Vaccine reluctance & General COVID Discussion

However, for the individual, that would be another 4-6 weeks (or whatever) of lower immunity from having only the first dose. But then that may be why three doses is preferable, since it gets to a useful level of immunity quickly with the second dose, followed by a stronger long term level of immunity after the third dose at a longer interval. From a public health perspective, it is also a possible concern that people may forget to get the second dose if the interval between them is longer.

The Pfizer under-5 vaccine is specified as a 3-dose vaccine (days 0, 21, 84) with 3mcg mRNA per dose. The Moderna under-5 vaccine is currently specified as a 2-dose vaccine (days 0, 28) with 25 mcg mRNA per dose.

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The small city to which we’ve retired includes parts of two counties. In one, about 65% of adults are considered fully vax’d while in the other it’s less than 40%. Hospitalizations have increased in recent weeks, likely following beach trips and parties after school ended. Covid remains a highly political issue here unfortunately, even for our D and SiL and his family.

We’re pretty much homebodies anyway, so are in no hurry to go to indoor events. H resumed quick trips (<10 items) to Publix and has remarked that he’s often the only white customer wearing a mask but that the few black customers are always masked. Make of that what you will.

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I’ve also noticed clear sociodemographic breakdowns vis-a-vis mask-wearing (or conversely, choosing not to wear a mask). My mother lives in a very ethnically and socioeconomically diverse community and reports that the majority of indoor shoppers are fully masked. On the contrary, in the predominantly white, upper middle class neighborhood in which I find myself now, the majority of residents have fully resumed their “pandemic-free” lives – socializing, traveling, shopping, and dining almost entirely mask-free.

Makes me wonder about the “politics of vulnerability” - those who may have already experienced insecurity and suffering in their lives, and so take the trouble to protect themselves, and those who may never have, and thus feel fairly invulnerable.

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My H just told my that his company had a meeting at their Florida office last week for the sales reps from all over the world and so far there are 8 people who have come down with Covid. All of the positive cases report no symptoms to just mild cold like symptoms.

My 3 year old granddaughter got her first dose today!

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Let us how it goes. Hope she has mild reactions.

That’s awesome. Good for her parents.

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So follow convenience and past narrative…but not updated science…wonder why there is resistance.

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Actually, the science points to three doses are more optimal – you get useful immune response after the first two doses, then a higher level after the third dose at a longer interval. I.e. best of both worlds, so you do not have to choose (when getting only two doses) between a longer time of vulnerability (by delaying the second dose) or lower long term immune response (by having the second dose at a shorter interval).

But realistically, science mostly does not really matter in people’s attitudes toward vaccination. Attitudes toward vaccination (and other COVID-19 related issues) are now mostly based on politics.

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" In their paper published in The Lancet Respiratory Medicine, the researchers report that a standard two-dose Oxford-AstraZeneca or Pfizer-BioNTech schedule generated a greater increase in antibodies in participants when immunized at a 12-week interval compared with a four-week interval, and this persisted to six months following the second dose.

In mixed schedules, only Pfizer-BioNTech followed by Oxford-AstraZeneca recorded a significantly stronger immune response in the 12-week versus 4-week interval groups, and only at 28 days following a second dose. No safety concerns were raised in this study of 730 participants.’

Parents should have this info at their fingertips!

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I doubt the average parent (remember most 25+ adults in the US don’t have a college degree) would be able to interpret this study for their children without considerable confusion, considering it was done in 50+ year old adults, and included one product that’s not even on the market in the US.

More importantly, physicians/pharmacists aren’t going to deviate from the dosing schedule on the actual EUA label based on one study, in the absence of FDA/CDC direction. (I am not saying the FDA/CDC have been adequate leaders during the pandemic).

