Covid-19 #29: Gazing Into the Abyss, Again

[Mr. Chatywin et al.]

40 minutes ago, williamjm said:

It is the standard in the UK for vaccinations. AZ (unlike Pfizer) have suggested that a larger gap than 3 weeks is more effective.

But there's a huge difference between waiting for than three weeks and taking over 100 days. It just seems wildly inconsistent. 

12 minutes ago, Clueless Northman said:

Looks like AZ testing made sure that the vaccines were still working as expected up to 12 weeks after 1st dose. On the other hand, I haven't seen similar updates from Pfizer, Moderna or J/J.

That said, my mom got her 2nd Pfizer close to 4 weeks after the first one, and I was under the impression 3/4 weeks were supposed to be standard for Pfizer - at least that there wouldn't be a significant drop in immunity if you waited 28 days instead of 21, though there might be if you waited 60-100 days. Both times, she just felt a bit of a sore arm for a few hours, some time after the jab, and she clearly had worse vaccine reactions than that in the past.

I got Pfizer and they didn't give me a choice about when my second shot was. It was prescheduled 21 days out. I just got to pick if I wanted a morning, midday or afternoon shot and they assigned you a time.

[Fragile Bird]

Here in Canada health officials have decided that we can wait 4 months between shots. My 2nd dose is scheduled for July 26th. If vaccine supply improves, I’ll get a call about moving up my 2nd dose.

[Iskaral Pust]

I’m booked for a vaccine shot tomorrow afternoon, although I don’t know which I’m getting.  

When my wife got her Moderna shot a couple of weeks ago, they gave her the follow-on appointment for three weeks later at the same location.  No need to play the appointment roulette again.

Hopefully vaccines will be approved soon for teenagers too and our son can get vaccinated this summer.

Considering we’ll still wear masks in public, and still won’t sit inside in restaurants, theaters, etc., I’m not sure this will provide much of a lifestyle change until September when my son and I will return to school and office in person.  And then whenever work travel resumes.

[Iskaral Pust]

1 minute ago, Chataya de Fleury said:

Uh, Moderna should be 4 weeks. Check it, please.

I may have misremembered the gap.  I was just impressed they gave her the follow-up appt when she got the initial jab so that she didn’t have to hunt around again to get that second appointment, especially with the eligible pool expanding in the meantime.

(I will ask her though to check the time lapse they gave her, thanks)

[Mr. Chatywin et al.]

Just now, Chataya de Fleury said:

Uh, Moderna should be 4 weeks. Check it, please.

And see, I came here to post something funny. This is my complaint though, all the different information. Everything says stay six feet apart. What's the real difference between five and seven feet when you need to figure out if you need to wait three or four weeks for your second shot when others elsewhere are being told several months is fine?

[kairparavel]

7 minutes ago, Tywin et al. said:

And see, I came here to post something funny. This is my complaint though, all the different information. Everything says stay six feet apart. What's the real difference between five and seven feet when you need to figure out if you need to wait three or four weeks for your second shot when others elsewhere are being told several months is fine?

The guidance in Canada isn't based on 'it's fine'. It's risk, based on an attempt to be equitable in distribution with the idea that some immunity for all is better than no immunity for some(many). Summer is coming, and it seems unreasonable and unsafe to ask half the adult population to wait until August to get their first shot.

[Mr. Chatywin et al.]

28 minutes ago, kairparavel said:

The guidance in Canada isn't based on 'it's fine'. It's risk, based on an attempt to be equitable in distribution with the idea that some immunity for all is better than no immunity for some(many). Summer is coming, and it seems unreasonable and unsafe to ask half the adult population to wait until August to get their first shot.

But that kind of plan doesn't account for if things go wrong. Everyone who got their first shot should be quickly scheduled for their second. To do otherwise is irresponsible in my book, even if you don't think the second shot has to happen exactly 21 or 28 days later. Over 100 days sounds absurd.

28 minutes ago, Chataya de Fleury said:

Six feet is a made up distance for “heavy droplets”. It’s not a magic number or bulletproof. Greater distance is generally safer.

That's kind of the point though. It's all arbitrary, and as people figure that out, they'll stop caring. It's already been very well documented in some states. 

[Zorral]

1 hour ago, Iskaral Pust said:

I’m booked for a vaccine shot tomorrow afternoon, although I don’t know which I’m getting.  

When my wife got her Moderna shot a couple of weeks ago, they gave her the follow-on appointment for three weeks later at the same location.  No need to play the appointment roulette again.

Hopefully vaccines will be approved soon for teenagers too and our son can get vaccinated this summer.

