The Vaccine Thread

[Todd Amunrud]

Thanks Octave. I guess I was trying to generalize the idea of immune responses and the concept of “natural immunity” versus unnatural immunity(vaccination). Duly noted.

[beeatnik]

https://www.smh.com.au/world/europe/...11-p58hpe.html

London: The Delta variant of COVID-19 has wrecked any chance of herd immunity, according to the Oxford scientist who led the AstraZeneca vaccine team, as he called for an end to mass testing so Britain could start to live with the virus.

Scientists who addressed Britain’s all-party parliamentary group on coronavirus said it was time to accept that there is no way of stopping the virus spreading through the entire population, and monitoring people with mild symptoms was no longer helpful.

Professor Andrew Pollard, who led the Oxford vaccine team, said it was clear that the Delta variant can still infect people who have been vaccinated, which made herd immunity impossible to reach, even with Britain’s high uptake.

[vertical_doug]

https://www.smh.com.au/world/europe/...11-p58hpe.html

London: The Delta variant of COVID-19 has wrecked any chance of herd immunity, according to the Oxford scientist who led the AstraZeneca vaccine team, as he called for an end to mass testing so Britain could start to live with the virus.

Scientists who addressed Britain’s all-party parliamentary group on coronavirus said it was time to accept that there is no way of stopping the virus spreading through the entire population, and monitoring people with mild symptoms was no longer helpful.

Professor Andrew Pollard, who led the Oxford vaccine team, said it was clear that the Delta variant can still infect people who have been vaccinated, which made herd immunity impossible to reach, even with Britain’s high uptake.

The UK was using a NHS app for vaccinations, PCR tests etc. The app also had blue tooth enabled proximity feature which would track your contacts with other NHS app holders. If you were in a certain promixity to a person who tested positive for COVID, NHS would notify you through the app with quarantine for 10 days (The dreaded PING). It sounded like a good idea at the time, but what happened was called the pingdemic. At it's peak, over a million people per week were being pinged regardless of vaccination status. The bluetooth could go through walls and such, so if a person with covid would sit next the tube next to the drivers compartment, even though the driver was sealed in, the driver would get pinged. In mid-July, Transport for London had to modify service and cancel trains (london Overground, District, Circle, Metropolitan lines), close stations because so many workers were getting pinged. Eventually it started to impact all businesses with people interactiing with the public and started to make it impossible to run a public facing business.

The bigger problem was pinged workers were not getting ill or testing positive. (I had several people in our office get pinged, no positive tests). I think this is forcing the UK Gov to rethink the whole system. This all happened with only a portion of the UK using the NHS app. If the entire UK population had enabled the app, the PINGS would have been multiples higher. It was completely untenable.

[Chik]

Not really, the folks who don't want the vaccine don't want to be inoculated and are looking for reasons to validate their stance. The anti-vaxx folks are necessarily against the vaccine being given, it's just that they don't want one. I've lost my sympathy for folks like that, but I think they've made the emotional investment by loudly proclaiming their opposition to the vaccine and now they're a victim of their own pride. They can't get the vaccine without losing face. The only repentant people are those who refused the vaccine and are now hospitalized and heading for a ventilator. A friend who is a Anesthesiologist in NV has to tell people that it's too late for the vaccine as she prepares them for the ventilator that may or may not save their lives.

I suppose I was being charitable.

[Will Neide]

At face value, it would not be surprising if previous infection + vaccination provided a more long-lasting and robust response to future exposure than vaccination alone.

This seems very probable. You are more likely to have a cocktail of antibodies from a natural infection to target various targets on the virus, as opposed to a singular spike protein antibody produced in response from the vaccine.

This is also why it's possible to get the vaccine and still have a negative antibody titer. Some manufacturers are looking for antibodies that target other areas of the virus besides the spike protein. If using titers for any kind of interpretation, it's very important to know what's being "targeted."

Given the choice, you'd definitely want to have the vaccine first before encountering the virus. I take it as a given that COVID isn't really going anywhere for a long time, and at some point we will all encounter it. It's just a matter of preparing your body for that battle.

[jclay]

Jan 21, 2021: 21.0 k (former record)

July 31: 21.7
Aug 6: 22.8
Aug 7: 23.9
Aug 8: 28.3
Aug 9: 28.3

Mid-day yesterday the data remained as above. A few hours later I did a screen refresh to see the number of new infections for the 10th. Lo and behold a couple of values changed, thusly:
Aug 8: 21.5k
Aug 9: 19.6
Hmmm. I sent an email inquiring as to the reason. I don't expect a reply and certainly it could be a legitimate error and correction but given who the FL guv is, and given the types of peeps he appoints to the top job of various state agencies, like the Dept of Health, I'm just a tad suspicious. I don't know anything about how Florida C19 data is handled but there is little that DeSantis could do, in the way of obfuscation or outright fraud in service to his political, anti Roe v Wade & general culture war ends, that would surprise me.

