Hospital vaccine mandate?

[miacomet]

My system has stated, post CMS announcement, that they will not have a vaccine mandate.
They also will not let patients select vaccinated caregivers.

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[Apollyon]

They also will not let patients select vaccinated caregivers.

So, THEORETICALLY, a pt could be seeing "Typhoid Mary, MD"?

 

[miacomet]

So, THEORETICALLY, a pt could be seeing "Typhoid Mary, MD"?

I think it's more likely to be Tyhpoid Mary, tech.
But yes.
How this will work with CMS dollars I have no idea, but they are digging in on their anti-vax stance.
I'm not allowed to go out of network, so I'm cancelling my colonoscopy until SOMETHING can be figured out. I'll keep my radiology appointments, but can't wear an N-95 during the colonoscopy.

 

[Birdstrike]

So, THEORETICALLY, a pt could be seeing "Typhoid Mary, MD"?

"Hey! What about Typhoid Mary, NP?"

 

[Birdstrike]

My system has stated, post CMS announcement, that they will not have a vaccine mandate.
They also will not let patients select vaccinated caregivers.

Are they going to require the weekly testing or just give the one finger salute to the Feds, all together?

 

[miacomet]

Are they going to require the weekly testing or just give the one finger salute to the Feds, all together?

The weekly testing is part of the OSHA standard.
I did not read anything about weekly testing in the CMS announcement- might you have a link?
They discourage testing right now. They barely test patients.

 

[Arcan57]

I can’t be bothered to endure mild inconvenience to save your life. Don’t you know that the people in the Towers and the servicemen and women that died in the subsequent wars sacrificed themselves so that no one would ever tell you to do anything that benefits society as a whole*. Uggh, I can’t do people right now.

*Lightly edited from Facebook repost from former ED RN turned NP applauding a county sheriff for refusing to enforce vaccine mandate.

 

[Old_Mil]

I never thought I’d live to see the day that entire states were anti-vaxers.

I'm not an "anti-vaxxer". I'd like nothing more than for Pfizer to have put an effective vaccine with a reasonable side effect profile on the market that I could recommend to everyone like I do a tetanus shot. Unfortunately they didn't, and so I don't.

By the way, the latest data out of India states that for boys the rate of hospitalization for vaccine side effects is 4x-6x that of contracting Covid.

 

[aafisahar]

I'm not an "anti-vaxxer". I'd like nothing more than for Pfizer to have put an effective vaccine with a reasonable side effect profile on the market that I could recommend to everyone like I do a tetanus shot. Unfortunately they didn't, and so I don't.

By the way, the latest data out of India states that for boys the rate of hospitalization for vaccine side effects is 4x-6x that of contracting Covid.

In America, it's 1000:1. No one with the vaccine is going to an LTACH with a trach and peg, or going to the crematorium after 45 days in the ICU.

 

[Old_Mil]

In America, it's 1000:1. No one with the vaccine is going to an LTACH with a trach and peg, or going to the crematorium after 45 days in the ICU.

The people most at risk for side effects from the vaccine aren't doing that if they contract covid either. For the "in America" crowd, global pandemic, global data.

 

[Old_Mil]

SARS-CoV-2 mRNA Vaccination-Associated Myocarditis in Children Ages 12-17: A Stratified National Database Analysis

Objectives Establishing the rate of post-vaccination cardiac myocarditis in the 12-15 and 16-17-year-old population in the context of their COVID-19 hospitalization risk is critical for developing a vaccination recommendation framework that balances harms with benefits for this patient...

www.medrxiv.org

 

[southerndoc]

I'm not an "anti-vaxxer". I'd like nothing more than for Pfizer to have put an effective vaccine with a reasonable side effect profile on the market that I could recommend to everyone like I do a tetanus shot. Unfortunately they didn't, and so I don't.

By the way, the latest data out of India states that for boys the rate of hospitalization for vaccine side effects is 4x-6x that of contracting Covid.

I see the data, but I have to agree with @aafisahar in that they may be hospitalized at a higher rate, but none of them are dying or going to a long-term rehab facility on a ventilator. In the US, children's hospitals are full right now where Covid is running rampant.

 

[Birdstrike]

By the way, the latest data out of India states that for boys the rate of hospitalization for vaccine side effects is 4x-6x that of contracting Covid.

Link, please.

Edit: I see that you added it above probably while I was typing. Will review.

