Pfizer starting another Vaccine trial

Was suggesting he’s learning from you(:

That's worth a chuckle...

David Weaver

..He's educated!

Re: Curious ...

TomD

"It's my opinion (and I'm not a medical professional) that anyone who hasn't had covid should have two shots."

Why? There are plenty of people who have very low risk, and taking the vaccine does not provide herd immunity it runs off variants. You only get B cell immunity.

I have no problem with the statement:

"Anyone who has a risk of getting COVID, and a risk of a bad health outcome, should get vaccinated"

There are lots of other reasons to take it, like if you would harm someone else you live with. But there needs to be a reason. Why would you take a vaccine when there is no reason.

But there are many people for whom that risk is basically zero. If there is one thing on which the science is crystal clear, it is on how to avoid getting viruses, and this virus in particular. It isn't at all difficult. Your lifestyle may not be a fit. But it isn't difficult.

And as we will probably all need to get vaccinated, the vaccine strategy will force that, because it is running off endless variants, there are still reasons to wait. There will be decidedly better and safer vaccines down the road. These could include whole vaccines, that provide the broad spectrum immune response, so that is safer in range of protection, and they will be fully tested, not reliant on emergence use authorizations. Again, don't wait if you are at risk, and want protection.

And there are social reasons not to take the vaccine, if you get out, get infected and spin off variants, and you could avoid that, one is not being a White Knight, and all the popular privilege stuff. You would know about that if you had three kids at University age.

Re: So, I wasn't wrong here, was I?

TomD

I am not too sure I have your point, but part of the reason "cases" are down is because they aren't testing for breakthrough cases among people who are vaccinated, unless they are hospitalized, or dead. There was also a reason related to differential rates of PCR cycles, but what I heard about that was it was bogus. The testing regime is in government (US) documents though.

Re: By the way...

TomD

From what you are looking at yes, but it spins off variants of concern. And as air travel works, and ramps up, those nice variants are going to end up in places where the vaccine is a luxury. So that should be interesting.

Re: There's a missing scenario here...

TomD

There isn't data, but they will work on it. Most likely this is a kabuki where the idea is that we aren't going to push 3 and give the feeling they are looking out for concerns. The Gov focus, right up to and past legal requirements is to push the number of people in the program, there is plenty of time later for boosters. Pfizer needs some buy in, but the gov is pushing the main agenda. This is what one would want.

Getting Covid is far better coverage than getting the vaccine, but it is risky for some. You get whole coverage, all the multiple different Immune systems get fired up, not just one. There is no reason to get the vaccine if you had COVID, that was over-reach.

Two reasons...

David Weaver

it reduces the risk of morbidity, malaise and serious sickness for people who don't take it seriously (and those folks are often part of the second reason).

reason two - to stop significant spread of covid at this point. If most are vaccinated or have had covid, then whatever remnants float around, so be it - they'll just lead to generally mild sickness (or asymptomatic) and fine immune systems (at least that's the best bet).

I have a very fit neighbor. He's a little older, but not retired. He goes to the gym every day and could physically put me under the table at anything (And has no preexisting conditions). Covid took him out of work for several months and he ended up spreading it to 10 people and almost killed his MIL. (He likes his MIL, so no need for MIL jokes!)

His MIL, wife and other relatives didn't listen to him after he'd had it for several weeks when he said he was still sick and to stay away, and they arrived in his house over the holidays despite his protest. I guess he was trying to please his mrs. who thought he was well enough not to spread things.

Not sure if they're all vaccinated now, but that was pre-vaccine.

If it's spreading little and in mild form, I don't think it presents much risk. I'm just not much for the idea that the better way to go about it is a .5% mortality rate or worse where medical attention is limited when the mRNA vaccines are extremely long lasting and as mentioned elsewhere here, even almost 30% of the adult population here unvaccinated (most probably in rural areas), delta is here and case rates are declining. ICU usage in the state is at about 1.4%.

