COVID-19 treatment and vaccine update thread

[El Guapo]

Regarding boosters:

Fauci also noted the need for a COVID-19 booster shot within a year or so after getting the primary shot.

"I think we will almost certainly require a booster sometime within a year or so after getting the primary because the durability protection against coronavirus is generally not lifelong similar to measles," he said.

On boosters...doesn't that have big implications for mask guidance? A booster being necessary implies that vaccine protection will fade at some undetermined amount of time. So at some point after you are fully vaccinated but before you get a booster, shouldn't you be wearing a mask essentially as if you were unvaccinated? Like if you're getting a booster after 365 days, I would assume on day 364 you should be masked.

I suppose I assume if they're saying get a booster within a year, that they're estimating that the protection won't fade until significantly after a year. But I'm also assuming that there's a lot of uncertainty in that.

[LordMortis]

So at some point after you are fully vaccinated but before you get a booster, shouldn't you be wearing a mask essentially as if you were unvaccinated?

I'm not following. Isn't getting a booster in a timely fashion precisely so you mitigate against the need for additional hygiene, so you don't transition back toward being unvaccinated? That's kinda the whole premise behind modern medicine. Keeping you at a level where you aren't prone to negative factor x and why i, in specific, am on so many maintenance drugs.

[Unagi]

I’m not following either.

If you would need to wear that mask on day 364 (ie. you’ve lost the protection of your vaccination), then they would probably have told you to get a booster on day 363. (Or more like day 350...)

Right ?

[ImLawBoy]

I think the point he's getting at is that protection obviously fades at some point, thus requiring a booster. Does it fade enough at the one year mark that you're not optimally protected at day 364? Or is a booster at day 365 enough to keep you at optimal levels of protection - does the booster come in before the protection is materially reduced.

[El Guapo]

I’m not following either.

If you would need to wear that mask on day 364 (ie. you’ve lost the protection of your vaccination), then they would probably have told you to get a booster on day 363. (Or more like day 350...)

Right ?

My point is, the coalescing around the conclusion that boosters will be needed indicates that there is widespread belief at this point that vaccination protection will fade over time. Such that as time goes on a vaccinated person will become at greater risk of infection, hospitalization, and death.

Now the current CDC guidance is that fully vaccinated people don't need to wear masks. But if the above is true, at some point a fully vaccinated person should wear a mask, right? That could be a long time (two years, three years or more), but it wouldn't be never, right? And while I'm sure that they would time the boosters to come before they expect them to be needed, there's so much uncertainty here that they could be wrong and boosters could matter sooner than they think, right? Or there could be significant variation between individuals (or between different vaccines), such that some individuals might become vulnerable at six months, others at two years, etc.

[Anonymous Bosch]

Taiwan's number of cases over the last 5 days have doubled their total of the last 14 months. In fairness, they had an incredibly low number of cases (compared to the US) - but still, something's up over there. They are up to 2533 cases total.

Realistically, this likely has something to do with it…

Taiwan vaccination rate surges dramatically

Just over 0.5% of Taiwanese vaccinated but fears of community transmission means more people now want jab

TAIPEI (Taiwan News) — A total of 129,669 people in Taiwan have been given at least one dose of a COVID-19 vaccine as of Thursday (May 13), accounting for just 0.55 percent of the population, according to the Taiwan Centers for Disease Control (CDC).

Taiwan received an initial batch of 117,000 doses of the Oxford-AstraZeneca vaccine in early March. Uptake had been slow due to the low number of COVID-19 cases and people deciding to see first what the side effects are for those who did get inoculated.

After Tuesday (May 11), Minister of Health and Welfare and CECC head Chen Shih-chung (陳時中) announced Taiwan had "entered community transmission." This prompted locals to immediately book a shot, and the surge in demand has resulted in vaccinations being fully booked till the end of May, CNA reported.

On Tuesday, more than 10,000 people were given shots. The single-day record of 16,180 jabs was the following day.

Two AstraZeneca doses must be given four to 12 weeks apart for full immunity. AstraZeneca claims an average "vaccine efficacy of 76 percent after a first dose, with protection maintained to the second dose. With an inter-dose interval of 12 weeks or more, vaccine efficacy increased to 82 percent."

