Pfizer effectiveness dramatic drop vs Delta

[NITRAS]

92% of our admissions are in unvaccinated. About 6-7% in vaccinated with a sprinkling of “partially vaccinated”.

I’m not sure i buy everything out there, but I do believe my own eyes.

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[Arcan57]

It's just something to be aware of. It's not something that should take precedence over any other bit of information on the subject.

Is it something to be aware of as an EM provider? It seems really damn important to know about if you’re a vaccine developer. At our level, it’s far more likely that someone unvaccinated hears us talking about it and comes away thinking “people with the vaccine actually get sicker from COVID”.

There’s a path forward where COVID becomes a manageable disease. And that path is going to involve a lot of needles in a lot of arms, probably on a regular basis. So it seems like our messaging should reflect that.
The more we validate arguments that (falsely) imply intellectual or moral superiority regarding the decision not to be vaccinated, the more suffering and death.

 

[Mount Asclepius]

The arrogance of medicine. The reality of nature. We seem to think we control disease, and yet the more I practice, the more I feel that how little of what we do matters (sorry Mel Herbert). Diet and exercise matter. Oxygen and steroids seem to matter for COVID-19. A lot of what we do in medicine doesn’t seem to matter. Call me cynical, but I feel humbled and awed by nature and the human body. I even once thought that for sure antibiotics mattered. Then watched as a fairly significant extremity cellulitis advanced and then receded on its own. I thought this pandemic would last 3 years, hoped it wouldn’t, but it appears we are in for a bit more regardless of what we do. The end of this pandemic is drawing near though.




Think big. Spend time with those that you care about today. Enjoy nature. We all only have so much time to do so.

 

[MechEDoc]

Australian cities/states go into hard lockdown to get back to elimination. It worked pretty well before delta.

Sydney/NSW tried to sort of neighborhood restrictions-lite, and to vaccinate their way out of it for this past outbreak – and it has failed miserably at 1) getting back to elimination, and 2) preventing their health system from being overrun. It also resulted in tendrils of delta getting out into neighboring states, triggering them to go into hard lockdowns. So, now, finally, NSW is in a hard lockdown with borders closed to other states. At 400 cases a day, though, it's going to take several weeks to get close to elimination-level again.

Good luck with that is multi unit apartments with any cross ventilation between units.

 

[turkeyjerky]

If we are forced to ration care, ie ventilators etc, here's how you'll see it done:

There will be a panel at your hospital of admin, physicians, and lawyers. Every day they will run the list of critical patients and decide who gets a vent base on severity of illness and likelihood of survival. They will use some type of measure, possibly SOFA score, as an attempt at objectively measuring mortality risk. The rationale is in part to limit any liability related to discriminatory practices. This will likely fall in line with local state measures for disaster planning.

Not saying this is better, or more fair, but this is likely the way it will be done.

Nah. Far more likely it'll be down to an individual doc to be forced to ration by "encouraging hospice". "Leadership" has deferred at every opportunity to actually lead throughout this whole thing. I saw a ton of this last winter.

The epidemiological data doesn’t seem to support prior infection with alpha as being superior to vaccination. Florida YOLO’d alpha and had tons of infections. They’re YOLO’ing Delta and still getting trashed with severe disease. NYC got absolutely wrecked during alpha, and largely vaxx’ed up and are doing pretty damn well.

An alternative explanation would be that actual rates of infection during 2020-early 21 were not nearly as high as most people would think. In reality NYC only had an attack rate of at most 15% during the first wave. The problem is that the healthcare system is really not set up for even this type of surge. Which is why people are perpetually perplexed that this disease can overwhelm our healthcare system w/o seeing people dead in the streets. Seemingly, the delta variant is infectious enough that it can cause a significant surge even with 60-70% population immunity. (Moreover there are probably some additional effects on infection rates from the fact that covid likely attacks family/household units rather than being randomly distributed through the population. My guess is that this would further increase the 'herd immunity' threshold).

