How Is Covid-19 Impacting Life in Your City?

[SteveD]

Originally Posted by the urban politician

^ I’m sorry to hear that. Nothing unreasonable about what you’re doing.

I have never had a patient experience what you are experiencing, though

That doesn't surprise me. My Doc said he hadn't heard about it and recommended that I proceed with the second shot. Based on my perception of the tone of his response, I ignored him. It came across as dismissive to me. This was a message exchange between the two of us on the practice's patient portal.

[woodrow]

Originally Posted by the urban politician

Yes. I talk to them every day. But I’m in a unique position being a healthcare professional and interacting with people face to face of varying backgrounds every day (I don’t WFH and associate with the same 5 people daily, which if you ask me only amplifies the irrational fear and ignorance out there)

Meeting people. Different people. Strangers. Every day. Who’d a thought that doing such a thing would be such a rare privilege? It’s become one now, and I feel blessed.

Anyhow, I regularly meet people who are scared of the vaccine, even though I strongly urge them to get it. Fear is a very powerful thing, it overrides pretty much every other sensibility—rational or not—that we have. Look at Pedestrian

What angle do you take with your patients? I mean, I haven't run into ANYONE who is against it. But I am bound to, and maybe (probably) even someone I know. I think I have all the facts at hand, but am curious if you might have good talking points, medical or otherwise.

[the urban politician]

Originally Posted by woodrow

What angle do you take with your patients? I mean, I haven't run into ANYONE who is against it. But I am bound to, and maybe (probably) even someone I know. I think I have all the facts at hand, but am curious if you might have good talking points, medical or otherwise.

I tell them that it is very important to get vaccinated, that the risk of anything bad happening is close to zero, that it will help us end the pandemic, and that the shot is basically free immunity.

It sways some people but not many of them.

Fear is the most stubborn emotion out there. Trust me.

That is why, this far into the pandemic and knowing what we know, we still can’t get our lives back to normal. Its the fear

[10023]

I have met more young people that are at least skeptical (if not afraid) of the vaccine than young people who are scared of Covid. And that’s probably justified. Covid is very rarely a problem for young, healthy people but mRNA vaccines are a brand new technology and no long-term studies of their effects exist.

Most people I know are just getting the vaccine out of worry that it will be a prerequisite to do the things they want to do. I’m only getting it so that I can travel freely in Europe.

[SteveD]

Originally Posted by 10023

I have met more young people that are at least skeptical (if not afraid) of the vaccine than young people who are scared of Covid. And that’s probably justified. Covid is very rarely a problem for young, healthy people but mRNA vaccines are a brand new technology and no long-term studies of their effects exist.

Most people I know are just getting the vaccine out of worry that it will be a prerequisite to do the things they want to do. I’m only getting it so that I can travel freely in Europe.

I'm very worried about that. I wonder how many people there are going to be such as myself who get the first shot but not the second one (for vaccines that have a two dose regimen). I have to travel for work.

[iheartthed]

Originally Posted by woodrow

Does anyone personally know anyone with vaccine hesitancy? I might have a cousin or two I haven't talked to in years, but I don't have a single close family member, friend, dentist, hair dresser, barista, etc. who either hasn't gotten the shot or is anxiously waiting to get one. I am curious if anyone has friends, family, colleagues, etc. who are not planning on getting a shot and if so are you going to encourage them to change their? More vaccinations, less variants.

There doesn't seem to be much trouble convincing people of any age in NY to get it. That might be because so many of us know people who got very ill from it last year. From social media posts, it seems like there is much more skepticism of the vaccine in Michigan. Of my network there, it looks like about half were eager to rush and get vaccinated when eligible, and half were either apathetic or outright skeptical.

[SIGSEGV]

Originally Posted by woodrow

Does anyone personally know anyone with vaccine hesitancy? I might have a cousin or two I haven't talked to in years, but I don't have a single close family member, friend, dentist, hair dresser, barista, etc. who either hasn't gotten the shot or is anxiously waiting to get one. I am curious if anyone has friends, family, colleagues, etc. who are not planning on getting a shot and if so are you going to encourage them to change their? More vaccinations, less variants.

yes, my sister-in-law's husband and his family. I think they finally stopped believing that it's a secret Bill Gates microchip, but they still don't want it.

[woodrow]

Originally Posted by 10023

I have met more young people that are at least skeptical (if not afraid) of the vaccine than young people who are scared of Covid. And that’s probably justified. Covid is very rarely a problem for young, healthy people but mRNA vaccines are a brand new technology and no long-term studies of their effects exist.

