Medical Discussion of Coronavirus

[CordMcNally]

do either of the vaccine releases describe serologic responses ? That would seem like a more durable outcome than getting covid or not as it’s gonna be pretty hard to control for everyone’s behavior.

if they could say 95% of the recipients demonstrated antibodies that would be very powerful IMO

I don't think we have the data. The vaccine information is being released through press releases which I don't believe has been done before. These things are obviously being rushed so we will likely have sub-optimal data to make great decisions on.

[HikingDO]

I just got my COVID antibody test drawn. I did the Pfizer trial vaccine. If I have antibodies they are from the vaccine. Hoping.

So what will you do if you’re negative? The whole ethical issue of the vaccine study is interesting to me. If they know you have such an effective response, do they not tell the placebo group so that the study can continue, hoping they don’t get covid and die? Personally, if I was negative, I’d be pulling myself out of the study and jumping in line for the real vaccine next month, but that’s just me.

[CordMcNally]

Looks like some dominoes are starting to fall with various lockdowns in Michigan and Washington.

[pulmdoc]

do either of the vaccine releases describe serologic responses ? That would seem like a more durable outcome than getting covid or not as it’s gonna be pretty hard to control for everyone’s behavior.

if they could say 95% of the recipients demonstrated antibodies that would be very powerful IMO

All of the vaccines had to demonstrate antibody response to move from phase II to phase III. Since we don't really know how much antibodies it takes for immunity, as well as finding out whether people vaccinated are protected from severe disease, phase III is necessary.

The "90% efficacy" is difficult for an average person to wrap their head around. What it really means is "in the trial, 90% of the people who caught COVID got the placebo not the real vaccine." Moderna reported 94.5%. I expect the other vaccines to report interim analysis soon as well; the explosion in cases has been good for their study because endpoints are defined based on #cases detected. Cases pile up quicker, endpoint reached sooner.

This is unquestionably good news. Based on what has been reported for endpoints, there is no way these vaccines will fall short of the 50% threshold and I expect them to apply and be granted EUA status this month. Hopefully that means actual vaccine distribution by Christmas.

[Random1]

So my daughter tested positive for the antibodies after an infectious period suspected of being Covid, it was earlier in the spring last year and local PCR testing was not available at the time.

Would you vaccinate?

Would you trust natural antibodies are just as protective from reinfection?

Would you retest for antibodies?

Someone at her work, tested positive for Covid, now they are requiring all employees get tested prior to coming back , but if you have the antibodies to Covid wouldn't that imply that you are not able to be infectious or transmit disease.

[CordMcNally]

So my daughter tested positive for the antibodies after an infectious period suspected of being Covid, it was earlier in the spring last year and local PCR testing was not available at the time.

Would you vaccinate?

Would you trust natural antibodies are just as protective from reinfection?

Would you retest for antibodies?

Someone at her work, tested positive for Covid, now they are requiring all employees get tested prior to coming back , but if you have the antibodies to Covid wouldn't that imply that you are not able to be infectious or transmit disease.

The answer to all of those questions is 'maybe'.

[Antares]

The meaning of the 94.5%:

”This first interim analysis was based on 95 cases, of which 90 cases of COVID-19 were observed in the placebo group versus 5 cases observed in the mRNA-1273 group, resulting in a point estimate of vaccine efficacy of 94.5% (p <0.0001).

A secondary endpoint analyzed severe cases of COVID-19 and included 11 severe cases (as defined in the study protocol) in this first interim analysis. All 11 cases occurred in the placebo group and none in the mRNA-1273 vaccinated group.

The 95 COVID-19 cases included 15 older adults (ages 65+) and 20 participants identifying as being from diverse communities (including 12 Hispanic or LatinX, 4 Black or African Americans, 3 Asian Americans and 1 multiracial).”

[Peds]

So my daughter tested positive for the antibodies after an infectious period suspected of being Covid, it was earlier in the spring last year and local PCR testing was not available at the time.

Would you vaccinate?

Would you trust natural antibodies are just as protective from reinfection?

Would you retest for antibodies?

Someone at her work, tested positive for Covid, now they are requiring all employees get tested prior to coming back , but if you have the antibodies to Covid wouldn't that imply that you are not able to be infectious or transmit disease.

i would wait until the vaccine data is more definitive on actual length of protection. i think so far the data on natural immunity is also lacking any long term protection.
is it like annual influenza? then no. is it like MMR? then yes.

having antibodies does not mean you cannot be contagious/spreader.

[STM]

So what will you do if you’re negative? The whole ethical issue of the vaccine study is interesting to me. If they know you have such an effective response, do they not tell the placebo group so that the study can continue, hoping they don’t get covid and die? Personally, if I was negative, I’d be pulling myself out of the study and jumping in line for the real vaccine next month, but that’s just me.

I'm also in the Pfizer study. I received a letter from Pfizer last week saying if EUA is granted, they've asked for permission to allow participants in the placebo group to cross-over to the vaccine group and get early access to the vaccine. Also, FWIW, I took an antibody test at LabCorp last week and was negative.

[Lordosis]

I have been seeing patients who want me to promise them I will get them the vaccine as soon as possible. I tried to explain that I do not have any secret doctor knowledge about the vaccine and they likely know more then I do because they have time to watch the news. But so far I do not think I am believed.

[CordMcNally]

I have been seeing patients who want me to promise them I will get them the vaccine as soon as possible. I tried to explain that I do not have any secret doctor knowledge about the vaccine and they likely know more then I do because they have time to watch the news. But so far I do not think I am believed.

I guess it doesn't help that I tell all the patients in the ER that their PCP can get them the vaccine now, if they wanted...

[Lordosis]

I guess it doesn't help that I tell all the patients in the ER that their PCP can get them the vaccine now, if they wanted...

You ******************************************!

[Hatton]

I'm also in the Pfizer study. I received a letter from Pfizer last week saying if EUA is granted, they've asked for permission to allow participants in the placebo group to cross-over to the vaccine group and get early access to the vaccine. Also, FWIW, I took an antibody test at LabCorp last week and was negative.

Interesting I have not received a letter from Pfizer. Hopefully that means I got the real vaccine. I reacted locally and felt nauseated and fatigued for 48 hours after the shot. I have thought I got the real vaccine all along. Hopefully I find out tomorrow or the next day.

[Larry Ragman]

Interesting I have not received a letter from Pfizer. Hopefully that means I got the real vaccine. I reacted locally and felt nauseated and fatigued for 48 hours after the shot. I have thought I got the real vaccine all along. Hopefully I find out tomorrow or the next day.

When I read up on the protocol I inferred they only notified those who got the placebo, so I agree your lack of notification means you got the actual vaccine. The control group are notified as an ethical matter once a vaccine is approved so they can get treatment if they desire.

[Larry Ragman]

So my daughter tested positive for the antibodies after an infectious period suspected of being Covid, it was earlier in the spring last year and local PCR testing was not available at the time.

Would you vaccinate?

Would you trust natural antibodies are just as protective from reinfection?

Would you retest for antibodies?

Someone at her work, tested positive for Covid, now they are requiring all employees get tested prior to coming back , but if you have the antibodies to Covid wouldn't that imply that you are not able to be infectious or transmit disease.

Only in a rational world. Our Occupational health doc is holding firm to the CDC position that the antibody testing is insufficiently accurate (I.e., false positives) to be used in return to work decisions. Ironically, the CDC also says that negative CV tests are insufficient to return to work in the event of a potential exposure. Catch 22.