Hospital vaccine mandate?

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I also would like to see a citation for that. It's going against everything else I've read in the literature.
I thought this article in medscape was a pretty easy to digest and useful summary. He cites pretty equivalent immunity rates between previously infected and vaccinated individuals, maybe a little higher for previously infected. 'Hybrid' immunity seems to be the most protective.

I wonder if there are efforts underway to create a vaccine w/ additional viral genes to create a more effective t-cell response.
 
Bad data in equals bad data out. Bad data equals a poorer understanding.

Natural immunity doesn't offer protection? Why is it termed immunity if it doesn't offer a degree of immunity? I can't say I've really seen many people with recurrent documented COVID-19 infections whether immunized or not.
I have seen it. The virus mutates and immunity wanes over time for some diseases. There are patients that got the alpha variant and are now re-infected with covid, but the delta variant. From a natural response, you don't control what the antibody targets (which means the targets can be sites on the virus that mutate) whereas the spike protein targeted by the vaccine has been relatively stable through the mutations. This is why we can't be vaccinated once for flu and be done.

We have pretty good data that the vaccine is safe and effective even with the new strains. What is the bad data around vaccine efficacy that you are referring to? The question of whether natural infection plus the vaccine vs vaccine alone is not relevant to the topic of this thread which was vaccine mandates in the hospitals nor is it relevant to public policy since the larger question of the efficacy of the vaccine has already been answered. Scientists can try and figure out the nuances of which combination of vaccines, infections, etc. are the most effective, but that is not useful for the discussions around the utility of the vaccine.
 
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I think it's totally reasonable to ask whether natural-induced immunity is [inferior/superior] to vaccine-induced immunity.
Sure, but the data shows the vaccine works and is safe in those who already had covid, so how is that question relevant to public policy, especially at this time? Why is that the question being asked?
 
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Sure, but the data shows the vaccine works and is safe in those who already had covid, so how is that question relevant to public policy, especially at this time? Why is that the question being asked?
Because if they're equivalent, then the argument for requiring previously infected individuals to get a vaccine falls down.
However, if that's the real agenda then the actual comparison we'd need to look at is how previous infection compares to previous infection + vaccination.
 
Sure, but the data shows the vaccine works and is safe in those who already had covid, so how is that question relevant to public policy, especially at this time? Why is that the question being asked?

The data shows that the vaccine has no or minimal short term side effects in most people. However, in some it has very serious ones. Do you know why that is? It's a little irresponsible to demand universal compliance with a medical treatment that carries with it risk of harm, don't you think?

Or is that just a management talking point when the objective is not to test/treat to reduce systemic costs.
 
What is the bad data around vaccine efficacy that you are referring to?
I was speaking in general terms of bad data and did specify vaccine efficacy. If you can’t reliable tell who has already previously been infected (asymptomatic or symptomatic) then it’s harder to draw downstream conclusions.
 
The data shows that the vaccine has no or minimal short term side effects in most people. However, in some it has very serious ones. Do you know why that is? It's a little irresponsible to demand universal compliance with a medical treatment that carries with it risk of harm, don't you think?

Or is that just a management talking point when the objective is not to test/treat to reduce systemic costs.
The same can be said for the flu vaccine, which has been mandated at most healthcare facilities for ages. Is that also ‘irresponsible’?
 
Can you please provide a citation for this claim?

You have to look at the current infection data for highly vaccinated counties outside the United States where large numbers of fully vaccinated individuals are contracting Covid... And next to no one with a previously DOCUMENTED case is. The CDC data on this is a case of GIGO.
 
The same cannot be said of the flu vaccine, which each year is formulated based on a variety of predicted permutations. That's why it's effectiveness varies from year to year. On the other hand, the Covid 19 vaccine relies on a specific antigenic subset at a given point in time. Apples and oranges.
 
You have to look at the current infection data for highly vaccinated counties outside the United States where large numbers of fully vaccinated individuals are contracting Covid... And next to no one with a previously DOCUMENTED case is. The CDC data on this is a case of GIGO.
You’re falling victim to base rate fallacy.
 
Sure, but the data shows the vaccine works and is safe in those who already had covid, so how is that question relevant to public policy, especially at this time? Why is that the question being asked?

Maybe it isn't relevant to public policy, I don't know. Even though I'm a physician it doesn't mean I always have to ask poignant, critical questions in every field of medicine or public health.
 
The data shows that the vaccine has no or minimal short term side effects in most people. However, in some it has very serious ones. Do you know why that is? It's a little irresponsible to demand universal compliance with a medical treatment that carries with it risk of harm, don't you think?

Or is that just a management talking point when the objective is not to test/treat to reduce systemic costs.

I dispute your use of the words "most" and "some". It appears I have different definitions of "most" and "some" than you. "Most" could me 80% and "some" could mean 20%.

In actuality "serious adverse side effects" from the vaccine are measured in peoples per million. like 5 people per million. I would not use "Most" to describe that cohort.

It's quite the human achievement that we developed a vaccine in 1 year that is as RIDICULOUSLY SAFE as it is. It is remarkable!