 

[Birdstrike]

Is it something to be aware of as an EM provider? It seems really damn important to know about if you’re a vaccine developer. At our level, it’s far more likely that someone unvaccinated hears us talking about it and comes away thinking “people with the vaccine actually get sicker from COVID”.

There’s a path forward where COVID becomes a manageable disease. And that path is going to involve a lot of needles in a lot of arms, probably on a regular basis. So it seems like our messaging should reflect that.
The more we validate arguments that (falsely) imply intellectual or moral superiority regarding the decision not to be vaccinated, the more suffering and death.

1) I'm pro-vaccine and have said so, multiple times on this forum.
2) I'm not in favor of suppressing scientific publications and free discussion of them, for any reason.

Picking and choosing which scientific studies people can and can't share and discuss, based on predetermined "messaging" has a name. It's called bias.

 

[Birdstrike]

...I still think the severity of the case is less in the vaccinated.

I agree.

 

[maxxor]

1) I'm pro-vaccine.
2) I'm not in favor of suppressing scientific publications and free discussion of them, for any reason.

How do you get from “yes this is a thing, and no, it’s not happening and isn’t a reason to avoid the vaccine” to “suppressing scientific publications”?

A concept of antibody dependent enhancement is something to keep in the back of our minds, if we start seeing sicker vaccinated patients compared to non vaccinated.

However, in the current reality people bringing it up is akin to concern trolling where someone introduces fear, uncertainty, and doubt because of a theoretical risk. It’s straight up standard misinformation tactic where someone “is just asking questions” to undermine whatever position for whatever motive. Things may change in the future, but as of today, it’s not relevant to current decision making. Avoiding a vaccine now because of potential ADE risk is not logical.

 

[Birdstrike]

How do you get from “yes this is a thing, and no, it’s not happening and isn’t a reason to avoid the vaccine” to “suppressing scientific publications”?

…Avoiding a vaccine now because of potential ADE risk is not logical.

I’m pro-vaccine.

I posted multiple journal articles as I often do. Some I agree with, some it don’t, some I'm not sure about. Some are even contradictory at times. It’s to generate discussion. People can do with the information what they will, and boy, do they!

How I got from Arcan’s post to “suppression of scientific publications” is not because he disagreed with it. I actually agree with his interpretation. His post was the type of response I was looking for, until he implied I was wrong to post as Journal of Infection article, with no comment and no conclusion of my own. But it’s okay for him to post the articles he posted?

I don’t think so.

That’s a form of intimidation, cyber-bullying, and outright bias; implying that by posting a scientific article by the Journal of Infection without comment I was causing “suffering and death.”

Furthermore, you put words in my mouth by implying I told people to “avoid a vaccine now because of potential ADE risk.” I never wrote that.

I’m been pro-vaccine since day #1 and continue to be so. I got vaxxed and got my whole family vaxxed, day 1. I’ve even gone so far as to talk about boosters, publically on this forum and in private.

I don't think any of that changes because certain people have a problem they need to take up with the Journal of Infection.

 

[Arcan57]

1) I'm pro-vaccine and have said so, multiple times on this forum.
2) I'm not in favor of suppressing scientific publications and free discussion of them, for any reason.

Picking and choosing which scientific studies people can and can't share and discuss, based on predetermined "messaging" has a name. It's called bias.

Are you in favor of bringing up concepts that don’t have any relevance to the discussion at hand and cloud the waters?

Forgive me if I’ve heard so many bad faith arguments that a link to an article about a potentially severe problem with vaccines presented by the OP of a thread doesnt feel neutral. The thread was started to provide anecdotal evidence that vaccinations aren’t very effective. The article didn’t include information about this doesn’t seem to be relevant to the currently available vaccines against the current dominant strains of COVID. There’s no discussion about whether this could happen just as easily with “natural” immunity. When you said that you are pro-vax, I was surprised because your commenting style and general tone slot very closely with some prominently anti-vax posters on this board.

