Coronavirus (Covid-19) informational thread

[Cave Man]

Moderna says COVID-19 vaccine protection wanes, makes case for booster

New data from Moderna Inc's large COVID-19 vaccine trial shows that the protection it offers wanes over time, supporting the case for booster doses, the company said in a news release on Wednesday.

www.reuters.com

It doesn’t wane enough to warrant boosters at this time.

 

[Cave Man]

That makes sense and seems likely. It’s been discussed Delta will likely start to weaken over the course of time, showing minor cold symptoms. I’m not saying that’s not a reason to not become vaccinated or anything of that matter, but more or less; become far less dangerous than how it has been.

This is pure speculation. It might but it might not. Look at influenza viruses - they are consistently pathogenic year after year.

 

[44267547]

This is pure speculation. It might but it might not.

I have no idea why you’re quoting me. I literally posted the word —likely— in my post. You’re replying to something that was already iterated. Everyone here already knows there’s no definitive course how this will all play out, hence the world likely.

For reference, again:

Relentless Power said:
That makes sense and seems likely. It’s been discussed Delta will likely start to weaken over the course of time,

 

[millerj123]

I have no idea why you’re quoting me. I literally posted the word —likely— in my post. You’re replying to something that was already iterated. Everyone here already knows there’s no definitive course how this will all play out, hence the world likely.

For reference, again:

Relentless Power said:
That makes sense and seems likely. It’s been discussed Delta will likely start to weaken over the course of time,

"Likely" means "probable" Is that not what you meant?

 

[44267547]

"Likely" means "probable" Is that not what you meant?

Not in the sense there’s a guarantee, but very well could happen. Maybe it didn’t make sense to that user You know…Kind of like using the word “unablovated” for example. We all have different interpretations of text. Amirite John?😁

 

[millerj123]

Not in the sense there’s a guarantee, but very well could happen. Maybe it didn’t make sense to that user You know…Kind of like using the word “unablovated” for example. We all have different interpretations of text. Amirite John?😁

Well, if we use a word to mean the opposite of what it means, why bother? That makes communication difficult.

 

[poorcody]

It doesn’t wane enough to warrant boosters at this time.

Yes it does. It really depends on your perspective.

When you first get a Pfizer or Moderna COVID vaccination, the inoculation actually acts like a traditional vaccine protecting you against the disease, but also has the pleasant surprise bonus of protecting you against infection. That protection against infection drops consistently over the following months, to the point where at six months it is very low by most of the studies. The protection against disease remains mostly or maybe entirely.

So you can say, the vaccine still fulfills its original intent (and the intent of all vaccines in general), so the booster is not needed. A valid argument.

Early data indicates getting the booster appears to restore your protection against infection. They don't know for how long, but it's reasonable to assume for a similar timeframe at this point (yet to be proven). So is it worth it to get a booster?

The risk of a booster seems about the same as the original vaccine. And if you didn't have severe reactions the first time around, it's unlikely you will the second. There seems to be little downside.

The upside? By avoiding infection, even temporarily, you gain these benefits:

• You avoid the chance of a breakthrough-infection that can lead to hospitalization. Numbers aren't clear on that, but it is not insignificant (10-20% maybe). Given many hospitals are still strained, this is important for you and society.
• You greatly reduce the risk of being a carrier that could infect other people who are much more vulnerable (e.g. children). If you only care about yourself, then skip that.
• If you assume catching it will only lead to mild flu-like symptoms, remember that is just the center of the bell-curve. There is no guarantee it will not be much worse in you. There's no guarantee you won't suffer some of the more serious effects like kidney damage or long-COVID. There is no guarantee you won't end up in the hospital for something unrelated like a car-accident, and your body might have to deal with multiple infections simultaneously, which can be deadly.
• If another variant develops, you are increasing your chances of pre-emptive protection from it.

Ultimately for me, I also felt the timing coincides well with a possible Detla-spread happening here in the Northeast U.S., as well as the reopening of schools, and the potential increased spread from "windows closing" and everyone going indoors. I'm hoping by Thanksgiving it will be evolved into just an endemic.

Would I get another booster in six months? I would re-evaluate the situation then. Delta is still widespread now, the risk is still high.

 

[Cave Man]

Yes it does. It really depends on your perspective.