And now:
Aug 10: 15.3k
Aug 11: 24.8

Data from this source: https://www.worldometers.info/coronavirus/usa/florida/

Diane Roberts sardonic latest (DeSantis merits nothing more): https://floridaphoenix.com/2021/08/0...-but-not-ours/

A question has been on my mind since seeing a "group" photo of folks at Sturgis: Once demand for C19 treatment exceeds supply, (and ignoring consideration of the danger the irresponsible demographic impose on HC workers) how do we as a society decide upon treatment priority? I'm a bit of a hard ass about that, philosophically anyway; from the Florida Phoenix: https://floridaphoenix.com/2021/08/1...he-vaccinated/

And for something a little more humane and (hopefully) constructive than my growing lack of sympathy with the anti-mask, anti-vaxer folks: https://floridaphoenix.com/2021/08/0...changed-essay/

It begins with this: "As hospitals again fill up with COVID-19 cases, the vaccinated are getting angrier at the unvaccinated. I get the anger. I also get what it feels like to be on the other side. Being an anti-vaxxer is a lot like being an evangelical Christian, and I’ve been both." As to her comment re "visibility" of the damage done by C19, she hit the nail on the head; people don't see it as they did with polio. I've felt the same way about highway accidents and deaths for decades; we're so damn efficient at cleaning up the messes that people don't grok the magnitude of destruction. Once the injured and dead are removed, just shove the mangled hardware onto the RoW for a few weeks. Maybe folks would drive with a little more consideration. Long odds but I suppose the notion, even if unrealized, makes me a token optimist?

The way I feel this morning...is it 5 O'Clock somewhere? I'm thinking it might be.

[Chik]

There is a significant level of vaccine hesitancy in Japan (one of the lowest vaccine confidence index in the world). So they're doing this:

COVID-19 "vaccine discount" for customers catches on at eateries, hotels

I hope it makes a difference.

[bigbill]

I suppose I was being charitable.

I suggest not "paraphrasing" someone's post to make a point.

[beeatnik]

Mid-day yesterday the data remained as above. A few hours later I did a screen refresh to see the number of new infections for the 10th. Lo and behold a couple of values changed, thusly:
Aug 8: 21.5k
Aug 9: 19.6
Hmmm. I sent an email inquiring as to the reason. I don't expect a reply and certainly it could be a legitimate error and correction but given who the FL guv is, and given the types of peeps he appoints to the top job of various state agencies, like the Dept of Health, I'm just a tad suspicious. I don't know anything about how Florida C19 data is handled but there is little that DeSantis could do, in the way of obfuscation or outright fraud in service to his political, anti Roe v Wade & general culture war ends, that would surprise me.

And now:
Aug 10: 15.3k
Aug 11: 24.8

Data from this source: https://www.worldometers.info/coronavirus/usa/florida/

Diane Roberts sardonic latest (DeSantis merits nothing more): https://floridaphoenix.com/2021/08/0...-but-not-ours/

Numbers, so many numbers.

aka

How bad is bad?


Los Angeles County August 11, 2020

Today, Public Health has confirmed 63 new deaths and 1,440 new cases of COVID-19. The number of new cases reported today is missing lab reports from one of the larger labs which is contributing to the lower number of new cases.

Today’s numbers do not include backlog numbers. The State indicated that a backlog of lab reports for L.A County from the State electronic laboratory system (ELR) should be reconciled this week. Data sources that track other key indicators, including hospitalizations and deaths, are not affected by this reporting issue.

There are 1,524 confirmed cases currently hospitalized and 32% of these people are confirmed cases in the ICU. Daily hospitalizations were over 2,000 patients a month ago.

http://publichealth.lacounty.gov/phc...w=25&start=301

Los Angeles County August 11, 2021

Today, Public Health confirms 28 new deaths and 3,498 new cases of COVID-19. Of the 28 new deaths reported today, six people who passed away were over the age of 80, 12 people who died were between the ages of 65 and 79, four people who died were between the ages of 50 and 64, and five people died were between the ages of 30 and 49. One death was reported by the City of Long Beach. In the past month, the County averaged around six daily deaths.

To date, Public Health identified 1,335,332 positive cases of COVID-19 across all areas of L.A. County and a total of 24,833 deaths.