 

[Birdstrike]

Are you in favor of bringing up concepts that don’t have any relevance to the discussion at hand and cloud the waters?

The article caught my attention, particularly as I keep hearing reports of "kids being sicker with covid this time around." There's probably no link; in fact, I'm certain there's no link. The article just happened to catch my attention, that's all. Perhaps it's not as relevant to EM as it could be, but still more relevant that our thread on grilling.

The thread was started to provide anecdotal evidence that vaccinations aren’t very effective.

This is categorically, 100%, provably false. Again, you're literally putting words where they don't exist. I started the thread. The thread was started with a 29 page study the Mayo Clinic is going to publish. Starting a thread with a Mayo Clinic comparative analysis that concludes both Pfizer and Moderna provide "significant protection from severe COVID infection, hospitalization and death" is "anecdote"?

There’s no discussion about whether this could happen just as easily with “natural” immunity.

I posted a journal article. The discussion happens afterwards. If you have something you want to add to the discussion, like the part in bold, you have to add it to the discussion. I can't read minds and post every possible reaction to a journal article, before they happen.

When you said that you are pro-vax, I was surprised because your commenting style and general tone slot very closely with some prominently anti-vax posters on this board.

You were "surprised" when I said I was pro-vax? I posted on this forum the very day (12/16/20) when I got vaxxed. I posted when I got my second shot. I posted my frustrations last winter in trying to find vaccination access for my elderly parents. I started a thread in recent days that my whole family is vaccinated. I've posted in recent days about boosters and how many people I know are already getting them. But you decided to accuse me of causing "suffering and death" because of my general "commenting style and tone" by which was to share a Journal of Infection article?

Forgive me if I'm confused.

 

[Arcan57]

No, I'm not in favor bringing up irrelevant concepts. The only reason that article caught my attention, and I'm not at all saying there is any link at all, but I keep hearing "kids are sicker this time" with COVID. I don't know there's any link. In fact, I think there is not any link. But it caught my attention. I support the vaccine.

But every time I keep hearing "kids are sicker this time around," I keep asking why? Is delta more virulent? Is it just because more kids have COVID now compared to the elderly and sick kids are generating more media attention? Has the virus changed things? Have immune systems changed?

Why are kids sicker now?

I don't know. I have no idea. I like to wonder, and ask questions.

But I haven't heard a good explanation.



This is categorically, 100%, provably false. Again, you're literally putting words where they don't exist. I started the thread. The thread was started with a 29 page study the Mayo Clinic is going to publish. Starting a thread with a Mayo Clinic comparative analysis that concludes both Pfizer and Moderna provide "significant protection from severe COVID infection, hospitalization and death" is "anecdote"?


I posted a journal article. The discussion happens afterwards. If you have something you want to add to the discussion, like the part in bold, you have to add it to the discussion. I can't read minds and post every possible reaction to a journal article, before they happen.




You were "surprised" when I said I was pro-vax? I posted on this forum the very day (12/16/20) when I got vaxxed. I posted when I got my second shot. I posted my frustrations last winter in trying to find vaccination access for my elderly parents. I started a thread in recent days that my whole family is vaccinated. I've posted in recent days about boosters and how many people I know are already getting them. But you decided to accuse me of causing "suffering and death" because of my general "commenting style and tone" by which was to share a Journal of Infection article?

Forgive me if I'm confused.

Sorry, was thinking of your other thread and merged them in my mind. I apologize. There’s been a lot of cross posting on similar topics and I did not exercise sufficient care in checking which thread I was commenting on. I agree that ADE does fit under this thread and apologize for my harsh words.
-Arcan

 

[Birdstrike]

Sorry, was thinking of your other thread and merged them in my mind. I apologize. There’s been a lot of cross posting on similar topics and I did not exercise sufficient care in checking which thread I was commenting on. I agree that ADE does fit under this thread and apologize for my harsh words.
-Arcan

Apology accepted. Let's move on.

