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16th December 2020, 10:25 PM | #161 |
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Two more people reacted to the vaccine, this time in AK and it sounds like it was more anaphylaxis than not. Symptoms were SOB and what was described as red rash. That suggests to me generalized erythema of some kind. One got epi and a night in the ICU.
The Latest: Alaska reports 2nd adverse reaction to vaccine
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Not saying they should stop the vaccinations. But that one dry run looking at having people get vaccinated in their cars then parking for 15 minutes sounds like an impractical way to manage a vaccine program. |
17th December 2020, 12:10 AM | #162 |
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I guess you're right. The bottleneck here will probably be how fast can they produce it.
It's hard to find answers as to exactly how many people have received the first shot already, but there is this: https://www.usatoday.com/in-depth/ne...us/3879655001/
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Hopefully they can increase that to around 20 million doses per week or more. Plus other countries will need it too. |
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18th December 2020, 02:24 PM | #163 |
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So entirely anecdotally a colleague came out in a rash the night after getting the Pfizer vaccine but was OK the next day. It seems much more immunogenic than most vaccines. FWIW I ran away back to work after being vaccinated and didn't have a reaction other than a sore arm and a slightly flu like reaction (fever) that night. Given a choice I would have hung on for the AZ/ Oxford vaccine but I had to be seen to be vaccinated, so now I just have to wait 21 days for booster.
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18th December 2020, 02:37 PM | #164 |
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19th December 2020, 10:27 AM | #165 |
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It seems to be a general rule in Denmark, recommended by the Danish Public Health Agency. There was a dilemma this year when the flu shots were administered because it obviously isn't a good idea to have people crowding waiting rooms and infecting each other with coronavirus. The solution they came up with was that people shouldn't stay at the place where they get the shot but near it. Influenzavaccination 2020 – kan beredskabet i forhold til anafylaksi tilpasses epidemien? |
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19th December 2020, 11:37 AM | #166 |
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The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.Bertrand Russell Zooterkin is correct Darat Nerd! Hokulele Join the JREF Folders ! Team 13232 Ezekiel 23:20 |
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20th December 2020, 02:08 AM | #167 |
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I just read an article that made me want to revisit this question:
Why Use Two Doses of COVID-19 Vaccines When One Works Almost as Well?
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I don't really know how well established this is, but if true, it would change the calculation considerably. The CEO of Pfizer understandably is concerned with maximizing the company's profit, and so would want to downplay just how effective that first dose is. (Because he wants to make sure that everyone who gets the first dose gets the second one too.) |
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20th December 2020, 07:33 AM | #168 |
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No mention of doing serology tests to see whether that patient even needs the vaccine. Seems like a potential waste of a dose. Or 50 million doses.
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20th December 2020, 07:44 AM | #169 |
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20th December 2020, 11:07 AM | #170 |
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The problems here are that we don't know how long protection lasts with 1 dose vs 2 doses. These vaccines haven't been available for long term outcome followup. Until they are, giving more people one dose might be a bad idea.
And more vaccinated people might remain susceptible and therefore continue the spread of the disease. You need to weigh more vaccine recipients vaccinated with more spread from those vaccinated vs fewer people vaccinated with less spread from those recipients. You need to consider with one dose, (whether 50 or 80%), how many recipients became mildly symptomatic or asymptomatic but were still capable of spreading the infection. There is so much it would be nice to know to make these decisions, but we simply cannot collect the data fast enough. And without the data, it's simply not safe to go vaccinating people off label. IOW we as prescribers need to follow the manufacturer's recommendations until more data is collected even if it means fewer people can get the vaccine initially. |
20th December 2020, 11:30 AM | #171 |
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20th December 2020, 01:56 PM | #172 |
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Has anyone brought up whether or not it is safe or effective to get more than one vaccine?
