Are vaccines the light at the end of the tunnel?

[zap99]

3 minutes ago, nocl said:

Still misusing efficacy.

 

Against B.117 and the original strain which is primarily what you have in country - yes it is having benefits.  Against  B.1.351 and similar strains not so much.

Efficacy

noun

FORMAL

the ability to produce a desired or intended result.

 

It works, so it's efficacous.

[nocl]

Just now, zap99 said:

Efficacy

noun

FORMAL

the ability to produce a desired or intended result.

 

It works, so it's efficacous.

In a general term using the oxford dictionary but you used it with a measurement value where there is a specific definition.   Much better to use effective which is how performance in the real world is described.

[zap99]

2 minutes ago, nocl said:

In a general term using the oxford dictionary but you used it with a measurement value where there is a specific definition.   Much better to use effective which is how performance in the real world is described.

I bow to your greater knowledge. I think that if they knew, the person who did not die would agree that it was effective. Just for fun, I looked at the ' effectiveness' of all 3. Pfizer, Modena and AZ. All about the same  with the South African and Brazilian variants. We predominantly have the Kent, or pesky British variant.     It works fine.

[nocl]

null

1 minute ago, zap99 said:

I bow to your greater knowledge. I think that if they knew, the person who did not die would agree that it was effective. Just for fun, I looked at the ' effectiveness' of all 3. Pfizer, Modena and AZ. All about the same  with the South African and Brazilian variants. We predominantly have the Kent, or pesky British variant.     It works fine.

Not sure where you are getting you info from but you stated performance against the SA variant is way off.

 

Here are a couple of papers/articles reporting the results of the AZ trial

 

https://www.nejm.org/doi/10.1056/NEJMoa2102214

A two-dose regimen of the ChAdOx1 nCoV-19 vaccine did not show protection against mild-to-moderate Covid-19 due to the B.1.351 variant.

 

https://www.cidrap.umn.edu/news-perspective/2021/03/astrazeneca-vaccine-doesnt-prevent-b1351-covid-early-trial

AstraZeneca vaccine doesn't prevent B1351 COVID in early trial

 

On the other hand the J&J  vaccine yielded 57% efficacy in their clinical trial in south Africa against B.1.351 lower than they results against B.117 or the original strain but far better than AZ 10% efficacy against B.1.351.

 

Pfizer in a small trial indicated 100% efficacy, but the trials size was too small to be adequately statistically powered.  Plus some Israeli qualitative data does some breakthrough of B.1.351 with the Pfizer vaccine.  So its efficacy is still expected to be good against B.1.351 type variants, but lower than against the original and B.117.

 

I can reference the actual papers if you would like.

 

 

[cangelmd]

4 hours ago, markeb said:

Curious what cangelmd thinks, but I’m betting physiology, not vaccine mass. Which is why it could be really hard to tease out causality. There’s a concept that temporal association does not equal causation. It may, but it’s hard to ignore this happened after that. 

Sorry had to work. Short answer, probably not dosage.

This is not my area of expertise, but I suspect they will reinstate the vaccine with some limitations similar to what happened with the AZ in the UK - although I’m worried the real damage will be to confidence in vaccines and that’s out of the barn.

I think the reason why the complication was in women is because thrombosis in younger people in general is more common in women. Blood clots in younger people are usually multifactorial, with one of the biggest risk factors being oral contraceptives. Pregnancy is a big risk factor, too - so it would be no big surprise that if something about the vaccine (maybe a cross-reacting antibody to a protein in the clotting cascade) caused increased clotting, that increased clotting would be first seen in women - we tend to have more of all those other risk factors.
I’m concerned that the central venous thrombosis may actually have some connection to the vaccine because it is such a rare and specific complication plus the low platelet count. Hopefully they will be able to quickly work backwards and either declare this a coincidence or identify groups that should not get J and J until the mechanism is better understood.

[markeb]

1 minute ago, cangelmd said:

Sorry had to work. Short answer, probably not dosage.