There are 1,573 people with COVID-19 currently hospitalized; an increase of 331 people in one week. Last Wednesday, there were 1,242 people hospitalized with COVID-19 illness. Testing results are available for nearly 7,560,000 individuals with 16% of people testing positive. Today’s test positivity rate is 4.6%.

http://publichealth.lacounty.gov/phc....cfm?prid=3304


Israel
On Wednesday morning, the Health Ministry reported 694 people were being treated in Israeli hospitals for the virus, among them 400 in serious condition, with 64% of those patients defined as serious cases being fully vaccinated, compared with 32% who were not. Another 2% were in the process of being vaccinated, and 2% were recovered.

There were another 5,755 people diagnosed with corona, according to the ministry, down from more than 6,000 on Tuesday, with 4.59% of those screened testing positive, a slight decrease from Tuesday’s 4.84%.

The death toll stood at 6,580. Since the beginning of August, more than 100 coronavirus patients have died, almost twice as many as in July and more than 10 times as many as in June.

Later, the Health Ministry updated the dashboard showing a total of 5,802 new cases from the day before and that serious patients had climbed to 405.

“We are preparing for a significant increase in the number of severe patients,” Bennett said at a news conference. “Our goal is to double the capacity of the healthcare system.”


https://www.jpost.com/israel-news/is...meeting-676412

More numbers.

4th Wave Peak daily cases per 100k

UK: 54183 cases July 17, 81 per 100k
Israel: 7071 cases Aug 9, 79 per 100k
Los Angeles County: 4283 cases Aug 7, 43 per 100k
Florida: 24753 cases Aug 11, 115 per 100k

Testing rates high: UK, Israel
Testing rates baseline?: LA Co
Testing rates low?: Florida

Vaccination Numbers

UK
ukvax.jpeg
Israel
israelvax2.jpeg
Florida
floridavax.jpeg


miamivax.jpg
lacountyvax.jpg

Peak deaths UK 4th wave: 146 deaths Aug 9, .22 daily deaths per 100k
Peak deaths US current wave: 715 deaths Aug 9, .21 daily deaths per 100k

Peak deaths LA County current wave: 28 deaths Aug 11, .28 deaths per 100k
Peak deaths Florida current wave: 84 deaths July 29, .39 daily deaths per 100k

[beeatnik]

Israel one of the few (the only?) nations which recognizes previous infection/natural immunity as protective.

israelprev.jpeg

But also...

https://www.allisrael.com/top-israel...ical-treatment

Not long after Israel’s prime minister said that unvaccinated Israelis are firing bullets of viral variants at their fellow citizens, a top Israeli doctor caused shockwaves across the country saying that patients who are unvaccinated against COVID-19 should not expect “compassion” from medical teams.

“I’ll say what we shouldn’t say because it’s not politically correct: As we reopen the corona wards, do not expect compassion from the medical staff when you reach them unvaccinated,” Dr. Sharon Einav, director of Surgical Intensive Care at Jerusalem's Shaare Zedek Medical Center, wrote in a Facebook post on Aug. 11.

The post – received with both outrage and support from Israelis, doctors and citizens alike – went viral (no pun intended). In her statement, Einav contends that with the resurgence of COVID across Israel, “medical staff are rebelling against the very thought that they will once again have to sacrifice their lives for those who have not bothered to do the minimum for themselves and for society.”

....

While Einav and Bennett put the onus on the unvaccinated, Israel is one of the world’s most highly vaccinated nations and even emerged from heavy restrictions in June. Now, with a resurgence in the number of new cases and patients hospitalized in serious condition, Israel is experiencing a new wave of COVID.

However, hospitals are also reporting that a majority of patients in COVID wards have had at least two shots of the Pfizer mRNA injection, although some note that the rate of unvaccinated patients is higher when considering the high rate of vaccinated Israelis.

Nevertheless, several doctors took issue with their colleague.

“Today is a dark day for medicine in Israel,” Dr. Moshe Kulikovsky wrote in response to Einav’s post. “A day that will be recorded thanks to you in the history of medicine in the young state of Israel in which you won a disrespectful place.”

Dr. Amir Shahar, director of Laniado’s emergency room, said all of his patients would be received “with compassion, without prejudice, without condescension.”

“Expect that,” he wrote.

“This is how I behaved in my 43 years as a doctor, and this is how I will behave until the end of my days,” he wrote. “I chose to be a doctor, and I stuck to my oath. The rabbi who founded the Laniado Hospital ordered: ‘Take care of every opportunity to alleviate the pain and suffering of the patients’ and I add: because everyone were created B’Tselem (in the image of God).”