I get that, but as a 56 year old I have more concerns (not fear) about Covid than about new pharma technology. But then mRNA has been in development for over a decade. To those concerned about it being new, so was the smallpox vaccine, the measles vaccine, and of course, the Polio vaccine. Got to start somewhere.

[JManc]

Originally Posted by 10023

I have met more young people that are at least skeptical (if not afraid) of the vaccine than young people who are scared of Covid. And that’s probably justified. Covid is very rarely a problem for young, healthy people but mRNA vaccines are a brand new technology and no long-term studies of their effects exist.

Most people I know are just getting the vaccine out of worry that it will be a prerequisite to do the things they want to do. I’m only getting it so that I can travel freely in Europe.

I think that is a pretty common sentiment among younger people in general. I never bothered with a flu shot until I was 45 because I always thought my odds of getting really sick were low while the shot itself could give me flu like symptoms.

[woodrow]

Originally Posted by JManc

I think that is a pretty common sentiment among younger people in general. I never bothered with a flu shot until I was 45 because I always thought my odds of getting really sick were low while the shot itself could give me flu like symptoms.

Same on flu shot, waited until I was 50. Even then, it was partially because my mom and my husband (and my doctor) kept haranguing me about it. And I considered how my getting the shot might keep another person from getting the flu. No hesitation with Shingrix; I had a friend who had terrible shingles so I was happy to get that shot. Side effects sucked. I am expecting my second Moderna is going to have bad side effects.

I just want more people to get the vaccine so we can open up more.

[iheartthed]

Originally Posted by JManc

I think that is a pretty common sentiment among younger people in general. I never bothered with a flu shot until I was 45 because I always thought my odds of getting really sick were low while the shot itself could give me flu like symptoms.

I got flu shots just about every year in middle and high school, but only because my parents were required to be vaccinated for work. I haven't gotten a flu shot since college, but I got the flu a couple of years ago and it was no fun at all. If it were more convenient to get the shot, I would do it every year without question.

[homebucket]

Originally Posted by SIGSEGV

yes, my sister-in-law's husband and his family. I think they finally stopped believing that it's a secret Bill Gates microchip, but they still don't want it.

Might be a dumb question but since you’re a physicist by trade, is it even theoretically possible to implant a chip into someone via a vehicle like a clear, colorless solution injected intramuscularly? I know things like valves and sensors can be implanted through major arteries and veins but you can actually see those with your naked eye.

[sopas ej]

Originally Posted by iheartthed

I got flu shots just about every year in middle and high school, but only because my parents were required to be vaccinated for work. I haven't gotten a flu shot since college, but I got the flu a couple of years ago and it was no fun at all. If it were more convenient to get the shot, I would do it every year without question.

I've been getting flu shots every year since I was 40, because it *is* convenient, at least for me---that was the age I started working for my current employer, who offered free flu shots via Rite Aid; a nurse and pharmacist would show up to my work, and anyone who wanted a flu shot could get one. But then 3 years ago, our stupid CEO/owner didn't want to sign the waiver that said Rite Aid wouldn't be responsible for anyone who might have a bad reaction from the flu shot, so those free flu shot clinics in the break room stopped. But I still go to Rite Aid to get my free flu shot (they accept my health insurance); you don't even need to make an appointment. I could also make an appointment at my doctor's office, but I find that to be more of a hassle.

[the urban politician]

Frequent vaccination secures a robust immune system, and it is even believed that vaccination confers protection against viruses OTHER than what the vaccine is for, by way of stimulating the T Cell system.

I view vaccination as training. If you want to win, you gotta train your soldiers

[10023]

Originally Posted by woodrow

I get that, but as a 56 year old I have more concerns (not fear) about Covid than about new pharma technology. But then mRNA has been in development for over a decade. To those concerned about it being new, so was the smallpox vaccine, the measles vaccine, and of course, the Polio vaccine. Got to start somewhere.

Right, but you are not a young person and so the calculus is obviously different.

And mRNA is new in a different way. It’s essentially a gene editing technology. Most of those earlier vaccines were a fairly tried and tested approach using attenuated virus. And many of those diseases, like smallpox or polio, are far more dangerous than Covid for the general population.

Really we should be strongly encouraging anyone over 50 to be vaccinated, leaving it up to personal preference (but free and widely available) for younger people, and not conferring any special privileges on the vaccinated. In other words treat it just like influenza, but with the government paying and a stronger PR effort.

[the urban politician]

Originally Posted by 10023

Right, but you are not a young person and so the calculus is obviously different.

