in the vaccinated group using its published efficacy numbers. They found 8 actual cases.
* For each expected case of the UK variant in the vaccinated group, they found 2.6 actual cases.

So, the real-life data is suggesting that the current mRNA vaccines will need to be boosted. And it also means the restrictions will have to remain in place in most international travel.

The study doesn't talk about severity and hospitalization, and I am hoping the results are similar to those from other vaccines - that is, the vaccines work. And that's the truly actionable metric now - at least until the boosters arrive.

I read the breakthroughs were all prior to 14 days post secondary vaccination. I haven't had a chance to look at the data. Do you know if that is true?

 

[Intr3pid]

I read the breakthroughs were all prior to 14 days post secondary vaccination. I haven't had a chance to look at the data. Do you know if that is true?

They did the study for two groups.

In the first group - which they called partially protected - they measured the infections from two weeks after the first dose to one week after the second. It is in this group that they found the 2.6-to-1 incidence of the UK variant.

In the second group - labelled fully protected - they measured the infections from one week onwards after the second dose. The South African variant's 8-to-1 incidence took place in this fully protected group. Refreshingly, protection against the UK variant was more in line - only at a 1.5-to-1 incidence.

Now, this isn't a large-scale study, so there will still be differences if you keep going. But, if you are to believe these numbers, here is what you could say:

1. Pfizer reported 95% efficacy against the wild-type or the original virus - which equates to a 5% incidence.
2. Using this study, in the fully protected group, the 5% will become 7.5% incidence for the UK variant (= 1.5 * 5%) and 40% incidence for the South African variant (= 8 * 5%).
3. In other words, if you take this study at face value, Pfizer would report a 92.5% efficacy against the UK variant and a 60% efficacy against the South African version.

------------------------------

The good news is, the UK variant is the dominant strain now in most places. Its presence (ironically) might kill the South African variant (the Indian double-mutant notwithstanding).

The supposed efficacy against the South African variant is still better than what a flu shot will offer. Plus, we should expect a lower incidence of severity and hospitalization regardless of efficacy.

 

[brentm77]

They did the study for two groups.

In the first group - which they called partially protected - they measured the infections from two weeks after the first dose to one week after the second. It is in this group that they found the 2.6-to-1 incidence of the UK variant.

In the second group - labelled fully protected - they measured the infections from one week onwards after the second dose. The South African variant's 8-to-1 incidence took place in this fully protected group. Refreshingly, protection against the UK variant was more in line - only at a 1.5-to-1 incidence.

Now, this isn't a large-scale study, so there will still be differences if you keep going. But, if you are to believe these numbers, here is what you could say:

1. Pfizer reported 95% efficacy against the wild-type or the original virus - which equates to a 5% incidence.
2. Using this study, in the fully protected group, the 5% will become 7.5% incidence for the UK variant (= 1.5 * 5%) and 40% incidence for the South African variant (= 8 * 5%).
3. In other words, if you take this study at face value, Pfizer would report a 92.5% efficacy against the UK variant and a 60% efficacy against the South African version.

------------------------------

The good news is, the UK variant is the dominant strain now in most places. Its presence (ironically) might kill the South African variant (the Indian double-mutant notwithstanding).

The supposed efficacy against the South African variant is still better than what a flu shot will offer. Plus, we should still expect a lower incidence of severity and hospitalization regardless of efficacy.

Thanks for all the details. I didn't have time to dig into this one. Looks like you were right about the boosters being helpful, but glad to see at least some protection (assuming the data holds out in larger samples). Want to see the info about severity of those cases, like you mentioned above.

Still confused about one of the scientists I follow, who is a molecular biologist for Moderna working in the vaccine space. She claims this:

"NO cases of B.1.351 14+ days post second dose. That’s vital. B.1.351 does not spread as efficiently and if anything we should take this as even more evidence that we need to continue increasing vaccination efforts."

And this:

Breakthrough cases will be rare. Also please note the fact 0 cases were detected 14 days post second dose. Immunity is not instantaneous after vaccination and needs time to set in, hence a short window someone can get infected.