My perspective is that they keep the great majority of people out of the hospital and dramatically lowers the death rate without a third dose, and that we are better off vaccinating the rest of the world so we can get this virus under control before novel variants of concern arise that make the vaccines ineffectual. The exception is for those who have underlying medical conditions (e.g., immunosuppression) that could benefit from third doses.

When you first get a Pfizer or Moderna COVID vaccination, the inoculation actually acts like a traditional vaccine protecting you against the disease, but also has the pleasant surprise bonus of protecting you against infection.

This is false. No vaccine prevents infection. It's for this reason that we have no HIV vaccine - it's the only one that must prevent infection (because it kills CD4+ helper T cells, the "generals" of the immune system).

That protection against infection drops consistently over the following months, to the point where at six months it is very low by most of the studies. The protection against disease remains mostly or maybe entirely.

This is not supported by the epidemiological data. Those who are vaccinated have significantly less chance of hospitalization and death, and the mean age of death is increased by at least 10 years in vaccinated persons who die.

The risk of a booster seems about the same as the original vaccine. And if you didn't have severe reactions the first time around, it's unlikely you will the second. There seems to be little downside.

We do not know this yet. What we do know is that the adenovirus vaccines (J&J, AstraZeneca) have a higher incidence of myocarditis and GBS. Could a third dose increase these even more, including the number of deaths? If so, then that could reduce vaccine uptake even more.

The upside? By avoiding infection, even temporarily, you gain these benefits:

Again, your premise that vaccines prevent infections is false. They are to prevent symptomatic disease and death.

• You avoid the chance of a breakthrough-infection that can lead to hospitalization. Numbers aren't clear on that, but it is not insignificant (10-20% maybe). Given many hospitals are still strained, this is important for you and society.

A better strategy is to penalize those who are not vaccinated, including increased insurance premiums and denying them ICU space if that space is limited.

• You greatly reduce the risk of being a carrier that could infect other people who are much more vulnerable (e.g. children). If you only care about yourself, then skip that.

Thus far, the only carriers I'm aware of are certain immunocompromised individuals. And as I stated above, this group is a candidate for boosters.

• If you assume catching it will only lead to mild flu-like symptoms, remember that is just the center of the bell-curve. There is no guarantee it will not be much worse in you. There's no guarantee you won't suffer some of the more serious effects like kidney damage or long-COVID. There is no guarantee you won't end up in the hospital for something unrelated like a car-accident, and your body might have to deal with multiple infections simultaneously, which can be deadly.

The risk of these are very, very low in vaccinated (2x) individuals. From a public health perspective, we are better off with more global vaccine penetrance.

• If another variant develops, you are increasing your chances of pre-emptive protection from it.

There will be more variants of concern because we are not vaccinating the great majority of the world's population. Indeed, this is one of the principal arguments for NOT giving a third dose.

Ultimately for me, I also felt the timing coincides well with a possible Detla-spread happening here in the Northeast U.S., as well as the reopening of schools, and the potential increased spread from "windows closing" and everyone going indoors. I'm hoping by Thanksgiving it will be evolved into just an endemic.

Would I get another booster in six months? I would re-evaluate the situation then. Delta is still widespread now, the risk is still high.

The vaccine is a bit less effective against delta but not much.

You should read this article.

 

[poorcody]

You should read this article.

Yeah I did when it was first mentioned in the New York Times. It's good. I found the Appendix of data really interesting too.

The thing is, you and it are arguing something different than I am. I agree that the U.S. booster doses would be better served going to the rest of the world as first shots. Clearly first- and second-shots for the whole world is more beneficial (to everyone) than most Americans getting boosters. That is the macro perspective.

The micro-perspective, is though, they're available to me -- should I get it? Ethically, getting one is not going to take one away from the rest of the world, because the U.S. government has decided to create a strategic stockpile of doses that will expire by the end of the year. Maybe it shouldn't be that way but that's the reality.

My perspective is that they keep the great majority of people out of the hospital and dramatically lowers the death rate without a third dose, and that we are better off vaccinating the rest of the world so we can get this virus under control before novel variants of concern arise that make the vaccines ineffectual. The exception is for those who have underlying medical conditions (e.g., immunosuppression) that could benefit from third doses.

Agreed.