 

[deleted836128]

In Australia - almost all the hospitalized patients in the ICU with COVID are vaccinated. This is not being reported widely.

Update: Retracting this. NSW Health director of health protection Dr. Jeremy McAnulty misspoke in a press conference when initially detailing the vaccination status of people in hospital. He initially said all cases were patients who had been vaccinated. Dr McAnulty later corrected himself, identifying that everyone in intensive care units (ICUs) in the state due to COVID-19 was NOT vaccinated.

 

[Dr Mantis Toboggan]

In Australia - almost all the hospitalized patients in the ICU with COVID are vaccinated. This is not being reported widely.

Which vaccine tho?

 

[emergentmd]

Vaccinated are not that protective. Seeing lots of positive vaccinated pts. You are seeing less in the hospital b/c most stay home thinking they are vaccinated and some seasonal allergies stuff.

If you tests all vaccinated people in the community, I bet the percentage will be higher than you could imagine and likely walking around spreading it.

Get vaccinated so you wont' be hospitalized. Don't think getting vaccinated will prevent you from getting it/spreading it b/c you will. Vaccination improves your chance greatly of getting pneumonia, chronic lung disease, and being on a ventilator and month of rehab. Choose what you want, but the betting person would say get it.

 

[d2305]

Astra Zeneca is prevalent there.

 

[Dr Mantis Toboggan]

Astra Zeneca is prevalent there.

Exactly. So unvaccinated essentially.

 

[Birdstrike]

In Australia - almost all the hospitalized patients in the ICU with COVID are vaccinated. This is not being reported widely.

I've seen reports of this also in Israel, also. I'm not sure if it's true or not. But think about it for a second. Even if true, it may not mean what you think.

The vaccinated population skews heavily towards and older population with comorbidities. The unvaccinated population, is largely much younger and healthy, including many in their teens and 20's and everyone under 12.

The vaccine could be working perfectly fine, and it wouldn't take very many breakthrough infections to still fill ICUs with vaccinated oldies, while the younger, less vaccinated population still is faring better, overall.

That might create a perception the vaccine isn't working well, when it still is. I'm just speculating. But that's one possibility, if the statistic is even true at all.

Now let's find some actual data on the question.

 

[turkeyjerky]

I've seen reports of this also in Israel, also. I'm not sure if it's true or not. But think about it for a second. Even if true, it may not mean what you think.

The vaccinated population skews heavily towards and older population with comorbidities. The unvaccinated population, is largely much younger and healthy, including many in their teens and 20's and everyone under 12.

The vaccine could be working perfectly fine, and it wouldn't take very many breakthrough infections to still fill ICUs with vaccinated oldies, while the younger, less vaccinated population still is faring better, overall.

That might create a perception the vaccine isn't working well, when it still is. I'm just speculating. But that's one possibility, if the statistic is even true at all.

Now let's find some actual data on the question.

Also, vaccines typically work less well in those most at risk

 

[thegenius]

Research "antibody dependent enhancement." Antibodies from a previous infection or vaccination can actually bind to the new strain of virus but instead of assisting the immune system to fight the virus, the antibodies actually help the virus enter the cells more effectively so that it is more virulent. some virologiest have said that previous versions of sars vaccines have killed their test animals because of this.

If you don't know about ADE you should not be making any statements about the safety of these vaccines. You do not have all of the information if this is the case. You probably haven't heard about ADE though because the experts voicing these concerns have had their interviews banned from YouTube and mainstream media will not interview them.

Ehh...No.

 

[thegenius]

Every single published study of prior infection vs vaccination has shown prior infection to be at least equivalent if not superior to vaccination. There is no rationale reason to think otherwise at this point. I'm not advocating for people to get their immunity via exposure to the virus but taking this position that the vaccine provides better immunity is devoid of logic and devoid of evidence. As far as NY vs FL, as far as I've seen FL still has the lower overall population adjusted death rate. NY's Delta season is likely to come this fall.

