Coronavirus Vaccines

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BABAR

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All medicine is a balancing act of risk vs benefit. Google Smallpox Vaccine Mortality (I can't seem to copy the link on my phone) and there is a JAMA article attributing 68 deaths in the US in the 60s. Polio vaccinations weren't perfect either, one distributor screwed up and sent out LIVE virus resulting in GIVING the recipients Polio. (Most but not all recovered. ) All vaccinations carry some risk. One of many questions is indeed going to be, "How much (and how long) do we have to test these new vaccines before we start mass vaccinations?"

Gonna be a tough sell for parents. Let your kid get Covid and chance of full recovery is for all practical purposes 100%? Or give them a new vaccine with an unproven track record?

For patients over 65 and adults with underlying conditions maybe the testing can be less rigorous, but even in the over 85 group most patients survive Covid.

I am strongly pro vaccination for proven vaccines, but while it is great the research is bearing fruit quickly, it ain't ripe yet.
 

cwbullet

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All medicine is a balancing act of risk vs benefit. Google Smallpox Vaccine Mortality (I can't seem to copy the link on my phone) and there is a JAMA article attributing 68 deaths in the US in the 60s. Polio vaccinations weren't perfect either, one distributor screwed up and sent out LIVE virus resulting in GIVING the recipients Polio. (Most but not all recovered. ) All vaccinations carry some risk. One of many questions is indeed going to be, "How much (and how long) do we have to test these new vaccines before we start mass vaccinations?"

Gonna be a tough sell for parents. Let your kid get Covid and chance of full recovery is for all practical purposes 100%? Or give them a new vaccine with an unproven track record?

For patients over 65 and adults with underlying conditions maybe the testing can be less rigorous, but even in the over 85 group most patients survive Covid.

I am strongly pro vaccination for proven vaccines, but while it is great the research is bearing fruit quickly, it ain't ripe yet.
I would read into the smallpox deaths vaccine deaths much. Your risk of death and disfigurement is much less than 68 in hundreds of millions of vaccines given. The reason they stopped smallpox vaccines has all to do with the risk versus benefit you stated. The US military has been giving smallpox vaccine for 20 years and I doubt there mroe than a small handful of serious reactions. I have seen 1-2 in over 100K given by units I have supervised. The biggest problem with small pox vaccine is giving it to the wrong person.

For example, some chronic dermatologic conditions are incompatible with receiving the vaccine.
 

cwbullet

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Gonna be a tough sell for parents. Let your kid get Covid and chance of full recovery is for all practical purposes 100%? Or give them a new vaccine with an unproven track record?
It would not be tough for me. Vaccinate your child or risk killing mom, dad, or the grandparents. Also, it will nto be unproven if released to the public.
 

Ez2cDave

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I am strongly pro vaccination for proven vaccines, but while it is great the research is bearing fruit quickly, it ain't ripe yet.
With some fruit, it doesn't matter if it is ripe, or not . . .

 
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BABAR

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It would not be tough for me. Vaccinate your child or risk killing mom, dad, or the grandparents. Also, it will nto be unproven if released to the public.
We may be saying the same thing. How much testing and what is the minimum time span for observation for possible side effects are required to move the meter from “unproven” to “proven”

Radiologists as well as the rest of the medical community thought gadolinium contrast agents (first used clinically in 1988) were perfectly safe, far safer than iodine agents which are relatively safe. A disease called Nephrogenic Systemic Fibrosis (NSF) was first formally recognized in 2000, and the causal agent of a COMBINATION of gadolinium contrast Given to patients WITH renal failure was recognized until 2006, 18 years after it was introduced. NSF (which was never common, hence the long time span it took to figure out it existed. Let alone link it to the cause) is now extremely rare because we screen for renal failure in at risk patient prior to administering it, but now we have found that a certain amount does accumulate in the brain (without toxic effects that we have so far identified) and so we use it only when strongly needed in kids.


Thalidomide was another great drug, except as Europeans found out in pregnant patients ..... four years after it was released. It still IS good drug when used appropriately

Again, I am NOT an “anti-vaccer”, but before we start throwing this at 100% of the world’s children I would like to see a track record of safety. How long? I dunno (I are just a Radiologist), but likely more than three months. It is VERY hard to prove a negative (hard to prove no long term effects) with medications.