 
The data shows that the vaccine has no or minimal short term side effects in most people. However, in some it has very serious ones. Do you know why that is? It's a little irresponsible to demand universal compliance with a medical treatment that carries with it risk of harm, don't you think?

It's not irresponsible because the risk of serious adverse affects from the vaccine is measured in single digits per million people. I cannot think of a treatment out there that is substantially more risky as compared to getting the actual disease.

Don't take this personally but I just don't feel you have an accurate risk profile on these vaccines.
 
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Sure, but the data shows the vaccine works and is safe in those who already had covid, so how is that question relevant to public policy, especially at this time? Why is that the question being asked?
The relevance to public policy is there are still billions of unvaccinated people in the world and the public health "experts" have been telling us that the unvaccinated masses are going to produce all the scary new variants. So instead of wasting vaccine on previously infected people who don't want it (or need it) we could ship some more internationally. Every single clinical outcomes study has shown previous infection to be equivalent or superior to vaccination with the exception of this deeply flawed, tiny, 2 month trial. This wouldn't even have been controversial 18 months ago.
 
The relevance to public policy is there are still billions of unvaccinated people in the world and the public health "experts" have been telling us that the unvaccinated masses are going to produce all the scary new variants. So instead of wasting vaccine on previously infected people who don't want it (or need it) we could ship some more internationally. Every single clinical outcomes study has shown previous infection to be equivalent or superior to vaccination with the exception of this deeply flawed, tiny, 2 month trial. This wouldn't even have been controversial 18 months ago.
Delta didn’t exist 18 months ago. Any other straw men to throw out?
 
This may be the study by the Cleveland Clinic Birdstrike was alluding to.

 
Which basic tenets are you referring to?
The ability of the human immune system to generate a durable humoral and cell mediated response to pathogens it has previously been exposed to. Thereby making you fairly unlikely to get significantly ill upon reexposure to the same virus. Same tenets that apply to our vaccination efforts in fact.
 
This may be the study by the Cleveland Clinic Birdstrike was alluding to.


Here is another similar study with the same results.



And another. This one is interesting I think because they comment specifically on "no evidence of waning immunity for up to 7 months." Which unfortunately does not seem to be the case for the vaccines.

 
Voting a constitutional right and nothing in the constitution mandates ID check. The "right" to spread a deadly communicable disease is not guaranteed by the constitution.

It is a right; as long as you can prove you have that right as an American of appropriate age. That's pretty implicit in the text. How might you prove that, I have no idea. If only there were an easy way...
 
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It is a right; as long as you can prove you have that right as an American of appropriate age. That's pretty implicit in the text. How might you prove that, I have no idea. If only there were an easy way...

There's no subtext in the constitution for you to prove anything. When this law was written, no form of voter ID existed. The burden of proof should be on the government to prove that you are not who you say you are; not the other way around.
 
There's no subtext in the constitution for you to prove anything. When this law was written, no form of voter ID existed. The burden of proof should be on the government to prove that you are not who you say you are; not the other way around.

Fair enough. Identity theft wasn't a thing back then.
 
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This may be the study by the Cleveland Clinic Birdstrike was alluding to.

There was also a German study, a recent study out of Emory, and a handful of others that looked at natural immunity...and they concluded what I hoped they would, that those that got covid before the vaccine was an option, and were healthy with a good immune system had a dependable level of protection. But I don’t know if that will hold true with delta or lambda... This weekend, yahoo had an article about delta evading natural immunity and lambda evading the vaccines...
my hospital had meeting with all the department directors to decide on vaccine mandates....I feel confident we didn’t need one in the past, or need one this coming week at least...i went with all the studies I knew of up to that point.
the discussion was about public trust, perception, feelings, policy, liability. What didn’t matter was data, medical knowledge or local stats.
 
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My
There was also a German study, a recent study out of Emory, and a handful of others that looked at natural immunity...and they concluded what I hoped they would, that those that got covid before the vaccine was an option, and were healthy with a good immune system had a dependable level of protection. But I don’t know if that will hold true with delta or lambda... This weekend, yahoo had an article about delta evading natural immunity and lambda evading the vaccines...
my hospital had meeting with all the department directors to decide on vaccine mandates....I feel confident we didn’t need one in the past, or need one this coming week at least...i went with all the studies I knew of up to that point.
the discussion was about public trust, perception, feelings, policy, liability. What didn’t matter was data, medical knowledge or local stats.
Are any of the studies you mentioned done during a time of Delta prominence? If you got Covid, you’re pretty protected against COVID. If you had Delta, you’re likely pretty protected against Delta. If you’ve had COVID, your protection against Delta seems to be lower than if you’ve been vaccinated.
 
Had a firefighter today who tested positive for COVID. Wasn't vaccinated and was confirmed to have had COVID in December 2020.
Can confirm I’ve seen a decent number of covid positive people who had prior covid infection and recovered.
 
Can confirm I’ve seen a decent number of covid positive people who had prior covid infection and recovered.

Have had several reinfections (who are unvaccinated) as well.

And FWIW...I read a snippet quoting a bench scientist saying preliminary in vitro data on lambda shows pfizer and moderna have activity against lambda, though J&J not so much.
 