 

[VA Hopeful Dr]

SARS-CoV-2 mRNA Vaccination-Associated Myocarditis in Children Ages 12-17: A Stratified National Database Analysis

Objectives Establishing the rate of post-vaccination cardiac myocarditis in the 12-15 and 16-17-year-old population in the context of their COVID-19 hospitalization risk is critical for developing a vaccination recommendation framework that balances harms with benefits for this patient...

www.medrxiv.org

So you're comparing apples to oranges here: vaccinated with myocarditis and unvaccinated admissions due to COVID.

What you SHOULD be comparing is myocarditis from the vaccine versus myocarditis from COVID infection. Those numbers tell a different story.

From your article, the highest rate of myocarditis from the vaccine is 162/million. Myocarditis after catching COVID is around 450/million from what I've been able to find. None of the sources I found addressed if there is a difference in severity between vaccine heart damage and infection heart damage. So if we assume they are equal, you're still 2.7X more likely to get myocarditis from COVID than from the vaccine.

 

[Arcan57]

So you're comparing apples to oranges here: vaccinated with myocarditis and unvaccinated admissions due to COVID.

What you SHOULD be compared is myocarditis from the vaccine versus myocarditis from COVID infection. Those numbers tell a different story.

From your article, the highest rate of myocarditis from the vaccine is 162/million. Myocarditis after catching COVID is around 450/million from what I've been able to find. None of the sources I found addressed if there is a difference in severity between vaccine heart damage and infection heart damage. So if we assume they are equal, you're still 2.7X more likely to get myocarditis from COVID than from the vaccine.

He's not arguing in good faith. He has his belief, he's not going to change it, and he can throw out a mix of poor quality studies and red herrings from now til the heat death of the universe. I suggest moving on.

 

[aafisahar]

He's not arguing in good faith. He has his belief, he's not going to change it, and he can throw out a mix of poor quality studies and red herrings from now til the heat death of the universe. I suggest moving on.

says he's not an anti-vaxxer but walks and talks like one......

 

[deleted206819]

SARS-CoV-2 mRNA Vaccination-Associated Myocarditis in Children Ages 12-17: A Stratified National Database Analysis

Objectives Establishing the rate of post-vaccination cardiac myocarditis in the 12-15 and 16-17-year-old population in the context of their COVID-19 hospitalization risk is critical for developing a vaccination recommendation framework that balances harms with benefits for this patient...

www.medrxiv.org

This is taking all comers from the VAERS database which has not been validated for accuracy. Anyone can report a potential VAERS complication.

Peer review of a VAERS dumpster dive

A new preprint study on COVID vaccine myocarditis dives into the VAERS dumpster with predictable and embarrassing results.

sciencebasedmedicine.org

Read this before making up your mind.

 

[Old_Mil]

So you're comparing apples to oranges here: vaccinated with myocarditis and unvaccinated admissions due to COVID.

I'm comparing the two data points that you would want to compare if you are comparing risk of hospitalization from the disease vs risk of hospitalization from the vaccine. Dismissing things as "poor quality studies" that don't agree with your point of view simply is a way of justifying confirmation bias.

 

[Birdstrike]

I'm gonna hit the easy button on this one, and go with the American Academy of Pediatrics:

“...this is an extremely rare side effect, and only an exceedingly small number of people will experience...for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment...myocarditis and pericarditis are much more common if you get COVID-19, and the risks to the heart from COVID-19 infection can be more severe.”

I don't see that they're missing anything.

 

[Old_Mil]

Think about that statement for a minute. If myocarditis and percarditis were much more common from Covid-19 in the healthy pediatric population, why would the risk of hospitalization after getting the vaccine be higher? We know that ACEP's and AAEM's pronouncements are often driven by...lets put it nicely, "non-scientific" considerations. What makes you think that AAP and AAFP are any different?

I'm surprised no one has tried to answer my post saying "Yeah, but the childhood obesity rates in the US are much higher than in India which makes us a different demogaphic."

That may be true. But once again, that comes down to "vaccinate at risk persons", not "mindlessly vaccinate everyone".

 

[southerndoc]

Think about that statement for a minute. If myocarditis and percarditis were much more common from Covid-19 in the healthy pediatric population, why would the risk of hospitalization after getting the vaccine be higher? We know that ACEP's and AAEM's pronouncements are often driven by...lets put it nicely, "non-scientific" considerations. What makes you think that AAP and AAFP are any different?

