Medical Discussion of Coronavirus

[snowcanyon]

Depends totally on vaccine uptake. I'm pro vaccine but am patiently waiting to see if this is the right choice for me. Preliminary data shows significantly lower efficacy in Asians, and that plus my age sub 50 and health status (very good), the individual risk benefit equation to me is still unclear.

The data was found to be unreliable regarding Asians FYI. I will try and find the link, but the analysis was not great.
I'd also like to fly and visit relatives in foreign countries etc.

[FIREshrink]

im not talking about forever, im talking about not grabbing it at the first chance. also my family life doesn’t change if i get vaccinated but my wife and kids don’t, so until at least my wife can get vaccinated, there is not a huge rush for me to get vaccinated, purely from a lifestyle point of view. i also can avoid working in the same room with known covid patients, using tele. but after 3-6+ months, as data is parsed more than any other vaccine project and probably any other pharmaceutical in human history, if the data stands up i will happily take the shot.

[PedsCCM]

im not talking about forever, im talking about not grabbing it at the first chance. also my family life doesn’t change if i get vaccinated but my wife and kids don’t, so until at least my wife can get vaccinated, there is not a huge rush for me to get vaccinated, purely from a lifestyle point of view. i also can avoid working in the same room with known covid patients, using tele. but after 3-6+ months, as data is parsed more than any other vaccine project and probably any other pharmaceutical in human history, if the data stands up i will happily take the shot.

I think this makes a lot of sense for many people. I'm just looking at getting vaccinated as volunteering for phase 4. I'm not sure I'd be as willing if it were purely a personal risk/benefit analysis. Vaccinations are supposed to begin early next week in our system and are not mandatory.

[triad]

I haven't heard much about monoclonal antibodies recently. Are they proving to be effective? what is the criteria for getting them?

[CordMcNally]

I haven't heard much about monoclonal antibodies recently. Are they proving to be effective? what is the criteria for getting them?

No. So far, they're doing about what every other treatment has done. At first it looks like good news and everyone gets excited and then come to find out it doesn't really do much. Plus, they're $$$$$.

[StarTrekDoc]

We're using bamlanivimab in recent diagnosis in high risk patients. Can't really tell if it works tremendously or not. I've had three patients receive it; none progressed to covid cascade issues, but two did develop bacterial PNA further down the road ~10dys which isnt' unexpected given their predisposing factors.

[wideopenspaces]

There's just a lot of unknowns and unanswered questions. My gut feeling is that those who don't get vaccinated as soon as given the chance will become partially stigmatized.

I am not sure about that. I'm very pro vaccine, as pretty much everyone here is, and I would definitely understand someone not wanting it. I just barely decided I would get it myself when it becomes available to me, and that's only because every freaking time I cover inpatient psych consults, the second I leave the room I find out the patient just tested positive and wasn't wearing a mask. If I didn't have that exposure, I'd wait it out longer. And I'm glad my husband won't be able to get it for months when we'll have more data on it. It's not mandatory at the VA yet so I assume lots of people will opt out.

[TheQuietOne]

You can find more information regarding the studies and data from the FDA meeting notes.

https://www.fda.gov/media/144245/download

From my reading, ~38,000 participants in study. Only 1712 participants in age >75. Vaccine efficacy ~95% but follow up time was only 2mo. No mention on transmission for those who did catch COVID after vaccination. For those 18-55 years old, side effects were more prevalent then those who were >55. About 60-80% pain/swelling at injection site, 16% fever after second dose, 40-60% fatigue and headache, 14-35% chills, 10% diarrhea, 10-38% muscle aches or joint pain for the younger age groups. 8 appendicitis in vaccine group vs 4 in placebo, considered unlikely to be due to the vaccine.

Hope everyone reviews the data themselves to decide on whether to get the vaccine or not. I am waiting to see Moderna’s data to decide.

[CordMcNally]

I am not sure about that. I'm very pro vaccine, as pretty much everyone here is, and I would definitely understand someone not wanting it.

Inside of medicine, I agree. Outside of medicine is where I'm not sure people will be as understanding. But, who knows.

[White.Beard.Doc]

I have decided to be vaccinated as soon as possible. Hopefully early next week. I feel the risk of the vaccine is likely small and the benefit to both myself and society very likely far outweighs that small risk.

Many of the hospital staff around me want to wait a bit before being vaccinated. If I end up in the ICU with Guillain-Barre, they say they probably won’t end up being vaccinated. Hah! Wish me luck.

