Covid Vaccines

[NateB]

I have several 18-30-year-olds that I tracking that have heart failure with an EF less than 40.

That is scary and the full extent won't be known for years. I imagine there are many under 40 who have had covid, but haven't had any reason for an echo or chest CTs. We might be surprised what we find among my own cohort in 15 years.

 

[cwbullet]

The US Military is now reviewing ways to screen AD who catch COVID. There is a significant risk for athletes to Sudden Cardiac Death for months after a COVID infection.

 

[ThirstyBarbarian]

My dad got his first shot at a big drive through vaccination program in the parking lot of Petco Park in San Diego on Wednesday. They are planning to get mom in there soon too. Many of their local friends who are 75+ years old have also had their first shot or are scheduled for the next week or so. It seems like things are moving pretty quickly for their age cohort in San Diego. I was so relieved to hear they are getting their vaccines. I’ve been extremely worried about my parents.

 

[Ez2cDave]

If the public does not accept the vaccine, businesses, schools, maybe even churches may require a covid card to attend.

I predict that the "Black Market" will be gearing up to produce cards.

Dave F.

 

[dr wogz]

and I'll add this:

Quebec vaccine plan may be rethought after troubling Israeli data, says provincial adviser

Quebec could change its vaccine strategy based on discouraging new data out of Israel about the efficacy of the first dose, on its own, of the Pfizer COVID-19 vaccine, says a top adviser in the province.

montreal.ctvnews.ca

 

[cwbullet]

I predict that the "Black Market" will be gearing up to produce cards.

Dave F.

It will be hard to do that, but I am sure they will try.

 

[OverTheTop]

I predict that the "Black Market" will be gearing up to produce cards.

Dave F.

I bet they are already counting future profits.

 

[Dustin Lobner]

Anyone have data on getting the shot (think it'd be Moderna here in Wisc) for someone who is pregnant? My wife is a) pregnant and b) super high risk, we're kicking around what she should do. I'm getting it ASAP, I'm in 1C.

 

[NateB]

I haven't seen any published studies about the vaccine and pregnancy. I don't think it has been studied yet.

I did see a pregnant woman in line when I got my first shot, but my group was all people involved in direct patient care with covid cases. I know the choice I would recommend for my wife in that situation and I know what she would do, but that is a personal risk / benefit assessment and a great question for your OB.

 

[Dustin Lobner]

I haven't seen any published studies about the vaccine and pregnancy. I don't think it has been studied yet.

I did see a pregnant woman in line when I got my first shot, but my group was all people involved in direct patient care with covid cases. I know the choice I would recommend for my wife in that situation and I know what she would do, but that is a personal risk / benefit assessment and a great question for your OB.

I'm kindof torn...I understand how the mRNA vaccine works (as much as an engineer who last took a bio class in college) can, and I don't really think there are issues with it. But...damn, just don't know.

 

[NateB]

I'm kindof torn...I understand how the mRNA vaccine works (as much as an engineer who last took a bio class in college) can, and I don't really think there are issues with it. But...damn, just don't know.

I understand that, these decisions aren't taken lightly. Weighing the risks of the vaccine, the risk of covid complications, and the risk of catching covid in the first place to 2 lives is no easy task. With so many hospital staff member being vaccinated by now, surely some of the docs have reports of pregnant patients getting one or opting out. There might be resources at your offices or at least common questions they have answered. I did find this: https://www.health.harvard.edu/blog...youre-pregnant-or-breastfeeding-2021010721722

 

[Exactimator]

My dad got his first shot at a big drive through vaccination program in the parking lot of Petco Park in San Diego on Wednesday. They are planning to get mom in there soon too. Many of their local friends who are 75+ years old have also had their first shot or are scheduled for the next week or so. It seems like things are moving pretty quickly for their age cohort in San Diego. I was so relieved to hear they are getting their vaccines. I’ve been extremely worried about my parents.

My in-laws will be at Petco tomorrow morning getting theirs. They're close to 80 and have lung issues that would make Covid deadly for them. They're very excited.