The MMWR study was published. There are multiple possible reasons a vaccine could provide better protection against a mutated virus than the body's response to the wild type. Antibodies elicited by mRNA-1273 vaccination bind more broadly to the receptor binding domain than do those from SARS-CoV-2 infection | Science Translational Medicine for one explanation.

I'll let you two continue to argue this while I drink a beer.

Edit: Specifically...this one:

 

[thegenius]

Exactly. So unvaccinated essentially.

LOL

 

[evilbooyaa]

In Australia - almost all the hospitalized patients in the ICU with COVID are vaccinated. This is not being reported widely.

Source? This is hearsay without a reliable source behind it...

 

[Arcan57]

I'll let you two continue to argue this while I drink a beer.

Edit: Specifically...this one:

View attachment 342140

That’s a tasty brew.

 

[deleted836128]

In Australia - almost all the hospitalized patients in the ICU with COVID are vaccinated. This is not being reported widely.

Update: Retracting this. NSW Health director of health protection Dr. Jeremy McAnulty misspoke in a press conference when initially detailing the vaccination status of people in hospital. He initially said all cases were patients who had been vaccinated. Dr McAnulty later corrected himself, identifying that everyone in intensive care units (ICUs) in the state due to COVID-19 was NOT vaccinated.

Retracting this. NSW Health director of health protection Dr. Jeremy McAnulty misspoke in a press conference when initially detailing the vaccination status of people in hospital. He initially said all cases were patients who had been vaccinated. Dr McAnulty later corrected himself, identifying that everyone in intensive care units (ICUs) in the state due to COVID-19 was NOT vaccinated. Basically more of what we have been seeing which is a relief. Vaccines apparently work.

 

[Old_Mil]

Vaccinated are not that protective. Seeing lots of positive vaccinated pts. You are seeing less in the hospital b/c most stay home thinking they are vaccinated and some seasonal allergies stuff.

If you tests all vaccinated people in the community, I bet the percentage will be higher than you could imagine and likely walking around spreading it.

Get vaccinated so you wont' be hospitalized. Don't think getting vaccinated will prevent you from getting it/spreading it b/c you will. Vaccination improves your chance greatly of getting pneumonia, chronic lung disease, and being on a ventilator and month of rehab. Choose what you want, but the betting person would say get it.

...and it's a very short step from this to my point: treat the patient, not the population. It is very well known which demographic of patient falls into the "pneumonia/ards/chronic lung disease/vent/death" category. It's not healthy teenagers or 20 somethings. Since it's known that the vaccine sometimes carries with it significant side effects, use it when it is appropriate...and DO NOT use it when it is not appropriate.

 

[Porfirio]

All this energy and time spent arguing over vaccines vs no vaccines. The data is clear. But why does that matter?

What matters is - we have a large population of people that will not be vaccinated (period end of statement) and this virus is going to burn through our population of both unvaccinated and vaccinated.

We should spend all our time and energy on pushing/forcing our corporate hospitals and government in spending more money on staff, supplies, and space to work.

 

[Birdstrike]

... this virus is going to burn through our population of both unvaccinated and vaccinated.

Let's assume for a minute, we in the USA get over 90% of our population vaccinated. Still, according to the CDC "the vaccinated can still get it and spread it." Add to that the fact that international travel will always connect us to third world countries where the great majority are unvaccinated. What do we have? A virus that's gong to burn through the population of vaccinated and unvaccinated.

It still make sense to maximize the percent vaccinated, to slow that process. But doing so can't change that a virus will virus. At least one prominent epidemiologist agrees.

We should spend all our time and energy on pushing/forcing our corporate hospitals and government in spending more money on staff, supplies, and space to work.