There could be selection bias here. Docs may diagnose it more frequently because they've heard it exists (i.e., they may not be checking troponins and EKG's on those not vaccinated) and they may be over-admitting vaccinated patients out of an abundance of caution from the vaccine.

Not everything is as straightforward as it seems.

 

[Birdstrike]

We know that ACEP's and AAEM's pronouncements are often driven by...lets put it nicely, "non-scientific" considerations. What makes you think that AAP and AAFP are any different?

I don't doubt there are plenty of people trying to influence their decisions.

 

[Birdstrike]

But once again, that comes down to "vaccinate at risk persons", not "mindlessly vaccinate everyone".

Who should get the vaccine and who shouldn't, in your opinion?

 

[aafisahar]

That may be true. But once again, that comes down to "vaccinate at risk persons", not "mindlessly vaccinate everyone".

Like I said earlier, I discharged two people last week to LTACH, trach/peg. One was early 20s, one was late 20s, both healthy, not taking any meds. By all accounts, they are low risk. Should they have gotten the vaccine based on your notion of "vaccinate at risk" people.

They get to live out the rest of their foreseeable life in an LTACH or on disability because they bought the same lies that you are spouting here.

 

[maxxor]

Like I said earlier, I discharged two people last week to LTACH, trach/peg. One was early 20s, one was late 20s, both healthy, not taking any meds. By all accounts, they are low risk. Should they have gotten the vaccine based on your notion of "vaccinate at risk" people.

They get to live out the rest of their foreseeable life in an LTACH or on disability because they bought the same lies that you are spouting here.

Is @Old_Mil even clinical at this point?

For what it’s worth, the disaster COVID CTs I’ve been reading is far younger and younger than January. Whatever received wisdom of “young people don’t get this” or “have limited risk” is not true for delta. And anyone who keeps bringing up old data is either out of touch or arguing disingenuously.

 

[Birdstrike]

For what it’s worth, the disaster COVID CTs I’ve been reading is far younger and younger than January.

I've also been hearing about more younger, severe cases of covid with Delta. Is it because Delta has higher morbidity and fatality rates in the young? Or it it because with the high risk being more likely to be vaccinated, and there's simply more focus on the younger cases, and an amplification?

In other words, were the severe young cases happening as often a year ago just as often, but we just didn't hear about them as much, because the sheer numbers in the older patients were getting all of the attention? Or has the case fatality rate increased in the young since Delta came along?

I don't know. I'm just asking.

 

[VA Hopeful Dr]

I'm comparing the two data points that you would want to compare if you are comparing risk of hospitalization from the disease vs risk of hospitalization from the vaccine. Dismissing things as "poor quality studies" that don't agree with your point of view simply is a way of justifying confirmation bias.

So wait, the vaccinated CAE's were all hospitalized? Where are you seeing that?

Also for what its worth, I never said anything about poor quality studies. No sure where you get that from.

 

[VA Hopeful Dr]

I've also been hearing about more younger, severe cases of covid with Delta. Is it because Delta has higher morbidity and fatality rates in the young? Or it it because with the high risk being more likely to be vaccinated, and there's simply more focus on the younger cases, and an amplification?

In other words, were the severe young cases happening as often a year ago just as often, but we just didn't hear about them as much, because the sheer numbers in the older patients were getting all of the attention? Or has the case fatality rate increased in the young since Delta came along?

I don't know. I'm just asking.

I think Delta is worse. I've had a number of patients who had COVID back in Nov-Jan, mild symptoms. They then got COVID again in July/August and were much sicker. None of them that I'm aware of got admitted, but it was a week of fevers, body aches, and awful cough now compared to congestion and slight cough the first time.

 

[Mount Asclepius]

I’d like to pose a slightly different idea for discussion. Anyone think that perhaps it’s primarily the body’s inflammatory response rather than the virus driving most morbidity and mortality? Seems to me that we might be doing that to some degree as well with the vaccine. However, I do think it is probably a more controlled exposure versus a completely unknown, variable viral load.

