The Vaccine

[Lurch]

Interesting - I see conflicting reports that Walensky unilaterally added the recommendation for people at risk of exposure

 

[tabbibus]

Interesting - I see conflicting reports that Walensky unilaterally added the recommendation for people at risk of exposure

Unilaterally may be referring to going against her CDC panel. Man, I can't imagine the push and pull behind the scenes. Politics (internal and interorganization), egos, careers... What we actually see is only but the tip of the iceberg.

 

[Julian]

This New York Times article grapples with some of the confusing parts of this - below is an excerpt

Over the two days, the panel wrestled with the public’s expectations for Covid vaccines, the safety of third doses and how a booster program would affect nursing home residents. Booster doses alone would not turn back the pandemic, some scientists noted: Only vaccinating the unvaccinated would do that.​

“We may move the needle a little bit by giving a booster dose to people,” said Dr. Helen Talbot, an associate professor of medicine at Vanderbilt University. But, she added, “the hospitals are full because people are not vaccinated.”​

The advisers also grappled with a lack of clarity on the goal of the vaccines: Should it be to prevent all infections, or to forestall severe illness and hospitalization?​

Many suggested that booster doses could do only the latter, and that trying to thwart all infections was impossible. That reasoning supported limiting who should receive the doses, the experts said.​

On Thursday, C.D.C. scientists presented models indicating that, if booster doses were to slightly increase people’s protection against hospitalization, the additional shots could prevent more than 2,000 hospitalizations for every million doses given.​

But it was not clear how long additional protection from a booster would last, raising the prospect that boosters would need to be given repeatedly.​

Boosters can reduce infections in nursing home residents, who are among those at highest risk. Even so, cases in nursing homes will persist when community transmission is high, according to a modeling study presented at the meeting.​

The advisers also wrestled with the practicalities of endorsing a booster shot for only Pfizer-BioNTech recipients, when close to half of vaccinated Americans have received Moderna or J. & J. vaccines.​

 

[tabbibus]

This New York Times article grapples with some of the confusing parts of this - below is an excerpt

Over the two days, the panel wrestled with the public’s expectations for Covid vaccines, the safety of third doses and how a booster program would affect nursing home residents. Booster doses alone would not turn back the pandemic, some scientists noted: Only vaccinating the unvaccinated would do that.​

“We may move the needle a little bit by giving a booster dose to people,” said Dr. Helen Talbot, an associate professor of medicine at Vanderbilt University. But, she added, “the hospitals are full because people are not vaccinated.”​

The advisers also grappled with a lack of clarity on the goal of the vaccines: Should it be to prevent all infections, or to forestall severe illness and hospitalization?​

Many suggested that booster doses could do only the latter, and that trying to thwart all infections was impossible. That reasoning supported limiting who should receive the doses, the experts said.​

On Thursday, C.D.C. scientists presented models indicating that, if booster doses were to slightly increase people’s protection against hospitalization, the additional shots could prevent more than 2,000 hospitalizations for every million doses given.​

But it was not clear how long additional protection from a booster would last, raising the prospect that boosters would need to be given repeatedly.​

Boosters can reduce infections in nursing home residents, who are among those at highest risk. Even so, cases in nursing homes will persist when community transmission is high, according to a modeling study presented at the meeting.​

The advisers also wrestled with the practicalities of endorsing a booster shot for only Pfizer-BioNTech recipients, when close to half of vaccinated Americans have received Moderna or J. & J. vaccines.​

Yeah, I get those points. They just sound so weak sauce. Again, we are swimming in doses. Lets use them. There's a reason most ED docs that I know have gotten boosters. ED docs, hospitalists, ICU docs, we are in the thick of it.

What? It may get too complicated? We may need to do it again? Those suck as reasons to not do it.

If the advisers are not clear of the role of the vaccine maybe they should go get educated on that first. We've been saying for so long now that we want to prevent severe illness. How is this still a question?

Not do boosters because we may only move the needle a bit? Most hospitalized are unvaxxed? So what? Should we not offer those who are doing it right an extra layer of protection simply because other people are not doing their part?

It all sounds very political / bureaucracy to me.

Also, I'm just responding to the NYT points, not to you Julian. Just in case my post seems too aggressive. haha.

 

[AZMark]

I would think CDCs goal is to seek the best outcome for society as a whole, recognizing that you have to crack a few eggs to make an omelette.

FDA is more focused on the safety of the individual.

Julians excerpt seems to indicate at least the CDC side of that.

 

[tabbibus]

I would think CDCs goal is to seek the best outcome for society as a whole, recognizing that you have to crack a few eggs to make an omelette.

FDA is more focused on the safety of the individual.

Julians excerpt seems to indicate at least the CDC side of that.

I like how you put it. My question is, why does it have to be one or the other if we have the capability to do both? Lets make a magical omelette!

 

[AZMark]

I like how you put it. My question is, why does it have to be one or the other if we have the capability to do both? Lets make a magical omelette!