Have had several reinfections (who are unvaccinated) as well.

And FWIW...I read a snippet quoting a bench scientist saying preliminary in vitro data on lambda shows pfizer and moderna have activity against lambda, though J&J not so much.
Here's a paper showing a small reduction in neutralization with convalescent sera and vaccine induced antibodies but overall still protective.


If anybody hasn't read anything by Dr. Monica Gandhi, an ID doc at UCSF, I highly recommend her. She talks extensively about the multitude of viral epitopes targeted by the Tcell response and the overall low likelihood of a variant that is substantially changed enough to evade this response. This likely holds even more true for those who have recovered from COVID as a majority of the overall Tcell response is actually directed against non-spike viral proteins which have very little selection pressure and are less likely to mutate.

I'd also recommend this weekly update from Public Health England. It contains a huge amount of information about the different variants with a slightly less sensationalist approach from what we tend to see here in the US. There's a ton of data on Delta obviously, but not yet much on Lambda. Some of this data is a bit interesting in my opinion, especially the secondary attack rates of Delta vs the other variants on Pages 31 & 32.

 
Yesterday, two COVID positive cases in elderly men who had been vaccinated (one had the sniffles, and the other was sick but safe to discharge)... and two positives in young people who both had COVID in January. We can’t run from this ****!
 
I saw a breakthrough infection last week (haven't had as many as most on this board as we're fairly low prevalence right now). Guy was in his 70s w/ multiple comorbidites. He was moderately symptomatic w/ flu-like sx and a cough. My guess is he would've been at least on HFNC and probably vented w/o the vaccine. (And he did fine too, in fact he was already getting better, just came in on the advice of his pcp to r/o PE since he had a history and wasn't on AC)
 
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Are any of the studies you mentioned done during a time of Delta prominence? If you got Covid, you’re pretty protected against COVID. If you had Delta, you’re likely pretty protected against Delta. If you’ve had COVID, your protection against Delta seems to be lower than if you’ve been vaccinated.
no, i think they were all before, and that why I think the protection against delta, lambda and new variants is NOT known. however, I think the cdc press release of "Debate is Over" is a bit click baitish for a small data mined paper. Wouldn't be surprised if they wrote the headline first, then went and found the data to fit it second. Taking select pieces of data from a small populations is what vaccine failure reports are based on as well. For me, Arcan reporting what he sees in real life, and others echoing what they see in breakthrough disease is more reliable than the cdc; the debate on here has value. I trust nameless, faceless er docs on the internet over nameless, faceless bureaucrats on the internet. Let the docs figure out what to do going forward and let the cdc, fda and the like go back to blackboxing droperidol and promoting tamiflu.
 
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I've never heard of anyone dying from a flu shot. I did know someone that got Guillian Beret, but he recovered.
 
I have seen 4 folks intubated in the ICU with COVID after getting vaccinated. They were all > 65 yr old. 2 have died so far. But that shouldn't be a surprise. In Israel 2/3 of serious cases are previously vaccinated. Why would they be giving 3rd shots otherwise ?
 
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Here’s your citation, just not the result you wanted.

Its amazing that "studies" like this pass for scientifically valid analysis.

Did you actually read this study? Its an observational piece of trash with wildly speculative conclusions.

This is why 90% of academic literature cannot be repeated when tested again. Are people actually interested in researching things anymore or just publishing confirmation-biased pieces of crap?
 
Its amazing that "studies" like this pass for scientifically valid analysis.

Did you actually read this study? Its an observational piece of trash with wildly speculative conclusions.

This is why 90% of academic literature cannot be repeated when tested again. Are people actually interested in researching things anymore or just publishing confirmation-biased pieces of crap?
Yeah, it's unfortunate the manner in which the media and the scientific community have interacted to publish so much garbage.

I do think that there's a role for vaccination in previously infected people, however unknown confounders in this study's population obviously could explain the difference.
 
It’s an observational study, hypothesis generating. I’d argue it’s more valid than the people trying to port non-Delta data or people looking at Israel and porting their vax/unvaccinated case rates while ignoring how demographically different the vax rates are in US vs Israel.

It’s also super optimistic to expect longitudinal prospective cohort data or an RCT on a disease that hit the US < 3 months ago. It’s cool and all to sneer at anything that’s not a rigorous RCT but right now any of the data we’re using to determine public policy is going to have significant confounders.
 
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It’s an observational study, hypothesis generating. I’d argue it’s more valid than the people trying to port non-Delta data or people looking at Israel and porting their vax/unvaccinated case rates while ignoring how demographically different the vax rates are in US vs Israel.

It’s also super optimistic to expect longitudinal prospective cohort data or an RCT on a disease that hit the US < 3 months ago. It’s cool and all to sneer at anything that’s not a rigorous RCT but right now any of the data we’re using to determine public policy is going to have significant confounders.
im curious what you think of the title. The cdc sounds like my wife in an argument. "Debate Over! followed by silent treatment. I appreciate that it made me stop and reconsider what I thought, but hypothesis generating is on the opposite end of definite conclusion.
 
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