Things were much different in January.

That said, I'm not one for forcing anyone to do anything, either. I think there ought to be some specific prophylaxis studies that seem to be swept under the rug (I would like to see an actual study and data and if things like ivermectin don't actually provide prophylaxis, that could be put to bed). Otherwise, if vaccine non-adherents would take it and it leads to less or milder sickness, I don't see the issue with it.

data suggested long ago two shots of mRNA was the way to go, that's what i did. Bill mentions volunteering - I would've but was never notified. Our local university health system has a vaccine group and they had an antibody-producing option within two weeks and blasted us with emails (I guess such places keep files or samples on hand and they already had one for SARS COV I). I was ready to try it at two weeks - I guess it never went anywhere, but I'd bet some of the folks in the labs used it.

Two parts...

David Weaver

You still have a large unvaccinated cohort. you can view case rates among those folks, also.

I'm sure there were a lot of folks who got covid who never reported anything. How do I know? I know several folks who were related to someone who got covid, they became ill about 3 days later and recovered without going to a physician.

There's no record of their illness.

My point with the vaccine is that I don't believe the hoopla early on about how dangerous asymptomatic individuals are vs. symptomatic. I'm sure they could spread the virus, but if one person isn't sneezing and another one is, the results will be very different.

The other thing you can observe is ICUs. I checked the CDC yesterday and the ICU usage by covid is about 1.5% of capacity in the state. It was far higher around the holidays, and for a while.

This is all supposing on my part, but I'm guessing that having less virus around means that the folks who do get it get milder cases on average (from being exposed to fewer virus copies when they are exposed) and a milder case at this point is supposedly associated with better immune accuracy. Those are all good long term trend. I think we have covid forever going forward, so getting robust immunity across the board and making it tolerable or almost insignificant would be a nice thing.

Re: Two reasons...

John in NM

As I recall, ivermectin is not much of an antiviral.

Required dosage to see some effect was so high that it was basically toxic to a broad spectrum of cells. I may have the details wrong, but that is the gist I remember. Struck me as better than the old syphilis "cure" of mercury but still a risky notion, basically flooding the body with toxins and hoping the side effects of that are less harmful than the disease itself.

It works as an anti-parasitic agent because it is very toxic to insects even at low levels, as opposed to toxic to mammals at higher levels. I wonder now if it is effective with trichinosis?

While I share your outlook on the civil rights of medical choices, I do find that there's an awful lot of frenzied straw grabbing these days, whether chloroquine or ivermectin or countless others. Some basic, wikipedia level reading is enough to dispel these snake oil cures for me - just as similar basic reading was enough to convince me that mRNA vaccines were an amazing innovation and likely to be pretty harmless in terms of side effects.

Basically its enough for me to understand that researchers have dropped these remedies after some initial work. I don't need to go check up on it beyond an hour or so for my own shallow level of interest.

In the interest of objectivity, I can tell you I'm pretty prejudiced against medical magic due to training a new guy at work last year, an individual who fell immediately for any dopey conspiracy theory making the rounds. That his enthusiasm for researching these theories did not match his enthusiasm for learning his new job was a source of extreme irritation to me So that set of experiences probably amplified my usual skeptical outlook and I would encourage you to use a healthy dose of salt when reading my comments!

Data mining and one prospective study

David Weaver

...suggests ivermectin isn't much of a treatment for people who already have established covid. Then again, neither is remdesivir nor is hydroxychloroquine. The chinese shared data on the latter two very early on, so the fact that they didn't do much wasn't a surprise. The fact that pushing one over the other became a pro-wrestling style political fight, I guess that wasn't much of a surprise, either.

What is a little more compelling is ivermectin as a prophylaxis, but I'm not aware of a large controlled study other than one by Indian docs, and I don't think it qualifies as a double blind type study.