To achieve herd immunity, over 70 percent of the population should be vaccinated, according to Taiwan Factchecker Center (TFC). This is the point at which there’s little opportunity for the disease to spread.

[stessier]

I’m not following either.

If you would need to wear that mask on day 364 (ie. you’ve lost the protection of your vaccination), then they would probably have told you to get a booster on day 363. (Or more like day 350...)

Right ?

My point is, the coalescing around the conclusion that boosters will be needed indicates that there is widespread belief at this point that vaccination protection will fade over time. Such that as time goes on a vaccinated person will become at greater risk of infection, hospitalization, and death.

Now the current CDC guidance is that fully vaccinated people don't need to wear masks. But if the above is true, at some point a fully vaccinated person should wear a mask, right? That could be a long time (two years, three years or more), but it wouldn't be never, right? And while I'm sure that they would time the boosters to come before they expect them to be needed, there's so much uncertainty here that they could be wrong and boosters could matter sooner than they think, right? Or there could be significant variation between individuals (or between different vaccines), such that some individuals might become vulnerable at six months, others at two years, etc.

So the answer is yes to all of it - but we also won't know until we go through it. Which isn't terribly helpful. We'll just have to trust that the boosters come out in time until there is evidence to the contrary.

[stessier]

Taiwan's number of cases over the last 5 days have doubled their total of the last 14 months. In fairness, they had an incredibly low number of cases (compared to the US) - but still, something's up over there. They are up to 2533 cases total.

Realistically, this likely has something to do with it…

Taiwan vaccination rate surges dramatically

Just over 0.5% of Taiwanese vaccinated but fears of community transmission means more people now want jab

TAIPEI (Taiwan News) — A total of 129,669 people in Taiwan have been given at least one dose of a COVID-19 vaccine as of Thursday (May 13), accounting for just 0.55 percent of the population, according to the Taiwan Centers for Disease Control (CDC).

Taiwan received an initial batch of 117,000 doses of the Oxford-AstraZeneca vaccine in early March. Uptake had been slow due to the low number of COVID-19 cases and people deciding to see first what the side effects are for those who did get inoculated.

After Tuesday (May 11), Minister of Health and Welfare and CECC head Chen Shih-chung (陳時中) announced Taiwan had "entered community transmission." This prompted locals to immediately book a shot, and the surge in demand has resulted in vaccinations being fully booked till the end of May, CNA reported.

On Tuesday, more than 10,000 people were given shots. The single-day record of 16,180 jabs was the following day.

Two AstraZeneca doses must be given four to 12 weeks apart for full immunity. AstraZeneca claims an average "vaccine efficacy of 76 percent after a first dose, with protection maintained to the second dose. With an inter-dose interval of 12 weeks or more, vaccine efficacy increased to 82 percent."

To achieve herd immunity, over 70 percent of the population should be vaccinated, according to Taiwan Factchecker Center (TFC). This is the point at which there’s little opportunity for the disease to spread.

Yeah, I did more reading and that is part. The other part is the way they were controlling it without the vaccine was strict border control, quarantining, and contract tracing . Being a tiny island, it worked quite well. And then someone got through undetected. Now there is a problem.

[LordMortis]

I would have to rely on the the developers and auditors of the vaccination to err on the side of caution. That's what we do. I'm on several maintenance meds and for all of them I have to rely on the system that released them and the doctors that trust the system enough to prescribe them to me. I mean either we trust the system or we don't, with the third option being getting the actual expertise necessary to know. That's beyond me, so that's right out.

Edit: or what Stess said. (and this is continuing El Guapo's concerns)

[El Guapo]

I’m not following either.

If you would need to wear that mask on day 364 (ie. you’ve lost the protection of your vaccination), then they would probably have told you to get a booster on day 363. (Or more like day 350...)

Right ?

My point is, the coalescing around the conclusion that boosters will be needed indicates that there is widespread belief at this point that vaccination protection will fade over time. Such that as time goes on a vaccinated person will become at greater risk of infection, hospitalization, and death.

