COVID-19 treatment and vaccine update thread

[Defiant]

New research suggests that Pfizer’s COVID-19 vaccine can protect against a mutation found in two highly contagious variants of the coronavirus.

The study is preliminary and has not yet been reviewed by experts, a key step for medical research.

https://www.today.com/health/pfizer-stu ... nt-t205341

[Defiant]

“We know that for the Moderna vaccine, giving half of the dose to people between the ages of 18 and 55, two doses, half the dose, which means exactly achieving the objective of immunizing double the number of people with the doses we have,” Slaoui said.

“We know it induces identical immune response” to the full dose, he added.

I'm confused. Are they halving the dose so that they can give people two doses where each dose is half sized? I guess that's one way of giving two "doses".

So I watched an interview where the Doctor explained the reasoning for halving the doses - that the Moderna virus has something like 3-4 times the messenger RNA than the Pfizer vaccine, which is why halving it should still work.

I'm not convinced.

[Smoove_B]

There's all kinds of great theories. However, until they're verified by scientific studies you roll out the vaccines using the schedule that was tested and approved. Full stop.

[malchior]

There's all kinds of great theories. However, until they're verified by scientific studies you roll out the vaccines using the schedule that was tested and approved. Full stop.

Seriously. It was tested for many reasons that haven't changed just for coronavirus.

[Defiant]

Agreed. But this was at least something resembling a reason for why it was suggested. (before, it looked like they were confusing it with the Oxford vaccine data or something)

[El Guapo]

There's all kinds of great theories. However, until they're verified by scientific studies you roll out the vaccines using the schedule that was tested and approved. Full stop.

Look, I just need you to tell me how I should feel about the Biden administration's decision to release all the doses. Sounds like I should be wary / skeptical?

[$iljanus]

There's all kinds of great theories. However, until they're verified by scientific studies you roll out the vaccines using the schedule that was tested and approved. Full stop.

Look, I just need you to tell me how I should feel about the Biden administration's decision to release all the doses. Sounds like I should be wary / skeptical?

If they do this you really are going to be a part of a huge clinical trial.

The Moderna vaccine having a higher concentration of mRNA could be a factor in maintaining a prolonged immune response. It could have advantages for T cell memory generation which will provide long term protection. It could bring out differences between younger people who have a better immune response and may only require one dose vs older people. You want to do this, do a controlled trial. In the meantime I want my 2 doses as studied.

Addendum: This is certainly something that should be revisited after some time as passed since by then we’ll have a large population to study.

[Smoove_B]

Look, I just need you to tell me how I should feel about the Biden administration's decision to release all the doses. Sounds like I should be wary / skeptical?

I feel like this is Biden's attempt to address the idea that there aren't enough doses being made available vs we don't have enough infrastructure in place to provide the doses that have already been distributed. If I could wave a magic wand and make 300 million doses available tomorrow, we still have an insane delivery problem.

My own state is desperately asking for volunteers now - just now - to try and fill gaps. They're asking retired medical staff to volunteer to provide vaccinations (smart) but they're not offering to vaccinate retired medical staff that would be staffing clinics (are you kidding me?) because unless they're over the age of 75, they're not in a category (retired medical) to be eligible for vaccination.

Cluster. F.

EDIT: big numbers are difficult

[LawBeefaroni]

Cluster. F.

Lack of leadership. It's not like vaccine categories are written in the state constitution or something. Identify problem, fix it. But no one has the leadership chops to make the tough (or in this case, not so tough) decisions and stick by them.

[$iljanus]

Worthwhile reading from a Science article just released addressing what kind of memory response people have 8 months after infection. Going to have to read through it. I’m curious about the age cohorts studied since there are differences in immune function depending on age.

https://science.sciencemag.org/content/ ... ce.abf4063

[stessier]

If I could wave a magic wand and make 300 doses available tomorrow, we still have an insane delivery problem.

It would be nice if you could find a few more magnitudes of them as long as we are dreaming.

[Smoove_B]

It would be nice if you could find a few more magnitudes of them as long as we are dreaming.

Brain is still faster than fingers - even after like 30+ years of typing practice.

As predicted:

https://twitter.com/jorgearangure/statu ... 2451061767

New York's strict vaccine guidelines forced one clinic to throw away vaccine doses after it couldn't find eligible people.