This is not my area of expertise, but I suspect they will reinstate the vaccine with some limitations similar to what happened with the AZ in the UK - although I’m worried the real damage will be to confidence in vaccines and that’s out of the barn.

I think the reason why the complication was in women is because thrombosis in younger people in general is more common in women. Blood clots in younger people are usually multifactorial, with one of the biggest risk factors being oral contraceptives. Pregnancy is a big risk factor, too - so it would be no big surprise that if something about the vaccine (maybe a cross-reacting antibody to a protein in the clotting cascade) caused increased clotting, that increased clotting would be first seen in women - we tend to have more of all those other risk factors.
I’m concerned that the central venous thrombosis may actually have some connection to the vaccine because it is such a rare and specific complication plus the low platelet count. Hopefully they will be able to quickly work backwards and either declare this a coincidence or identify groups that should not get J and J until the mechanism is better understood.

 

I was thinking along the same lines, but also not my area of expertise. It's been a long time since I looked at them from a basic/applied sciences standpoint, but the things the female body has to do to so many processes to allow it to carry a "foreign object" to term really introduces a lot more complexity in things you never think of...  It doesn't surprise me if this is in some way related to the vaccine that it would appear in younger women (first?).

[jagoffee]

5 hours ago, nocl said:

They issued a pause.  That is the regulatory level of action that occurs when there is a safety signal of this kind.  A pause is a recommendation that all use of the product be stopped.  Since the product was not withdrawn a state could continue to use it.  But if they do they face considerably more liability if any body injected during the pause were to develop the problem.

 

For the FDA to force stoppage rather than recommend they would need to withdraw the EUA.  Something that the data does not yet support.  It is a rather rare indication and an investigation is required. I stand behind by comments about showing how closely the FDA look at safety issues. One of the reasons why this was probably triggered is that J&J uses similar technology as AZ.  When one drug in a class has a problem any other drugs in the same class will be scrutinized looking for the same issue.

 

I expect that there will be a label change either restricting the population for which the vaccine is recommended or will result in a warning added to look out for blood clots and not to treat with Hiparin, the normal treatment for clots.  Instead using an alternative therapy.

I knew you would have a good explanation.  At this point, I just wanted to understand.  Thank you.

[UnorigionalName]

49 minutes ago, cangelmd said:

Sorry had to work. Short answer, probably not dosage.

This is not my area of expertise, but I suspect they will reinstate the vaccine with some limitations similar to what happened with the AZ in the UK - although I’m worried the real damage will be to confidence in vaccines and that’s out of the barn.

I think the reason why the complication was in women is because thrombosis in younger people in general is more common in women. Blood clots in younger people are usually multifactorial, with one of the biggest risk factors being oral contraceptives. Pregnancy is a big risk factor, too - so it would be no big surprise that if something about the vaccine (maybe a cross-reacting antibody to a protein in the clotting cascade) caused increased clotting, that increased clotting would be first seen in women - we tend to have more of all those other risk factors.
I’m concerned that the central venous thrombosis may actually have some connection to the vaccine because it is such a rare and specific complication plus the low platelet count. Hopefully they will be able to quickly work backwards and either declare this a coincidence or identify groups that should not get J and J until the mechanism is better understood.

 

I don't want to put a direct link. But go look at NEJM. There's some pretty significant evidence. Original article from the 9th.

 

 

Edited April 14, 2021 by UnorigionalName

[cangelmd]

13 hours ago, UnorigionalName said:

 

I don't want to put a direct link. But go look at NEJM. There's some pretty significant evidence. Original article from the 9th.

 

 

I will look. I’m trying to not blow out of proportion or understate, which is hard to express in a post. I’m very concerned with this situation that there is some connection to the vaccine. I am not sure that it will or should stop administration of the vaccine in the midst of a pandemic - that’s where changing who is eligible comes into play. Unfortunately, a large number of people who would otherwise be good candidates for J and J might not end up getting it. I will check out your link when I can

Edited April 15, 2021 by cangelmd

[K.T.B.]

