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Are vaccines the light at the end of the tunnel?


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20 hours ago, Oville said:

 

As a true Florida resident, over 65 and with asthma controlled by steroid inhaler I can’t get a vaccine.  I could care less about snowbirds.  Good for you Hcat. As I   probably spend  triple the time in FL as you I’m totally frustrated 

Hi Katie

We've been enjoying  Florida and paying  full taxes and car registration fees for many years..  Love it  in the summers when many residents head north!  We are not short term snowbirds that are here and gone after two or three months., esp now that we are retired. But even so, if folks meet criteria, that's what counts.  Makes us  all safer.

 

Hope you connect soon.

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10 hours ago, TeeRick said:

Yes that would be plenty.  I hope for that scenario some time later this year.  

 

What I am trying to point out is that in my state and many others, people (beyond hcw's) who are qualified for the vaccine (65+, or 18-64 with specific medical conditions) are not getting it or appointments for it in any logical organized manner.  Many here report their "stories" of how they got the vaccine for themselves or elderly relatives.  These stories involve luck, ingenuity, happenstance, anything but a defined process that can be counted on.  Maybe some states like FL are somewhat more successful because they have put a plan together and executed it for 65+.  

I would agree that things could be better.  The states should follow a practice that is fairly common in the medical industry when there is a shortage.  Set up a registry where anyone that wants a vaccination can sign up and then have the state notify people when their turn has come up.  The registry would include all of the relevant information (age, medical conditions, occupation, etc) so the prioritization could be applied.  I have set up such when we were releasing a new product and the supply was going to be limited.  Patients were prioritized based upon medical need.

 

The way it is now there is no info of how many remain in the given categories, what the expectation is for how long to get to the next group and the luck factor of timing in getting an appointment.

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56 minutes ago, Baron Barracuda said:

Tough news out of South Africa where they've halted distribution of the Astra Zeneca vaccine after small study indicated it had little effect against the local variant.  

 

https://www.statnews.com/2021/02/07/south-africa-halts-rollout-of-astrazenecas-covid-19-vaccine-after-shot-falters-against-variant/

Another strike against them getting approval in the US, since one of the concerns in the increasing presence of the variants in the US.

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4 hours ago, mimbecky said:

Exactly....Here, the superstations etc are all in either the south bay (nearer the border) and in Escondido which also has a prominence of Latinos and more of a reliance on mass transit.  I haven't really heard anyone complaining- everyone in my surrounding areas just jump in their cars.  As long as they don't limit vaccines to those zip codes, we are good.  I figure, all the Caucasians showing up may help increase the trust but maybe I am naïve. Most of our hospitals are not giving out vaccines.

 

Keep in mind that the demographics of Escondido have been changing and more have been moving there getting priced out of the San Diego, Poway and 4S Ranch areas and  is now 35.5% caucasians.

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31 minutes ago, nocl said:

Another strike against them getting approval in the US, since one of the concerns in the increasing presence of the variants in the US.

But it's a stretch to make any conclusions based on the tiny amount of data they're using. It's based on a whopping 42 cases.

 

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2 minutes ago, D C said:

But it's a stretch to make any conclusions based on the tiny amount of data they're using. It's based on a whopping 42 cases.

 

Which is not really a small number when dealing with these kinds of situations.  Lets see what was Moderna's EUA based on  150 cases or something near that number, same with Pfizer's vaccine.

 

If they are not showing any efficacy at 42 cases it is unlikely that they would show atleast 50% efficacy at 4 times that number with that particular strain.

 

 

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44 minutes ago, nocl said:

I would agree that things could be better.  The states should follow a practice that is fairly common in the medical industry when there is a shortage.  Set up a registry where anyone that wants a vaccination can sign up and then have the state notify people when their turn has come up.  The registry would include all of the relevant information (age, medical conditions, occupation, etc) so the prioritization could be applied.  I have set up such when we were releasing a new product and the supply was going to be limited.  Patients were prioritized based upon medical need.