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Maybe later.... |
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20th December 2020, 02:26 PM | #173 |
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"Brazilian president Jair Bolsonaro has again lashed out at coronavirus vaccines, saying that Pfizer’s shot could turn people into crocodiles, among other bizarre claims. During the outlandish rant on Thursday, Mr Bolsonaro suggested that the vaccine could also lead to women growing facial hair and men speaking with effeminate voices. "Some people say I’m giving a bad example. But to the imbeciles, to the idiots that say this, I tell them I've already caught the virus, I have the antibodies, so why get vaccinated?” he said on Thursday." https://uk.news.yahoo.com/bolosonaro...161207091.html |
20th December 2020, 02:29 PM | #174 |
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Maybe later.... |
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20th December 2020, 02:29 PM | #175 |
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The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.Bertrand Russell Zooterkin is correct Darat Nerd! Hokulele Join the JREF Folders ! Team 13232 Ezekiel 23:20 |
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21st December 2020, 08:00 AM | #176 |
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21st December 2020, 08:14 AM | #177 |
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21st December 2020, 01:48 PM | #178 |
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22nd December 2020, 01:47 AM | #179 |
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22nd December 2020, 04:33 AM | #180 |
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22nd December 2020, 06:00 AM | #181 |
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22nd December 2020, 06:10 AM | #182 |
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The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.Bertrand Russell Zooterkin is correct Darat Nerd! Hokulele Join the JREF Folders ! Team 13232 Ezekiel 23:20 |
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23rd December 2020, 04:20 PM | #183 |
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I dunno. If you could vaccinate the entire population of a region with a vaccine that is 70% effective, wouldn't that eliminate transmission? A one-dose vaccine that could be stored and transported in standard refrigerators and ice chests might actually be as desirable, maybe more so, than a 95% effective vaccine that is hard to make, store and transport, and requires two shots?
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23rd December 2020, 08:01 PM | #184 |
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As you can imagine, it is not as straightforward as that. A third variabel needs to be taken into considerations - duration of immunity.
The Lancet has a fairly straightforward description of the issue. In short (my bolding), these are the numbers for vaccines that give life-long protection, and assuming an R0 value before lockdowns of between 2·5 to 3·5. For a vaccine with 100% efficacy we estimate the herd immunity required is about 60–72%.The article is probably worth reading to get the full idea being presented rather than my very very brief summary of the key points. |
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23rd December 2020, 09:27 PM | #185 |
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The Pfizer vaccine is 91% effective after one dose, 95% after two. It's been suggested (by Tony Blair) that a single dose be given whilst supplies are low.
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23rd December 2020, 11:09 PM | #186 |
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Isnt it only touted as 52% effective after one jab and only 95% effective after the second jab?
That article seems to support that, as does a Dec 11 article in the BMJ. Blair is wrong (as well as being a war criminal). |
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23rd December 2020, 11:10 PM | #187 |
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Two issues with this
1. You will never vaccinate the entire population. There are some people who will refuse to be vaccinated and others cannot be vaccinated for legitimate reasons. If only 80% were vaccinated that means 0.8 X 0.7 = 56% effective. 2. You could still import cases and it could spread for sometime before dying out. This would be true if one patent spread it to many people. |
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23rd December 2020, 11:47 PM | #188 |
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24th December 2020, 12:14 AM | #189 |
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Ah, here's the guy's reasoning:
https://www.theguardian.com/world/20...-covid-adviser
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24th December 2020, 01:38 AM | #190 |
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Here in Texas many providers are getting say 500 doses and vaccinating 250 people now, holding the rest of the doses and then vaccinating again in 2-4 weeks (depending on which they got). But the State has said: do not do that; vaccinate as many as possible.