I was more skeptical of the vaccine than almost everyone else on this forum. However, I’m one of the few that can be skeptical, but open minded, looking at the mounting data and allow my mind to be changed regarding the safety profile and risk/benefit. I wanted to be a late adopter, but not necessarily a never adopter. I fairly recently received my second dose just prior to all the mandates. For complete disclosure, I’m almost fairly positive my spouse and I had COVID-19 about 1.5 years ago as well. I still think most people have been exposed/infected prior to vaccination, but doubt the vaccine is causing very significant harm at this point. You can decline vaccination, but you will eventually be exposed/infected by COVID-19 at least once, and likely more than that. There are risks of immunization, and we shouldn’t delegitimize that, although major adverse affects appear very uncommon. The risk/benefit analysis has shifted though over the past year.

 

[dadaddadaBATMAN]

I’d like to pose a slightly different idea for discussion. Anyone think that perhaps it’s primarily the body’s inflammatory response rather than the virus driving most morbidity and mortality? Seems to me that we might be doing that to some degree as well with the vaccine. However, I do think it is probably a more controlled exposure versus a completely unknown, variable viral load.

I was more skeptical of the vaccine than almost everyone else on this forum. However, I’m one of the few that can be skeptical, but open minded, looking at the mounting data and allow my mind to be changed regarding the safety profile and risk/benefit. I wanted to be a late adopter, but not necessarily a never adopter. I fairly recently received my second dose just prior to all the mandates. For complete disclosure, I’m almost fairly positive my spouse and I had COVID-19 about 1.5 years ago as well. I still think most people have been exposed/infected prior to vaccination, but doubt the vaccine is causing very significant harm at this point. You can decline vaccination, but you will eventually be exposed/infected by COVID-19 at least once, and likely more than that. There are risks of immunization, and we shouldn’t delegitimize that, although major adverse affects appear very uncommon. The risk/benefit analysis has shifted though over the past year.

In general terms the immune response isn’t just “more” or “less” it has significant qualitative differences.

Helper Th1, 2 and 17 have common pathways but pretty different responses. Different amounts of nk cells, cd8 and other responses all carry weight, and are partially directed by these. The discussion of serological/humoral immunity is likely a distraction since we know these cell mediated pathways are significantly more important in many viral infections, though of course antibodies probably play a role in defending against low viral loads, opsonization, etc.

if the vaccine lead to pathological immune states we would see more people who died after having it. We’d see more people in the hospital. We’d see more dramatic symptoms.

not a single one of those patterns has born out. It seems likely that if you’re going to have a pathological cytokine storm it will come from the disease, or from overwhelming infection.

Edit: I would also argue that the risk benefit hasn’t really changed much in the last year. The initial data was compelling. Subsequent data has reproduced the initial findings. Hundreds of millions of doses have been given without significant differences in major adverse events, and with a repeatedly demonstrated mortality benefit even in this more infectious variant.

 

[thegenius]

I’d like to pose a slightly different idea for discussion. (1) Anyone think that perhaps it’s primarily the body’s inflammatory response rather than the virus driving most morbidity and mortality? Seems to me that we might be doing that to some degree as well with the vaccine. However, I do think it is probably a more controlled exposure versus a completely unknown, variable viral load.

I was more skeptical of the vaccine than almost everyone else on this forum. (2) However, I’m one of the few that can be skeptical, but open minded, looking at the mounting data and allow my mind to be changed regarding the safety profile and risk/benefit. I wanted to be a late adopter, but not necessarily a never adopter. I fairly recently received my second dose just prior to all the mandates. For complete disclosure, I’m almost fairly positive my spouse and I had COVID-19 about 1.5 years ago as well. I still think most people have been exposed/infected prior to vaccination, but doubt the vaccine is causing very significant harm at this point. You can decline vaccination, but you will eventually be exposed/infected by COVID-19 at least once, and likely more than that. There are risks of immunization, and we shouldn’t delegitimize that, although major adverse affects appear very uncommon. The risk/benefit analysis has shifted though over the past year.

1. Yes

2. LOL

 

[dchristismi]

My hospice certifications for covid-19 respiratory failure with desire for liberation from mechanical ventillation continue to decimate families. Did a cert yesterday for a Dad whose two daughters died the week before. Mom recovered. All unvaxxed. Dad obese but otherwise not in terrible shape. And they do seem to be getting younger.