Not to make this all political, but just heard on the news that the "red states" are severely lagging behind in getting people vaccinated.  They have the doses available, but people aren't doing it.  That's very disappointing.

[Mary229]

23 minutes ago, K.T.B. said:

Not to make this all political, but just heard on the news that the "red states" are severely lagging behind in getting people vaccinated.  They have the doses available, but people aren't doing it.  That's very disappointing.

I am in Texas, as red as red can be, and every single dose the federal government sends to Texas is distributed during the week it is designated for.  So maybe your report is from a biased source

[terrydtx]

3 minutes ago, Mary229 said:

I am in Texas, as red as red can be, and every single dose the federal government sends to Texas is distributed during the week it is designated for.  So maybe your report is from a biased source

I am also in Texas and agree no dosses are going unused. In San Antonio we are getting close to 50% of adults with at least the first shot. If the fake news is the source, it is going to be biased. 

[K.T.B.]

13 minutes ago, Mary229 said:

I am in Texas, as red as red can be, and every single dose the federal government sends to Texas is distributed during the week it is designated for.  So maybe your report is from a biased source

 

It was an overall assessment, not one state in particular.  

[Mary229]

2 minutes ago, K.T.B. said:

 

It was an overall assessment, not one state in particular.  

Which state.  Most southern states have dashboards where YOU can look to see the distribution.  You tell me the state and I will provide the information.  You don't need to rely on mass media for your facts.  Generalizations are easy to throw around but facts are harder to fake

Edited April 15, 2021 by Mary229

[TrulyBlonde]

14 minutes ago, Mary229 said:

Which state.  Most southern states have dashboards where YOU can look to see the distribution.  You tell me the state and I will provide the information.  You don't need to rely on mass media for your facts.  Generalizations are easy to throw around but facts are harder to fake

My little ski town. Liberal, Sanctuary City, Heavily Dem, actually has so many cancellations now, they are forgoing the mass vaccination. It will instead be done by physician or pharmacy. Hispanic workforce is anti-vax. I have been begging my housekeeper and offered to pay her to get it. Nope. She is paid $35 and hr. and I am sure I can find someone else to do the job. 

We do love our Texans who come to get out of the heat. Especially the vaccinated ones 😉

[Mary229]

Just now, TrulyBlonde said:

My little ski town. Liberal, Sanctuary City, Heavily Dem, actually has so many cancellations now, they are forgoing the mass vaccination. It will instead be done by physician or pharmacy. Hispanic workforce is anti-vax. I have been begging my housekeeper and offered to pay her to get it. Nope. She is paid $35 and hr. and I am sure I can find someone else to do the job. 

We do love our Texans who come to get out of the heat. Especially the vaccinated ones 😉

 

 

Two sources for you but first a quote from the second source as of April 14.  And realize April 14 was mid week and  the dosages are delivered on Sunday/Monday.  Colorado is only in stage 1 and 2 for some reason.  The Hispanic population may be a more youthful population and not yet eligible.  

 

Colorado
Doses distributed to state: 4,181,590 
Doses administered: 3,464,019 
Percentage of distributed vaccines that have been administered: 82.84

 

https://covid19.colorado.gov/vaccine-data-dashboard

 

https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-covid-19-vaccines-administered.html

[cangelmd]

14 hours ago, UnorigionalName said:

 

I don't want to put a direct link. But go look at NEJM. There's some pretty significant evidence. Original article from the 9th.

 

 

 

15 hours ago, UnorigionalName said:

 

I don't want to put a direct link. But go look at NEJM. There's some pretty significant evidence. Original article from the 9th.

 

 

Found an article in NEJM from April 9, concerning the AZ vaccine, but the findings likely apply to J and J as well. Compelling evidence that these rare events may be related to the vaccine. I still think the syndrome is rare enough to allow continued use, but maybe only older people or men? We will see.

[cangelmd]

1 hour ago, K.T.B. said:

Not to make this all political, but just heard on the news that the "red states" are severely lagging behind in getting people vaccinated.  They have the doses available, but people aren't doing it.  That's very disappointing.