Should I rebook my 2020 summer trip to Norway that I cancelled earlier this year? Before the prices start to go up to normal?

[Tim]

Thoughts on a clinic or physician actually spreading C-19 to patients, relatives, or the public?

I would have a hard time dealing with a January 2021 appointment for 93 year old grandma getting covid from her geriatric physician that decided to wait to get vaccinated. I could rationalize it. I really could. But I could also find myself having some negative thoughts. Very negative thoughts. Especially if the good old doc was a symptomatic. That would be a bitter pill to swallow.
Grandma wasn’t eligible yet because she’s not in a long term care facility.

Not sure if anyone saw the logistics presentation yesterday. Quite impressive down to FedEx delivering a box packed with dry ice. Yes, I am convinced the logistics side can deliver the vaccine to any place one can get mail, FedEx, or Amazon.

Quite honestly, I expect 59,475 tier 1 healthcare workers to be vaccinated next week in my county, in the 21 hospitals identified.
975, 1950, 2925, 3900, 4875, 5850 all nice round numbers that will not come close covering all healthcare personnel. Didn’t expect it. I do expect cooperation. No need to provide additional overhead, more of a take it or leave it lottery. If you want to think about it fine. Go to the back of the line. You had a chance at priority status, use it or lose it. You see, grandma, my spouse and I really really want it.

Multiple vaccines coming down the pipeline. Not so sure any should go back to the same priority list. I will take the first vaccine available. Which brings up the point of availability being diverted to other countries. I would suggest everyone think twice under the assumption you will have it available a second time.

Yes, I am seeing signs of politicizing this as a “First 100 day success” and Pfizer playing politics. I wish all would cheer for success in the next 60 days as well as the following 100. Finish strong.

My prediction is multiple vaccines available on demand by next summer. Same life cycle as testing went through. By next fall testing for C-19 will be red-tape. Why am I being tested? “That’s the rules.”

The unknown is the needed vaccination cycle, annual or periodic booster.

[Anne]

Inside of medicine, I agree. Outside of medicine is where I'm not sure people will be as understanding. But, who knows.

We have so many older veterans calling every day asking when they can get it. The PCPs have been inundated with these requests. Granted, when you are in the military you are used to being stuck with everything under the sun whether you want it or not, but every older veteran I’ve talked to lately wants it. Might change if the first ones have significant s/e—word spreads like wildfire. We will see.

[Peds]

Pfizer/Biontech vaccine now not recommended if someone has used an epipen before?
Has this been reported before?
This isnt even true for influenza anymore....

https://www.cnn.com/2020/12/09/health/covid-vaccine-allergies-health-workers-uk-intl-gbr/index.html

[Tim]

Pfizer/Biontech vaccine now not recommended if someone has used an epipen before?
Has this been reported before?
This isnt even true for influenza anymore....

https://www.cnn.com/2020/12/09/healt...gbr/index.html

https://www.cnbc.com/2020/12/09/coronavirs-oxford-astrazeneca-vaccine-to-immunize-the-planet-more-effectively-lancet-editor-says.html

There seems to be much public relations originating out of UK right now. Is it “science” or opinions with a goal for a particular vaccine?
As the physician said, “That is the 100 million dollar question.” Clearly he wasn’t targeting a British audience.

[Hatton]

You can find more information regarding the studies and data from the FDA meeting notes.

https://www.fda.gov/media/144245/download

From my reading, ~38,000 participants in study. Only 1712 participants in age >75. Vaccine efficacy ~95% but follow up time was only 2mo. No mention on transmission for those who did catch COVID after vaccination. For those 18-55 years old, side effects were more prevalent then those who were >55. About 60-80% pain/swelling at injection site, 16% fever after second dose, 40-60% fatigue and headache, 14-35% chills, 10% diarrhea, 10-38% muscle aches or joint pain for the younger age groups. 8 appendicitis in vaccine group vs 4 in placebo, considered unlikely to be due to the vaccine.

Hope everyone reviews the data themselves to decide on whether to get the vaccine or not. I am waiting to see Moderna’s data to decide.

Thanks for the link. In looking at the actual stats on the vaccine versus placebo on local skin reaction, fever, and fatigue I really believe I received the real vaccine and not the placebo. I had an antibody test drawn at my local hospital lab that was nonreactive. I have tried to contact Pfizer about this but did not get much of response. I did get a call. I think no one knows what to do. I may have t cell immunity or I may be a failure. My options are repeat the test, get revaccinated when my number comes up or just do nothing. Unclear when and if Pfizer will unblind the study. What would the group do?