Now they often aren't even getting intubated and families just opt for CMO from HHF. None that I recall have been vaccinated, and the families often make a point to say so, and the kids often feel terribly guilty. (I talk to the admissions nurses via phone - they're the ones at the hospitals.) Being in Florida means that the rest of the family is often up north and mom and dad moved down when they retired. Or mom and dad moved down, mom died and dad remarried and there are fragments of families, stepfamilies... yeah, complicated.

Guilt is a terrible feeling, and it's just... so sad.

 

[MechEDoc]

That may be true. But once again, that comes down to "vaccinate at risk persons", not "mindlessly vaccinate everyone".

Isn't "mindlessly vaccinate everyone" the approach our society takes with pertussis to protect infants who are at risk and can't be vaccinated? After all, most pertussis boosters are for people who are at very low risk.

What about "my freedoms!!!" and "let those sheeple neonates wear masks if they don't feel like their immune systems are strong enough"?

 

[Old_Mil]

Isn't "mindlessly vaccinate everyone" the approach our society takes with pertussis to protect infants who are at risk and can't be vaccinated? After all, most pertussis boosters are for people who are at very low risk.

What about "my freedoms!!!" and "let those sheeple neonates wear masks if they don't feel like their immune systems are strong enough"?

Do you believe that the incidence and severity of the Covid-19 vaccine's side effects are in any way similar to that of Pertussis vaccine?

At this point, we know that both the incidence and the severity of side effects from the Covid-19 vaccine are significantly higher than other vaccines we recommend on a regular basis. It's therapeutic value is substantially lower. Don't you think those facts should play into any risk/benefit analysis?

 

[Old_Mil]

Is @Old_Mil even clinical at this point?

For what it’s worth, the disaster COVID CTs I’ve been reading is far younger and younger than January. Whatever received wisdom of “young people don’t get this” or “have limited risk” is not true for delta. And anyone who keeps bringing up old data is either out of touch or arguing disingenuously.

Up until a few months ago I was. Are you a radiologist or an EP?

 

[Arcan57]

Up until a few months ago I was. Are you a radiologist or an EP?

Ah, that explains it.

 

[Mount Asclepius]

1. Yes

2. LOL

Not a helpful or worthwhile response. You think there are very many people anymore whose opinion isn’t set in stone? Good luck finding them. Essentially everyone’s view of the vaccine is entrenched at this point.

“It is the mark of an educated mind to be able to entertain a thought without accepting it.” - Aristotle

I would bet there are very few people anymore willing to entertain alternative views related to COVID-19. And no, I don’t mean ideas that are clearly in the realm of conspiracy theory.

 

[Mount Asclepius]

if the vaccine lead to pathological immune states we would see more people who died after having it. We’d see more people in the hospital. We’d see more dramatic symptoms.

Thanks for your response. I wonder if it is dose dependent. Perhaps immune competent (including non-elderly and non-obese) are infected with a very small viral load that their body quickly fights off developing a degree of immunity before their system goes into overdrive. If you were to receive 10x or 100x the vaccine dose, perhaps we would see more adverse reactions.

I would also argue that the risk benefit hasn’t really changed much in the last year. The initial data was compelling.

I’d argue it definitely has. We knew from the beginning COVID-19 was very unlikely to cause significant morbidity or mortality for healthy, younger individuals. On the other hand, we didn’t know a ton about the vaccine. Initial data for a new therapy is always compelling (especially if industry funded). Then the meta-analysis comes out and frequently shows no benefit. I think time and evidence has shown a benefit, but for most of medicine that often isn’t the case.

 

[Birdstrike]

Ah, that explains it.

In all fairness to @Old_Mil , it explains exactly what? Certainly, you're not implying that someone is automatically wrong after not having worked an ED shift in a "few months."

Let's face it. None of us here, are vaccinologists. We are Dunning-Krugering the subject to death, though.

 

[Arcan57]

In all fairness to @Old_Mil , it explains exactly what? Certainly, you're not implying that someone is automatically wrong after not having worked an ED shift in a "few months."

Let's face it. None of us here, are vaccinologists. We are Dunning-Krugering the subject to death, though.

It explains espousing a world view that is a little out there pre-Delta but completely out of step with the Delta world. There’s also an element of not having skin in the game which makes it easier to vocalize beliefs that are harmful to others.

 

[Mount Asclepius]

It explains espousing a world view that is a little out there pre-Delta but completely out of step with the Delta world. There’s also an element of not having skin in the game which makes it easier to vocalize beliefs that are harmful to others.