[LordMortis]

Brain is still faster than fingers - even after like 30+ years of typing practice.

Could be worse. Your brain and your fingers could be wandering in different directions all the while swearing they are right next to each other after 40+ years of typing.

[Anonymous Bosch]

As predicted:

https://twitter.com/jorgearangure/statu ... 2451061767

New York's strict vaccine guidelines forced one clinic to throw away vaccine doses after it couldn't find eligible people.

It strikes me that with all the states using race-based ‘equity’ metrics to distribute early COVID vaccines and threatening hefty fines for any deviations from protocol, it's about as surefire a recipe as there could possibly be to slow down the process of actually getting vaccines into arms. Because realistically, those threatened with fines of tens or hundreds of thousands of dollars will inevitably be that much more methodical and painstaking while doing their job.

[Ralph-Wiggum]

Worthwhile reading from a Science article just released addressing what kind of memory response people have 8 months after infection. Going to have to read through it. I’m curious about the age cohorts studied since there are differences in immune function depending on age.

https://science.sciencemag.org/content/ ... ce.abf4063

Just did a quick read through of this paper. As you state, it looks like some aspects of the immune response are still around at high levels 8 months from infection (they don't have data past 8 months). Interestingly, they mentioned that there's just as much heterogeneity in the immune response months after infection as there is early on; they mention as much as a 200 fold difference in immune system responses to Covid. So sounds like people whose immune systems don't mount much of a response aren't likely to "catch up" over time so to speak in their response.

[Defiant]

Only allowing a small percentage of people to get the vaccine (based on vulnerability and/or likelihood of exposure) made sense when there was only a limited amount of vaccine. Now with only a fraction of the vaccine being used, maybe they should open it up and allow everyone (or at least, a much larger group than are now eligible) that wants one to get a vaccine, but give anyone who is in one of those high vulnerability/exposure groups top priority, with the ability to immediately skip to the front of the line when they want a vaccine. Sort of like the VIP pass at Disneyland/world.

[Smoove_B]

It strikes me that with all the states using race-based ‘equity’ metrics to distribute early COVID vaccines and threatening hefty fines for any deviations from protocol, it's about as surefire a recipe as there could possibly be to slow down the process of actually getting vaccines into arms.

I mean, I'm not on the front lines giving vaccines (nor did I assist in the policy development for my state), but we're not at "race based equity metrics" at this point. Right now it's all about vaccinating a core set of people that fit in a very narrow employment and demographic window.

What should be happening is (since no one asked me) is there needs to be rolling appointments and backup notifications. If someone in 1a is scheduled for a vaccination today and they miss it, they're shuffled off to the back of the 1a line and that vaccine goes to the next 1a person that arrives that day. If they have 25 1a appointments and it's clear that 5 people have already missed their appointment, then they need to notify by telephone people on standby to come and get it. Ideally these are also people in 1a, but realistically they're is going to be so many more people in 1b, 1c and beyond that can likely show up "on call" to get these shots.

Someone tracking metrics makes sure that they're not giving out more shots to non-designated groups (%, number) than a certain agreed upon number per day/per week and they continue to rip through as many as possible.

Throwing out vaccines is beyond unacceptable.

[Daehawk]

And make appointments to get a vaccine. Just showing up does not work.

[Smoove_B]

And make appointments to get a vaccine. Just showing up does not work.

It's currently by appointment only in my state. I cannot imagine offering it any other way at this point, but if locals don't have the ability to schedule appointments in advance (online portal, phone banks, etc...) then it has to be complete chaos.

[Daehawk]

76% of COVID-19 patients who get hospitalized still have at least one symptom 6 months later, a study found


Three-quarters of hospitalized COVID-19 patients in Wuhan, China had at least one lingering symptom six months after getting sick, a new study found.

Around 63% of patients reported fatigue or muscle weakness — the most common long-term symptom.

Doctors say long-term COVID-19 cases resemble chronic fatigue syndrome, an illness that can last several years or more.