And mRNA is new in a different way. It’s essentially a gene editing technology. Most of those earlier vaccines were a fairly tried and tested approach using attenuated virus. And many of those diseases, like smallpox or polio, are far more dangerous than Covid for the general population.

Really we should be strongly encouraging anyone over 50 to be vaccinated, leaving it up to personal preference (but free and widely available) for younger people, and not conferring any special privileges on the vaccinated. In other words treat it just like influenza, but with the government paying and a stronger PR effort.

56 is old? Holy shit!

And I disagree that we should be targeting any age group for vaccination. All adults should be encouraged to get the shots. I’m not as irrationally freaked about variants as some others are, but we DO have to acknowledge that as long as the viral load is high in the public, the virus will gradually evolve into resistant strains. Keeping viral levels low within the population is the best way to dramatically slow that process down.

[muertecaza]

Originally Posted by woodrow

Does anyone personally know anyone with vaccine hesitancy? I might have a cousin or two I haven't talked to in years, but I don't have a single close family member, friend, dentist, hair dresser, barista, etc. who either hasn't gotten the shot or is anxiously waiting to get one. I am curious if anyone has friends, family, colleagues, etc. who are not planning on getting a shot and if so are you going to encourage them to change their? More vaccinations, less variants.

My mother-in-law is beyond hesitant. She's the type that sends me Sherri Tenpenny videos she found on Facebook. It has been quite discouraging. We've been able to have someone frank conversations with her about vaccines, but the conversations end up being a constant moving of the goalposts--it's either that they are too new and untested, or they cause cancer, or they will damage our immune systems, or the virus isn't even a big deal, etc. etc. I'm not going to be able to change her mind. And honestly at this point I'm less worried about her getting COVID than I am about what it says about her worldview in general when she's buying what people like the Tenpenny lady are selling.

[Pedestrian]

At last some concrete data:

CDC Identifies Small Group of Covid-19 Infections Among Fully Vaccinated Patients
By Robbie Whelan
April 15, 2021 8:37 am ET

The U.S. Centers for Disease Control and Prevention has identified a small cohort of approximately 5,800 cases of Covid-19 infection among more than 66 million Americans who have completed a full course of vaccination.

These so-called breakthrough cases, which are defined as positive Covid-19 test results received at least two weeks after patients receive their final vaccine dose, represent 0.008% of the fully vaccinated population.

Officials said such cases are in line with expectations because the approved vaccines in the U.S. are highly effective but not 100% foolproof. They are a reminder that even vaccinated people are at risk and should continue to take precautions such as masking and social distancing in many circumstances . . . .

The Wall Street Journal contacted health departments in all 50 states and the District of Columbia to ask how many breakthrough cases had been identified. Twenty-three states responded, reporting a total of 4,172 breakthrough cases.

One area of focus for the CDC is conducting genomic sequencing on respiratory samples from patients with breakthrough cases, so that the agency can track genetic variants of the coronavirus for clues as to how they interact with the vaccines. Public-health officials are studying whether certain mutations of the coronavirus are more resistant to vaccine-based immunity.

The CDC has established a database to record details of each breakthrough case, including patient demographics, geographic location, time since vaccination, vaccine type and virus lineage . . . .

Of the breakthrough cases identified by the CDC, more than 40% occurred in people older than 60, while 65% of the cases were in female patients, according to Tom Clark, leader of the vaccine evaluation team at the federal agency. The CDC found that 29% of breakthrough infections were asymptomatic and 7% of patients experiencing a breakthrough infection were hospitalized. So far, 74 people have died after experiencing breakthrough infections. The agency is expected to publish some of these findings next week . . . .

Currently there are five variants of the SARS-CoV-2 virus circulating in the U.S., several of which scientists believe to be more easily transmissible among humans than the originally identified version of the virus. Public-health officials believe that studying breakthrough cases will help them better understand how variants work . . . .

https://www.wsj.com/articles/cdc-ide...d=hp_lead_pos7

A few comments:

- The overall number and percentage of breakthrough cases isn't surprising and, in fact, is reassuring. Even more reassuring to me is that the CDC seems to be on top of genomic sequencing of breakthrough cases to determine whether they are viruses against which the vaccines are effective most of the time or possibly new mutant strains against which the vaccine my have significant lesser effectiveness. So far, that hasn't been the case.

- What is a bit surprising to me although maybe it shouldn't be is that 74 breakthrough cases have died. Recall that in phase 3 testing with the Moderna and Pfizer vaccines, there were NO deaths among vaccinated individuals.