Ironically the population most at risk (elderly) also sometimes has the poorest immunologic response to vaccination. The Flu vaccine has a 70-90% effectiveness in young patients, only 27-45% in the elderly

Certainly better than nothing. We just need to be very careful that the “cure” doesn’t turn out to be as bad or worse than the disease. I fervently (but not feverishly!) hope a proven safe vaccine is available soon!
 

cwbullet

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We may be saying the same thing. How much testing and what is the minimum time span for observation for possible side effects are required to move the meter from “unproven” to “proven”

Radiologists as well as the rest of the medical community thought gadolinium contrast agents (first used clinically in 1988) were perfectly safe, far safer than iodine agents which are relatively safe. A disease called Nephrogenic Systemic Fibrosis (NSF) was first formally recognized in 2000, and the causal agent of a COMBINATION of gadolinium contrast Given to patients WITH renal failure was recognized until 2006, 18 years after it was introduced. NSF (which was never common, hence the long time span it took to figure out it existed. Let alone link it to the cause) is now extremely rare because we screen for renal failure in at risk patient prior to administering it, but now we have found that a certain amount does accumulate in the brain (without toxic effects that we have so far identified) and so we use it only when strongly needed in kids.


Thalidomide was another great drug, except as Europeans found out in pregnant patients ..... four years after it was released. It still IS good drug when used appropriately

Again, I am NOT an “anti-vaccer”, but before we start throwing this at 100% of the world’s children I would like to see a track record of safety. How long? I dunno (I are just a Radiologist), but likely more than three months. It is VERY hard to prove a negative (hard to prove no long term effects) with medications.

Ironically the population most at risk (elderly) also sometimes has the poorest immunologic response to vaccination. The Flu vaccine has a 70-90% effectiveness in young patients, only 27-45% in the elderly

Certainly better than nothing. We just need to be very careful that the “cure” doesn’t turn out to be as bad or worse than the disease. I fervently (but not feverishly!) hope a proven safe vaccine is available soon!
In this day and age, you have to have a little faith.
 

Ez2cDave

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It would not be tough for me. Vaccinate your child or risk killing mom, dad, or the grandparents. Also, it will not be unproven if released to the public.
The problem is that Mom or Dad could, just as easily, bring it home to Grandma & Grandpa. That is where "forced / mandatory" vaccination begins to rear it's ugly head . . .

Did anyone catch Mark Dershowitz's recent comments ?

 

cwbullet

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The problem is that Mom or Dad could, just as easily, bring it home to Grandma & Grandpa. That is where "forced / mandatory" vaccination begins to rear it's ugly head . . .

Did anyone catch Mark Dershowitz's recent comments ?

It is legal, but we rare;y do it. We are more likely to require it for your kid to attend school or travelers. Soft requirements accomplish the same thing.
 

Ez2cDave

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It is legal, but we rare;y do it. We are more likely to require it for your kid to attend school or travelers. Soft requirements accomplish the same thing.
I will "reserve final judgment", until I see how the Government decides to "roll this out" and their "compliance" policy.
 

boatgeek

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It is legal, but we rare;y do it. We are more likely to require it for your kid to attend school or travelers. Soft requirements accomplish the same thing.
You can guarantee that students will need COVID vaccines to return to school, similar to your local regulations about measles. Likely the same for college campuses and for people working or living in old folks’ homes. I expect that a lot of government agencies will strongly recommend them for their employees and most medium to large companies will have vaccinations readily available if not a requirement to come back to the office or factory.
 

cwbullet

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You can guarantee that students will need COVID vaccines to return to school, similar to your local regulations about measles. Likely the same for college campuses and for people working or living in old folks’ homes. I expect that a lot of government agencies will strongly recommend them for their employees and most medium to large companies will have vaccinations readily available if not a requirement to come back to the office or factory.
I am really speaking all schools such as elementary, middle and high.
 

