Will vaccines now be required?

[nomad098]

26 minutes ago, cangelmd said:

Sorry, can’t resist opportunity to talk about the tests.

Lateral flow is just not a great technology, one, and secondly sample type has crucial differences from optimal sample type for PCR. When you read a study comparing lateral flow to PCR, you really have to get in the weeds, to see if proper sampling was done for each. That rarely happens because you need to sample pts with 2 different swabs - who signs up for that? Best case for lateral flow is 90% agreement with PCR - and you only get that in highly symptomatic pts. Real world, all comers with more mild more non-specific symptoms, the agreement is about 80%.

 

As for the Portugal court case, that 97% false positive is asking the question, when do you call something negative. Normally, the lower limit of detection (the LOD) of a PCR test would be determined by comparison to viral culture results and by clinical observations- graphing clinical disease to test results. It’s tricky in PCR because PCR may be more sensitive than culture. When you are talking about quarantining people, perhaps retesting after a couple of days, you might want to observe and retest, even if there is a 97% chance that initial result was falsely positive. In normal clinical practice that would likely be the point at which the lab would just call the test “negative”, even if they were wrong 3 times out of 100.

You can begin to see the problems with asking lab tests to be accurate in a way that they were never designed to be - even a test system as sensitive and specific as PCR, which is accepted as DNA evidence in murder cases! Clinical lab tests are meant to be used as a piece of a diagnostic puzzle by clinicians who have training, experience and context to interpret that result. People, the press, politicians are assuming 100% sensitive and specific, 100% of thectime

 

Part of the problem seen in Liverpool was that lateral flow tests carried out by lab trained personnel was around 76% accurate and throwing up a lot of false negatives. When performed by the average person this dropped to 50% with a higher rate of false negatives.

 

False negatives would cause far greater problems for cruise lines than false positives. 

 

One of the best explanations for RT-PCR test I've seen for us trying to learn more thank you 

Edited December 11, 2020 by nomad098

[larry_s_taco]

17 hours ago, nocl said:

The reasons why the advice evolved is actually pretty simple and pretty logical.

 

At the start nothing was known about this virus. With the lack of information the advice was based upon using other viruses behaviors.  As more was learned, at a very rapid pace, the advice changed to be more specific to this virus. Now there is a lot more known, so it is not surprising that the advice has changed considerably.

 

It is how science works going from the unknown to the known.  There is still a lot more to be learned, so expect future changes as well.

 

 

Well said. 

[Lady Chew]

9 hours ago, TeeRick said:

Or a branding iron?

Remember the scar we all carried from childhood on our arms from the smallpox vaccine?  Or are you too young for that?

 

I remember there were a few times we had to prove to school authorities we had had the vaccination by simply showing the scar, since it was so distinctive.  However, my mother did not want her children to have those big scars, so she had ours injected on the underside of our arms.  When I was in the fifth grade with a broken arm and a cast almost up to my shoulder, I couldn't show the scar.  They didn't believe I had the scar, I asked them to bring in my two younger siblings to show their scars.  Of course now, many years later, the scar is long gone.

 

Back to our regularly scheduled program ... 

[cangelmd]

5 hours ago, markeb said:

 

You put a tattoo in the right ear of a heifer when you vaccinate them for brucellosis... 🤯

Ow! I helped my dad paint them with “purple medicine” crystal violet, when they got tagged.

5 hours ago, nomad098 said:

 

Part of the problem seen in Liverpool was that lateral flow tests carried out by lab trained personnel was around 76% accurate and throwing up a lot of false negatives. When performed by the average person this dropped to 50% with a higher rate of false negatives.

 

False negatives would cause far greater problems for cruise lines than false positives. 

 

One of the best explanations for RT-PCR test I've seen for us trying to learn more thank you 

Thanks, didn’t read as clearly to me. I tried a longer one, but it was too long.

Our experience with lateral flow Covid and even the Abbott IdNow, is that there is nothing to doing the test, but there are little tricks about sample handling that maybe techs are more tuned in to? All the instruction is virtual and it just isn’t the same as having someone who has lots of real experience on real patient specimens coming in and training the staff - it’s more about that, than the initials behind the operators name. These tests are intended to be run by high school grads. LOL, as we say, if the Med Director can be trained, anyone can do it.

[Edinburghgirl1]

NCL are looking into having had the vaccine a prerequisite for cruising. Wonder if Celebrity  will follow suit?  
 

https://www.travelweekly.com/Cruise-Travel/Norwegian-is-looking-into-the-legality-of-vaccination-requirement

[ipeeinthepool]

46 minutes ago, Edinburghgirl1 said:

NCL are looking into having had the vaccine a prerequisite for cruising. Wonder if Celebrity  will follow suit?  
 

https://www.travelweekly.com/Cruise-Travel/Norwegian-is-looking-into-the-legality-of-vaccination-requirement

 

That's the only path that makes sense to me.

[yorky]

This is certainly going to be the number one topic on here for the coming months in my view. No doubt some heated debate coming our way.

[Cruise a holic]

I think it makes sense.  The staff, guests and any celebrity port workers, including check in staff should be required to have vaccination.