- Finally, 40% of the breakthrough cases were in people older than 60 whereas (by subtraction) 60% were younger than 60. Given the preponderance of older people among those so far vaccinated, this is a bit surprising. One possibility is that it's because the younger people who were vaccinated early were largely at higher than typical risk--health care workers and so on. In any case, this would seem to confirm that the vaccine works at least as well in older people as in younger in spite of their supposedly weaker immune systems.

[Pedestrian]

Originally Posted by SteveD

I'm very worried about that. I wonder how many people there are going to be such as myself who get the first shot but not the second one (for vaccines that have a two dose regimen). I have to travel for work.

Why aren't you getting the second shot?

There are studies that show that DELAYING the second shot beyond the 3 or 4 weeks used in the trials is not only not a bad thing, the vaccine may be MORE effective if you do that. It's part of the justification used in the UK and some other places for intentionally trying to maximize first doses while intentional delaying second doses.

Originally Posted by SteveD

I'm very pro-science, pro-vaccine, but I canceled my 2nd Moderna shot. I'm still within the 42 day window, which ends one week from today.

I had decades of mild, manageable tinnitus. About 5 days after my first Moderna shot, it got suddenly and dramatically worse, and it remains that way today. The prospect of it getting even worse with a second shot was untenable to me.

There are increasing numbers of people reporting this same condition. I'm on a FB COVID vaccine tinnitus group started just a couple weeks ago that now has over 1,000 members. So far, it's not getting much attention or generating much news.

Ah. Well the good news is that even one dose offers considerable protection.

[Pedestrian]

Originally Posted by 10023

I have met more young people that are at least skeptical (if not afraid) of the vaccine than young people who are scared of Covid. And that’s probably justified. Covid is very rarely a problem for young, healthy people but mRNA vaccines are a brand new technology and no long-term studies of their effects exist.

Most people I know are just getting the vaccine out of worry that it will be a prerequisite to do the things they want to do. I’m only getting it so that I can travel freely in Europe.

Originally Posted by 10023

And mRNA is new in a different way. It’s essentially a gene editing technology. Most of those earlier vaccines were a fairly tried and tested approach using attenuated virus. And many of those diseases, like smallpox or polio, are far more dangerous than Covid for the general population.

Really we should be strongly encouraging anyone over 50 to be vaccinated, leaving it up to personal preference (but free and widely available) for younger people, and not conferring any special privileges on the vaccinated. In other words treat it just like influenza, but with the government paying and a stronger PR effort.

The mRNA vaccines are likely among the safest possible vaccines and even though there's not long-term testing (nor will such necessarily be generally applicable even when we have relatively long term experience with the coronavirus mRNA vaccines), it's hard to come up with a theory on how they could do harm which is in contrast to traditional vaccines and other techniques. mRNA, unlike other forms of RNA, does not get incorporated into the human genome and its existence within the body is transitory. It is soon destroyed by the body. It is emphatically NOT a gene editing technology.

Over the past decade, major technological innovation and research investment have enabled mRNA to become a promising therapeutic tool in the fields of vaccine development and protein replacement therapy. The use of mRNA has several beneficial features over subunit, killed and live attenuated virus, as well as DNA-based vaccines. First, safety: as mRNA is a non-infectious, non-integrating platform, there is no potential risk of infection or insertional mutagenesis. Additionally, mRNA is degraded by normal cellular processes, and its in vivo half-life can be regulated through the use of various modifications and delivery methods. The inherent immunogenicity of the mRNA can be down-modulated to further increase the safety profile. Second, efficacy: various modifications make mRNA more stable and highly translatable. Efficient in vivo delivery can be achieved by formulating mRNA into carrier molecules, allowing rapid uptake and expression in the cytoplasm. mRNA is the minimal genetic vector; therefore, anti-vector immunity is avoided, and mRNA vaccines can be administered repeatedly.

https://www.nature.com/articles/nrd.2017.243

Finally, you are also incorrect in saying that this technology is "brand new". In fact, there has been a lot of research with it and numerous prototype vaccines previously created. As the CDC put it:

Researchers have been studying and working with mRNA vaccines for decades. Interest has grown in these vaccines because they can be developed in a laboratory using readily available materials. This means the process can be standardized and scaled up, making vaccine development faster than traditional methods of making vaccines.

mRNA vaccines have been studied before for flu, Zika, rabies, and cytomegalovirus (CMV).

https://www.cdc.gov/coronavirus/2019...ines/mrna.html

This idea that mRNA vaccine technology is entirely new and untried is a media fiction you have bought hook, line and sinker. You don't even know how it works.

For a MUCH more thorough discussion of the research and past vaccines, see https://www.nature.com/articles/nrd.2017.243