This is false. No vaccine prevents infection. It's for this reason that we have no HIV vaccine - it's the only one that must prevent infection (because it kills CD4+ helper T cells, the "generals" of the immune system).

No, it is true. You're right that most vaccines don't, but some do. It's been a topic of inquiry for a while. From this article in Nature back in February:

"Although most clinical trials of COVID-19 vaccines showed that vaccines prevented the disease, some trial results also offered clues that shots might prevent infection. A vaccine that is highly effective at preventing people from acquiring the infection in the first place would help to reduce transmission.."​

There are a bunch of studies on it. One from April on the CDC website confirms infection-protection:

Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA

mRNA COVID-19 vaccine effectiveness against SARS-CoV-2 infection

www.cdc.gov

This is not supported by the epidemiological data. Those who are vaccinated have significantly less chance of hospitalization and death, and the mean age of death is increased by at least 10 years in vaccinated persons who die.

Look at the data on the Appendix of the Lancet Study I linked above. There is data, it's preliminary, and we need more, but it does exist.

We do not know this yet. What we do know is that the adenovirus vaccines (J&J, AstraZeneca) have a higher incidence of myocarditis and GBS. Could a third dose increase these even more, including the number of deaths? If so, then that could reduce vaccine uptake even more.

We only have booster data on Pfizer. But Israel has given out millions of boosters and did not see greater side effects than the original two rounds, and strong protection, at least in the very short-term.

A better strategy is to penalize those who are not vaccinated, including increased insurance premiums and denying them ICU space if that space is limited. [..] There will be more variants of concern because we are not vaccinating the great majority of the world's population. Indeed, this is one of the principal arguments for NOT giving a third dose. [..] The vaccine is a bit less effective against delta but not much.

I agree on all these points.

 

[poorcody]

Gottlieb was on CNBC this morning and had this to say about getting a booster:

"The boosters very clearly restore the immune protection that we perceived the vaccinations to have initially. Whether that’s going to exist in perpetuity we don’t know but you derive a more robust immune response from getting a booster and if you want to kind of carry yourself through this Delta wave — if you think this is going to play itself out over the next 3 or 4 months — you can get extra immunity going into this last surge of infection — the boosters should provide that opportunity."

Regarding the state and future of the Delta wave:

"Right now it is really hard because we are in the throes of this Delta wave across the country — the situation looks like it is getting better across the country because it is being driven by sharp declines of cases in the South but the situation in the mid-West and the West is very difficult. You see very dense epidemics in the mid-West and West and I think there is a question of whether or not we have more spread here in the Northeast as the Delta works its way through the country. It hasn't happened yet [in the Northeast], I still think there is a risk that we are going to see a pickup of infections — you are starting to see it in New England and the Great Lakes region — so I don’t think “we” [the Northeast] are going to dodge Delta entirely. I don’t think it will look anything like the mid-West or the South looked like but we will see a pickup of infections. Right now you look at New York 26 cases per 100,000 per day, Massachusetts 20, Connecticut 12 — those are pretty low levels. I wouldn’t be surprised to see us get to 40 cases per 100,000 people per day — it’s not the 120 that Florida experiencing but it’s a pickup from where we are right now."

 

[pshufd]

Gottlieb was on CNBC this morning and had this to say about getting a booster:


Regarding the state and future of the Delta wave:

We spent a bit over a week in MA and VT and are back in NH now. The numbers in VT look high in relation to prior waves but the prior waves were really small. MA is well-vaccinated but still has a fair number of cases but ample hospital capacity. NH, chart below, is just sideways around about half of the all-time peak.

In MA, people were wearing masks and generally doing the right thing. VT has a very high vaccination rate, highest in the country for fully vaccinated. About half were taking precautions and half weren't (my observation). At home, some take precautions and some don't. I go to the local gym which has a daycare with a lot of kids and they have recovered from pre-pandemic levels and are aggressively staffing up. There was one COVID case and it was early in the pandemic. It was an infant in the daycare only. So the infant caught it somewhere else and didn't infect anyone there.

I peeked into a spin class this morning. There were ten people in the class - it's a former squash court, ventilation is poor and it was dark. And they've been doing the spin classes for a couple of weeks. I am unaware of any infections outside of the infant at any of this gym's facilities. So things don't really feel all that bad. Yes, we're wearing masks, socially distancing, sanitizing but life feels normal. That is I don't stress about things like I did a year ago when numbers were climbing to the sky.