The initial post sent a chill among Israelis who have chosen to not be vaccinated. While Einav said it was important to highlight the suffering of hospital workers who are burnt out and “broken,” her words came as the climate is increasingly hostile toward Israelis who chose not get vaccinated.

An Israeli activist, Efrat Fenigson, said on Twitter, “The real pandemic here right now is the wild incitement of the government against unvaccinated. The new enemy of the state is this group of 3+ million people (they claim 1+ but it doesn’t add up) including children.”


israelvaxxed.jpg

[bigbill]

I live in Mohave County, AZ and we're a hotspot due to the low vaccination rates and cases occurring in children too young for vaccination. According to the county health department, over 90% of people hospitalized with Covid were not vaccinated. The predominant vaccine in this area was the Moderna followed by J&J. https://covid-19-mohave.hub.arcgis.com/

At work, we are all back in masks regardless of vaccination. This is to protect the unvaccinated workers who vehemently object to the jab. I hear rumors that the vaccinated are actually superspreaders, that just as many vaccinated people are dying, and no one understands the long-term effect of the vaccinations. The first two are outright false, the third is thought-provoking but this isn't a "brand-new" untested vaccine, it's been in development for 20 years.

In all honesty, I really don't care about the folks who refuse the vaccine other the hassle of masking up again. I just feel fortunate the my appendicitis was two weeks ago and not this week because the hospitals are beyond capacity with sick, unvaccinated people.

[beeatnik]

I hear rumors that the vaccinated are actually superspreaders, that just as many vaccinated people are dying, and no one understands the long-term effect of the vaccinations. The first two are outright false, the third is thought-provoking but this isn't a "brand-new" untested vaccine, it's been in development for 20 years.

In all honesty, I really don't care about the folks who refuse the vaccine other the hassle of masking up again. I just feel fortunate the my appendicitis was two weeks ago and not this week because the hospitals are beyond capacity with sick, unvaccinated people.

They used to call this super spreading:

https://www.cbsnews.com/news/carniva...ovid-outbreak/

As for hotspots with high vaccination, Miami has a higher case rate than Mojave, 105 per 100k versus 49 per 100k and vaccination rate of 70.8% one dose versus 39.6%.

Nealy twice the vaccination for twice the cases
miamicovidz.jpg


mohavecovidz.jpg

In terms of breakthrough infections or hospitalizations, here's what LA County is publishing:
labreakthroughs.jpg
25% of cases, but likely much, much higher.

But those are just numbers, here's the reality on the ground, testing volume as high as the horrific January surge and vaccination status not documented by many testing locations. Wife and I got tested this afternoon because she fears she has a "breakthrough" infection; she's symptomatic and spent the whole day in bed. Well, I think one would have to be delusional to think the few hundred cars I saw at the testing site were filled with unvaccinated persons.

These are concerning trends.
testing.jpg

augtesting.jpg

[fastupslowdown]

I was a bit sad to read this so soon.
---------------------
(Wall Street Journal) -- WASHINGTON -- The Biden administration is expected to announce that Americans who have been fully vaccinated against Covid-19 should receive a booster shot to ensure continued protection, according to people familiar with the discussions.
The booster shot would be administered eight months after the second shot of the vaccine was received, the people said.
Senior Biden administration health and medical officials have been discussing the possibility of calling for booster shots for weeks and are nearing agreement on the issue, said the people, who added that a final decision hasn't been made. A formal announcement could come as soon as later this week.

-Mike G

[zachateseverything]

They used to call this super spreading:

https://www.cbsnews.com/news/carniva...ovid-outbreak/

As for hotspots with high vaccination, Miami has a higher case rate than Mojave, 105 per 100k versus 49 per 100k and vaccination rate of 70.8% one dose versus 39.6%.

Nealy twice the vaccination for twice the cases
miamicovidz.jpg


mohavecovidz.jpg

In terms of breakthrough infections or hospitalizations, here's what LA County is publishing:
labreakthroughs.jpg
25% of cases, but likely much, much higher.

But those are just numbers, here's the reality on the ground, testing volume as high as the horrific January surge and vaccination status not documented by many testing locations. Wife and I got tested this afternoon because she fears she has a "breakthrough" infection; she's symptomatic and spent the whole day in bed. Well, I think one would have to be delusional to think the few hundred cars I saw at the testing site were filled with unvaccinated persons.

These are concerning trends.
testing.jpg

augtesting.jpg

Occam's razor would suggest that given Miami Dade county has a population density ~100 times higher than Mohave county it's reasonable to expect more community spread there even if the vaccination rate is much higher.