Amen. I mentioned this on another thread. We're two years into this and we're still hanging out hat on the panic-surge-lockdown-normal-panic-surge-lockdown-normal, model? We're in year two of "impending healthcare collapse" and no one has even talked about maybe shoring up a system they claim is under "impending collapse" every two months? It's complete madness.

You're right. It would be money well spent, much better than millions of dollars spent on useless plexiglass and endless stimulus checks.

 

[GassYous]

Let's assume for a minute, we in the USA get over 90% of our population vaccinated. Still, according to the CDC "the vaccinated can still get it and spread it." Add to that the fact that international travel will always connect us to third world countries where the great majority are unvaccinated. What do we have? A virus that's gong to burn through the population of vaccinated and unvaccinated.

It still make sense to maximize the percent vaccinated, to slow that process. But doing so can't change that a virus will virus. At least one prominent epidemiologist agrees.



Amen. I mentioned this on another thread. We're two years into this and we're still hanging out hat on the panic-surge-lockdown-normal-panic-surge-lockdown-normal, model? We're in year two of "impending healthcare collapse" and no one has even talked about maybe shoring up a system they claim is under "impending collapse" every two months? It's complete madness.

You're right. It would be money well spent, much better than millions of dollars spent on useless plexiglass and endless stimulus checks.

Where are you going to get all those doctors, nurses, janitors, secretaries, midlevels, etc. to staff the place? Then what are you going to do with them when they're not needed? Where are all these facilities going to be located?

 

[Birdstrike]

Where are you going to get all those doctors, nurses, janitors, secretaries, midlevels, etc. to staff the place?

They spent $5 trillion on "pandemic stimulus." I don't ever want to hear the "but we don't have the money" argument, ever again.

Then what are you going to do with them when they're not needed?

If they're "not needed" then they shouldn't keep claiming "the healthcare systems are collapsing" every two months. Either the system is in trouble, or it's not. You can't have it both ways.

Where are all these facilities going to be located?

I can't spell out the locations for you. That's above my pay grade.

 

[ER BlueBlood]

They spent $5 trillion on "pandemic stimulus." I don't ever want to hear the "but we don't have the money" argument, ever again.

If they're "not needed" then they shouldn't keep claiming "the healthcare systems are collapsing" every two months. Either the system is in trouble, or it's not. You can't have it both ways.

I can't spell out the locations for you. That's above my pay grade.

And +1.5 Trillion on Afghanistan, money def shouldn’t be our issue

 

[evilbooyaa]

Retracting this. NSW Health director of health protection Dr. Jeremy McAnulty misspoke in a press conference when initially detailing the vaccination status of people in hospital. He initially said all cases were patients who had been vaccinated. Dr McAnulty later corrected himself, identifying that everyone in intensive care units (ICUs) in the state due to COVID-19 was NOT vaccinated. Basically more of what we have been seeing which is a relief. Vaccines apparently work.

I read this as Jimmy McNulty. Having just recently finished the Wire, I was wondering where the hell Dominic West went after The Affair.

Thanks for the update!

 

[AlvinKamara]

Is there a chance that delta rips through the country so furiously that it helps create a high enough level of seroprevalence to prevent future surges?

 

[deleted836128]

Is there a chance that delta rips through the country so furiously that it helps create a high enough level of seroprevalence to prevent future surges?

If we let it. 🙂More lockdowns, mask mandates, etc. aren’t going to get us there...

 

[Birdstrike]

Is there a chance that delta rips through the country so furiously that it helps create a high enough level of seroprevalence to prevent future surges?

Vaccine-based immunity + naturally-acquired immunity = combined herd immunity ?

Since we now know the vaccinated can also spread the virus in significant numbers, my best guess is that it's our only way out of this, if there is a way out of this. But I'm just spit-balling. I don't have a very high level of confidence in anyone's predictions about this virus, including my own.