At our office, holding doses was the plan but I talked them out of it. We need to get as many as possible vaccinated and more doses are coming. From my own experience, which is obviously limited, I think a lot of doctors signed up to be vaccinators with the wrong idea. Sign up started way before approval, before priority groups were established and before it was 100% clear exactly what was going to happen. From my conversations with other office managers and doctors, they thought they were signing up to be able to purchase the vaccines and that they would have some say in who they give the vaccine to. But that’s not how it is at all. At my clinic, there’s a lot of regret about getting involved in this at all. It’s a lot of work for basically nothing in return. Sure, we can bill insurance for administration, but the fees paid are not really enough to cover the extra labor. Your average clinic is not set up to be a mass vaccination site on this scale. We get 500 doses next week and we are expected to administer those -only to healthcare workers, with all the work that entails, and be ready for the next shipment in a week. While running normal clinic. During a pandemic where we are supposed to keep people distanced. But the wife of one of the owners (who is a PA and thinks she runs the place) was insistent that we get it. Why? She wanted to make sure she had it so her family would be amongst the first to get it. Seriously. Now that she knows that isn’t going to happen, she has abandoned any responsibility for it at all, which basically leaves the logistics of this nightmare in my lap. I’m not happy and I told the doctors that today. I never thought we should do this ... not that I don’t want to be a part of the solution but because we aren’t setup for it. Honestly, this initial wave should have been in the hands of county health authorities and big facilities like hospitals. Clinics like us shouldn’t have gotten it until the supply is large enough that we can start giving it to our patients. Sorry for the long post, but I thought I’d give you some insight from ground level. |
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24th December 2020, 02:00 AM | #191 |
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24th December 2020, 05:39 AM | #192 |
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I personally can’t find any articles on the New England Journal of Medicine site that that claim 91% efficacy after only the first jab. All seem to indicate 50+% then 95%+ after the second.
I literally don’t know where they are getting there numbers - but frankly I wouldn’t trust Blair if he told me snow was cold, so perhaps my assessment may be a little blinkered. |
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24th December 2020, 10:07 AM | #193 |
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Exactly. It's hard to believe that clinic managers in the UK, Germany, Japan or anywhere else could game their health care systems to benefit their families. Even if your doses actually go to the people who are supposed to get them. they are coming out of a limited supply chain and being taken from facilities that are better equipped to deal with them.
Maybe you could anonymously drop a dime on this owner's wife? There must be some regulatory authority you could complain to. |
24th December 2020, 11:09 AM | #194 |
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I’m going to take the approach that, since I’m the vaccine coordinator of record I am coordinating how we do this. If I find out she’s sneaking people in to jump the line and the docs don’t back me up when I put a stop to it, I will resign and report. Now, the State has made clear that if we have doses left over and have made every attempt vaccinated all available priority group members, they want us to pivot and start vaccinating anyone. They’d rather doses not go to waste. But I don’t anticipate we will have left over after reaching out to all the clinics, home health, hospice, skilled nursing, etc. We have a large network of healthcare entities and not enough doses as is. |
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24th December 2020, 11:11 AM | #195 |
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24th December 2020, 01:37 PM | #196 |
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The rate the vaccine is being rolled out in Scotland, it will take just short of 4 years to do everyone.
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24th December 2020, 04:26 PM | #197 |
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24th December 2020, 04:31 PM | #198 |
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I'm not sure what you mean by this. And there are plenty of countries having plenty of distribution problems.
The US sent doses to state departments of health. If a clinic in TX got doses before people in higher tiers got them, that would be the TX department of health making those decisions. In this state (WA) distribution is being well managed so far. And providers have to account for every dose reporting back the the DoH. |
24th December 2020, 04:33 PM | #199 |
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24th December 2020, 06:41 PM | #200 |
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It was Prof David Salisbury, a former director of immunisation at the Department of Health who made the 91% after the first jab claim - this was his own interpretation of the published research.
The authors disagree with his interpretation. [Salisbury] New England Journal of Medicine study had reported the first dose of the Pfizer/BioNTech vaccine to have 91% efficacy, compared with 95% for two doses. That level of protection, he [Salisbury] said, was justification for administering only one dose to a larger group at first, followed by the second when possible.Tony Blair at made his argument based on the known efficacy and is merely promoting the idea of getting more people vaccinated with an initial jab, given the number of vaccines available. “Does the first dose give you substantial immunity – and by that I mean over 50% effectiveness? If it does, there is a very strong case for not, as it were, holding back doses of the vaccine,” Blair said.I will grudgingly admit that Blair may well have a valid argument given the circumstances in the UK. |
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