 

The way it is now there is no info of how many remain in the given categories, what the expectation is for how long to get to the next group and the luck factor of timing in getting an appointment.

Makes sense... a rational plan based on med need not politics! Avoids folks having to chase appts in sev locations each day appts open up. Would lessen  disappointment & frustation

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26 minutes ago, lyndarra said:

Why would they ask that? Curious.

So they can track who is actually receiving vs the demographics to see how well each group is doing in getting vaccinated.  It will tell them if they are having an access or PR problem in each group.  

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12 hours ago, nocl said:

Which is not really a small number when dealing with these kinds of situations.  Lets see what was Moderna's EUA based on  150 cases or something near that number, same with Pfizer's vaccine.

 

If they are not showing any efficacy at 42 cases it is unlikely that they would show atleast 50% efficacy at 4 times that number with that particular strain.

 

 

The AZ/Oxford vaccine trial reported in S.Africa had an average age of 31 years and had little efficacy against the variant strain there preventing mild to moderate cases in younger people.  But if it prevents severe cases, hospitalizations and deaths (even at reduced efficacy) in the older, at-risk population (not tested) then it would still be a step forward there.  So let's not dismiss it so quickly at this point.

https://www.bbc.com/news/world-africa-55975052

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6 hours ago, yorky said:

The crowds and parties in Tampa are crazy, up to 50% not wearing masks. What is wrong with these people.

I guess you can predict that in 5-10 days the Tampa area and the US in general will see a Super Bowl surge.  Hopefully it will not be as bad as the holiday surges.  I am more worried about the indoor mask-less parties with friends, families and neighbors watching the game causing the surge, than the crazy outdoor partiers.

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7 minutes ago, TeeRick said:

The AZ/Oxford vaccine trial reported in S.Africa had an average age of 31 years and had little efficacy against the variant strain there preventing mild to moderate cases in younger people.  But if it prevents severe cases, hospitalizations and deaths (even at reduced efficacy) in the older, at-risk population (not tested) then it would still be a step forward there.  So let's not dismiss it so quickly at this point.

https://www.bbc.com/news/world-africa-55975052

 

I'm not sure if they can ethically do that now, though. Not when there are other vaccines that did show efficacy against that strain. The J&J vaccine had efficacy against this strain and prevented serious illness. Yes, the efficacy against serious illness has generally been higher for all the vaccines, but...

 

This is arguably a predictable outcome of having this many vaccines more or less all at once. There's a point, which is regulatory art as much as science, where one of the vaccines is going to emerge as a standard (could be more than one), and further clinical trials are going to be A to B comparisons, not placebo controlled. But (even with small numbers) running a clinical trial to look for prevention of severe effects when your data doesn't show prevention of mild disease should raise ethical caution flags.

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30 minutes ago, TeeRick said:

The AZ/Oxford vaccine trial reported in S.Africa had an average age of 31 years and had little efficacy against the variant strain there preventing mild to moderate cases in younger people.  But if it prevents severe cases, hospitalizations and deaths (even at reduced efficacy) in the older, at-risk population (not tested) then it would still be a step forward there.  So let's not dismiss it so quickly at this point.

https://www.bbc.com/news/world-africa-55975052

 

Agreed. It doesn't make a lot of sense to be up in arms about mild/moderate cases if it helps minimise the most severe cases and deaths.   It's as if they're taking a "nothing is better than imperfection" approach. 

 

3 minutes ago, markeb said:

 

I'm not sure if they can ethically do that now, though. Not when there are other vaccines that did show efficacy against that strain. The J&J vaccine had efficacy against this strain and prevented serious illness. Yes, the efficacy against serious illness has generally been higher for all the vaccines, but...

 

This is arguably a predictable outcome of having this many vaccines more or less all at once. There's a point, which is regulatory art as much as science, where one of the vaccines is going to emerge as a standard (could be more than one), and further clinical trials are going to be A to B comparisons, not placebo controlled. But (even with small numbers) running a clinical trial to look for prevention of severe effects when your data doesn't show prevention of mild disease should raise ethical caution flags.