And I follow r/HermanCainAward and do realize that there are some places that are horribly bad right now.

 

[poorcody]

We spent a bit over a week in MA and VT and are back in NH now. The numbers in VT look high in relation to prior waves but the prior waves were really small. MA is well-vaccinated but still has a fair number of cases but ample hospital capacity. NH, chart below, is just sideways around about half of the all-time peak.

Gottlieb says whatever is going to happen in the Northeast will probably be done by Thanksgiving. That's what I'm aiming for to finally "exhale".

 

[pshufd]

Gottlieb says whatever is going to happen in the Northeast will probably be done by Thanksgiving. That's what I'm aiming for to finally "exhale".

My feeling is that New England is currently a feedback loop. When the numbers go up, people mitigate and are more careful. When the numbers go down, people relax. And so we're going sideways.

 

[A.Goldberg]

After exposure, right, rather than onset of symptoms? So for a respiratory disease with an incubation period of about 5 days, it means taking them daily as a preventative measure. Nice little earner if it works.

After symptom development, to be clear. That said, when dealing with the influenza virus (comparable in that it’s a respiratory virus, has antiviral therapeutics, and a vaccine) the incubation period is often just a day or two- generally far faster than COVID.

Merck’s press release says that participants had symptom onset within 5 days of assignment to a group (drug or placebo), but that could mean 99% of people started within 48hrs and 1% on day 5. So it’s not really clear. Participants also only had mild-moderate symptoms and as I mentioned before, early on the study was also testing the drug in severely ill patients but had to stop because it was not helpful. It should also be noted this interim study was based off data from 775 participants, which is a pretty small sample size (and 50% of their full recruitment sample size of 1,550- which is still smaller than I would expect, especially when there will inevitably be participant drop out- 20% is the average on clinical trials across all drug types).

The potential problem I see is that people will become symptomatic, wait a day or two or three to get tested, then take another day or two to get the result, and then by the time they start the medication it’s too late. It is possible the medication could be started without laboratory confirmation, but that might depend on how expensive the treatment the medicine is. If it costs $100 that’s one thing, if it costs $3,000, thats another. If it’s super expensive, using it unnecessarily would be incredibly wasteful in terms of healthcare spending.

Often times the costs of new medications have little to do with the cost of development and production and instead are based on their value compared to the alternative. If you consider the average COVID hospitalization is $40,000-80,000, decreasing hospitalizations by 50% would mean it has a very high value. Assuming the molupiravir gets authorization it will be interesting to see who will be paying for it (govt vs. insurance).

Looking at Merck’s study’s interim results, molupiravir decreased hospitalization and deaths by 50%. It’s not clear if these participants were vaccinated, not vaccinated, or both- and if the latter how they dealt with that in presenting their results. While 50% reduction is a highly significant result, the effectiveness of the vaccine is far greater in terms of preventing hospitalization and death, overwhelmingly the people hospitalized and dying from COVID are unvaccinated.

Most of the vaccinated who end up in the hospital are people who were unlikely to form a strong immune response to the vaccine in the first place. That’s really where I see a drug like molupiravir having the best utility. I’m afraid there will be a sizable population who believe because this drug exists (assuming it even makes it to market) that it precludes them from getting vaccinated.

At the same time, I’ afraid of the possibility that the drug will have high clinical utility but the FDA either does not authorize or heavily restricts its use because of a fearful assumption it will reduce vaccination participation. Normally this isn’t something that would seriously cross my mind, but some of their judgements in the past couple years have been rather poor and shortsighted.

We’ll have to wait to see the results once the trial is actually completed, peer reviewed, and published before there can be any serious discussion of this. Unfortunately press releases always leave a lot of questions than answers.

 

[pshufd]

Not feeling well this evening and a bit worried that I have COVID. I ran a few miles this afternoon and felt chilled at the end and very tired so I went under the blankets and warmed up for an hour. I was at the dentist yesterday for a procedure, ran, lifted and played tennis so pretty tired last night. I have the feeling that I caught something because my average resting heartrate is about 15 beats higher than normal.

No real COVID symptoms (I looked them up) though I have some muscle aches but those are in specific parts of my body that I worked out yesterday.

No fever, and a tiny headache.