Ez2cDave

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You can guarantee that students will need COVID vaccines to return to school, similar to your local regulations about measles. Likely the same for college campuses and for people working or living in old folks’ homes. I expect that a lot of government agencies will strongly recommend them for their employees and most medium to large companies will have vaccinations readily available if not a requirement to come back to the office or factory.
Here, in North Carolina, "year-round" Public Schools are re-opening on August 5 and the "traditional" Public Schools are re-opening on August 17, all at full capacity, including School Buses.

https://www.wfae.org/post/nc-schools-will-reopen-early-add-5-days-more-pay-still-question

Clearly, there will be no vaccine available that soon.

Dave F.
 
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boatgeek

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Here, in North Carolina, "year-round" Public Schools are re-opening on August 5 and the "traditional" Public Schools are re-opening on August 17, all at full capacity, including School Buses.

https://www.wfae.org/post/nc-schools-will-reopen-early-add-5-days-more-pay-still-question

Clearly, there will be no vaccine available that soon.

Dave F.
I wasn’t very clear in what I meant. When a vaccine is available, students will be required to have it. Until then, schools are rolling the dice with all of those little Petri dishes.
 

Ez2cDave

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I wasn’t very clear in what I meant. When a vaccine is available, students will be required to have it. Until then, schools are rolling the dice with all of those little Petri dishes.
Agreed . . . Personally, I think that the Schools should be the LAST thing to re-open !

Dave F.
 

Reinhard

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Agreed . . . Personally, I think that the Schools should be the LAST thing to re-open !
I guess you wouldn't like our priorities here in Austria. Schools have started to reopen but brothels are still closed. 😜

Seriously though, schools are tricky. They are high risk, but they have also a profound influence on the future of a generation. Opening them during an uncontained outbreak would be irresponsible, but when there is some room for relaxation there are some other things that can wait bit longer in my opinion, for example many types of mass gatherings, especially recreational ones.

Reinhard
 

Ez2cDave

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I am not sure. We are on uncharted territory.
Chuck,

My position on why schools should open last is based on :

(1) Children are a very common vector of disease.
(2) They sit in close proximity to each other, for extended periods of time, either in classrooms or on school buses.
(3) Children typically practice poor hygiene. ( nose-picking, spitting, bathroom issues, open coughing / sneezing, etc. ).
(4) They have close, physical contact with each other ( "boyfriend's", "girlfriend's", fighting, etc. ).
(5) Cafeteria "behavior".
(6) No opportunity for frequent hand-washing.
(7) They will "ferry" the disease back & forth, daily, sharing it with others & bringing it home to their families, who will then continue the cycle of transfer.

Dave F.
 
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cwbullet

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Chuck,

My position on why schools should open last is based on :

(1) Children are a very common vector of disease.
(2) They sit in close proximity to each other, for extended periods of time, either in classrooms or on school buses.
(3) Children typically practice poor hygiene. ( nose-picking, spitting, bathroom issues, open coughing / sneezing, etc. ).
(4) They have close, physical contact with each other ( "boyfriend's", "girlfriend's", fighting, etc. ).
(5) Cafeteria "behavior".
(6) No opportunity for frequent hand-washing.
(7) They will "ferry" the disease back & forth, daily, sharing it with others & bringing it home to their families, who will then continue the cycle of transfer.

Dave F.
I understand the concerns but think schools can reopen if done properly. Just not sure we can do it properly in the US.
 

Alan Whitmore

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I would like to contribute a very short essay I wrote a few weeks ago for a different group (my family) about the antibody test for prior exposure to SARS CoV-2. It's a little long, and most will not care to read it, so I will attach it as a .pdf rather than take up space on the interface. It relates directly to vaccine development, because one of the ways that any putative vaccine will be evaluated during the pre-clinical and clinical trials will be the determination of how well that vaccine induces anti-viral antibody response. Vaccine development is not easy. Some of our contributors to this list have made very thoughtful and well-stated additions to the discussion, and we all agree that a useful and effective vaccine is, at best, some years away, and at worst, may not be possible.
For the foreseeable future, self-isolation and social distancing are our best options.

Alan Whitmore
 

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