OT - the Delta and Booster Thing

Re: OT - the Delta and Booster Thing

paul in AZ

You are asking question(s) for which there is no definitive answer so far.

I doubt that woodworkers on this site will come up with the final answer.

Give it a rest.

Re: OT - the Delta and Booster Thing

Dave Bair

I will only say this: we are nothing like the greatest generation who managed to pull together, recognize the common good, and sacrifice to obtain it. More americans have died from covid than died in WWII. And we're letting it continue!

Ditto

Re: you guys are welcome...

David Weaver

..not to read or to complain, either way.

I certainly wouldn't read something you wrote and then determine since I didn't like it, I should complain instead of just not reading it. But it's not my place to tell anyone else to do that, either.

Agree...

David Weaver

The idea of solving the problem and doing actual problem solving is now divisive.

I've heard more assertions detached from reality in terms of one side or the other (both ways) than anyone would've heard in a southern pro wrestling promotion in the 1960s.

I guess it sells advertisements. It sure would be nice to solve problems instead - open data, universally, accessible for individuals to literally see how much risk they're taking if they think they want to be conspiracists.

In short, probably not worth it...

John in NM

Disclaimer, I'm not a data guy, so I end up depending on articles that draw conclusions from the data rather than drawing my own. From what I've read, breakthrough infections are typically very mild for vaccinated people - typically asymptomatic, a few as serious as a four day head cold. One figure I recall quoted was 0.004% of vaccinated breakthrough cases require hospitalization.

From a practical point of view then, I would not worry in the least about whether a mild infection were better than a booster. Either way the risk to you is extremely low and the question strikes me as similar to putting a great deal of thought into how to avoid ever having something as simple to fix as a flat tire.

From a less practical point of view, perhaps the best course would be to avoid annoying the wife

Re: OT - the Delta and Booster Thing

John McGaw

I am an old man assume that many of our regulars are in the same boat. I intend to become much older so if a booster becomes available I'll certainly get it ASAP and in the mean time I will continue masking and distancing and washing. All of these are relatively simple and if it saves me from even the mildest of symptoms it will be worth it. The hospitals are busy enough without a visit from me.

Re: OT - the Delta and Booster Thing

John K Jordan

>>>I am an old man assume that many of our regulars are in the same boat. I intend to become much older so if a booster becomes available I'll certainly get it ASAP and in the mean time I will continue masking and distancing and washing. All of these are relatively simple and if it saves me from even the mildest of symptoms it will be worth it. The hospitals are busy enough without a visit from me.

Same here. My son with immune system compromised by chemotherapy is getting his now, we will get the third show when available. BTW, the state health department is not calling it a "booster" shot but a "third" shot. Pfizer.

Re: OT - the Delta and Booster Thing

TomD

It would be a huge outlier ifvyou get a far better effect from having the virus than getting the shot, and it is also highly likely more durable. We won't know for a while since the general trend is to accept any claim made for vaccines, though they turn out to be less effective than promised, and to underclaim for typical responses to infection from disease, since "we haven't seen the data yet", which is true.

There is a recent quality study out of the UK that says that the incidence of long COVID in kids has been vastly over-estimated, though to some extent the article started with such a high estimate that it really was not terribly reassuring.

The CDC just came out with the results of blood samples taken from 1.4 million people that show that the incidence of protection by having had COVID was twice as high as had been previously believed, and that total US "immunity" may be around 80 percent. Studies of this kind have been pretty slow in coming.

There have been instances of people getting their kids seized by authorities for relatively minor covid infractions like the adult not wearing a mask out of doors while with a child. Though that might have been OZ. So there is a custody risk of some unspecified magnitude of pursuing a child infection strategy, though that does appear to be what a lot of school boards in Canada did last winter, unintentionally, with ludicrous standards. They failed to follow their own medical panel standards by a long shot, and upon testing it turned out that air quality standards (CO2 levels are a good marker for potential exposure to COVID) did not even meet the standards for general air quality in 1/3rd of schools in my region. COVID blew up in Schools first in Ontario, and led to long lockdows for everyone.

Ontario is generally a very well run place, but one gem this school year is they decided to advance some 11 year olds for vaccination since some 11 year olds will be at school with 12 year olds who can be vaccinated. This notwithstanding that the actual testing being done mainly in the US will not be available for child vaccine safety until 2022, or 2023.