Now the current CDC guidance is that fully vaccinated people don't need to wear masks. But if the above is true, at some point a fully vaccinated person should wear a mask, right? That could be a long time (two years, three years or more), but it wouldn't be never, right? And while I'm sure that they would time the boosters to come before they expect them to be needed, there's so much uncertainty here that they could be wrong and boosters could matter sooner than they think, right? Or there could be significant variation between individuals (or between different vaccines), such that some individuals might become vulnerable at six months, others at two years, etc.

So the answer is yes to all of it - but we also won't know until we go through it. Which isn't terribly helpful. We'll just have to trust that the boosters come out in time until there is evidence to the contrary.

I do take some comfort by places like Israel being so far ahead of us in vaccinations, such that presumably they'll go through the kinks of this first and we'll get to learn from their experiences.

[Smoove_B]

So the answer is yes to all of it - but we also won't know until we go through it. Which isn't terribly helpful. We'll just have to trust that the boosters come out in time until there is evidence to the contrary.

Yeah, as I've said before the experiment continues. We know now that the vaccines reduce viral load in people that have been vaccinated, making it unlikely for them to transmit the virus to others. However, I think they need to continue to monitor that and see what happens after 6, 8, 10+ months of post vaccination. Is protection from illness still strong? Is the ability to inhibit colonization in the throat/nose still present (minimizing spread)?

As strange as it sounds, we still need to do more testing. However, instead of testing to control outbreaks we should be testing the population at large to see if there are asymptomatic cases circulating at low levels among communities of people that are vaccinating. Until we can get an idea of how much the virus is still out there meandering around, I still think we're still doing too much guessing. I haven't seen anything (yet) suggesting sentinel surveillance of vaccinated populations is happening, but maybe someone is doing a study somewhere.

In terms of staying on top of what's happening, there are a few different measures to watch, but here's a good site that should help as they're doing all the heavy lifting by combing three different useful metrics into their "risk score" for any given area.

If only there was some national public health based organization that could have used similar quantitative guidelines to help communities figure out what made the most sense for them in terms of masking and other pandemic policies.

[stessier]

Good news on the storage of the Pfizer vaccine- it can last in a normal fridge up to a month!

The US Food and Drug Administration on Wednesday announced a big change in the way doses of Pfizer-BioNTech’s COVID-19 vaccine can be handled. From now on, undiluted vials of the mRNA vaccine can stay at normal refrigerator temperatures for up to a month rather than the previous limit of just five days.

The change has the potential to significantly ease storage issues and promote the use of the highly effective vaccine, which has been hindered in some settings by its ultra-cold storage requirements.

For long-term storage, the vaccine still requires ultra-cold freezer temperatures—between -80°C to -60°C (-112°F to -76°F). But the vials can be transported and temporarily stored at normal freezer temperatures—between -25°C to -15°C (-13°F to 5°F)—for up to two weeks. According to yesterday’s update, the undiluted vials can then be thawed and kept at normal refrigerator temperatures—between 2°C to 8°C (35°F to 46°F)—for up to a month. Once the vials are diluted and ready for use, they must be used within six hours, according to the FDA’s detailed handling guide.

[dbt1949]

I found it interesting the other day when our governor said that one of the reasons we have a lower vaccination percentage is because of all the conspiracy nuts we have in this state.
Can you say Trump supporters?

[Jaymon]

Ive got both my shots now. Pfizer. the first one gave me flu symptoms for about 12 hours. The second was milder, some joint soreness and nausea, but not as long or as bad. Mrs Jaymon got the oneshot J&J and didn't really notice anything.

[Blackhawk]

Two shots plus two weeks. I'm now

Spoiler:

[El Guapo]

My wife is hitting Immunity Day tomorrow. Hopefully my soon to be 12 YO daughter can get her shots starting in late July, and then my 8 YO son can get them in September or so.

[Daehawk]

My wife is hitting Immunity Day tomorrow. Hopefully my soon to be 12 YO daughter can get her shots starting in late July, and then my 8 YO son can get them in September or so.

Same here. Tomorrow marks exactly 2 weeks since my 2nd shot.