 

This will help to assure guests that cruising is a safe way to travel.  It will encourage cruise vacations.

[ECCruise]

If one does, they all will do.  No question.

[nomad098]

I posted this on a RCL thread but I thought it would add to the conversation here looking at the different regulatory approaches 

 

Looking at the FDA recommendations it is different to the UK ones.

 

WHAT SHOULD YOU MENTION TO YOUR VACCINATION PROVIDER BEFORE YOU GET THE PFIZER-BIONTECH COVID-19 VACCINE?

Tell the vaccination provider about all of your medical conditions, including if you:

• have any allergies

• have a fever

• have a bleeding disorder or are on a blood thinner

• are immunocompromised or are on a medicine that affects your immune system

• are pregnant or plan to become pregnant

• are breastfeeding

• have received another COVID-19 vaccine

 

WHO SHOULD GET THE PFIZER-BIONTECH COVID-19 VACCINE?

FDA has authorized the emergency use of the Pfizer-BioNTech COVID-19 Vaccine in individuals 16 years of age and older.

 

WHO SHOULD NOT GET THE PFIZER-BIONTECH COVID-19 VACCINE?

You should not get the Pfizer-BioNTech COVID-19 Vaccine if you:

• had a severe allergic reaction after a previous dose of this vaccine

• had a severe allergic reaction to any ingredient of this vaccine

 

It looks like North America are going to be the phase IV (marketing trial) for most of the rest of the world this is not having a go at North America but pointing out that they will be testing the vaccine on previously untested groups. And without any sarcasm and with genuine feeling good luck to them.

 

If more people can be tested safe to have the vaccine than it would make having a vaccine requirement more appealing in the short term but negate the need in the longer term.

 

https://www.fda.gov/media/144414/download

[TeeRick]

11 hours ago, Lady Chew said:

 

I remember there were a few times we had to prove to school authorities we had had the vaccination by simply showing the scar, since it was so distinctive.  However, my mother did not want her children to have those big scars, so she had ours injected on the underside of our arms.  When I was in the fifth grade with a broken arm and a cast almost up to my shoulder, I couldn't show the scar.  They didn't believe I had the scar, I asked them to bring in my two younger siblings to show their scars.  Of course now, many years later, the scar is long gone.

 

Back to our regularly scheduled program ... 

Lady Chew- great story!  Thanks for sharing!

[4774Papa]

On 12/5/2020 at 3:15 PM, cl.klink said:

Once a critical mass of us have been vaccinated, or if vaccination is a pre-requisite to cruise, when do you think that the cruise experience itself changes back (or close to) what we had before -- no masks, no distancing, free to do what you like in ports?

 

- Joel

The U.S. Department of Health and Human Services and Department of Defense announced on Friday that they will purchase 100 million additional doses of Moderna's coronavirus vaccine candidate. 

...The purchase will bring the total doses of Moderna's vaccine owned by the federal government to 200 million, HHS said... 

An FDA advisory panel is scheduled to meet Dec. 17 to review the application. 

By the end of 2020, it expects to have approximately 20 million vaccine doses available in the U.S... 

“Securing another 100 million doses from Moderna by June 2021 further expands our supply of doses across the Operation Warp Speed portfolio of vaccines,” said HHS Secretary Alex Azar said in a statement Friday. 

“This new federal purchase can give Americans even greater confidence we will have enough supply to vaccinate all Americans who want it by the second quarter of 2021.”

[laslomas]

I know I would like to know that fellow passengers had the vaccination. But with cruisers coming from all parts of the globe, what will be the proof required? That could prove tricky.

 

[TeeRick]

5 minutes ago, nomad098 said:

I posted this on a RCL thread but I thought it would add to the conversation here looking at the different regulatory approaches 

 

Looking at the FDA recommendations it is different to the UK ones.

 

WHAT SHOULD YOU MENTION TO YOUR VACCINATION PROVIDER BEFORE YOU GET THE PFIZER-BIONTECH COVID-19 VACCINE?

Tell the vaccination provider about all of your medical conditions, including if you:

• have any allergies

• have a fever

• have a bleeding disorder or are on a blood thinner

• are immunocompromised or are on a medicine that affects your immune system

• are pregnant or plan to become pregnant

• are breastfeeding

• have received another COVID-19 vaccine

 

WHO SHOULD GET THE PFIZER-BIONTECH COVID-19 VACCINE?

FDA has authorized the emergency use of the Pfizer-BioNTech COVID-19 Vaccine in individuals 16 years of age and older.

 

WHO SHOULD NOT GET THE PFIZER-BIONTECH COVID-19 VACCINE?

You should not get the Pfizer-BioNTech COVID-19 Vaccine if you:

• had a severe allergic reaction after a previous dose of this vaccine

• had a severe allergic reaction to any ingredient of this vaccine

 

It looks like North America are going to be the phase IV (marketing trial) for most of the rest of the world this is not having a go at North America but pointing out that they will be testing the vaccine on previously untested groups. And without any sarcasm and with genuine feeling good luck to them.