I assume she misread the study, because I trust your detailed summary vs. her tweets.

 

[Intr3pid]

Thanks for all the details. I didn't have time to dig into this one. Looks like you were right about the boosters being helpful, but glad to see at least some protection (assuming the data holds out in larger samples). Want to see the info about severity of those cases, like you mentioned above.

Still confused about one of the scientists I follow, who is a molecular biologist for Moderna working in the vaccine space. She claims this:

"NO cases of B.1.351 14+ days post second dose. That’s vital. B.1.351 does not spread as efficiently and if anything we should take this as even more evidence that we need to continue increasing vaccination efforts."

And this:

Breakthrough cases will be rare. Also please note the fact 0 cases were detected 14 days post second dose. Immunity is not instantaneous after vaccination and needs time to set in, hence a short window someone can get infected.

I assume she misread the study, because I trust your detailed summary vs. her tweets.

The way they wrote their findings was admittedly very confusing. I had to keep their conclusions in front of me to understand what they were saying in the details. Here is an easier-to-read part which sheds light on what they did:

"...we tested the hypothesis that the B.1.1.7 and B.1.351 strains are able to overcome BNT162b2 mRNA vaccine protection. To this end, we identified individuals with documented SARS-CoV-2 infection – symptomatic or asymptomatic (hereby denoted as carriers) amongst members of the Clalit Health Services (CHS), the largest health care organization in Israel, which insures 4.7 million patients (53% of the population).

We focused on vaccinated carriers, divided into two categories: (a) individuals who had a positive PCR test that was performed between 14 days after the 1st dose and a week after the 2nd dose (denoted as partial effectiveness, PE), and (b) individuals who had a positive PCR test that was performed at least one week after the second vaccine dose (denoted as full effectiveness, FE). "

This distinction is in line with how Pfizer reported its results:
https://www.healthline.com/health/why-two-doses-of-covid-vaccine#immunity-after-second-dose
Regardless of what the molecular biologist read, I agree with her vaccination conclusion. We need to get it done a pronto!

 

[Intr3pid]

Now, for some good news, Regeneron's COVID treatment is ready to be approved for expanded use:

https://www.cnbc.com/2021/04/12/cov...-antibody-drug-as-preventative-treatment.html
This is the antibody cocktail given to Trump last year. The Phase 3 results are reporting an 81% reduction in symptoms (or the risk of contracting them).

I think having an effective treatment on board is critical to containing outbreaks on longer cruises.

 

[cgolf]

Well we got good news, our family will be vaccinated by mid May. I got my second shot yesterday and overall feel pretty good, not perfect, but pretty good.

 

[Birdie dog]

Well, I just finished my 36 hours in three days in the ER. This weekend was terrible.
We're a tourist destination in a red state. And we're overrun by people who want to be free and do what they want and not follow health guidelines. Although I'm fully vaccinated, I still wear masks and our businesses have signs saying masks are required. I picked up dinner on my way home, and of course there are the texting with no masks on people waiting to pick up their food because the rules aren't for them.
Some things I saw this weekend: we're seeing a few people with covid who have been vaccinated. At least one this weekend. That person was very old, and their chest x ray was fine. They had other complaints. Our ED head sent an email to our infectious disease doctor. To paraphrase, in the tens of thousands of vaccines we've given *we have a mass vaccination site* we've had 12 fully vaccinated people develop covid. None needed ventilation, none died. At least half of those were "very elderly* (older than 78) or immunocompromised. They're testing all of those people for variants.
We admitted a 27 year old to our ICU step down.
The 33 year old died. She claimed no health problems, but she certainly looked like she was going to die on arrival. She was transferred from our ICU to a a tertiary centre and placed on ECMO.
The husband who declined his covid vaccine (his wife was fully vaccinated) died. He was in his 50s.
We are rarely seeing sick elderly people due to them all being vaccinated. We did have one 92 year old who was covid positive- she'll probably also die. She wasn't vaccinated, but she told me "But, I don't leave my house". I told her frankly that someone in her family did her wrong and brought it to her. Our admissions to the covid unit have continued to climb and as of last evening, our ICU and ICU step-down were full and we have twice as many admitted than we had two weeks ago.
And people can't understand why businesses/countries etc aren't welcoming the unvaccinated with open arms?