 

[bravotwozero]

I know the covid-19 virus behaves a little differently than H1N1 Flu, but some of the patterns of the historical outbreak still apply. With the 'spanish' flu overtime, you had subsequent waves and outbreaks, but they progressively got smaller and smaller as more people got infected, either died or survived and became immune. I don't see why that won't happen with covid.

 

[Nephro critical care]

Some Americans will be eligible for booster shots beginning in late September, federal officials say.

3rd booster is coming by late September.

 

[Nephro critical care]

I think just like in December/ January health care workers and nursing home residents will be 1st in line to get new shot. I am thinking should I get a booster of the old vaccine or wait for a delta specific booster ?
My concern is whether boosting with vaccine to a supra high level of non neutralizing antibodies make me vulnerable to antibody dependent enhancement?

 

[Birdstrike]

I am thinking should I get a booster of the old vaccine or wait for a delta specific booster ?

Didn't the Pfizer CEO just say their delta-specific booster isn't scheduled to be done with trials until 2022? I'm not sure what Moderna's time schedule is.

Since it's looking like protection wears off in 6-12 months, I think it makes sense to get a booster of the old, soon. Then, by the time the more specific booster is ready, it'll be time for another anyways. Why they're waiting that long, when delta will probably wane by then and there will likely be a new dominant variant by 2022, is another issue.

My concern is whether boosting with vaccine to a supra high level of non neutralizing antibodies make me vulnerable to antibody dependent enhancement?

So far, hasn't the antibody dependent enhancement been mostly confined to in vitro? Has been any evidence of it playing out like that in populations? I don't know.

Either way, we can keep an eye on Israel. They've been giving boosters for a while now. If something like that happens there, I suppose we'll know soon?

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

 

[DoctwoB]

Didn't the Pfizer CEO just say their delta-specific booster isn't scheduled to be done with trials until 2022? I'm not sure what Moderna's time schedule is.

Since it's looking like protection wears off in 6-12 months, I think it makes sense to get a booster of the old, soon. Then, by the time the more specific booster is ready, it'll be time for another anyways. Why they're waiting that long, when delta will probably wane by then and there will likely be a new dominant variant by 2022, is another issue.


So far, hasn't the antibody dependent enhancement been mostly confined to in vitro? Has been any evidence of it playing out like that in populations? I don't know.

Either way, we can keep an eye on Israel. They've been giving boosters for a while now. If something like that happens there, I suppose we'll know soon?

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

ADE is a highly theoretical concern and there is no evidence for it with coronavirus vaccines. As such, it shouldn't be part of the discussion regarding boosters until/unless some data develops showing it.


What we really need is a system that is more adaptive to new strains/variants. It should take very little time to isolate a new emerging dominant strain and create a new mRNA sequence, obviously longer then that to ramp up production. What I don't get, is what is the purpose of running new trials every time there is a modest change in the mRNA sequence. We've been taking flu shots for years with new combinations of different H's and Ns without long term trial data. We should do the same here, pick the X number of most prealent emerging variants and make a booster with them.

 

[Nephro critical care]

I am following studies in Israel very closely. So far it seems that the 3rd booster is working well and is 86% effective.
It is concerning though that the demographics of seriously ill patients in Israel has changed in a month. At the beginning of July seriously ill patients were nearly all unvaccinated. Now more then 2/3 are vaccinated. Indeed scientists in Israel have commented how the virus has changed in 2 weeks.
Is it because of a depletion of antibody titers or because antibodies despite high titers are no longer neutralizing the virus?

 

[Birdstrike]

I am following studies in Israel very closely.

If you have links to the ones you've read in the last two weeks, please share. Particularly those related to the success rate of the booster and the % vaccinated/unvaccinated of the severely ill.

