Coronavirus: What questions do you have?

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cwbullet

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The high rate of breakthrough infection are not a sign of the vaccine not working. It will get worse because the vaccination rate is increasing. When people with COVID vaccines out number those without, the break through rate will increasingly become the majority. Hopefully, the number of infections will decrease overall.
 
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ThirstyBarbarian

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I have a question about vaccine doses — the size, number, and timing.

Moderna calls for 100 micrograms of mRNA and a second 100 micrograms dose at 4 weeks.

Pfizer calls for 30 micrograms of mRNA and a second 30 micrograms dose at 3 weeks.

Johnson and Johnson calls for 1 dose only.

Now it looks like there are differences in effectiveness between these vaccines and differences in how long they stay effective. And maybe those differences have to do with the the size, number, and timing of the doses. For example, if the Pfizer doses were bigger, or the second doses were given at 4 weeks instead of 3, then maybe Pfizer would be more effective or last longer. Maybe if J&J called for a second shot after the first, then it might be more effective.

How was the current dosing schedule determined for these vaccines, and once it has been approved, how easy is it to change?

During testing, before the vaccines were approved, did the companies try out different dosages and different timing intervals and decide these were the best? Or did they make an educated guess, commit to testing the dosage they picked, and then submit those results for approval? For example, did Pfizer test 3 weeks and 4 weeks and decide 3 weeks was better? Did J&J test 1 shot and 2 shots and decide 1 was enough? Or did they only only test the one dosing schedule that was approved?
 

Bat-mite

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I have a question about vaccine doses — the size, number, and timing.

Moderna calls for 100 micrograms of mRNA and a second 100 micrograms dose at 4 weeks.

Pfizer calls for 30 micrograms of mRNA and a second 30 micrograms dose at 3 weeks.

Johnson and Johnson calls for 1 dose only.

Now it looks like there are differences in effectiveness between these vaccines and differences in how long they stay effective. And maybe those differences have to do with the the size, number, and timing of the doses. For example, if the Pfizer doses were bigger, or the second doses were given at 4 weeks instead of 3, then maybe Pfizer would be more effective or last longer. Maybe if J&J called for a second shot after the first, then it might be more effective.

How was the current dosing schedule determined for these vaccines, and once it has been approved, how easy is it to change?

During testing, before the vaccines were approved, did the companies try out different dosages and different timing intervals and decide these were the best? Or did they make an educated guess, commit to testing the dosage they picked, and then submit those results for approval? For example, did Pfizer test 3 weeks and 4 weeks and decide 3 weeks was better? Did J&J test 1 shot and 2 shots and decide 1 was enough? Or did they only only test the one dosing schedule that was approved?
Very curious to see Chuck's answer to this. I can say, though, that the three-week / four-week thing was kind of nebulous. For instance, I got Pfizer, but my doses were four weeks apart because that's how Walgreen's was doing it. Apparently, Pfizer was found to be effective even if doses were separated by a few months.
 

Marc_G

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Note that phase 1 trials, spring 2020, were done using various dosages then looking at the antibody levels generated, as well as the reports of adverse reactions in the recipients. This data guided the development of the actual treatment regimens.

This article may be of interest:

 

Peartree

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My wife got the Pfizer vaccine, I got Moderna. She already got a booster. I would be due between Thanksgiving and Christmas, I think, if Moderna boosters are approved. Have you heard any news about the progress of their application? Last I heard they had left out critical data that rendered an FDA evaluation impossible and were asked to resubmit it, or something. Have you heard anything else?
 

Tech 68

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Let's hope this is what we were all waiting for...
Or maybe not...

 

Bat-mite

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Well, let's hope the FDA does its job and fully evaluates all the data and makes a wise decision. Meanwhile, I think it would behoove us to trust the FDA over and above any new report. Lots of drugs fail to get FDA approval. If this one is dangerous, let the process render the correct decision.

Meanwhile, if I were a young person of reproductive age with COVID, in the hospital, and the choice was A) take this drug and live, and maybe not be able to have kids, or B) die now and definitely never have kids, the answer seems obvious.
 