[Smoove_B]

https://twitter.com/apoorva_nyc/status/ ... 4550300676

At hospitals affiliated with NYU, Columbia, Harvard and Vanderbilt, 20- and 30-something grad students, IT and billing staff and administrators (none of whom see patients) have been vaccinated ahead of the elderly and other high-risk populations 1/x

[raydude]

Here in Northern VA, my wife is a neurology NP with a private practice not affiliated with a hospital. As such she and the doctor she works with were trying to figure out how they can determine when/where they can get a vaccine. Turns out INOVA hospital in Fairfax had a website where they could sign in, and both got their shots this evening. My wife then was asked to make an appointment for her follow-up shot, which is a couple weeks from now.

[El Guapo]

Do we have any early data / indications on whether the vaccines prevent spread as well as preventing illness? My understanding is that the jury has been out on spread, but just wondering whether there's any info at this point, or about when we might know.

[noxiousdog]

Do we have any early data / indications on whether the vaccines prevent spread as well as preventing illness? My understanding is that the jury has been out on spread, but just wondering whether there's any info at this point, or about when we might know.

No, but note that it's very rare for a vaccine not to do both. There's only 1 or 2 (I've heard both numbers) vaccines that allow for transmission after innoculation.

[Defiant]

Plans have stalled for a large study on U.S. college campuses that was intended to answer a question critical to the coronavirus pandemic response: Do the new Covid-19 vaccines stop the virus from spreading, in addition to protecting individuals from getting sick?

A network of medical researchers who have helped run federally funded studies of Covid-19 vaccines were hoping to start a clinical trial of Moderna Inc.’s shot in more than 20,000 college students in January. The study would test whether the vaccine prevented transmission of the coronavirus from person to person and whether it prevented infections that don’t trigger symptoms.

But last week, the researchers told about 20 universities that were considering participating in the study that it wouldn’t move forward yet, according to people involved in the effort. The researchers weren’t able to secure federal funding for the trial, which would have cost several hundred million dollars, and faced time constraints in getting the complex study up and running so it could yield results before students ended the spring semester, these people said.

https://www.wsj.com/articles/covid-19-v ... 1609436842

[Smoove_B]

Do we have any early data / indications on whether the vaccines prevent spread as well as preventing illness? My understanding is that the jury has been out on spread, but just wondering whether there's any info at this point, or about when we might know.

Very little info, but as more people are vaccinated, we'll get more information:

This uncertainty is a consequence of the extremely rapid vaccine development process. Normally, a vaccine trial would observe recipients of a vaccine for a longer period of time, showing not just whether they became ill, but whether they spread contagion, before a vaccine entered wide use. While it’s likely that the various coronavirus vaccine candidates provide at least some reduction in transmission, it’s simply too soon to know for sure, or to what degree.

Note:

According to the FDA, most vaccines that protect from viral illnesses also reduce viral transmission by those who are vaccinated, and there is reason for optimism that the current wave of COVID vaccines will, as well. Most notably, Moderna’s vaccine trial showed some reduction in asymptomatic infections as measured through nasal swabs, which could suggest reduced transmission after vaccination. Dr. Eric Topol of the Scripps Research Translational Institute has described those findings as inconclusive, but promising on the question of post-vaccine transmission.

The next question is will the vaccines reduce transmission for the newly discovered variants that are more easily transmitted? Again, no one knows.

This is also why (even before the variant), the post-vaccinated world isn't going to be like a light switch. We're still going to be wearing masks and ideally engaging in all the risk reducing behaviors until it's clear the vaccines are working. The bigger picture, however, is what global vaccination efforts look like. Until X% of people around the world are vaccinated, the virus will continue to represent a risk for populations that can't vaccinate (like kids) and groups that refuse.

[stessier]

Anecdotally, in the 500 person manufacturing facility where I work, it sounds like about 20% of the people are willing to get the shot. If we told them they could stop wearing masks, I wonder how high we could get that number (some of the work we do is rather like a cardio workout and doing so in N95s is extremely unpleasant).

[El Guapo]

Anecdotally, in the 500 person manufacturing facility where I work, it sounds like about 20% of the people are willing to get the shot. If we told them they could stop wearing masks, I wonder how high we could get that number (some of the work we do is rather like a cardio workout and doing so in N95s is extremely unpleasant).

Can't they just offer like a $100 bonus for getting vaccinated? Seems like it's in the best interest of the company to make sure that their workforce isn't getting sick, and I wouldn't think that it would take a ton of money to get people off the fence about vaccination.