If you have girls it might be interesting to see what data Pfizer got on their only recently completed reproductive health safety testing, there have been a lot of troubling field reports. And it might be interesting to know when we will see tests on a younger cohort on that subject. You could also check to see where WHO, UK, and EU are on child/teen vaccinations, they were significantly lagging at one point, even though some of that is around the vaccinate the world first stuff, it is still significant for our children medically.

A starting point would be to test kids to see if they have already been infected, since you can't be blamed for that. It boggles the mind that isn't standard. It is interesting that the CDC has recently completed some data as per above, presumably not because they consider it irrelevant.

Re: OT - the Delta and Booster Thing

TomD

That is interesting, it isn't a booster, they just rolled out that language because it seemed normalizing. Maybe they will eventually stop calling it a "vaccine" as it does stop infection, replication, or transmission, and to some extent it also misses the regulatory threshold of 50% protective. It is strongly protective against serious disease, it seems, which is major.

The oldster thing is a far clearer case, there is plenty of evidence that adverse incomes increase exponentially with older age, there is another end to that line.

Re: Agree...

TomD

Apparently there are well developed tools you can plug your data into to get a sense of your personal risk, very specifically. I have not pursued it as I am basically a mid-Atlantic lighthouse keeper, lifestyle wise.

Vaccination vs. Get-the-disease

Wiley Horne

Two words for you, David: Long Covid. Permanent impairment.

Because: if you choose acquired immunity, you don’t get to choose the severity of the disease. The disease chooses you, picks you (or your children) out of the herd.

Thinking about your children, since you’ve had your shots.

Wiley

Nomenclature....

John in NM

I read an article this morning that made that same point about a third shot being better described as part of a complete regimen than as a booster shot. It made a lot of sense, but also made me wonder if the true vaccinologist would ever describe anything as a "booster"

There is a lot of sensible thinking on both sides of the question of third shot vs. not for the average person. As much as I would personally like as much immunity as is available to me, I also see a lot of sense in the argument that the focus should stay on distributing the two shot regimen as far and wide as possible. To me that makes more long term sense.

Re: Nomenclature....

John K Jordan

>>>>made me wonder if the true vaccinologist would ever describe anything as a "booster"

The CDC apparently uses "booster" to describe certain tetanus shots:

https://www.cdc.gov/vaccines/parents/diseases/tetanus.html

JKJ, not a medical professional

Wrong start here....maybe I wasn't clear...

David Weaver

the vaccine is the tool that allows you to get natural immunity later (at least if you're following the data - there's so much of it it's hard to argue against at this point).

The very young can seemingly (not always, but materially so) get infected, have a transient infection and move on. Late teens and symptoms start showing up. Around there with obesity and diabetes or other factors and things go downhill quickly.

So while, I'm not a fan of people going vaccine-less, it's their choice at this point and not mine - and not what I'd advocate following data.

It's also probably going to be an unfortunate reality that if we actually make data-based decisions to get the best possible outcome and to attempt to get the best outcome for the next variant, and so on, not everyone will get the same thing. Perhaps at 44, I would be better off getting covid after 2 vaccines. The chance of long covid is very slim.

But that doesn't mean someone 75 with diabetes would make the same choice - our odds would be different.

This all follows my original post to bill (and it's not really to bill, it's to the point of the original discussion), where is the data saying we need a booster. And now the question changes a bit (at the time, I also posed the question of how do we know we'll be better off in the long term with boosters vs. natural immunity - which doesn't mean only gained through lack of vaccination).

I think we owe it to ourselves to track the outcomes and try to get the right answer. We originally thought we were in for bowling a frame. Now, it's clear we very well may be in for a chess match. If you're going to win in chess, you need strategy and tactics. We're grasping at tactics bit by bit, but what's the strategy? If your opponent makes a move, your possible combinations change and your odds change with them.

The question about whether or not a booster is necessary is past me - for me, I don't think it is at this point, but you always have to observe - it can be uncomfortable to constantly say that your answer could change (I know that this is not you, so it's not aimed at you, but rather the team-based game that everyone seems to have fallen into . What does your "team" say? Well, you don't want to agree with the other "team". That kind of thing).

I posted this study sort of as a continuation, but I have less interest in anyone solving things here and more in seeing that we continue to see actual data as it comes along, and not just data that fits a source's goal. We owe it to each other. We're in it together. It may be no surprise, but when I was younger, I would pick a conclusion and dig in. I would ride it until it was completely indefensible. At some point, I decided to instead see if I could:

1) constantly challenge what I'm seeing or thinking instead

2) also see not if I could absolutely not get out of agreeing with someone that I wanted to disagree with but instead see if there was any way that I could agree with them and find common ground instead.