Anyway, positive tests aren't really the metric that matters. Hospitalizations and deaths are what matters and are exceedingly rare in vaccinated individuals, even if they're symptomatic.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
https://slate.com/news-and-politics/...ion-death.html

[beeatnik]

Occam's razor would suggest that given Miami Dade county has a population density ~100 times higher than Mohave county it's reasonable to expect more community spread there even if the vaccination rate is much higher.

Anyway, positive tests aren't really the metric that matters. Hospitalizations and deaths are what matters and are exceedingly rare in vaccinated individuals, even if they're symptomatic.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
https://slate.com/news-and-politics/...ion-death.html

Two questions.

Should we be seeing case rates of 100 plus per 100k in an area where 70% of the total, not just over 12, population is vaccinated?

Can we continue to expect linear outcomes (end points) from an unexpectedly dynamic vaccine? Israel data does not align with the situation in the South.

[bigbill]

Occam's razor would suggest that given Miami Dade county has a population density ~100 times higher than Mohave county it's reasonable to expect more community spread there even if the vaccination rate is much higher.

Anyway, positive tests aren't really the metric that matters. Hospitalizations and deaths are what matters and are exceedingly rare in vaccinated individuals, even if they're symptomatic.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
https://slate.com/news-and-politics/...ion-death.html

Spot on. There are only three population centers in Mohave County with the largest, Lake Havasu City having the most cases. Bullhead City has high numbers because it's connected by a bridge across the Colorado River to Laughlin, NV, a mini-Vegas. Kingman has high numbers because the regional medical center where the outlying area patients die. Mohave is the fifth largest county in the nation and has a population <250K.

Comparing a densely populated city to a mostly-rural enormous county doesn't really present useful data. I have friends working at the hospital, we made them intubation boxes to protect the folks inserting an airway, there are no vaccinated people on ventilators.

[beeatnik]

We’ve used the cases per 100k metric since the start of the pandemic. How would you normalize these two seemingly heterogeneous areas. Should Miami be reporting 1000 cases per 100k to be comparable to your 40?

Spot on. There are only three population centers in Mohave County with the largest, Lake Havasu City having the most cases. Bullhead City has high numbers because it's connected by a bridge across the Colorado River to Laughlin, NV, a mini-Vegas. Kingman has high numbers because the regional medical center where the outlying area patients die. Mohave is the fifth largest county in the nation and has a population <250K.

Comparing a densely populated city to a mostly-rural enormous county doesn't really present useful data. I have friends working at the hospital, we made them intubation boxes to protect the folks inserting an airway, there are no vaccinated people on ventilators.

[Matthew Strongin]

Spot on. There are only three population centers in Mohave County with the largest, Lake Havasu City having the most cases. Bullhead City has high numbers because it's connected by a bridge across the Colorado River to Laughlin, NV, a mini-Vegas. Kingman has high numbers because the regional medical center where the outlying area patients die. Mohave is the fifth largest county in the nation and has a population <250K.

Comparing a densely populated city to a mostly-rural enormous county doesn't really present useful data. I have friends working at the hospital, we made them intubation boxes to protect the folks inserting an airway, there are no vaccinated people on ventilators.

It's worth adding, as someone on the ground in Miami, that there are no surprises with how out of control the spread is right now. A quick 30 minute ride through the city will tell you that life here has resumed as if covid was done. No masks. No distancing. No precautions. When you account for the number that aren't fully vaccinated, the percentage of vaccinated people that won't realize the full benefits of protection (remember efficacy numbers and no one should expect 100% protection), and the constant influx of tourists here to party, the "susceptible" population is easily large enough to explain those numbers.

[thollandpe]

Should we be seeing case rates of 100 plus per 100k in an area where 70% of the total, not just over 12, population is vaccinated?

Another question: If vaccination rates are for the people who reside there, how do they apply to a place like Miami that has a very significant transient/tourist population?

[j44ke]

I was a bit sad to read this so soon.
---------------------
(Wall Street Journal) -- WASHINGTON -- The Biden administration is expected to announce that Americans who have been fully vaccinated against Covid-19 should receive a booster shot to ensure continued protection, according to people familiar with the discussions.
The booster shot would be administered eight months after the second shot of the vaccine was received, the people said.
Senior Biden administration health and medical officials have been discussing the possibility of calling for booster shots for weeks and are nearing agreement on the issue, said the people, who added that a final decision hasn't been made. A formal announcement could come as soon as later this week.

-Mike G

I’ve seen boosters in fall 2021 mentioned as part of the projected scenario almost since the beginning of vaccination effort. Right on time then. The surprise was when the Biden administration said they weren’t necessary back a month or two ago.