Committees don’t really stick their necks out in any organization. That’s why someone has the ultimate say.

 

[Julian]

Committees don’t really stick their necks out in any organization. That’s why someone has the ultimate say.

Yeah, which is why I find their decision strange. FDA says boosters are safe, and help reduce severe disease - so the safe choice would have been to say - let anyone get them. Perhaps behind all this is a very real concern about supply of vaccines - everyone seems to say....we have plenty....but perhaps we don't have that much actually ON HAND????

 

[Bruce]

but perhaps we don't have that much actually ON HAND????

Arkansas needs to inject 6,036,000 doses to have two doses in each of the 3,018,000 residents.

2,861,996 doses have been injected so far.

3,174,004 more doses need to be injected for all residents to have two doses.

The state has 864,974 doses on hand. Those would be split between Pfizer, Moderna and Johnson and Johnson.

Based on national estimates it is likely that more than 600,000 Arkansans are eligible for a third dose. That likely would be sufficient to consume all Pfizer doses on hand if all 600,000 went for a booster.

Then we have the 5 to 12 year olds who are likely to be eligible for Pfizer dosing in October.

We likely need more than 2,909,030 additional doses to be delivered to the state to cover two doses for everyone and three for those that are currently authorized for a booster.

So, yes the Pfizer supply became much tighter with boosters being authorized.

 

[tabbibus]

Arkansas needs to inject 6,036,000 doses to have two doses in each of the 3,018,000 residents.

2,861,996 doses have been injected so far.

The state has 864,974 doses on hand. Those would be split between Pfizer, Moderna and Johnson and Johnson.

Based on national estimates it is likely that more than 600,000 Arkansans are eligible for a third dose. That likely would be sufficient to consume all Pfizer doses on hand if all 600,000 went for a booster.

Then we have the 5 to 12 year olds who are likely to be eligible for Pfizer dosing in October.

So, yes the Pfizer supply became much tighter with boosters being authorized.

Thanks for those numbers. Interesting

 

[Lurch]

Committees don’t really stick their necks out in any organization. That’s why someone has the ultimate say.

Lol. I see it everyday, the Abilene Paradox. No one wants to be the only one challenging consensus, even though some/most/all may not even agree with it. It can be lonely out here on exile island, but I'm strangely comfortable with it.

 

[Jim_in_Delaware]

I would think CDCs goal is to seek the best outcome for society as a whole, recognizing that you have to crack a few eggs to make an omelette.

FDA is more focused on the safety of the individual.

Julians excerpt seems to indicate at least the CDC side of that.

I agree.

FDA is charged with regulating vaccines and determines whether a vaccine is safe and effective for its intended use and, if so, ultimately approves prescribing information that includes indications and usage, dosage and administration, contraindications, etc.

Once a vaccine is approved by the FDA, the CDC looks at disease epidemiology, burden of disease, economic analyses and implementation issues in establishing how the vaccine should be used in the civilian population.

Bottom line, FDA is responsible for the safety and effectiveness of the vaccine and CDC is responsible for the public policy surrounding the use of the vaccine. Both agencies use advisory committees for external input, to add to their internal reviews, but the final decisions falls to the Agencies themselves.

Jim

 

[mwalker4]

I have my physical next week and my goal is to convince my Doctor that I'm old enough, fat enough, and high enough cholesterol to give me the booster. I will let everyone else debate the finer points of policy.

 

[Bruce]

I have my physical next week and my goal is to convince my Doctor that I'm old enough, fat enough, and high enough cholesterol to give me the booster. I will let everyone else debate the finer points of policy.

You might try your luck at a pharmacy first and possibly skip the convincing.

My parents got their boosters about 30 minutes ago.

 

[mwalker4]

You might try your luck at a pharmacy first and possibly skip the convincing.

My parents got their boosters about 30 minutes ago.

I don't meet any of the automatic criteria. i.e. I'm 57, overweight bmi 29, and am on Lipitor. Do you think the pharmacy would make it happen?

 

[Bruce]

I don't meet any of the automatic criteria. i.e. I'm 57, overweight bmi 29, and am on Lipitor. Do you think the pharmacy would make it happen?

It would be up to the pharmacist but the number of people who have received boosters before the CDC recommendation suggests that pharmacies are permissive.

 

[Murf'n'surf]

Some interesting data from today

Looks like hotspots are moving north and GA is getting lighter

View attachment 163987

GA is definitely downtrading

View attachment 163988

Finally, amazing to see how delta has taken over fully.

View attachment 163989

Where are these other variants (past Delta) surging? What are their symptoms if different than Delta?

 

[tabbibus]

The other variants on the left of the graph are the older variants from the prior waves. As you move further into the present it is all delta

 

[Murf'n'surf]

The other variants on the left of the graph are the older variants from the prior waves. As you move further into the present it is all delta

Thanks.....I was totally reading that wrong!

 

[the MfM]

So who is the science denier now - the FDA or CD(rent)C?

Maybe the surgeon general should have the final say.