And even if someone has a point that I cannot get to fit into the new #2, be friends with them, anyway. If they want to be - some people say no to that unless they can get you to be on their "team" about everything, and that's OK.

I'm anxious to see if new data comes out that agrees with the israeli article, and whether or not it survives peer review. It's extremely important at this point. We may survive even if it's buried in favor of a blanket policy that's not optimal, but I think we owe less "I'm right" to each other and more "we are all going to try to solve the problem as well as possible, even if we have to admit that changes over time".

My dad is 73...so is my mother...

David Weaver

..if a booster comes along, I intend that unless there's data showing otherwise, that they should get it.

Memory is starting to steal my mother, but I don't need to see her stolen any sooner.

My horizon is longer - I don't see a point in my lifetime that we're not seeing seasonal covid variants (seasonal probably isn't even the right word).

This is a different thing (observing outcomes, making choices to try to make the future as good as possible) than suggesting nobody should get a booster. I still may get one (I got the first two shots as soon as my cohort was available).

I just hope as a whole, we don't go into our old ways of reacting poorly, taking the public temperature (polls, etc) to see what the decision should be, then making a good decision only partly too late and coming back later to day "we did the best we could".

So far, we can't say that. Each time I see large factions ignoring data or saying they're fake, it tells me we have a long way to go.

the last part is often lost...

David Weaver

..we see things in our own shoes and forget that for a lot of us, humanity may be better served if we gave up our "boosters" to get someone else functionally immune to start with.

to my knowledge, none of the variants we're dealing with originated here. That should tell us something.

I hope we have the sense to measure different cohorts, even if they aren't a matter of policy - but it would sure be nice if the information was public and sortable, too.

I suspect that anyone compromised or even "just" older may be better off with the boosters, and others may not. For society as a whole, we may be better off doing both. I hope we have the sense to realize sometimes answers have more than one part.

Re: OT - the Delta and Booster Thing

David Weaver

I think the tests are kind of shaky after the local antibodies are gone (not a doctor, not versed in the rush of antibodies vs. the "marrow" kind that last longer and are made at low levels, potentially for life).

Something that shouldn't be too surprising is different outcomes with different variants. Kentucky data showed the earlier variants seemed to respond better to vaccines and the reinfection rate was lower for vaccinated folks.

Israel's data on delta seems to show the opposite. It's important to understand why rather than dismiss one or the other - they could both be legitimate and accurate studies with results that would be duplicated if run again - simply due to the effectiveness of different immunity to different variants.

The kids are fully in school here - mine are young. My mrs. is jumping ugly for my daughter to turn 12 in a couple of months and that's fine - whatever she chooses will be fine (I'm staying out of it, though I suspect that my daughter would be better off getting "the real thing" now as all of us are vaccinated and there is nobody compromised here). The situation may be different for others.

Dotted around my neighborhood are people who didn't get vaccinated and got "the real thing" and had unexpectedly bad outcomes (talking about younger folks who ended up in the hospital for something that should have been preventable). Of course, some older folks and relatives of neighbors also died early on.

With all of these things, if we're going to make good choices, we have to know the full set of information (for example, as you propose some troublesome information about the vaccine, we should also be aware of whether or not the effect of having had covid does the same thing or worse).

Yeah...

John in NM

I didn't mean to doubt the use of the word in general, I just couldn't quite grasp the difference between a 2-3 shot regimen with long intervals between shots and a booster. There seems to be some disagreement even in the medical community and I kind of wonder if "booster" is somewhat of a layman's term that gets used in place of explaining nuances with greater precision, yet still offends the sensibilities of the practicing specialists.

I also wonder a bit if the more accurate use of booster would be a modified vaccine targeting specific variants rather than a third shot of the same as you got the first time. That seems plausible too, but like you, I am no expert on this stuff.

A bit wider picture

Wiley Horne

Delta is not the last variant, just the latest in the news. Mu is coming. And then epsilon, zeta, eta, theta, etc. Best to keep up with the protection that science makes available.

I think the study data ...

David Weaver

..may have not been noticed. This is the delta part, and this is where we have to observe if we're trying to get the right answer not assume that we always provide a better solution.