 

[DisneYE]

Well, I just finished my 36 hours in three days in the ER. This weekend was terrible.
We're a tourist destination in a red state. And we're overrun by people who want to be free and do what they want and not follow health guidelines. Although I'm fully vaccinated, I still wear masks and our businesses have signs saying masks are required. I picked up dinner on my way home, and of course there are the texting with no masks on people waiting to pick up their food because the rules aren't for them.
Some things I saw this weekend: we're seeing a few people with covid who have been vaccinated. At least one this weekend. That person was very old, and their chest x ray was fine. They had other complaints. Our ED head sent an email to our infectious disease doctor. To paraphrase, in the tens of thousands of vaccines we've given *we have a mass vaccination site* we've had 12 fully vaccinated people develop covid. None needed ventilation, none died. At least half of those were "very elderly* (older than 78) or immunocompromised. They're testing all of those people for variants.
We admitted a 27 year old to our ICU step down.
The 33 year old died. She claimed no health problems, but she certainly looked like she was going to die on arrival. She was transferred from our ICU to a a tertiary centre and placed on ECMO.
The husband who declined his covid vaccine (his wife was fully vaccinated) died. He was in his 50s.
We are rarely seeing sick elderly people due to them all being vaccinated. We did have one 92 year old who was covid positive- she'll probably also die. She wasn't vaccinated, but she told me "But, I don't leave my house". I told her frankly that someone in her family did her wrong and brought it to her. Our admissions to the covid unit have continued to climb and as of last evening, our ICU and ICU step-down were full and we have twice as many admitted than we had two weeks ago.
And people can't understand why businesses/countries etc aren't welcoming the unvaccinated with open arms?

Gosh. This is quite unsettling.
But at the same time, it's good news that the vaccines are doing its magic on the elderly.
I also live in a red state, also with a lot of vacationing folks, and let me tell you, very few seem to care there's a pandemic out there. Donut joints, restaurants, stores, the majority of ppl aren't wearing masks. At the main state-wide grocery store, employees don't enforce the mask rule. At least 1/4 of ppl inside aren't wearing them.
Looks like it's going to be a long year (again) due to ppl's carelessness..

Also, thank you for what you do, for your service.

 

[brentm77]

The way they wrote their findings was admittedly very confusing. I had to keep their conclusions in front of me to understand what they were saying in the details. Here is an easier-to-read part which sheds light on what they did:

"...we tested the hypothesis that the B.1.1.7 and B.1.351 strains are able to overcome BNT162b2 mRNA vaccine protection. To this end, we identified individuals with documented SARS-CoV-2 infection – symptomatic or asymptomatic (hereby denoted as carriers) amongst members of the Clalit Health Services (CHS), the largest health care organization in Israel, which insures 4.7 million patients (53% of the population).

We focused on vaccinated carriers, divided into two categories: (a) individuals who had a positive PCR test that was performed between 14 days after the 1st dose and a week after the 2nd dose (denoted as partial effectiveness, PE), and (b) individuals who had a positive PCR test that was performed at least one week after the second vaccine dose (denoted as full effectiveness, FE). "

This distinction is in line with how Pfizer reported its results:
https://www.healthline.com/health/why-two-doses-of-covid-vaccine#immunity-after-second-dose
Regardless of what the molecular biologist read, I agree with her vaccination conclusion. We need to get it done a pronto!

I discovered where the "no S.A. variants breakthroughs after 14 days" idea is coming from. It is from a Twitter thread from one of the study authors. Since it isn't in the study, and it is only Twitter, I won't take it seriously unless the study is updated and clarified. In short, the author is claiming that the breakthroughs in the second group were between week one and week two after the second shot,. If true, that would be very important information, and it would be negligent to not clarify that information in the study. I am hesitant to even post this, given the source, but thought it might be worth flagging to watch for further clarification in the future.