My mother who lives in Glendale is very frustrated trying to get a vaccine reservation. L.A. ran out of doses. I have a friend who had a reservation, was in line at a drive thru location and got turned away when they ran out.

 

[Ez2cDave]

duplicate . . . sorry

 

[JLP1]

This last Thursday one of our local TV stations busted the CEO of one of our largest hospitals here in Houston. The CEO confirmed that foreign nationals were flying into Houston and receiving the vaccine that was suppose to be for Texans. Reports have stated that some of these foreigners have paid as much as $30,000 US for the shots. The governor was just down here bragging about how well this hospital system was managing the distribution of the vaccine. They control over 80,000 doses and the only way (they say) you can get an appointment is that you have to be in their database of past or current patients or front line first responders. The health departments have been setting up sites for the shots but they only get a few hundred or maybe a thousand or so doses at a time. When the lines for appointments open they either crash or book up in 15 or 20 mins. This is worse than trying to buy a perfect flight stratologger.

This whole vaccine rollout has just been another event in a long list of events that the United States has touched that has turned into a large SNAFU........

 

[cwbullet]

The US Military is not reviewing ways to screen AD who catch COVID. There is a significant risk for athletes to Sudden Cardiac Death for months after a COVID infection.

Corrected typo: The US Military is now reviewing ways to screen AD who catch COVID. There is a significant risk for athletes to Sudden Cardiac Death for months after a COVID infection.

 

[afadeev]

In Illinois, essential worker and over 65 are in wave 1B which starts February 1 and goes through April. General public starts in May.

In NJ, vaccine eligibility had been expanded to Phase 1b ("individuals at risk"), which includes over 65 and folks with certain co-morbidities, including smoking (yeah, don't ask).
Unfortunately, that means little in practice. My parents and the mother in law, all of whom qualify, are on a permanent wait list. And that assumes that they had signed up for the right waiting list to begin with, since there is a lot of confusion as to what web site people should go to register for the vaccine.

NJ's stated goal is to vaccinate 70% of the adult population, or 4.7 million adults, within 6 months (by May).
So far, we are up to 500K folks vaccinated in a little over 1 month.
With ~100K vaccine dozes allocated to the state per week, we can only get 1/2 of the way to the stated goal in the remaining 5*4=20 weeks.

500,000 New Jersey residents vaccinated; 2 patients have aggressive variant

All six of the New Jersey's coronavirus vaccine mega sites are now open, with residents lining up at two new locations at the Meadowlands in East Rutherford and at the Atlantic City Convention Center.

abc7ny.com

Assuming the situation in NJ is representative of the progress in other states, the US would on track to achieve ~35% of adult population vaccinated by May, and maybe ~70% of the adult population by the end of this year. That assumes there will be sufficient voluntary demand for the vaccine to ever get to the 70% mark.

In NJ numbers, by the end of the year we might hit 4.7M vaccinated out of 9M of total population. Or ~52% of the overall population vaccinated.
Not great, but it is what it is.

We will still be managing this pandemic well into 2022, and beyond.

a

 

[aerostadt]

I am over 70 and got my first shot(Pfizer) yesterday with no immediate side effects. I noticed last night in bed more than 12 hours later my shoulder was a little bit sore with no discoloration. The shoulder is still a little bit sore today, but in no way is it debilitating.

 

[Ez2cDave]

It will be hard to do that, but I am sure they will try.

Good enough to fool the TSA, probably not . . . However, good enough to fool the "Greeter" at Walmart or restaurant employees, should be pretty easy.

Dave F.

 

[modeltrains]

I will say that the vaccine has to have less long-lasting side effects than catching COVID.

I sure hope so, some Covid patients have ended up joining a world my Dad and I have ended up inhabiting.
And it is a seriously un-fun world.

https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173

The bottom line

How many people may become long haulers? We can only guess. Right now, more than seven million Americans have been infected by the virus. It’s not unthinkable that 50 million Americans will ultimately become infected. If just 5% develop lingering symptoms, and if most of those with symptoms have ME/CFS, we would double the number of Americans suffering from ME/CFS in the next two years. Most people who developed ME/CFS before COVID-19 remain ill for many decades. Only time will tell if this proves true for the post-COVID cases of ME/CFS.