Retrospective data mining also shows a similar effect for prophylaxis - it appears to prevent replication in vitro, but so does a lot of stuff that doesn't show up in vivo. It's a curiosity to me (I'm double pfizered - those are all just things of interest - my next preferred exposure is by droplet and not by shot, and not by prophylaxis of any type).

https://www.youtube.com/watch?v=XYv30g7TKVM

I have no idea if this prospective study has been debunked, but it didn't involve harmful doses and is one of the few that is prospective and addresses prophylaxis. *this kind of thing would seem to be important in the rest of the world where some of the vaccine types and take rates don't seem to be as effective*.

For those who don't want to watch the video (I don't blame you), it's Indian front line health care workers, more than 3,000 of them who took a prophylaxis regimen. The "takers" group was more than twice the size of the non-takers (individuals got to choose whether they wanted prophylaxis or not), and the relative risk after the study period showed efficacy above 80% (retrospective data mining consistently shows 50-80%, but studies cloud this when they require this or pretty much anything as treatment mid-course). The study appears to have been run by physicians (not bloggers), and while it's not double blind, there's no immediate obvious bias that I can see.

Being a cynical crank, I still think that means "do it again with a different setup - take a group that won't be vaccinated because they choose not to be, do a double blind study over a few months with several hundred, evaluate the "take" group for any biases and adjust and see what the results are"

If you can do it twice, things get interesting.

When these kinds of things tread into politics, then I'm uninterested. Politics is just another form of professional wrestling promoting to me - the reason that I dig in on discussion like this is we have an opportunity to prove things. That would mean not like remdesivir and hydroxychloroquine, where the first studies in china failed to show significant effect - but that something can be done several times with the same statistically significant results.

It counts right now.

(why do I call politics pro wrestling? If your favorite wrestler gets blinded by something that another guy pulls out of his pants, puts in his mouth and spits in your "hero's" face, then that's cheating and you'll get really mad. If your guy is getting beat and he pulls something out of his pants and spits it in the other guy's face and the other guy gets pinned, then you're overjoyed and cheering. "he deserved it".

That's politics, except people try to claim that they have intelligent reasons, and there's two promoters instead of one, and they both label good guy and bad guy differently. )

We have the luxury in the US of staying out of these alternative options. Our primary option is *really really good*.

I'm learning from the CDC now - 99%

David Weaver

...they were quoted as saying 99% of deaths now are among unvaccinated individuals.

This isn't great news for those who haven't had the vaccine (and probably not covid previously in that 99%, either, at least not commonly), but it's fantastic news for folks who did get vaccinated.

These are the kinds of questions dataheads have.

( a second reference to the CDC says 98-99%, or 150 out of the most recent 18,000 deaths are fully vaccinated individuals. Something is amiss with those quotes - maybe 98 or 99% depends on something not reported, or on single or two shots).

still best thing I've gotten in the last decade (the two shots), and I expected worse side effects as my doc and hubby got into the moderna trial and the husband spent 3 days in bed after shot 2 with a fever as high as 104 -but as many of the accounts go, on day 4, he popped out of bed like the prior 3 days didn't occur.

Lingering covid effects

Wiley Horne

Hi David,

“ I have a very fit neighbor. He's a little older, but not retired. He goes to the gym every day and could physically put me under the table at anything (And has no preexisting conditions). Covid took him out of work for several months….”

______

I’m curious about this neighbor—is he still going to the gym and doing cardio?

Today, I talked with two people who got covid, before the vaxx was available. My dentist, and a nurse (male) who came around to check my wife’s vitals and general condition. Both the dentist and the nurse had been regular gym-goers, like 4 days/week, before covid. Now the dentist, who is in his 60’s, cannot do cardio because of lung damage. And the nurse, in his 40’s, can lift, but cardio is very painful. Again, lungs.

Only one point: (a)getting covid, or (b) getting the two shots, will each provide some immunity. Maybe complete immunity. But it’s not 6 of one and a half-dozen of the other. Because you don’t want to find out what happens after covid—possibly find out your life is diminished. Better to deal with 1-2 day after-effects of the second shot.