. . .


The study does drop a one line that might allude to what the author is saying above, but certainly doesn't say what she is saying:

"Some subjects in this cohort may have been infected before the immunity from the boost was fully established, and it is thus possible that enhanced immunity from the boost, which develops over time, may more effectively prevent infection with the B.1.351 variant."

In any case - I don't mean to beat this horse to death. I appreciate your insight and positive points to help with this disappointing news.

 

[Birdie dog]

I'd also read that Pfizer did well against the SA variant. I'd have to search for the source. But, I don't every quote FB or twitter.

 

[blabadie]

Simultaneously, the Chinese vaccines are getting a lot of flak. Apparently, their published efficacy numbers don't quite match up to the real-life data.

https://www.foxnews.com/health/chinese-vaccine-effectiveness-not-high
While that doesn't affect people in North America or Europe directly, most cruise staff is sourced from the countries using (or looking to use) the Chinese vaccines - such as:

https://www.abc.net.au/news/2021-04...accines-astrazeneca-supply-problems/100057448
The cruise lines may end up sourcing their own vaccines to protect their staff. The best case scenario is that all vaccines can be reconfigured to improve their efficacy - we will need every one of them!

I'd also read that Pfizer did well against the SA variant. I'd have to search for the source. But, I don't every quote FB or twitter.

I have read similarly. My impression from all this is that Pfizer IS protective against the SA variant (although probably not as protective as against other strains---but good enough that IF someone got infected by the SA variant, it wouldn't be a severe illness).

https://medicalxpress.com/news/2021-04-pfizerbiontech-vaccine-effective-safrica-variant.html

 

[kathi]

I just want to say thank you to the doctors and scientists on this thread who keep updating the discussion. This is my "go to" place for detailed info on the vaccine studies, in language regular people can understand but that is not so dumbed down to be useless. I'm a scientist (but not THAT kind).. It' so refreshing to read through this thread and see the respect and sense of collegiality. You all have my gratitude.

 

[cgolf]

Well, I just finished my 36 hours in three days in the ER. This weekend was terrible.
We're a tourist destination in a red state. And we're overrun by people who want to be free and do what they want and not follow health guidelines. Although I'm fully vaccinated, I still wear masks and our businesses have signs saying masks are required. I picked up dinner on my way home, and of course there are the texting with no masks on people waiting to pick up their food because the rules aren't for them.
Some things I saw this weekend: we're seeing a few people with covid who have been vaccinated. At least one this weekend. That person was very old, and their chest x ray was fine. They had other complaints. Our ED head sent an email to our infectious disease doctor. To paraphrase, in the tens of thousands of vaccines we've given *we have a mass vaccination site* we've had 12 fully vaccinated people develop covid. None needed ventilation, none died. At least half of those were "very elderly* (older than 78) or immunocompromised. They're testing all of those people for variants.
We admitted a 27 year old to our ICU step down.
The 33 year old died. She claimed no health problems, but she certainly looked like she was going to die on arrival. She was transferred from our ICU to a a tertiary centre and placed on ECMO.
The husband who declined his covid vaccine (his wife was fully vaccinated) died. He was in his 50s.
We are rarely seeing sick elderly people due to them all being vaccinated. We did have one 92 year old who was covid positive- she'll probably also die. She wasn't vaccinated, but she told me "But, I don't leave my house". I told her frankly that someone in her family did her wrong and brought it to her. Our admissions to the covid unit have continued to climb and as of last evening, our ICU and ICU step-down were full and we have twice as many admitted than we had two weeks ago.
And people can't understand why businesses/countries etc aren't welcoming the unvaccinated with open arms?

Gosh. This is quite unsettling.
But at the same time, it's good news that the vaccines are doing its magic on the elderly.
I also live in a red state, also with a lot of vacationing folks, and let me tell you, very few seem to care there's a pandemic out there. Donut joints, restaurants, stores, the majority of ppl aren't wearing masks. At the main state-wide grocery store, employees don't enforce the mask rule. At least 1/4 of ppl inside aren't wearing them.
Looks like it's going to be a long year (again) due to ppl's carelessness..