 

If more people can be tested safe to have the vaccine than it would make having a vaccine requirement more appealing in the short term but negate the need in the longer term.

 

https://www.fda.gov/media/144414/download

It is interesting that the FDA did go ahead and approve the Pfizer vaccine for 16 and 17 years too.  That was the big debate at the Advisory Committee meeting and why a few members had reservations about limited safety data in this group and voted against the vaccine.  Since the under 18 group is for the most part not at risk of severe COVID and will not even get the vaccine for many months anyway, I was surprised by FDA authorization in the EUA to include them at this time.

[TeeRick]

18 hours ago, yorky said:

Very true, we look to be in a favourable position in the UK at the moment which may put us in a better position for travel. Personally we won’t be travelling abroad next year anyway, our first foreign holiday will be the Asia cruise in Feb 2022. Hopefully everyone will have been vaccinated by then.

Our next scheduled cruise is on Silhouette out of Southampton in Aug 2021 to Norway so we are watching the UK situation with keen interest for an number of reasons.

[TeeRick]

This very topic has been discussed at great length on two other ongoing threads.  Maybe they should all be merged?  Why start another?  

 

[RickT]

Until Covid 19 is eliminated (or otherwise eradicated to the point of it being extremely rare) than I for one would only cruise if others onboard have been vaccinated.  I’ve no idea when I’ll receive my vaccination but until I do I wouldn’t even think of sailing.

 

stay safe!

[latserrof]

TeeRick,

Thanks for all the info, analysis and links. Pretty complex stuff, but I believe that at the end of one of your recent posts (sorry, I can't find it), you said something to the effect of "we'll be cruising before we know it."  Do you believe that, or were you being facetious, please?

 

[K.T.B.]

5 hours ago, ECCruise said:

If one does, they all will do.  No question.

 

Agreed, and I hope they do.  It's as much about passenger safety as it is for the crew.

[K.T.B.]

On 12/11/2020 at 11:06 AM, TeeRick said:

Or a branding iron?

Remember the scar we all carried from childhood on our arms from the smallpox vaccine?  Or are you too young for that?

 

They need to make the injections create a specific looking scar like the smallpox shot did!  

Edited December 12, 2020 by K.T.B.

[LGW59]

6 hours ago, TeeRick said:

This very topic has been discussed at great length on two other ongoing threads.  Maybe they should all be merged?  Why start another?  

 

I so agree, I wish the CC moderators would merge ALL of the vaccine posts into one.  Very pleased with the approvals etc in Europe and US, but there are WAY too many separate threads, just combine them already.  We know what to look for if/when we want it. 

[TeeRick]

For those younger members here, before your time, many of us got a smallpox vaccine by intradermal injection (just under the skin).  It left a unique and recognizable scar that took many years to fade.

 

 

[TeeRick]

20 hours ago, latserrof said:

TeeRick,

Thanks for all the info, analysis and links. Pretty complex stuff, but I believe that at the end of one of your recent posts (sorry, I can't find it), you said something to the effect of "we'll be cruising before we know it."  Do you believe that, or were you being facetious, please?

 

I truly believe it! Honestly!  With a vaccine approved, another one coming later this week, and more on the way, the tide will be turning (cruise metaphor!).  But we will need to be patient and allow the process to play out. IMO, I think probably limited cruising by second half of 2021.  And perhaps even "normal" cruising in 2022.  

[ipeeinthepool]

Perhaps one in each arm to show that you've received both Covid shots.

[cangelmd]

On 12/12/2020 at 8:09 AM, nomad098 said:

I posted this on a RCL thread but I thought it would add to the conversation here looking at the different regulatory approaches 

 

Looking at the FDA recommendations it is different to the UK ones.

 

WHAT SHOULD YOU MENTION TO YOUR VACCINATION PROVIDER BEFORE YOU GET THE PFIZER-BIONTECH COVID-19 VACCINE?

Tell the vaccination provider about all of your medical conditions, including if you:

• have any allergies

• have a fever

• have a bleeding disorder or are on a blood thinner

• are immunocompromised or are on a medicine that affects your immune system

• are pregnant or plan to become pregnant

• are breastfeeding

• have received another COVID-19 vaccine

 

WHO SHOULD GET THE PFIZER-BIONTECH COVID-19 VACCINE?

FDA has authorized the emergency use of the Pfizer-BioNTech COVID-19 Vaccine in individuals 16 years of age and older.

 

WHO SHOULD NOT GET THE PFIZER-BIONTECH COVID-19 VACCINE?

You should not get the Pfizer-BioNTech COVID-19 Vaccine if you:

• had a severe allergic reaction after a previous dose of this vaccine

• had a severe allergic reaction to any ingredient of this vaccine

 

It looks like North America are going to be the phase IV (marketing trial) for most of the rest of the world this is not having a go at North America but pointing out that they will be testing the vaccine on previously untested groups. And without any sarcasm and with genuine feeling good luck to them.

 

If more people can be tested safe to have the vaccine than it would make having a vaccine requirement more appealing in the short term but negate the need in the longer term.

 

https://www.fda.gov/media/144414/download

Little confused, what are the UK recommendations  for comparison?