David, this caution is not aimed at you—you’re a two-shot advocate and have made that clear. It’s just that your mention of your neighbor brought to mind my two conversations today. Getting immune the old-fashioned way can have debilitating consequences.

Wiley

Re: Lingering covid effects

David Weaver

It took several months before he felt up to going back to the gym. We talk over the fence a lot during summer, but not in winter, so I didn't see him for a while and didn't think much of it. His wife got it and was over it almost instantly.. he expressed some displeasure with that

Perhaps....

John in NM

But I think it will take a lot of studies to identify an association - basically its trying to prove a negative.

In the case of that Indian study it appears to be a completely uncontrolled one. While there does appear to be a reduction in disease acquisition for the study participants, one could attribute that to a number of other explanations.

I don't know if the guy discussing it covered that towards the end, perhaps he did. I'm afraid I disliked his presentation so I did not continue past getting the gist - he reminded me a bit of a more reserved version of my conspiratorial trainee last year.

The dose does strike me as larger than what I just went and looked up. 200 mg/kg seems to be typical, 33% lower than what the study spec'd, and more importantly, a single yearly dose seems to be typical - that study gave the larger dose twice in less than a week. I have no idea if that is a significant overage for the drug.

The drug is used widely for parasite control in animals, but it should be noted that the genetics of some dog breeds leave them susceptible to poisoning by normal dosages. Perhaps one would find similar effects in humans if as widely used as it is with animals. Given its mode of action for killing parasites, I would be pretty cautious with it in humans. Its significant to me that the two areas of problems noted are with pets rather than livestock. Around here unexplained death of livestock is simply accepted by ranchers when its low level. There could easily be similar toxicity problems in cattle and sheep and probably no one would notice and associate it with the yearly parasite treatment if it were under 1% or so.

All in all, it still strikes me as a unicorn hunt....

In the interest of accuracy..

David Weaver

...more updated data in PA shows that the case rate *is* now rising slightly - more so in lower populated areas (those areas have lower vaccination rates). 66% at least one shot in the county that Pittsburgh is in, for example, and 41% in the rural county where I grew up (not so good).

Wild guess that 1/6th or 1/7th of the population has had covid there (there's contention re: the number of unreported mild or asymptomatic cases) - that would put the "some immunity" at a little over 70% and a little under 50%, respectively (with lots of uniformity assumptions that may not hold).

Re: Data mining and one prospective study

TomD

Double blind studies aren't required, they basically set up a standard that will see many people die before something like ivermectin got out there during a pandemic. They also pretty much ensure that only new drugs will get used because there is no profit in old drugs, yet they often have many uses. There is nothing wrong with the highest standards in vetting drugs, but one should realize that while that may be a research requirement, it is not a medical care requirement. Doctors can and do a lot of off-label prescribing. And if at that point you say, "where was the study", you are bringing the wrong tool. The question is what were the results.

It is clearly saving lots of lives in places where it is in use. There were extremely adverse effects in India when they banned it, and went to a vax strategy, which is not to say vax isn't good, but there was a time lag. The Indian Bar is now suing the WHO for spreading false information on Ivermectin, that led to the change in policy, which should be good for a laugh.

We now have several peer reviewed studies that have been completed on Ivermectin, so the no peer reviewed study bugaboo is now gone.

-------------------------------------------------

Ivermectin as a replacement for Vax is a more questionable proposition. There are a bunch of reasons for that: 1) That would require long term use of the drug which is the kind of thing where one would like to have serious review of the consequences of that use. I gather the fact it is used long term in anti parasitic situations, is not enough, possibly dosage differences. 2) From a public health perspective, people are notorious for dropping medications, so you don't really know you have coverage, the way you do with the vaccines. 3) US tolerance for medical costs is pretty high, but for a lot of people the NA cost of Ivermectin is not cheap. 4) You can hardly get any doctors to prescribe it.