I should probably try to figure out how to get tested. I mentioned it to my daughter and she said that there was a really bad cold going around.

I only got five hours of sleep last night so it's also possible that it's exhaustion.

For those who have had it, what's the onset like?

 

[Mainsail]

Not feeling well this evening and a bit worried that I have COVID. I ran a few miles this afternoon and felt chilled at the end and very tired so I went under the blankets and warmed up for an hour. I was at the dentist yesterday for a procedure, ran, lifted and played tennis so pretty tired last night. I have the feeling that I caught something because my average resting heartrate is about 15 beats higher than normal.

No real COVID symptoms (I looked them up) though I have some muscle aches but those are in specific parts of my body that I worked out yesterday.

No fever, and a tiny headache.

I should probably try to figure out how to get tested. I mentioned it to my daughter and she said that there was a really bad cold going around.

I only got five hours of sleep last night so it's also possible that it's exhaustion.

For those who have had it, what's the onset like?

If it were me, I would not self-diagnose. I would not rely on MR posts and boards to diagnose. See your doctor and/or get tested. You sound like a healthy person that has been vaccinated, so even if you test positive, the odds are heavily in your favor. Obviously, if positive, you will want to self quarantine so you aren’t spreading it around.

Best of luck. Hope all is well!

 

[poorcody]

Not feeling well this evening and a bit worried that I have COVID. I ran a few miles this afternoon and felt chilled at the end and very tired so I went under the blankets and warmed up for an hour. I was at the dentist yesterday for a procedure, ran, lifted and played tennis so pretty tired last night. I have the feeling that I caught something because my average resting heartrate is about 15 beats higher than normal.

I went through something similar this week: had a sore throat on Tuesday, congestion in the lungs the next day...

The easiest thing to do is go to CVS and get a home COVID test. They usually keep them behind the counter at the Pharmacy. They cost $25 for two-set. The tests are "antigen"-based which are not quite as good as PCR that labs use, but apparently pretty good. You swap your nose a few times (you don't have to go very far up the nose unlike other tests), you dab a few drops of liquid on a card, stick the swap in the card, and you have a result within 15 minutes.

Mine came back negative. There is an old-fashion coronavirus (i.e. cold virus) going around here, so I think that's what I got. It is mostly gone a few days later. Hope you feel better.

 

[pshufd]

If it were me, I would not self-diagnose. I would not rely on MR posts and boards to diagnose. See your doctor and/or get tested. You sound like a healthy person that has been vaccinated, so even if you test positive, the odds are heavily in your favor. Obviously, if positive, you will want to self quarantine so you aren’t spreading it around.

Best of luck. Hope all is well!

I don't think that the "See your doctor" is part of the process as there's nothing the doctor can do. Your doctor probably won't want to see you anyways. If you're in good shape, stay home. If you're having problems, go to the ER.

I was unable to find testing for today at the local CVS but the process looks straightforward. I may look at other places (WalGreens, Rite-Aid). An appointment is needed though and I don't know functional they are on the weekend.

 

[pshufd]

I went through something similar this week: had a sore throat on Tuesday, congestion in the lungs the next day...

The easiest thing to do is go to CVS and get a home COVID test. They usually keep them behind the counter at the Pharmacy. They cost $25 for two-set. The tests are "antigen"-based which are not quite as good as PCR that labs use, but apparently pretty good. You swap your nose a few times (you don't have to go very far up the nose unlike other tests), you dab a few drops of liquid on a card, stick the swap in the card, and you have a result within 15 minutes.

Mine came back negative. There is an old-fashion coronavirus (i.e. cold virus) going around here, so I think that's what I got. It is mostly gone a few days later. Hope you feel better.

That sounds like a good way to go.

I'm generally feeling better today with a little food. It seems like I was retaining a lot of water for some reason. There's something bothering my body but it's not slowing me down that much. My body stress levels are in the 40s today which is elevated. Whatever happened, happened during the day yesterday as body stress is in the blue zone in the morning and then went up a lot in the evening.

 

[44267547]

Get tested. Agreed what Mainsail posted. I wouldn’t be asking the internet, when time is just being wasted on your own self diagnosis. Plus we know, this virus affects everybody completely different, and asking randoms on a discussion site isn’t the best direction.