Also, thank you for what you do, for your service.

Please be careful getting politics into the thread so it doesn't lock again.

As the vaccine rolls out more I think mask fatigue will creep in for everyone sadly, and I hope that doesn't put us in a bad spot as a country. Also has anyone seen the numbers on where we will vaccinate everyone that wants it? I saw 59% somewhere which is concerning because that likely wouldn't be enough for herd immunity.

 

[TestingH2O]

Also has anyone seen the numbers on where we will vaccinate everyone that wants it? I saw 59% somewhere which is concerning because that likely wouldn't be enough for herd immunity.

That's 59% of adults. Remember, children make up about 25% of the population. So long as kids can't get the vaccine, we definitely won't come close.

 

[Maggie'sMom]

As the vaccine rolls out more I think mask fatigue will creep in for everyone sadly, and I hope that doesn't put us in a bad spot as a country. Also has anyone seen the numbers on where we will vaccinate everyone that wants it? I saw 59% somewhere which is concerning because that likely wouldn't be enough for herd immunity.

I saw a poll on the news last week that indicated 70% of adults wanted to be vaccinated.

Hopefully, Pfizer will get the approval for 12-16 year olds soon.

I get my second dose of the Pfizer vaccine tomorrow and my 17yo daughter gets her second dose next week.

 

[Cheburashka]

I just don't understand why it can't be a simple opt in process. No one is REQUIRED to have a passport unless they are traveling somewhere that requires it. Well, if we see vaccinations are required to participate in certain activities, anyone should be able to choose to get one so they can participate. Just like people are not required to travel to Switzerland, a country that requires a passport, no one is required to take a cruise, a type of travel that might require a vaccine. No one's freedoms are being violated. Everyone remains free to participate in the activities that have requirements.

When you leave the country, absolutely. Within the U.S., it's another matter. That's where the federal government or state governments trying to mandate vaccination for domestic travel & activities becomes an issue in regards to citizens' rights.

 

[TestingH2O]

When you leave the country, absolutely. Within the U.S., it's another matter. That's where the federal government or state governments trying to mandate vaccination for domestic travel & activities becomes an issue in regards to citizens' rights.

How does that align with the argument that a private business can set its rules and regulations? I mean, unless someone is in a protected class, isn't the argument that a business can choose who it serves? Isn't that why cake bakers don't have to make cakes for a gay couple? The domestic travel issue I think is a foregone conclusion, but there seems to be a lot of case law that supports private businesses being able to set their own rules so long as they don't discriminate against a protected group.

 

[o&smom]

That's 59% of adults. Remember, children make up about 25% of the population. So long as kids can't get the vaccine, we definitely won't come close.

You have to also add in those who had Covid and have immunity for the total of herd immunity.

 

[cgolf]

That's 59% of adults. Remember, children make up about 25% of the population. So long as kids can't get the vaccine, we definitely won't come close.

I saw a poll on the news last week that indicated 70% of adults wanted to be vaccinated.

Hopefully, Pfizer will get the approval for 12-16 year olds soon.

I get my second dose of the Pfizer vaccine tomorrow and my 17yo daughter gets her second dose next week.

I hope it is the higher number and the polls are wrong and it is even higher than that. As has been discussed I believe herd immunity is needed to slow down the variants as well. Hoping as well that the 12-16s get rolled in and even younger. Have seen daycares have kids get sick with the UK variant.

You have to also add in those who had Covid and have immunity for the total of herd immunity.

I think that is partially true, except that I believe that some of the vaccines are more capable with the variants than the natural immunity. Still need more science to study this. They are doing the best they can, but this is an active everchanging situation and data from last week may not be relevant anymore.

 

[Maggie'sMom]

Found an NPR/Marist poll that shows the 70% number. It was conducted 3/30. Numbers are trending towards more adults deciding to get vaccinated.

http://maristpoll.marist.edu/npr-marist-poll-the-biden-administration/#sthash.O0n8pQgh.PTLdyvAo.dpbs