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cwbullet

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Today, Israeli research reported a high level of myocarditis than expected with mRNA vaccines. First, the research primarily looked at Pfizer and second, it was short lived and resolved. The news is presenting this as a reason not to get the vaccine. It is still fairly rare and I would get the vaccine.
 

Bat-mite

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Today, Israeli research reported a high level of myocarditis than expected with mRNA vaccines. First, the research primarily looked at Pfizer and second, it was short lived and resolved. The news is presenting this as a reason not to get the vaccine. It is still fairly rare and I would get the vaccine.
And, as has already been established and discussed in this very thread, you can also get myocarditis from the virus itself.

It still is like you are standing in front of two barns and you need to escape through on of them. One is full of pits and snakes, the other is full of pits and snakes, and it is on fire.
 

BABAR

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And, as has already been established and discussed in this very thread, you can also get myocarditis from the virus itself.

It still is like you are standing in front of two barns and you need to escape through on of them. One is full of pits and snakes, the other is full of pits and snakes, and it is on fire.
I’d adjust that a bit. The first barn has one snake, and the second barn has 100 snakes, 50 pits, and is on fire.

math and logic do not seem to be Americans‘ strong suits. Of course we aren’t alone.

Moderna calls for 100 micrograms of mRNA and a second 100 micrograms dose at 4 weeks.but

Pfizer calls for 30 micrograms of mRNA and a second 30 micrograms dose at 3 weeks.
i saw the difference in volume of mRNA too. There may be more to it, (there usually is) , but Occam’s razor suggests this may be a good reason why Moderna lasts longer. Sort of begs the question, “why doesn’t PFizer just bump up the dose?” Would they not only lose their full FDA approval but also have to run the gamut of full safety trials just to get another EUA. I am sure there is considerable cost in making the basic mRNA, but probably little if any additional cost in packaging, storing, refrigerating, and shipping a triple size dose.

i dunno, maybe Pfizer during testing found more complications with a higher dose?

Chuck, looking at the current numbers, you think the FDA is going to reverse itself on boosters soon?

also, is the reason the “rest of the world” is not getting enough vaccine because the rich nations are hogging it all and giving some boosters before the ”rest of the world” gets primary shots, or because “the rest of the world” has issues with storage, distribution, and qualified people to administer the vaccine? Or both?

finally, is the apparent evidence that boosters work encouraging in that the new variants aren’t really developing a strong resistance to the vaccine, but more that the vaccines are just wearing off too fast? That would suggest that the virus isn’t as good at evading immunity as we think, we can fight it with either more frequent boosters or (ideally) a vaccine that induces a longer lasting immunity.
 

cwbullet

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i saw the difference in volume of mRNA too. There may be more to it, (there usually is) , but Occam’s razor suggests this may be a good reason why Moderna lasts longer. Sort of begs the question, “why doesn’t PFizer just bump up the dose?” Would they not only lose their full FDA approval but also have to run the gamut of full safety trials just to get another EUA. I am sure there is considerable cost in making the basic mRNA, but probably little if any additional cost in packaging, storing, refrigerating, and shipping a triple size dose.
True. I think it is dose-dependent.

i dunno, maybe Pfizer during testing found more complications with a higher dose?
Most likely.

Chuck, looking at the current numbers, you think the FDA is going to reverse itself on boosters soon?
Magic eightball says maybe. I quit betting on the FDA years ago. It is starting to become political.

also, is the reason the “rest of the world” is not getting enough vaccine because the rich nations are hogging it all and giving some boosters before the ”rest of the world” gets primary shots, or because “the rest of the world” has issues with storage, distribution, and qualified people to administer the vaccine? Or both?
I think you are right. This stuff is hard to store.

finally, is the apparent evidence that boosters work encouraging in that the new variants aren’t really developing a strong resistance to the vaccine, but more that the vaccines are just wearing off too fast? That would suggest that the virus isn’t as good at evading immunity as we think, we can fight it with either more frequent boosters or (ideally) a vaccine that induces a longer lasting immunity.
I do not think the vaccines have anything to do with the resistance. I think it is more due to a lack of full acceptance. To be honest, I am not surprised that the vaccine wanes in 6-12 months. Flu vax wane also. The only vaccines that do not are the ones in which the virus is unlikely to mutate.
 