[jztemple2]

My wife is hitting Immunity Day tomorrow. Hopefully my soon to be 12 YO daughter can get her shots starting in late July, and then my 8 YO son can get them in September or so.

Same here. Tomorrow marks exactly 2 weeks since my 2nd shot.

Weirdly my wife went for a mammogram and a bone density test and they had to verify that she was four weeks beyond her last shot of Moderna.

[gilraen]

Weirdly my wife went for a mammogram and a bone density test and they had to verify that she was four weeks beyond her last shot of Moderna.

The vaccine can cause swollen lymph nodes, which can screw up the mammogram interpretation. There's a number of diagnostic tests that are supposed to wait at least 4 weeks after the mRNA vaccine (for example, it can interfere with the reading of a TB skin test).

[jztemple2]

Weirdly my wife went for a mammogram and a bone density test and they had to verify that she was four weeks beyond her last shot of Moderna.

The vaccine can cause swollen lymph nodes, which can screw up the mammogram interpretation. There's a number of diagnostic tests that are supposed to wait at least 4 weeks after the mRNA vaccine (for example, it can interfere with the reading of a TB skin test).

Thanks for the info! OO folks are the smartest folks. Or at least the best looking

[Jeff V]

. Or at least the best looking

Hey hey HEY! Her husband is here too, you know! Knock off with the flirting!

[hitbyambulance]

to mark my two weeks post-vax tomorrow, i ate INSIDE a restaurant in Minneapolis today. that felt really strange. (tables were well spaced and facial coverings were worn when not at the table and, well... not many people were in there)

[Smoove_B]

Dupe

[Smoove_B]

https://twitter.com/EricTopol/status/13 ... 5134774278

Today, 162 days after the 1st dose was administered, and >287 million shots, the majority of Americans are vaccinated (≥1)

Enjoy that news and try not to dig into the demographic information regarding who's been vaccinated as it will spiral you into frustration and depression.

[LawBeefaroni]

Low hanging fruit is off the board. Now the real work begins....

[Ralph-Wiggum]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

[El Guapo]

United Airlines is giving away free tickets via lottery to vaccinated customers.

Seems like good news. Honestly since a lot of red states are going to make 'vaccination passports' difficult, giving away stuff via voluntary lottery seems like one of the best tools available to increase vaccination rates among hesitant folk.

[Zaxxon]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

[Lorini]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

One dose helps, and I thought I read where Pfizer thinks one dose may be all you need of its vaccine, so I don't mind them using percentages of people who got one dose. From what I can see, if 90% of the people only got one dose we'd be fine.

[Blackhawk]

Tomorrow I'm planning my first 'browsing' trip in a year plus. That means just going to stores of interest and walking the aisles, collecting ideas and familiarizing myself with the contents (invaluable information when you have non-mainstream hobbies and just need 'a round thing, about so tall' and need to find one.) I'm past my two-plus-two-weeks, but I will still be wearing a mask.

Although... honesty time. I was a Menards (a big hardware store) yesterday. The place was probably two square blocks, and the ceilings high enough to fly kites in. I saw three people in the entire store. I kept my mask on, but if I were in the same situation again, I'd probably take it off, at least until I got to the cashier.

[Zaxxon]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

One dose helps, and I thought I read where Pfizer thinks one dose may be all you need of its vaccine, so I don't mind them using percentages of people who got one dose. From what I can see, if 90% of the people only got one dose we'd be fine.

It's not so much the one dose vs 2, as the '% of eligible population,' since the 'eligible' part isn't something the virus takes into account.

[El Guapo]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

One dose helps, and I thought I read where Pfizer thinks one dose may be all you need of its vaccine, so I don't mind them using percentages of people who got one dose. From what I can see, if 90% of the people only got one dose we'd be fine.

It's not so much the one dose vs 2, as the '% of eligible population,' since the 'eligible' part isn't something the virus takes into account.

Very rude of the virus, IMO.