 

[DoctwoB]

I am following studies in Israel very closely. So far it seems that the 3rd booster is working well and is 86% effective.
It is concerning though that the demographics of seriously ill patients in Israel has changed in a month. At the beginning of July seriously ill patients were nearly all unvaccinated. Now more then 2/3 are vaccinated. Indeed scientists in Israel have commented how the virus has changed in 2 weeks.
Is it because of a depletion of antibody titers or because antibodies despite high titers are no longer neutralizing the virus?

If you're looking at the study I saw, the topline number, that initial 2 dose pfizer vaccine efficacy at preventing hospitalization is down to 67%. However, i've read a few interesting threads from statisticians that this data may be a good example of something called Simpson's paradox, where vaccine efficacy appears higher in younger patient and in older patients then if you lump both cohorts together.

The reason for this is that older patients are much more likely to be vaccinated and also more likely to be hospitalized regardless of vaccine status. Younger patients are the opposite, less likely to be vaccinated and less likely to be hospitalized regardless of vaccine status. Thus most hospitalizations will be in vaccinated individuals even if the vaccine is effective. Diving into the data, it appears that right now with delta, vaccine efficacy at preventing hospitalization in people over 50 is 85% and 92% in those under 50.

This data, while much better then the topline number (67% efficacy) still is somewhat concerning given the decline from 98-99% in the initial studies. I know I'll be getting my booster.

 

[Birdstrike]

i've read a few interesting threads from statisticians that this data may be a good example of something called Simpson's paradox, where vaccine efficacy appears higher in younger patient and in older patients then if you lump both cohorts together.

I didn't know there was a fancy name for this concept, but it makes sense. I was explaining this a little bit further up the thread, here ⬇️.

I've seen reports of this also in Israel, also. I'm not sure if it's true or not. But think about it for a second. Even if true, it may not mean what you think.

The vaccinated population skews heavily towards and older population with comorbidities. The unvaccinated population, is largely much younger and healthy, including many in their teens and 20's and everyone under 12.

The vaccine could be working perfectly fine, and it wouldn't take very many breakthrough infections to still fill ICUs with vaccinated oldies, while the younger, less vaccinated population still is faring better, overall.

That might create a perception the vaccine isn't working well, when it still is.

 

[Birdstrike]

Here's your Simpson's Paradox, @DoctwoB :

"A Grim Warning From Israel...

Israel has among the world’s highest levels of vaccination for COVID-19...As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19...59% were fully vaccinated."

Source: Science

 

[Birdstrike]

Just think about what happens if, in theory, we got to a point where 100% of people are vaccinated. 100% of deaths, hospitalizations and cases will be in the vaccinated. It's impossible for it to be otherwise. The closer you get to the population being fully vaccinated, the higher the percentage of pathology in the vaccinated, even if the vaccine is very effective. It's impossible to avoid that, even with the most effective vaccination possible, because the number of vaccinated eventually will outnumber the unvaccinated by such a large amount, their cases outnumber the unvaccinated, even though their risk is much lower.

I've have some slides that prove it if anyone's interested (which is doubtful, lol).

 

[Birdstrike]

TLDR version: An increased percentage of deaths being vaccinated does not (necessarily) equal vaccine ineffectiveness. It could be from an increasing percentage of vaccinated, overall.

 

[thegenius]

What we really need is a system that is more adaptive to new strains/variants. It should take very little time to isolate a new emerging dominant strain and create a new mRNA sequence, obviously longer then that to ramp up production. What I don't get, is what is the purpose of running new trials every time there is a modest change in the mRNA sequence. We've been taking flu shots for years with new combinations of different H's and Ns without long term trial data. We should do the same here, pick the X number of most prealent emerging variants and make a booster with them.

Sounds reasonable to me

 

[bravotwozero]

TLDR version: An increased percentage of deaths being vaccinated does not (necessarily) equal vaccine ineffectiveness. It could be from an increasing percentage of vaccinated, overall.

Iceland also has a very high vaccination rate. Their cases have gone up with delta, but their rate of hospitalizations and deaths was not high.