Peartree

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My wife got the Pfizer vaccine, I got Moderna. She already got a booster. I would be due between Thanksgiving and Christmas, I think, if Moderna boosters are approved. Have you heard any news about the progress of their application? Last I heard they had left out critical data that rendered an FDA evaluation impossible and were asked to resubmit it, or something. Have you heard anything else?
Bump

On another note, they think my wife may come home from the hospital some time tomorrow but likely will be on supplemental oxygen. Fingers crossed. Baby steps in the right direction is still positive.
 

ThirstyBarbarian

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Bump

On another note, they think my wife may come home from the hospital some time tomorrow but likely will be on supplemental oxygen. Fingers crossed. Baby steps in the right direction is still positive.
That’s good news about your wife!
 

kuririn

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I'm getting my Pfizer booster tomorrow. A text message from the pharmacy suggests "drinking 16 oz. of water to lessen the chance of any side effects from the vaccine".
How does drinking water lessen the side effects? I fail to see the connection.
 

jd2cylman

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I'm getting my Pfizer booster tomorrow. A text message from the pharmacy suggests "drinking 16 oz. of water to lessen the chance of any side effects from the vaccine".
How does drinking water lessen the side effects? I fail to see the connection.
Being hydrated?:dontknow:
 

cwbullet

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I'm getting my Pfizer booster tomorrow. A text message from the pharmacy suggests "drinking 16 oz. of water to lessen the chance of any side effects from the vaccine".
How does drinking water lessen the side effects? I fail to see the connection.
There is some evidence that being dehydrated my increase some symptoms. Most Americans are 5% dehydrated.
 

manixFan

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I'm getting my Pfizer booster tomorrow. A text message from the pharmacy suggests "drinking 16 oz. of water to lessen the chance of any side effects from the vaccine".
How does drinking water lessen the side effects? I fail to see the connection.
There is some evidence that being dehydrated my increase some symptoms. Most Americans are 5% dehydrated.
The science seems a bit iffy, but if you do a Google search on "dehydration and side effects from vaccine" you'll get a fair number of articles that explain how being well-hydrated might help. And some that will say there is no real benefit. The main points seem to be that being well hydrated means normal blood volume and pressure, which may help prevent the vaccine from causing local side effects, and that many of the vaccine side effects are the same the ones suffered if you are dehydrated, so drinking water before the shot may help lessen them. Also, if you do get nauseous and don't eat, you will won't get as dehydrated since you are fully hydrated at the start.

I get my booster shot on Tuesday. I don't see any possible harm in drinking a couple of extra glasses of water before I get the shot, so I'll try and do so. There's no way to know if it will help, but it seems unlikely I'll regret that decision.


Tony.

a 'pro' hydration article:
(and yes, I fully admit Bustle is not a great health and wellness source)

Here's one that quotes a couple of studies and virologists that water won't help:
but if you read the 2017 study that is cited and seems most relevant, it only looked for side-effects in the very short term (20 minutes post shot) — basically whether or not kids passed out after getting a vaccine shot, and how much pain they experienced. So it’s hard to extrapolate that study to the types of side-effects reported post Covid vaccination.
 
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BABAR

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I'm getting my Pfizer booster tomorrow. A text message from the pharmacy suggests "drinking 16 oz. of water to lessen the chance of any side effects from the vaccine".
How does drinking water lessen the side effects? I fail to see the connection.
I am up for Thursday, combined flu and Pfizer booster. I plan on being hydrated, also plan on hitting the acetaminophen/ibuprofen combo immediately.
 

NateB

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Got my booster last Wednesday. I was a little sore Wednesday night and Thursday, but it wasn't quite the stabbed by a soldering iron feeling I had with the 2nd. It was more comparable to my 3rd hepatitis shot or just a little worse than a typical flu shot. That's all subjective of course. I was well hydrated with black coffee and naproxen that day.
 