Red states and New York, I’ve read that it is one of the worst.

 I can only speak to my red state - through this whole pandemic, there are 3 groups - the careful, the careless, and the clueless. Many of us have shifted from one group to another at different times and for different situations.

Speaking to vaccination, the “careful” would be better described as the “motivated” - those people pretty much have all gotten at least one shot. Now it is time for the heavy lifting.

Public health in general is poorly funded, and ours is worse than most. To date, much of their pure manpower has been concentrated on more rural and/or underserved areas - the National Guard has been helping with this. In the cities, public health has worked with the hospitals to hold mass vaccination sites weekly, rotating through different hospitals/locales. Publix, CVS Walmart seem to have plenty of appts, except during first week after groups opened.

My criticism is I don’t see any publicity other than the local evening news (they are very faithful) about when and where the clinics are. I think they have started in last 2 weeks walk-in first doses, they are just beginning to identify and engage churches and other leaders.

I see for every anti-vaxxer, there are 2-3 people who just haven’t gotten around to it - inertia, the clueless. Many may not get vaccinated unless being non-vaccinated prevents them from doing s9mething they want to do.

Finally, because of that poor funding sometimes the reporting is not so great, so I agree, go to the local trackers, not national media. And look at the spread between first and last, sometimes it’s not so wide- but that doesn’t make a good headline.

[Mary229]

@cangelmd  

  Alabama does seem a bit slower than other states.  Are they having difficulty delivering to rural locations.  That was a major issue in Texas last month when the state organized teams to travel to rural communities and administer especially to the home bound and those with limited mobility and transportation options.  Again this is as of Wednesday and the doses sent represent those for the entire week until next Sunday

 

https://alpublichealth.maps.arcgis.com/apps/MapSeries/index.html?appid=d84846411471404c83313bfe7ab2a367

Edited April 15, 2021 by Mary229

[Oville]

I’m not seeing Red Vs Blue on today’s chart from the CDC.  It’s all over the place

 

37%	23%	250,998,265	194,791,836	78%
New Hampshire	54%	26%	1,039,375	1,008,027	97%
Palau	50%	42%	24,600	16,012	65%
Maine	46%	30%	1,074,270	947,441	88%
Connecticut	46%	29%	3,201,205	2,572,005	80%
New Mexico	45%	30%	1,791,315	1,530,389	85%
Massachusetts	45%	27%	5,610,090	4,800,301	86%
Vermont	44%	28%	538,360	440,821	82%
New Jersey	43%	28%	6,636,645	5,874,832	89%
Rhode Island	42%	30%	833,545	733,129	88%
South Dakota	42%	29%	764,525	603,930	79%
Pennsylvania	41%	24%	10,014,035	7,936,989	79%
New York	40%	26%	15,145,335	12,633,362	83%
Wisconsin	40%	26%	4,322,845	3,759,176	87%
Maryland	40%	25%	4,640,710	3,765,018	81%
California	40%	22%	30,837,670	23,721,226	77%
Minnesota	40%	27%	4,033,140	3,543,372	88%
Virginia	40%	24%	6,431,875	5,268,328	82%
American Samoa	40%	31%	43,810	34,786	79%
Guam	40%	23%	140,740	105,497	75%
Colorado	40%	24%	4,308,370	3,527,781	82%
Delaware	39%	23%	761,005	599,682	79%
Illinois	39%	23%	9,692,575	7,582,133	78%
Nebraska	39%	26%	1,470,820	1,208,422	82%
Iowa	39%	26%	2,331,755	1,970,222	84%
Alaska	39%	31%	722,835	499,742	69%
Kansas	38%	24%	2,225,795	1,688,602	76%
Washington	38%	25%	5,740,920	4,641,399	81%
Hawaii	38%	26%	1,202,300	881,413	73%
Washington, D.C.	37%	21%	653,655	471,911	72%
Kentucky	37%	25%	3,298,245	2,653,617	80%
North Dakota	37%	27%	561,930	499,005	89%
Montana	37%	25%	856,275	643,288	75%
Oregon	36%	23%	3,150,545	2,415,448	77%
Michigan	36%	24%	7,643,000	5,697,977	75%
Ohio	36%	24%	8,774,035	6,847,460	78%
Northern Mariana Islands	36%	27%	62,910	33,791	54%
Oklahoma	36%	24%	3,277,215	2,356,622	72%
Arizona	36%	23%	5,444,665	4,250,790	78%
Florida	36%	22%	16,827,365	12,302,529	73%
North Carolina	35%	22%	7,783,060	5,844,600	75%
Nevada	34%	22%	2,142,040	1,709,620	80%
West Virginia	34%	25%	1,441,565	1,036,782	72%
Utah	34%	18%	2,064,210	1,755,776	85%
Texas	33%	21%	20,671,965	15,610,120	76%
South Carolina	33%	21%	3,646,715	2,734,788	75%
Missouri	32%	21%	4,443,455	3,263,224	73%
Arkansas	32%	20%	2,243,300	1,508,295	67%
Wyoming	32%	23%	460,205	317,111	69%
Indiana	31%	21%	4,640,750	3,443,028	74%
Georgia	31%	17%	7,539,135	5,061,522	67%
Idaho	31%	21%	1,214,365	917,256	76%
Tennessee	31%	18%	4,826,180	3,320,761	69%
Louisiana	30%	21%	3,421,430	2,355,526	69%
Alabama	29%	18%	3,493,380	2,168,891	62%
Mississippi	28%	20%	2,119,115	1,392,708	66%