Delta shmelta. We act like a variant is completely different than the disease itself. It’s still COVID. Maybe slightly more/less infectious or more/less lethal. The general overreaction to an expected variant through a natural evolutionary process needs to subside.

 

[VA Hopeful Dr]

Delta shmelta. We act like a variant is completely different than the disease itself. It’s still COVID. Maybe slightly more/less infectious or more/less lethal. The general overreaction to an expected variant through a natural evolutionary process needs to subside.

Umm, have you not seen the literally overflowing hospitals? Physicians calling dozens of hospitals to find an open ICU bed?

My hospital has 20% more COVID patients admitted right now compared to the worst of what we had back in January and case numbers show no signs of going down.

And that's with almost 50% of the eligible population vaccinated compared to almost no one back in January.

But sure, it's "just a variant".

 

[Birdstrike]

If we are all about science then we should accept natural immunity >= vaccination. When friends asks me why the need to get the vaccine when they caught covid pre vaccination, I just shrug and tell them its bad science.

people who has tested positive should have the same rights as someone not vaccinated.

Major hospital system exemption for natural immunity

Spectrum Health workers can use natural immunity as vaccine mandate exemption

Spectrum Health will grant temporary exemptions from its employee vaccine mandate to individuals who can prove they have naturally acquired immunity to COVID-19.

www.detroitnews.com

 

[Mount Asclepius]

Umm, have you not seen the literally overflowing hospitals? Physicians calling dozens of hospitals to find an open ICU bed?

My hospital has 20% more COVID patients admitted right now compared to the worst of what we had back in January and case numbers show no signs of going down.

And that's with almost 50% of the eligible population vaccinated compared to almost no one back in January.

But sure, it's "just a variant".

We were also like that for a while pre-delta. Our volume of admitted COVID-19 patient was actually 3x higher at one point pre-delta than it is currently with over 90% delta. It varies based upon location. We will have continued surges and spikes related to outbreaks as well as new variants. This is likely a 3 year pandemic. October 2019 to October 2022.

 

[VA Hopeful Dr]

We were also like that for a while pre-delta. Our volume of admitted COVID-19 patient was actually 3x higher at one point pre-delta than it is currently with over 90% delta. It varies based upon location. We will have continued surges and spikes related to outbreaks as well as new variants. This is likely a 3 year pandemic. October 2019 to October 2022.

Except we don't have to. This is pretty much an epidemic of the unvaccinated. We're running around 9-10% vaccinated patients admitted. If everyone was vaccinated instead of 280 admissions we'd have maybe 60.

 

[Mount Asclepius]

Except we don't have to. This is pretty much an epidemic of the unvaccinated. We're running around 9-10% vaccinated patients admitted. If everyone was vaccinated instead of 280 admissions we'd have maybe 60.

I partially agree with the heart of your post. I think regardless of immunizations this pandemic is still going to last 3 years. We are at about 30% of admits being previously immunized. Although most ICU admits (>90%) are non-immunized. I think bed shortages are related more so to a system designed like the hotel industry and capitalism to always run at 100% capacity with no room built in for stresses to the system.

 

[rokshana]

says he's not an anti-vaxxer but walks and talks like one......

Generally when you have to say you are NOT something… you usually are…

 

[WilcoWorld]

Do you believe that the incidence and severity of the Covid-19 vaccine's side effects are in any way similar to that of Pertussis vaccine?

yes

my tdap hurts!

 

[WilcoWorld]

I’d argue it definitely has. We knew from the beginning COVID-19 was very unlikely to cause significant morbidity or mortality for healthy, younger individuals. On the other hand, we didn’t know a ton about the vaccine. Initial data for a new therapy is always compelling (especially if industry funded). Then the meta-analysis comes out and frequently shows no benefit. I think time and evidence has shown a benefit, but for most of medicine that often isn’t the case.

Just to be clear - you're saying that the evidence has become more compelling, right?

The "natural course" of this disease continues to cause death and ICU congestion in all of our hospitals. In this time I have admitted ZERO patients to the hospital for adverse vaccine reactions. The vaccine now has millions more cases and several more months worth of data and still appears very, very effective at preventing severe disease.

I agree - the data has become more compelling.

 

[WilcoWorld]

I also agree with what I take to be your earlier point - we should strive for humility in our assessments of certainty.

If you aren't open to being wrong, then you aren't doing science.