[Kraken]

When I had a couple of skin lesions removed today, I reminded my doc that I'm fully vaxxed and he invited me to unmask. I asked him if he has many patients who aren't vaccinated. Some, he said. More than he'd like. Some can't be, for one reason or another. Some are taking a wait-and-see attitude. And some just flat-out refuse and won't discuss it. I asked him if he knows who is and who isn't. If they were vaxxed by the state, or by CVS, or by Walgreens, he gets that info. Otherwise, it's the honor system.

That must be really frustrating.

[Zaxxon]

Went to the bike shop today to pick up my new bike, and for the first time saw a 'you must be masked or vaxxed' sign. Great sentiment, but I guess this is the practical outcome of our new honor system.

FWIW, I'm vaxxed but I still masked.

[Daehawk]

[Max Peck]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

One dose helps, and I thought I read where Pfizer thinks one dose may be all you need of its vaccine, so I don't mind them using percentages of people who got one dose. From what I can see, if 90% of the people only got one dose we'd be fine.

I don't know if Pfizer has said anything like that (particularly since they'd prefer to sell you 2 doses a head rather than 1), but the studies underlying the Canadian decision to delay the 2nd dose indicated that by the time that the 2nd dose would normally be administered, both the Pfizer/BioNTech and Moderna vaccines have an efficacy of 92% from the first dose alone. However, the last I heard it is not yet known just how long they will remain effective without the second dose.

[Lorini]

Isn't that 50% a bit better than it sounds since a sizable proportion of the population is either not eligible (e.g. >12) or just recently became eligible?

Agree. I am glad to see someone referring to the % of the entire population (which is the % that actually matters) rather than the somewhat misleading '% of eligible people who have received at least 1 dose'. The latter makes for good political messaging but the former is more useful IMO.

One dose helps, and I thought I read where Pfizer thinks one dose may be all you need of its vaccine, so I don't mind them using percentages of people who got one dose. From what I can see, if 90% of the people only got one dose we'd be fine.

I don't know if Pfizer has said anything like that (particularly since they'd prefer to sell you 2 doses a head rather than 1), but the studies underlying the Canadian decision to delay the 2nd dose indicated that by the time that the 2nd dose would normally be administered, both the Pfizer/BioNTech and Moderna vaccines have an efficacy of 92% from the first dose alone. However, the last I heard it is not yet known just how long they will remain effective without the second dose.

https://www.cnbc.com/2021/03/29/cdc-stu ... ctive.html And for the US, the US already bought (under the previous administration) all the doses we'd need for two doses a person so they don't see any extra money from us. There was a question of two dose efficacy at first, so the information in the link is newish.

[Max Peck]

That was intended as a throw-away joke. In actual fact, Pfizer can sell every single dose they're capable of producing for the foreseeable future, regardless of whether the customers use 1 or 2 doses per person. However, given the information in the link you provided, it seems that the responsible course of action will be to continue with the 2-dose regimen.

However, he said he worries that people will now think one dose of the vaccines is “good enough” and won’t return for a second shot. He said studies have shown immunity appears to be actually more “durable” after the second dose, meaning protection may last longer.

“The reason that they are two-dose vaccines is that the second doses give you a titer of neutralizing antibodies, virus-specific neutralizing antibodies that is almost 10 growth fold greater than after the first dose,” he told CNBC. Neutralizing antibodies play an important role in defending cells against the virus.

Secondly, and more importantly, scientists also detected so-called T cells, another important part of the immune response that usually provides longer-lasting immunity, he said.

[Sudy]

Finally got my first dose booked for Thursday. The province only opened it up to my age bracket a week ago, though I probably could have snuck in under a high-risk health condition earlier. Annoyingly, I'd passed on other options in the past week as I didn't understand how to book locally. There's a provincial booking option, a municipal one, and a third option to go through pharmacies. The one I needed was the one I didn't know existed until just now. It's hard to blame anyone since this has been such a chaotic process, and more options are obviously better. But considering there are people out there who are actually lazier than me (shocking) or have more limited transportation, it's frustrating.

[Zaxxon]

Colorado's joining the sweepstakes program. Not sure whether this is the same way that Ohio and other states did it (I think it is), but they are incentivizing earlier vaccinations by including people in every drawing after their shot(s)--so if you are jabbed by 6/1 you're in all 5 drawings, by 6/8 you're in 4, etc.