 

[Mary229]

2 minutes ago, Oville said:

I’m not seeing Red Vs Blue on today’s chart from the CDC.  It’s all over the place

 

37%	23%	250,998,265	194,791,836	78%
New Hampshire	54%	26%	1,039,375	1,008,027	97%
Palau	50%	42%	24,600	16,012	65%
Maine	46%	30%	1,074,270	947,441	88%
Connecticut	46%	29%	3,201,205	2,572,005	80%
New Mexico	45%	30%	1,791,315	1,530,389	85%
Massachusetts	45%	27%	5,610,090	4,800,301	86%
Vermont	44%	28%	538,360	440,821	82%
New Jersey	43%	28%	6,636,645	5,874,832	89%
Rhode Island	42%	30%	833,545	733,129	88%
South Dakota	42%	29%	764,525	603,930	79%
Pennsylvania	41%	24%	10,014,035	7,936,989	79%
New York	40%	26%	15,145,335	12,633,362	83%
Wisconsin	40%	26%	4,322,845	3,759,176	87%
Maryland	40%	25%	4,640,710	3,765,018	81%
California	40%	22%	30,837,670	23,721,226	77%
Minnesota	40%	27%	4,033,140	3,543,372	88%
Virginia	40%	24%	6,431,875	5,268,328	82%
American Samoa	40%	31%	43,810	34,786	79%
Guam	40%	23%	140,740	105,497	75%
Colorado	40%	24%	4,308,370	3,527,781	82%
Delaware	39%	23%	761,005	599,682	79%
Illinois	39%	23%	9,692,575	7,582,133	78%
Nebraska	39%	26%	1,470,820	1,208,422	82%
Iowa	39%	26%	2,331,755	1,970,222	84%
Alaska	39%	31%	722,835	499,742	69%
Kansas	38%	24%	2,225,795	1,688,602	76%
Washington	38%	25%	5,740,920	4,641,399	81%
Hawaii	38%	26%	1,202,300	881,413	73%
Washington, D.C.	37%	21%	653,655	471,911	72%
Kentucky	37%	25%	3,298,245	2,653,617	80%
North Dakota	37%	27%	561,930	499,005	89%
Montana	37%	25%	856,275	643,288	75%
Oregon	36%	23%	3,150,545	2,415,448	77%
Michigan	36%	24%	7,643,000	5,697,977	75%
Ohio	36%	24%	8,774,035	6,847,460	78%
Northern Mariana Islands	36%	27%	62,910	33,791	54%
Oklahoma	36%	24%	3,277,215	2,356,622	72%
Arizona	36%	23%	5,444,665	4,250,790	78%
Florida	36%	22%	16,827,365	12,302,529	73%
North Carolina	35%	22%	7,783,060	5,844,600	75%
Nevada	34%	22%	2,142,040	1,709,620	80%
West Virginia	34%	25%	1,441,565	1,036,782	72%
Utah	34%	18%	2,064,210	1,755,776	85%
Texas	33%	21%	20,671,965	15,610,120	76%
South Carolina	33%	21%	3,646,715	2,734,788	75%
Missouri	32%	21%	4,443,455	3,263,224	73%
Arkansas	32%	20%	2,243,300	1,508,295	67%
Wyoming	32%	23%	460,205	317,111	69%
Indiana	31%	21%	4,640,750	3,443,028	74%
Georgia	31%	17%	7,539,135	5,061,522	67%
Idaho	31%	21%	1,214,365	917,256	76%
Tennessee	31%	18%	4,826,180	3,320,761	69%
Louisiana	30%	21%	3,421,430	2,355,526	69%
Alabama	29%	18%	3,493,380	2,168,891	62%
Mississippi	28%	20%	2,119,115	1,392,708	66%