Considering we’ll still wear masks in public, and still won’t sit inside in restaurants, theaters, etc., I’m not sure this will provide much of a lifestyle change until September when my son and I will return to school and office in person.  And then whenever work travel resumes.

So glad you and your wife are getting your doses.  That kids can get vaccinated too is the thing that's made me most optimistic in a long time.

[DireWolfSpirit]

So today it was announced that we will be able to get our Covid immunization shots right at work, starting the week of April 12th. I'm pretty tickled that our employer has made the arrangements for us so we will not have to spend countless hours on finding, scheduling and traveling for our shots. This is particularly nice for me as I'm terrible about making and keeping appointments.

 I will procrastinate (something terrible) these little life details. A lot of it stems from being a bit phobic about phone calls in general. I don't like talking on the phone.

Anyways as I mentioned earlier, I'm incredibly grateful to my employer for arranging this.

The idiots that have already announced they will not bother taking advantage of the opportunity are a never ending source of amazement to me.

It's everything I can do to keep myself from wishing they get themselves a case of this virus that they arrogantly refuse to respect or protect themselves from. You reap what you sow and so forth.

[Which Tyler]

9 hours ago, Tywin et al. said:

But there's a huge difference between waiting for than three weeks and taking over 100 days. It just seems wildly inconsistent.

Bear in mind, we simply don't know what the ideal time-frame between first and second doses is. Moderna and Pfizer trialled 3 week gap, and found the vaccine effective - therefore they recommend a 3 week gap. There was no information whatsoever about any different intervals; and it absolutely should NOT be confused with "3 weeks is better than 13, or 30 weeks".

IIRC, we don't even know for sure that 2 doses is better than 1 (last research I saw said that it was likely, but didn't have the numbers to reach 95% confidence - IIRC)

We do "know" from the UK that a single dose of Pfizer reaches peak effectiveness at 5 weeks post-injection, at which point the effectiveness plateaued (as opposed to reduced) - though we don't know how long that plateau would last. We also "know" that Z was still increasing in effectiveness at 6 weeks - which was the latest data at the time of that review (which in turn was 4-5 weeks ago).

  

6 hours ago, Chataya de Fleury said:

Vaccines have been tested at certain intervals, and that is arguably more important.

Have they? have you a link to that research please?
I've only seen AZ having been tested at different intervals - and that largely due to cock-up

[Padraig]

29 minutes ago, Which Tyler said:

Have they? have you a link to that research please?

I imagine she means what you said.  The initial trials had a 3 to 4 week gap.

6 hours ago, Tywin et al. said:

But that kind of plan doesn't account for if things go wrong. Everyone who got their first shot should be quickly scheduled for their second. To do otherwise is irresponsible in my book, even if you don't think the second shot has to happen exactly 21 or 28 days later. Over 100 days sounds absurd.

That's kind of the point though. It's all arbitrary, and as people figure that out, they'll stop caring. It's already been very well documented in some states. 

It depends what you mean by arbitrary.  We know that standing right beside somebody makes it much easier for somebody to pick up COVID.  If you avoid people completely, no issue.  Given how society functions, the latter option isn't particularly realistic.  There is some science behind the 6 foot restriction.  But really, people just need some guidance on risk management.  They shouldn't stop caring just because it is not 100% reliable.

Oh, and as for the 12 week thing, I imagine if you have a very good health system, arranging second shots is straight forward enough.

Looks like we are going to hear more about AZ this week.  This is a good summary of the current state of play.

There is also good news on the Valneva vaccine, although it's still a long way from production.  And 2 different takes on Europe.  This one is "cute".

[Fragile Bird]

1 hour ago, Padraig said:

 This one is "cute".

I see Politico doesn’t consider Canada part of the West. Contrary to the story, Canada has also approved four vaccines, Pfizer, Moderna, AZ and J&J.

[rotting sea cow]

Apparently EMA has confirmed a link of the AZ vaccine with that rare blood disorder (I wish people stop calling it 'blood clots'). Full report should be out later today together with new recommendations.

https://www.euroweeklynews.com/2021/04/06/breaking-news-european-medicines-agency-confirms-blood-clot-link-with-astrazeneca-covid-vaccine/

 

[Mr. Chatywin et al.]

2 hours ago, Which Tyler said:

Bear in mind, we simply don't know what the ideal time-frame between first and second doses is.

That's kind of the point though. We're putting the car together as we're driving it, and all the different information is going to confuse a lot of people, and you have to keep in mind most people aren't following the updates anywhere as closely as most of the people reading this thread.

2 hours ago, Padraig said:

They shouldn't stop caring just because it is not 100% reliable.