[stessier]

Anecdotally, in the 500 person manufacturing facility where I work, it sounds like about 20% of the people are willing to get the shot. If we told them they could stop wearing masks, I wonder how high we could get that number (some of the work we do is rather like a cardio workout and doing so in N95s is extremely unpleasant).

Can't they just offer like a $100 bonus for getting vaccinated? Seems like it's in the best interest of the company to make sure that their workforce isn't getting sick, and I wouldn't think that it would take a ton of money to get people off the fence about vaccination.

You would think - but from conversations, that wouldn't even come close. Probably closer to 10x that and you'd still have hold outs thinking we were trying to kill them. The workforce is very adverse to it. We get $600/year for filling out an anonymous health survey - less than 50% of us do.

[Smoove_B]

Anecdotally, in the 500 person manufacturing facility where I work, it sounds like about 20% of the people are willing to get the shot. If we told them they could stop wearing masks, I wonder how high we could get that number (some of the work we do is rather like a cardio workout and doing so in N95s is extremely unpleasant).

Our state news organization published a primer on employers and vaccination:

Can my employer require me to be vaccinated for the coronavirus?

Yes.

The Employment Opportunity Commission (EEOC) issued guidance recently that employment law experts had been expecting. It said the Americans With Disabilities Act (ADA), which gives workers some rights when it comes to an employer requiring certain medical exams, doesn’t apply when it comes to COVID vaccines.

...

Employers have an obligation to ensure that their employees have a healthy and safe work environment...

...

Employers may require vaccines if the failure to vaccinate will result in a direct threat to other employees....

Possibly applicable:

What if my boss doesn’t require it? Can I be fired if I don’t want to work with unvaccinated coworkers?

You have options.

Ford said that COVID-19 has presented employers with many unprecedented challenges, but each worker’s case presents variables and should be handled on a case-by-case basis.

There may also be different circumstances depending on the job and the industry.

So...it depends. Add in whatever State laws you might have that could possible cover this as well. It's going to be interesting.

[Defiant]

We get $600/year for filling out an anonymous health survey

Then how do they know who to send the $600 to?

[stessier]

Anecdotally, in the 500 person manufacturing facility where I work, it sounds like about 20% of the people are willing to get the shot. If we told them they could stop wearing masks, I wonder how high we could get that number (some of the work we do is rather like a cardio workout and doing so in N95s is extremely unpleasant).

Our state news organization published a primer on employers and vaccination:

Can my employer require me to be vaccinated for the coronavirus?

Yes.

The Employment Opportunity Commission (EEOC) issued guidance recently that employment law experts had been expecting. It said the Americans With Disabilities Act (ADA), which gives workers some rights when it comes to an employer requiring certain medical exams, doesn’t apply when it comes to COVID vaccines.

...

Employers have an obligation to ensure that their employees have a healthy and safe work environment...

...

Employers may require vaccines if the failure to vaccinate will result in a direct threat to other employees....

Even if the company had the legal right to force the vaccine, I really doubt they would. It's not the culture.

[Smoove_B]

Even if the company had the legal right to force the vaccine, I really doubt they would. It's not the culture.

That's why I included the next part for you.

I think it's going to be interesting because there's going to be scenarios where people get sick in the workplace over someone's refusal to get a vaccine - it's just a matter of time. How that ultimately ends up likely depends on how sick that person gets and whether or not there's chronic conditions or worse associated with that exposure. I'm guessing it won't be the companies that ultimately make the decision, but their insurance carriers. Those that don't have vaccination requirements will likely (and rightfully) end up paying higher premiums to cover events that could have been prevented.

[Skinypupy]

A third Dem has tested positive after being locked in a room with the GOP members who refused to wear masks.

https://twitter.com/mkraju/status/1349028322085384193

A third Dem tests positive and blames maskless Rs. “I am now in strict isolation, worried that I have risked my wife’s health and angry at the selfishness and arrogance of the anti-maskers who put their own contempt and disregard for decency ahead of the health” of colleagues

Fuck this death cult.