 

Thanks for posting this.  I do want to remind people that the states can only administer what is delivered to them.  The real measure is how many vaccines for the week are not delivered by week's end.  Texas looks awful on this chart but they have a history of delivering every single vaccine provided.  

[jagoffee]

I am not sure what the implication/ motive is to compare red vs blue.  Rural vs urban population might be more meaningful, but does it really matter?

 

The fact that 80% of over 65% population has had at least one dose and 60% have both is awesome. Also the fact that almost 50% of the population that is 18 years or older in the US has had at least one dose is also impressive IMO.  
 

I for one am thankful that the administration continues to stay the course.  I hope they do not take vaccines away from certain states and give them to other states.  
 

I know in IL they are trying to get the 65 years and older number higher  by going to people homes that cannot leave the house.  It makes since that this age group is having the best results since it has been a focus from almost the beginning.  
 

see attached

https://covid.cdc.gov/covid-data-tracker/#vaccinations

 

You are not likely to see these numbers in news reports.

Edited April 15, 2021 by jagoffee

[Mary229]

7 minutes ago, jagoffee said:

 Rural vs urban population might be more meaningful, but does it really matter?

This is important because it indicates a delivery issue.  It is unfortunate that they pulled the JNJ vaccine because it would be easier to deliver to rural, small communities who don't have the storage facilities required for the RNA vaccines.  Of course that is important to the policy makers not us

[jagoffee]

2 minutes ago, Mary229 said:

This is important because it indicates a delivery issue.  It is unfortunate that they pulled the JNJ vaccine because it would be easier to deliver to rural, small communities who don't have the storage facilities required for the RNA vaccines.  Of course that is important to the policy makers not us

True.  Actually the CDC and FDA did not actually phase or pull the J&J vaccine, they just recommended that the states quit administered it.  Of course, some harm has already been done even if they change their recommendation soon,  

[TrulyBlonde]

1 hour ago, Mary229 said:

 

 

Two sources for you but first a quote from the second source as of April 14.  And realize April 14 was mid week and  the dosages are delivered on Sunday/Monday.  Colorado is only in stage 1 and 2 for some reason.  The Hispanic population may be a more youthful population and not yet eligible.  

 

Colorado
Doses distributed to state: 4,181,590 
Doses administered: 3,464,019 
Percentage of distributed vaccines that have been administered: 82.84

 

https://covid19.colorado.gov/vaccine-data-dashboard

 

https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-covid-19-vaccines-administered.html

Nice info.Thanks. She is eligible and I even signed her up. She said she did not get the email or text. I also offered other alternative sites to get vaccinated. 

We are currently offering vaccine to ages 16 and up.