But many will, and they'll be able to justify their decisions by saying it's not 100% reliable. This is prevalent in our current times as the death of expertise is on the rise.

[rotting sea cow]

On 4/5/2021 at 1:44 PM, A wilding said:

Agreed. We appear now to be living in a post truth world, where the science is widely disbelieved. (Possibly at least partly because scientific fact is frequently distorted for commercial of political gain.)

What do you mean with that? Is there a single unique truth somewhere? Like in times where religion dominated our lives?

On 4/5/2021 at 1:44 PM, A wilding said:

If you put out a nuanced news story that there is a tiny risk of serious blood clotting, but that you are more likely to be hurt in a road accident, and that the risk is lower than using oral or injected contraceptives (and in the US less than that of being gunned down by a nutter), then it is not going to be read rationally by people. A substantial number will immediately assume that the vaccine is dangerous and promptly refuse to take it, and launch a crusade to tell others not to as well. Many other people will be left with a vague impression that maybe it isn't safe and perhaps they shouldn't take it.

The story of this blood disorder is far more nuanced than you suggest. First, these aren't simple "blood clots" but a more complicated picture. Second, risk benefit calculation is complicated by the fact the affected population seems to be younger women who are less affected by severe covid. How much, I don't know, but several young women have died already and we have no word about recovery prospects for those hospitalized, sinus vein thrombosis doesn't sound fun at all. Third, there are alternatives. It isn't like AZ is the only vaccine out there. Four, in these times being responsible and transparent are fundamental to (re)gain the trust of the population. Governments and health authorities have made so many mistakes, once for all they have to show they can act and set the things straight.

 

[RhaenysBee]

Well I don’t know about Europe, but we seem to think that we can reopen once we vaccinate 2.5M people (which is a little over 25% of the population) with the first dose.  Just why? Why would you think that? 

anyway. Can one consume alcohol before and after the vaccination without that interfering with its efficiency and/or causing health issues? 

A friend of mine google researched this topic and found some article according to which one shouldn’t drink 45 days(!) after receiving Sputnik? I don’t pretend to understand how vaccines and virology works but this just seems... off. I also never heard of anybody mentioning that their GP and/or vaccine notification spoke of any preparation or aftercare that should proceed and succeed, respectively, vaccination. 

I don’t know, at this point, I don’t believe anything or anything. And the conclusion of any covid related topic is always the same anyway: imminent  death. Got covid previously? Well, long term complications might kill you. Have covid now? Well new variants are several times as aggressive and kill the young and strong as well. Recovered with light symptoms? Well, reinfection especially with a variant is sure to kill you. About to get a vaccine? Well, if you have early or asymptotic covid with it, it’s hospital for you and we all know barely anybody gets out of there; if you don’t have covid with it, blood clot death for you; if you have alcohol in the next 6 weeks, the vaccine doesn’t work so covid will eventually kill you. Already vaccinated? Well, you can still contract the variants which will kill you. No vaccine in sight? Well, self isolate, though delivery people and your upstairs neighbor from their balcony may still infect and kill you. My point is, the media is exhausting. 

 

 

[Mudguard]

3 minutes ago, rotting sea cow said:

Apparently EMA has confirmed a link of the AZ vaccine with that rare blood disorder (I wish people stop calling it 'blood clots'). Full report should be out later today together with new recommendations.

https://www.euroweeklynews.com/2021/04/06/breaking-news-european-medicines-agency-confirms-blood-clot-link-with-astrazeneca-covid-vaccine/

 

If the story holds, then I think it was irresponsible for AZ and others to claim that there was no evidence of any link immediately after the story about the thrombosis issue broke.  There was certainly evidence, but it was just being interpreted differently by different parties. AZ keeps doing things that border on shady behavior, when they could have just stated that they were reviewing the data.

And it's so easy to manipulate statistics to hide bad results or to show good results, like with AZ lumping all cases of thrombosis together and claiming that the number of cases is actually lower than expected, so there couldn't be a problem.  Bad or misleading use of statistics were also used in a Swedish study on coronavirus infections in schools, which has now been heavily criticized, but not before the study was used by many countries or states to open up schools. 

That said, if the thrombosis issue is as rare as reported, on the order of 1 per 100,000, then the benefit of vaccination with AZ probably still makes sense if you don't have access to other vaccines.  But people should be informed so they can watch out for this complication and seek prompt care.

[rotting sea cow]

19 minutes ago, RhaenysBee said:

Well I don’t know about Europe, but we seem to think that we can reopen once we vaccinate 2.5M people (which is a little over 25% of the population) with the first dose.  Just why? Why would you think that? 

because the other 25% already got covid? No idea, really, the numbers are going down anyway so with warmer weather might be safer enough.