[Smoove_B]

In case you all need something to read/share/post : Why you should still wear a mask and avoid crowds after getting the COVID-19 vaccine:

In the short run, it will take some time for the vaccine's effectiveness to build up. (Effectiveness is defined as not getting sick with COVID-19. If 100 vaccinated people are exposed to a virus, and 50 of them subsequently develop symptoms, that vaccine is 50% effective.)

With the Pfizer vaccine, a study published in the New England Journal of Medicine in December found that protection doesn't start until 12 days after the first shot, and reaches 52% effectiveness a few weeks later. A week after the second vaccination, the effectiveness rate hits 95%. In its application for authorization, Moderna reported a protection rate of 51% two weeks after the first immunization, and 94% two weeks after the second dose."

"That's not 100%," says Paul Offit, director of the Vaccine Education Center and a member of the FDA's vaccine advisory board. "That means one out of every 20 people who get this vaccine could still get moderate to severe infection."

So how will we get an answer to whether vaccinated people can infect others?

If someone is found to be shedding virus, then researchers will check to see if that virus is capable of reproducing itself, and if it is, whether there's enough to infect other people. That raises another unknown: It's not yet clear what an infectious dose would be.

Nailing down the answers to all these questions is a laborious process. And no one is saying yet how soon the results of these sorts of studies of the Pfizer or Moderna vaccines will be available.

There are other ways to get at the answer. The COVID-19 Prevention Network has proposed an experimental study that would involve vaccinating more than 20,000 college students with Moderna's vaccine, checking them multiple times per week for virus shedding, and doing contact tracing when infections occurred. The trial, which would cost several hundred million dollars, has so far been turned down by federal funders.

[LordMortis]

A week after the second vaccination, the effectiveness rate hits 95%.

I was thinking 2 weeks after the 2nd vaccination I would be willing to be around people willing to be around me maskless but generally wear a mask in public. I don't see me leaving the house to be around people until I'm comfortable being around them without a mask. My thinking was based on Internet reading from around the time Pfizer began promoting their release. Until I talk to a health care person spiking me, that's the guidance I will keep built in my head.

Also I won't do this forever and I can only imagine I'm more patient than the average person. A year is a lot of time to give up and we're already approaching giving up a year of our lives.

[hitbyambulance]

Also I won't do this forever and I can only imagine I'm more patient than the average person. A year is a lot of time to give up and we're already approaching giving up a year of our lives.

i wonder what the average X months/years is for an average person is just going to try to go back to 'normal' things in their life because THEY JUST CAN'T TAKE IT ANYMORE, heedless of the self risk of infection (excluding the average Trumpist, where X = 0 minutes)

[paulbaxter]

I would totally volunteer some free time to give injections just in exchange for being able to get one myself. I'm a nurse who works only over the phone, so I'm not frontline, and thus not eligible to get vaccinated yet. I'm surprised I haven't found anyone in my area looking for part time/per diem folks to administer. CVS seems to think they are going to hire a bunch of full time nurses to do this, but I don't know where they are going to find them.

[Daehawk]

News says you can be a carrier even with both vaccine doses.

[Smoove_B]

J&J vaccine could be game changer:

The two vaccines available now — one by Pfizer and another by Moderna — require two doses: a priming shot and then a booster three or four weeks later, depending on which company’s injection you get.

But another vaccine on the horizon — developed by Johnson & Johnson — would require only a single dose.

...

The vaccine is still in development, but the New Brunswick-based company is expected to release the findings of its Phase 3 clinical trial — known as “Ensemble” — later this month, the company says.

“We hope to have that information very soon,” Johnson & Johnson CEO Alex Gorsky said Monday at J.P. Morgan’s annual health care conference.

The company aims to meet the necessary benchmarks by as early as Jan. 21, according to reports. Johnson & Johnson did not respond to a request for comment regarding its timeline.

Even better:

Like Oxford/AstraZeneca, Johnson & Johnson’s vaccine also doesn’t require ultra-cold storage like Pfizer’s version does.

“The vaccine technology we’ve used can remain stable for two years at -4° F, and at least three months at 35 [to] 46° F, which is about the temperature of your home refrigerator,” Mammen said in the statement.

Many experts believe vaccines like the Johnson & Johnson and AstraZeneca doses can be more rapidly scaled up and more easily delivered, as they don’t require special freezers.

As great as it would be here in the U.S. right now, it likely has more significance for other parts of the globe in terms of delivery.