I don't see the ethics issue.  

"You might still get sick after the Ox-AZ vaccine" should be acceptable if it's also followed by "but it will reduce or eliminate severe illness and deaths".  

 

We see that with influenza every year.  Even if the vaccine misses the target, it still tends to turn severe illness into mild illness.  That's a win.    

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6 hours ago, yorky said:

The crowds and parties in Tampa are crazy, up to 50% not wearing masks. What is wrong with these people.

A Reporter ( ?? ) from Canada overheard a lady from Glasgow ask

 " What is wrong with these people "?

AND the answer is---------

" GEEZ-- Can't nobody have No fun-- It's Sooper Bole an I ain't not gowna selbrate when my teem winz " !

 

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2 minutes ago, D C said:

I don't see the ethics issue.  

"You might still get sick after the Ox-AZ vaccine" should be acceptable if it's also followed by "but it will reduce or eliminate severe illness and deaths".  

 

But I can already do that with J&J. AND have effects against the mild and moderate effects of this strain.

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1 hour ago, TeeRick said:

The AZ/Oxford vaccine trial reported in S.Africa had an average age of 31 years and had little efficacy against the variant strain there preventing mild to moderate cases in younger people.  But if it prevents severe cases, hospitalizations and deaths (even at reduced efficacy) in the older, at-risk population (not tested) then it would still be a step forward there.  So let's not dismiss it so quickly at this point.

https://www.bbc.com/news/world-africa-55975052

If, If, If  they do not know if it prevents serious illness with that strain. We do know  others do have more efficacy against that strain. The SA government felt it was enough to stop their roll out.

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1 hour ago, markeb said:

 

But I can already do that with J&J. AND have effects against the mild and moderate effects of this strain.

I agree, but there isn't a J&J vaccine in South Africa right now as far as I know.

This is a "nothing is better than imperfection" approach at the moment. 

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21 minutes ago, D C said:

I agree, but there isn't a J&J vaccine in South Africa right now as far as I know.

This is a "nothing is better than imperfection" approach at the moment. 

There isn't a J&J vaccine in South Africa right now because it has not been approved.  It would be logical to assume that a country that is hosting one of the Phase III trials would be one of the countries that would be first in line for the vaccine when it does get approved.  Even an EUA takes a little time.

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1 minute ago, deadzone1003 said:

There isn't a J&J vaccine in South Africa right now because it has not been approved.  It would be logical to assume that a country that is hosting one of the Phase III trials would be one of the countries that would be first in line for the vaccine when it does get approved.  Even an EUA takes a little time.

Exactly my point.  They have a vaccine, but are choosing nothing instead of it.  

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12 minutes ago, D C said:

Exactly my point.  They have a vaccine, but are choosing nothing instead of it.  

Then, what good is a vaccine if it doesn't work very well?  It is their choice.  They have limited funds to throw around.

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20 minutes ago, deadzone1003 said:

Then, what good is a vaccine if it doesn't work very well?  It is their choice.  They have limited funds to throw around.

If it turns deaths into illness, and severe illness into moderate/mild illness, then it's worth its weight in gold.  Sick is better than dead, and a little sick is better than a lot sick, no?

 

The news reports suggest that they halted the administration because there were some mild/moderate illnesses without understanding the effect on deaths or severe illnesses. 

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22 minutes ago, D C said:

If it turns deaths into illness, and severe illness into moderate/mild illness, then it's worth its weight in gold.  Sick is better than dead, and a little sick is better than a lot sick, no?

 

The news reports suggest that they halted the administration because there were some mild/moderate illnesses without understanding the effect on deaths or severe illnesses. 

That is your valuation of the situation where you value life.  That is great if you have unlimited resources.  In the meanwhile, they have to do a cost/benefit analysis because there is limited funds.  They have an inexpensive vaccine, J&J, in the horizon which they have tested on their own population while the Astra-Zeneca just doesn't do the job for what they will be paying.  

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