"In a separate analysis that compared vaccine and natural immunity regardless of the time of infection, fully vaccinated patients had a higher risk of infection (OR 5.96, 95% CI 4.85-7.33) and symptomatic disease (OR 7.13, 95% CI 5.51-9.21)."

This is just for delta. This data to me is almost unbelievable (it doesn't compare unvaccinated individuals who never had covid, so it shouldn't be read as such - it's people who have had covid, and people who have been vaccinated).

The data pool for those who had covid was 63,000 individuals, and the vaccinated group was much larger (because it's israel and that's what the cross section there looks like). There was a small single-vaccinated group, too, that probably didn't fare as well (I didn't may much attention to it).

There were no deaths in any group (that's important - we're talking about what limits further disease and hopefully with the endpoint of limiting severe disease and death).

Not sure if there are behavior differences or what adjustments have been made otherwise, but the key number there is that the risk of fully vaccinated folks to get a breakthrough delta case vs. those who have had covid previously is 7 times higher.

(worth going back and checking)

"The researchers adjusted for covariates including age, sex, socioeconomic status, and comorbidities, including cardiovascular disease, hypertension, diabetes, kidney disease, obstructive pulmonary disease, immunocompromised conditions, and cancer."

Good. The study is in peer review - we'll see how it holds up. It doesn't appear to have been a sham study at this point, but the 7 times factor with a pretty definitive range in 2 standard deviations is stark.

It should be top priority for the CDC to be examining data in the US to see if the same outcome is observable here. What I suspect we'll see for boosters is comparison of the booster to populations where it looks more favorable, such as double vaccinated vs. booster without controlling for prior covid.

By mentioning other future variants, in the context of this study, you may be unintentionally making my point.

Re: I think the study data ...

TomD

It is no surprise that natural immunity would be far stronger and more durable. Natural immunity fires on all cylinders, it is normal for T-Cell immunity to wain. The preliminary Israel study shows a 13-20X advantage.

Israel is an interesting example because they threw all their eggs in the Pfizer basket and seem to be having worse outcomes. In the UK where there were a multiple vaccines taken, and where they are seen to be somewhat similar to Israel at stage, they are having better outcomes. It would make sense. Though national comparisons are more a parlour game than to be taken seriously.

The booster for Pfizer... Assuming one does not want to bait the virus and go all natural, consider that it is about 4 times weaker than Moderna, otherwise said to be similar. And the J&J and the AZ just keep pumping the spike protein like they are a bucket shop. So basically you just have a weaker dose with the Pfizer, but with any luck that might mean less up front problems. So it isn't so much a booster as a staged delivery of a gene therapeutic.

If you want to bait the virus, one might want to wait until the Pfizer anti-V is out since it is supposed to help you survive the disease you will get when you are double vaccinated. Good to know their confidence level. But that would mean that should you tempt fate, you would have an out. Assuming you are not already intimate with a horse doctor. The other big win might be that an Anti-V will make the chance of driving variants by vaccinating into a pandemic, lower. Not sure, but not vaccinating and only using theraputics is a way to do that, with the obvious loss potential.

The Israel Study is generating statements in favor of just letting kids slide, but so far they seem luke warm. Nobody is going to admit the disaster that vaccinating a whole generation of kids could lead to. If only in terms of vaccinating them against a stronger cure. An example would be Ross Clark at the UK The Spectator.

Re: OT - the Delta and Booster Thing

TomD

Up here with a provincial population of 15 million one child under 12 died, and one would wonder what their pre-infection prognosis was. It is interesting (I hope I am not repeating) that the data for the under 12 kids will take till '22 or '23 to be completed. Why so long, and what are they worried about? As you are about to experience, there is only a 1 day difference between the two cohorts.

Re: I think the study data ...

Wiley Horne

Hi David,

“ By mentioning other future variants, in the context of this study, you may be unintentionally making my point.”

Your point. What is it? You’re a little shy about stating your point. Yes, the study finds that Covid survivors have acquired the strongest immunity. Better than vaccine. So what? Do you suggest foregoing vaccination, if this study result is replicated elsewhere? There have been on the order of 1 million deaths in this Nation among the unvaccinated, who did not survive to have this great immunity.

My point. Vaccine is a dominant strategy. Because you may or may not be a covid survivor, unless you’ve been vaccinated. And if you are a survivor but also a carrier, your wife, children, mom and dad, other relatives and friends/ acquaintances may not be.

Wiley