For this and many other reasons, the strain on the American health care system and economy from the pandemic will not end soon, even if we develop and deploy a very effective vaccine by the end of 2021.

Long-COVID Cases Rise as Stigma of Chronic Fatigue Taunts

An estimated 5 million people could be headed toward a long-COVID diagnosis and their care is unclear. Investigators studying viral infection and chronic fatigue have ideas for rehabilitation.

www.medscape.com

"It's not a surprise that patients are being dismissed because there's already this sort of grandfathered-in sense that fatigue is not real," said Jennifer Frankovich, MD, a pediatric rheumatologist at Stanford University in Palo Alto, California. "I'm sure that's frustrating for them to be tired and then to have the clinician not believe them or dismiss them or think they're making it up. It would be more helpful to the families to say, 'You know what, we don't know, we do not have the answer, and we believe you'."

 

[cwbullet]

I want to share a question patients are asking me:

If I am vaccinated, why do I have to wear a mask?

Answer: We are in a pandemic and the virus is all around us. The vaccine protects against or lowers the risk of serious symptomatic infections and death 90% of the time. There is still a 10% risk of serious or symptomatic infection (I know that is oversimplified). It is not worth the risk to your family, friends, and coworkers to not further lower the risk. Relying solely on vaccines to curb the spread of COVID-19 is a fool’s errand.

The bottom line: This is not just about me and wearing a mask (convenience or hassle), it is about protecting us as a community.

 

[modeltrains]

And those of us with messed up immune systems appreciate the thoughtfulness!

The only social media I do is Tumblr which used to be owned by Yahoo and I think is now owned by Verizon's parent company, and the disability and the chronic illness communities on there do talk about our appreciation for the general public wearing masks since we still have to go get groceries, got to laundromat to do laundry, so forth and so on.

 

[hobie1dog]

Hopefully I can get the 1 dose version when they open it up for High Risk people

 

[SkyFire]

 

[modeltrains]

(Amazon delivery guys giving vaccine)

Now that could work. Don't want our regular Mail carrier, he gets too many things in the wrong boxes.

 

[ksaves2]

This is why I volunteer to take it. I took my second done and had to miss work today. It had kicked my butt a little. My immunologist, biochemist, and ID doc all think I must form a higher than normal immune response.

I will say that the vaccine has to have less long-lasting side effects than catching COVID. I have several 18-30-year-olds that I tracking that have heart failure with an EF less than 40.

Holee molee,

Folks who for all intensive purposes were "normal" before acquiring Covid and now have CHF/impaired ejection fractions at a relatively young age? That is an un frick'en revelation. No, I'm not being derogatory.

I retired from practice July 1st and in a 30+ year career I had 3 patients who suffered from a severe viral pneumonia where the specialists in the very well qualified tertiary care center where I transferred them to couldn't quite pin down what virus took the patients down. They were on ventilators and took a heck of a long time to recover to even go home. All three were actually physically/mentally handicapped in some ways afterwards. I had a long term relationship with all these patients before they were ill.

I signed their disability papers and I have to state I ABSOLUTELY hate goldbricks, drones and people trying to take advantage of the system. (I've fired patients because of that.) These folks unfortunately had long term side effects of their illnesses and to this day I still don't know what they had. I know they HAD something really bad though. (Physician's intuition here mind you.)

This was years ago, way, way, way before this Covid thing so there is only one correlation I want to make here. A severe viral illness like Covid can maybe leave one with long term problems as I have seen with "BAD" viral pneumonic/pneunomia infections in the past unrelated to Covid.

This fact has hit the secular press so often, I cannot believe all these people are "faking it".

The bad thing though is if someone recovers from Covid-19 in an uncomplicated manner and tries to "game" the system. That is my fear I'm glad I won't have to face since I'm retired.

Oh since I'm retired, I'm off the priority list for the vaccine as I'm 64. I don't mind as I can hunker down at home without issue. Rather have my practicing colleagues get it first so they're safer.
People are doing well with distancing and masks so I have no fear about going out and shopping. (I'm widowed so have to do all the domestic chores now.)