We had an article in our community about a month back, where a local doctor had said that just because you have ‘cold like symptoms’, don’t assume that it’s not C/19. If you’re vaccinated, it might just be having mild effects that are posing from the virus that could change quickly —versus— somebody that might be unvaccinated would be dealing with more severe effects.

 

[poorcody]

I don't think that the "See your doctor" is part of the process as there's nothing the doctor can do. Your doctor probably won't want to see you anyways.

It's actually kind of funny, I feel like it used to be doctors would say, "Maybe you should come in" for pretty much everything. Now it's like they answer the phone and the first thing they say is, "Don't come in!"

 

[pshufd]

Get tested. Agreed what Mainsail posted. I wouldn’t be asking the internet, when time is just being wasted on your own self diagnosis. Plus we know, this virus affects everybody completely different, and asking randoms on a discussion site isn’t the best direction.

We had an article in our community about a month back, where a local doctor had said that just because you have ‘cold like symptoms’, don’t assume that it’s not C/19. If you’re vaccinated, it might just be having mild effects that are posing from the virus that could change quickly —versus— somebody that might be unvaccinated would be dealing with more severe effects.

The problem with this approach is that you may wind up getting tested for allergies (which I have for nine months) or any number of things that aren't COVID. I don't understand why people wouldn't try to figure out what they have exactly rather than using a shotgun approach. At any rate, whatever it was looks like it is gone now. My current best guess is West Nile.

I started feeling fine last night.

One of my sisters is a bit of a hypochondriac and has been tested a number of times. She lives in the best vaccinated state in the country for fully vaccinated and she lives on 70 acres of wooded land and she works pretty hard on avoiding contact with people. She takes far more precautions than we do and we're already pretty careful.

 

[44267547]

The problem with this approach is that you may wind up getting tested for allergies (which I have for nine months) or any number of things that aren't COVID. I don't understand why people wouldn't try to figure out what they have exactly rather than using a shotgun approach. At any rate, whatever it was looks like it is gone now. My current best guess is West Nile.

I started feeling fine last night.

One of my sisters is a bit of a hypochondriac and has been tested a number of times. She lives in the best vaccinated state in the country for fully vaccinated and she lives on 70 acres of wooded land and she works pretty hard on avoiding contact with people. She takes far more precautions than we do and we're already pretty careful.


View attachment 1861499

Dehydration? Maybe over exertion from the exercise. That looks like a Garmin evaluation tool kit. Nice layout with the stress metric.

 

[pshufd]

Dehydration? Maybe over exertion from the exercise. That looks like a Garmin evaluation tool kit. Nice layout with the stress metric.

Dehydration is a possibility as the symptoms are consistent but I had ten cups of fluids that day. I have had cramping for a few days so it's possible that it could be low electrolytes but this didn't feel like that. I know what moderate and severe dehydration look like and this didn't feel like that. I almost died once from severe dehydration so I'm careful about getting enough fluids and Garmin Connect makes it easy to manage that.

I've found the Garmin stress indicator to be predictive for cold/flu in the past. It usually flares up 24 hours before an illness. There are research papers on the use of fitness trackers for medical diagnostics.

I suspect West Nile because:

1) We have had more rain this year than I can ever recall and we've had a couple of reports of West Nile in mosquito monitoring.
2) I was bitten a few times playing tennis on Thursday afternoon. They went right through my shirt. I did spend some time trying to shoo them away but they kept coming back. There are no respiratory symptoms with West Nile.
3) I noticed a new business last month across the highway:

 

[pshufd]

Back to Covid: I read on Reddit yeterday that Palisades, CA has a 97.5% vaccination rate for over 12. So I had a look through the LA county vaccination rates and found:

Commerce 91%
Culver City 90.8%
El Segundo 90.4%
Irwindale 99.5%
Century City 94%
Cheviot Hills 92.1%
Downtown LA 99.4%
Elysian Park 99.3%
Westchester 99.8%
Charter Oak 90%
Marina del Rey 95.5%
Saugus/Canyon Country 90.7%
Valencia 91.6%
Westfield/Academy Hills 90.2%

These numbers are stunning to me. We have two towns in my state above 90% vaccination rate. Our active case rate is 0.13% so we don't have a lot of COVID. Our vaccination rate is around 60% - just trying to imagine if it were 99%.