Quote

anyway. Can one consume alcohol before and after the vaccination without that interfering with its efficiency and/or causing health issues? 

It lowers you immune system so you shouldn't for few days

Quote

A friend of mine google researched this topic and found some article according to which one shouldn’t drink 45 days(!) after receiving Sputnik? I don’t pretend to understand how vaccines and virology works but this just seems... off. I also never heard of anybody mentioning that their GP and/or vaccine notification spoke of any preparation or aftercare that should proceed and succeed, respectively, vaccination. 

45 days! No wonder that vaccine uptake is so low in Russia. It might be just Putin plan to end rampant alcoholism. Yes, it's just too much.

 

Quote

I don’t know, at this point, I don’t believe anything or anything. And the conclusion of any covid related topic is always the same anyway: imminent  death. Got covid previously? Well, long term complications might kill you. Have covid now? Well new variants are several times as aggressive and kill the young and strong as well. Recovered with light symptoms? Well, reinfection especially with a variant is sure to kill you. About to get a vaccine? Well, if you have early or asymptotic covid with it, it’s hospital for you and we all know barely anybody gets out of there; if you don’t have covid with it, blood clot death for you; if you have alcohol in the next 6 weeks, the vaccine doesn’t work so covid will eventually kill you. Already vaccinated? Well, you can still contract the variants which will kill you. No vaccine in sight? Well, self isolate, though delivery people and your upstairs neighbor from their balcony may still infect and kill you. My point is, the media is exhausting.

Don't worry too much. Really. You got covid and recovered. Get your vaccine when it's available to you. This is not the black death and at some point this will be in the distant past.

ETA: Forgot about this. How much truth is in this article

https://www.voanews.com/covid-19-pandemic/falling-flies-hungarys-roma-community-pleads-covid-19-help

It fits in my view that marginalized communities are more affected by the pandemic, but good data is hard to come by.

 

 

[IheartIheartTesla]

Regarding the 6 feet rule, I remember seeing a youtube video of a fluid dynamic simulation demonstrating that droplets from sneezes could easily travel 8-9 feet from the nostrils. The distance would of course be smaller for regular breathing etc., although these (average) distances vary even by the volume of a person talking, for example. The 6 feet is a basically a compromise that is arrived at from the intersection of science and human behavior. Anything less would increase risk, anything more (I imagine the thought process goes) would turn people off and increase non-compliance. And of course masks in combination with this edict does lower risk further.

[Mudguard]

9 hours ago, Tywin et al. said:

But that kind of plan doesn't account for if things go wrong. Everyone who got their first shot should be quickly scheduled for their second. To do otherwise is irresponsible in my book, even if you don't think the second shot has to happen exactly 21 or 28 days later. Over 100 days sounds absurd.

You say this from the point of view of a country with arguably the best supply of vaccine in the world.  Yeah, the US has the luxury of relatively ample supply so we can generally stick to the standard dosing interval.

But most other countries don't have nearly enough supply, and the delivery times are hard to accurately predict, unlike with the US.  These countries face a very difficult decision, which states in the US also faced early on when the vaccine pipeline was just getting going. Do you vaccinate as many people as possible with a single dose, or do you only vaccinate half the number and reserve half of the supply for the second dose? 

There's data that suggests that a single shot of these vaccines provides very good protection, about 70 to 80 percent, for at least months.  And the studies are certainly ongoing, so the estimated length of protection from the single shot doses is lengthened for each month they don't observe a drop off in efficacy.  If they see a drop in efficacy, I'm sure they'll schedule the second dose for everyone ASAP and adjust their dosing planning accordingly. 

You say that 100 days is absurd, but it's not.  Immunity normally won't just disappear in a short period of time, and could very well last for years, even after a single shot.  Also consider the J&J vaccine which is a single shot vaccine and is similar to the AZ vaccine (both are adenovirus based dna vaccines).  If the mRNA vaccines generate a strong response after a single shot, it wouldn't be surprising for the protection to last a long time as well.  The data collection around this is ongoing, so we should get a warning if this is not the case.

Countries also know how dangerous and deadly Covid-19 is and how prevalent it is in their country.  You can estimate roughly how many lives you can save if you vaccinate double the number.  

It's a risk to not hold any vaccine in reserve, but I think it's a reasonable level of risk given what we know about the vaccines and Covid-19.  I actually think it's the right call to vaccinate as many people as possible, which will help knock down the rate of infection quicker.