Here is the FDA report on it’s authorization for vaccines for under 5. A few interesting take aways…

https://www.fda.gov/media/159195/download

‘Observed estimates of vaccine effectiveness against symptomatic disease due to the Omicron variant include the following: 8.8% (95% CI, 7.0 to 10.5) at 25 or more weeks since primary vaccination in adults; 59.5% among adolescents 12 to 15 years of age 2 to 4 weeks after dose 2, 16.6% during month 2 after the second dose, and 9.6% during month 3 after the second dose’

Yup 8.8% effective…

‘Vaccine effectiveness was inferred by immunobridging based on a comparison of immunogenicity endpoints (SARS-CoV-2 neutralizing antibody geometric mean concentrations (GMTs) and seroresponse rates 1 month after Dose 3) between participants 6-23 months of age from study C4591007 (n=146) and participants 16 through 25 years of age from study C4591001’

So, using the adult data (based on the 3 - 4 week interval for initial doses) it was decided that this applied to the under 5 crowd. Even though we now know longer spacing is beneficial…Not feeling really good here…

’ > In a combined analysis of both age groups, VE was 80.4% (95% CI: 14.1%, 96.7%) with 3 cases in the BNT162b2 group and 7 cases in the placebo group. Interpretation of post-Dose 3 efficacy data for both age groups, and for the age group of 6 months through 4 years overall, is limited for the following reasons:

  • Vaccine efficacy post Dose 3 cannot be precisely estimated due to the limited number of cases accrued during blinded follow-up, as reflected in the wide confidence intervals associated with the estimates.
  • These descriptive efficacy data are preliminary, as the protocol specified 21 cases have not yet been achieved.
  • There were highly variable dosing intervals between doses 2 and 3, with median intervals of 112 (range 56 to 245) days among participants 6-23 months of age and 77 (range 42 to 239) days among participants 2-4 years of age in the Dose 3 evaluable efficacy population.
  • The median blinded follow-up time post Dose 3 in the analyses was only 35 days for participants 6-23 months of age and 40 days for participants 2-4 years of age.’

Sample size of 7…???

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I am in a John’s Hopkins study of semi-quantitative antibody levels to COVID, for those with chronic illness. Originally they reported specific scores up to 2500 and a score >2500. The study now reports specific scores up to 25,000 and > 25,000.

Six months after my second shot (Pfizer) my level was 1078.
Six months after my third shot (Pfizer booster) level was appro. 6,074
Seven months after my third shot (Pfizer booster) level was 5,368
I then had my 4th shot (Moderna, 2nd booster) a few days later
Two weeks after this booster my level was >25,000!

I test at one month, three months, six months and will report. This says nothing about T or B cells but still might be of interest.

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this is more important:

“Observed estimates of primary series mRNA vaccine effectiveness against hospitalizations due to the Omicron variant in adults have been reported at 41%-57% at 6-9 months or longer after the second dose”

Also, from

"As of January 8, 2022, during Omicron predominance, COVID-19 incidence and hospitalization rates in Los Angeles County among unvaccinated persons were 3.6 and 23.0 times, respectively, those of fully vaccinated persons with a booster, and 2.0 and 5.3 times, respectively, those among fully vaccinated persons without a booster. "

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I talked to a woman this weekend on the beach. She and her husband, in their 40s, were very fit. She’d had the booster, he hadn’t. They each got COVID. She had a very mild case but he got very, very ill.

New Jersey’s Covid dashboard has a graph, if you drill down a bit, with cases broken down by vaccine status. Cases, hospitalizations, and deaths are continually much, much higher for unvaxxed, in absolute numbers, even though the state has a high vaccination rate.

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During the height of COVID and long after we were required to take our temperatures upon entering work (health care) and D2 a health professions grad student had to report her temperature via an app daily even on the weekends to her college department.

With covid cases RAMPANT it seems - like you might as well assume any room you enter for any event that covid is in the room - while I know this is not possible but I sort of feel like we should just test daily to really know who has it! I truly wonder if I have had it already and not even known it. I actually would like to know if I have had it.

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Yes, I attended an outdoor event last Wednesday night. The hostess coughed a little and said, “It’s just allergies.” Well, it wasn’t - she tested positive the next day. I was nervous because I spent a good bit of time talking to her. I never developed any symptoms, but who knows, maybe I got it?

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Went to another large work conference last week. Over 100 attendees plus many trailing spouses and children since it was in a nice location. Virtually no masks worn anywhere. I have since heard of 3 people getting covid. One was a close coworker that I was sitting next to at the conference for hours every day. I have had no symptoms and have tested negative. I have asked around and no one seems to know of any besides these three.

I’ve doubted the usefulness of temperature tests. I think the allowable safe temp was above 98.6 (100 ??). Anyway, My normal temp is around 97.6. My kids also run low. If my temp were to scan at 98.6 - I would be running a fever. If my temp scanned at 99 + I would be ill. Yet. I’d be passing the temp check.

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