Best regards,
A. Kurt Savegnago, M.D.
(I don't usually write M.D. after my name but that's what I did for a living for a long time.)

 

[cwbullet]

Holee molee,

Folks who for all intensive purposes were "normal" before acquiring Covid and now have CHF/impaired ejection fractions at a relatively young age? That is an un frick'en revelation. No, I'm not being derogatory.

I retired from practice July 1st and in a 30+ year career I had 3 patients who suffered from a severe viral pneumonia where the specialists in the very well qualified tertiary care center where I transferred them to couldn't quite pin down what virus took the patients down. They were on ventilators and took a heck of a long time to recover to even go home. All three were actually physically/mentally handicapped in some ways afterwards. I had a long term relationship with all these patients before they were ill.

I signed their disability papers and I have to state I ABSOLUTELY hate goldbricks, drones and people trying to take advantage of the system. (I've fired patients because of that.) These folks unfortunately had long term side effects of their illnesses and to this day I still don't know what they had. I know they HAD something really bad though. (Physician's intuition here mind you.)

This was years ago, way, way, way before this Covid thing so there is only one correlation I want to make here. A severe viral illness like Covid can maybe leave one with long term problems as I have seen with "BAD" viral pneumonic/pneunomia infections in the past unrelated to Covid.

This fact has hit the secular press so often, I cannot believe all these people are "faking it".

The bad thing though is if someone recovers from Covid-19 in an uncomplicated manner and tries to "game" the system. That is my fear I'm glad I won't have to face since I'm retired.

Oh since I'm retired, I'm off the priority list for the vaccine as I'm 64. I don't mind as I can hunker down at home without issue. Rather have my practicing colleagues get it first so they're safer.
People are doing well with distancing and masks so I have no fear about going out and shopping. (I'm widowed so have to do all the domestic chores now.)

Best regards,
A. Kurt Savegnago, M.D.
(I don't usually write M.D. after my name but that's what I did for a living for a long time.)

Kurt,

CHF is still rare with COVID in the young, but Sudden Cardiac Death and CHF with an ejection fraction of 40 or less is scary. We have had a large number of infections in the military and less than 20 deaths, but we are struggling with how to manage a return to full activity after what might have been very large stress on the body.

I am seeing some patients appear to game the system, but I have to believe that is rare. I hope.

 

[cwbullet]

Hopefully I can get the 1 dose version when they open it up for High Risk people

It is a live or atenuated virus and I would guess the protection will be 45-55%. Just a guess based on early data. I think ti based on Adenovirus.

 

[jsdemar]

It is a live or atenuated virus and I would guess the protection will be 45-55%. Just a guess based on early data. I think ti based on Adenovirus.

The J&J vaccine is derived from work they did on an Ebola vaccine. It's a full DNA Adenovirus with modifications to make your cells produce corona spike proteins. Same goal as the Pfizer and Moderna, but I more stable than an mRNA strand. This make it shipable and storable at standard refrigerator temperatures. The two phase 3 trials going on now are testing a large population with a single dose and a double dose. Single dose with easier distribution would be a game changer. Fingers crossed.

 

[hobie1dog]

The J&J vaccine is derived from work they did on an Ebola vaccine. It's a full DNA Adenovirus with modifications to make your cells produce corona spike proteins. Same goal as the Pfizer and Moderna, but I more stable than an mRNA strand. This make it shipable and storable at standard refrigerator temperatures. The two phase 3 trials going on now are testing a large population with a single dose and a double dose. Single dose with easier distribution would be a game changer. Fingers crossed.

I like this statement, but with my condition I need the maximum protection. With my lungs basically at 40% operating capacity, I'm dead if I get the virus.

 

[jsdemar]

I like this statement, but with my condition I need the maximum protection. With my lungs basically at 40% operating capacity, I'm dead if I get the virus.

Johnson & Johnson’s COVID-19 vaccine was shown to be 90% efficacious in interim results, according to findings published in the New England Journal of Medicine.

https://www.nejm.org/doi/full/10.1056/NEJMoa2034201