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Just curious, what is the mortality rate for those put on respirators now that Delta is prevalent? I seem to remember you saying it was about 20% last year when we had the original Covid? I was surprised when the news here reported that locally 50% of patients on respirators didn't survive and wondered if that was correct. Note: Idaho has the third highest deaths per 100,000 currently.
 

cwbullet

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Just curious, what is the mortality rate for those put on respirators now that Delta is prevalent? I seem to remember you saying it was about 20% last year when we had the original Covid? I was surprised when the news here reported that locally 50% of patients on respirators didn't survive and wondered if that was correct. Note: Idaho has the third highest deaths per 100,000 currently.
The early reports were for a death rate of over 90% for those on respirators. We got pretty good at avoiding them on the second spike and lowered that rate. It was about 50% on the second spike. Many of the hospitals I support were in the 20% for a while but that has raised a little. Our population is a little younger so that may have skewed the numbers. I do not have recent numbers but an educated guess is that the US is at 45% and we are a touch lower. As will all medical data, some facilities do better and others more poorly, but over time, each drifts toward the average.

We were early adopters of proning and we have used a lot of EUA and new treatments most do not have available. Heck, we used infusions before many facilities had them. I have talked about the new dialysis filters. They will be mainstream soon.
 

cwbullet

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Got my booster last Wednesday. I was a little sore Wednesday night and Thursday, but it wasn't quite the stabbed by a soldering iron feeling I had with the 2nd. It was more comparable to my 3rd hepatitis shot or just a little worse than a typical flu shot. That's all subjective of course. I was well hydrated with black coffee and naproxen that day.
Which shot?
 

NateB

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At least in my area, covid cases are going down, but our hospitals aren't seeing much relief yet. I know covid cases require longer admission, so any decrease in admissions will lag behind confirmed cases, but admissions for other illnesses are climbing. What is the prediction for census this year? Even with covid coming and going in waves, do you think the high census and acuity will continue all Fall and Winter?
 

BABAR

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At least in my area, covid cases are going down, but our hospitals aren't seeing much relief yet. I know covid cases require longer admission, so any decrease in admissions will lag behind confirmed cases, but admissions for other illnesses are climbing. What is the prediction for census this year? Even with covid coming and going in waves, do you think the high census and acuity will continue all Fall and Winter?
My information is from my experience, so anecdotal (take with a grain of salt.)

Seeing much more imaging for chest pain, abdominal pain, and change of mental status (Chest CT, Abdomen and Pelvic CT, and Head CT respectively.)

A small portion of these have active Covid, most don’t have active Covid, but not sure if they are past infections or never infected.

while The NUMBER of exams is increasing, the positive percentage rate for things like Pulmonary Embolism, Diverticulitis and Appendicitis and Ischemic bowel, and Stroke respectively is about the same. So I AM seeing more frequent disease, but I am also seeing more negative studies. Emphasize just because your X-rays and labs are negative, doesn’t mean your symptoms are all in your head (unless your symptoms really ARE in the head region, like headache, mental status changes, stroke symptoms, etc.)

My suspicion is many of these cases are Covid survivors presenting with complications, some of which are recognizable /diagnosable disease as above, and some of which are likely causing symptoms but not severe enough to show up on imaging studies.

I suspect what I am seeing is the “tip of the iceberg” of Long Covid.

So I expect although the death rate will fall a few weeks after the active case peak falls, ER visits and hospitalizations are going to be well above “pre-Covid” for a while.

@cwbullet , can you give a SWAG on the U.S. Population

%Vaccinated, never infected?

%Vaccinated, past infected?

%Unvaccinated, past infected?

and most importantly, the major “at risk” population
%Unvaccinated, not (yet) infected?
 
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cwbullet

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Pfizer. I get the flu shot in a few weeks with my annual physical.
I am making an appointment to get seen. I am having trouble losing weight and I am dog tired since catching COVID. I am just not recovering as I did before. It could be that I am just getting old.
 
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