Hospital vaccine mandate?

[Siggy]

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Why aren't the parents and grandparents already vaccinated if they are higher risk and concerned? If they are, then aren't they protected? Why is it the 17 year old's responsibility that their parents and grandparents aren't vaccinated, or by the fact that they were exposed by them instead of someone else? The world belongs to the youth in my opinion, not those that would have already by far exceeded their life expectancy if they had been alive only 100 years ago. This assumes that everyone hasn't already or won't eventually be exposed. This assumes that we actually have or will ever control nature (and if we do, is that a good thing?).

They should be... but I'm gonna bet that if the parents aren't vaccinating their kids, they probably aren't vaccinating themselves. If the grandparents are dependent on the parents for transport, then there's going to be a good chance that they aren't vaccinated either.


...and the lack of small pox, polio, mumps, rubella, and measles in non-anti-vax populations generally indicates that we can control nature to some extent.

I mean.. if "we can't control nature, and even if we do, is it a good thing?" is your stance, do you prescribe tetanus boosters? Why? It's not like we can control nature. Heck, all of medicine is about controlling nature. There's nothing natural about the cath lab or the resuscitation bay.

 

[Siggy]

Anecdote time: Two former neighbors of mine, in their 70's, recently decided to finally see their grandkids after 2 years of not being able to. I'm not sure what changed after 2 years, because Grandma and Grandpa declined the vaccine and were still at risk. The asymptomatic grandkids spread COVID to both of them during the visit. Grandpa died. Grandma lived.

Are the grandkids to blame? Should they live in guilt for the rest of their lives?

In my opinion, no. The adults made the decision to not get vaccinated. The blame, and responsibility, should not be on the minor children. Although, they probably will always blame themselves.

Wasn't the entire argument 4 months ago was that this wasn't supposed to happen? Kids weren't supposed to transmit the virus (yes, I know things change... but that was the entire argument to throwing open the doors to the school house and no masks for kids!). If the kids knew that they were the vector that led to the death of their grandparents, do you think that they aren't going to blame themselves?

 

[Dred Pirate]

just read 30% of hospitals have COVID vaccine mandates - what I would like to see what percentage of USA hospital employees are covered by these mandates . My educated guess that it is much higher than 30%. - I am guessing the hospitals that require the vaccines are much larger on average than the hospitals that don't require it. I could see most of the small rural hospitals, which tend to have communities that tend to have a different political views than the larger metro areas and university towns (albiet most of the small rural hospitals are part of larger systems), be much more hesitant in instituting these mandates. They are also the hospitals that will have a much harder time recruiting to fill the spots vacated by those that refuse vaccination.

30% of US hospitals mandate vaccination for employment - Becker's Hospital Review | Healthcare News & Analysis

In 4 1/2 months, the number of U.S. hospitals mandating COVID-19 vaccination for their workforce has gone from zero to 1,850.

www.beckershospitalreview.com

 

[Birdstrike]

Wasn't the entire argument 4 months ago was that this wasn't supposed to happen?

Isn't that the whole story of COVID? What we 'knew' 4 months ago, no longer applies. Rinse. Repeat. You want to be right (or wrong)? You will be. Just wait 4 months.

 

[Dr Mantis Toboggan]

Wasn't the entire argument 4 months ago was that this wasn't supposed to happen? Kids weren't supposed to transmit the virus (yes, I know things change... but that was the entire argument to throwing open the doors to the school house and no masks for kids!). If the kids knew that they were the vector that led to the death of their grandparents, do you think that they aren't going to blame themselves?

If my patients are any indication, no, they’re not going to blame themselves at all…

 

[1DeletedAccount]

They should be... but I'm gonna bet that if the parents aren't vaccinating their kids, they probably aren't vaccinating themselves. If the grandparents are dependent on the parents for transport, then there's going to be a good chance that they aren't vaccinated either.


...and the lack of small pox, polio, mumps, rubella, and measles in non-anti-vax populations generally indicates that we can control nature to some extent.

I mean.. if "we can't control nature, and even if we do, is it a good thing?" is your stance, do you prescribe tetanus boosters? Why? It's not like we can control nature. Heck, all of medicine is about controlling nature. There's nothing natural about the cath lab or the resuscitation bay.

Perhaps. I don’t blame the 17 year olds though, and doubt they will blame themselves either.

You’re right that we can to some extent. However, to my knowledge, we as society historically haven’t all collectively looked at the big picture of medicine evaluating overall good because we are in our individual silos in place and time usually thinking something is better than nothing until grandpa with 15 medications rolls in the door after falling down altered. Sometimes we help, but not always. That’s why it’s an art and an evolving science. I don’t think we’ve every understood all the implications of what we do. Not necessarily arguing against trying to control nature, but it’s worth reflecting on and evaluating if only having partial control is beneficial if we have a limited understanding.

One day we’ll have a better understanding, just like we do now compared to the past. Maybe some day people will live to be 150-200 years old or forever without experiencing much disease. Maybe that same day the earth will become overpopulated and the climate destroyed. Maybe we’ll all live on other planets or space colonies. A lot is possible, but there are sometimes unintended consequences of even good intentions.

More of a rhetorical question just to provoke some critical analysis of medicine in general. The more I’m in medicine, the more skeptical I become of just how much benefit we provide. I think we often think that we are doing more good than we probably really are. We resuscitate a lot of people near the end of their lives where the outcome doesn’t change. I’m equally guilty. People on hospice without intervention can live longer. My questions are just as much for me as anyone else and seem unanswerable. My skepticism has served me well though. Apologies for the long philosophical explanation.

 

[1DeletedAccount]

just read 30% of hospitals have COVID vaccine mandates - what I would like to see what percentage of USA hospital employees are covered by these mandates . My educated guess that it is much higher than 30%. - I am guessing the hospitals that require the vaccines are much larger on average than the hospitals that don't require it. I could see most of the small rural hospitals, which tend to have communities that tend to have a different political views than the larger metro areas and university towns (albiet most of the small rural hospitals are part of larger systems), be much more hesitant in instituting these mandates. They are also the hospitals that will have a much harder time recruiting to fill the spots vacated by those that refuse vaccination.

30% of US hospitals mandate vaccination for employment - Becker's Hospital Review | Healthcare News & Analysis

In 4 1/2 months, the number of U.S. hospitals mandating COVID-19 vaccination for their workforce has gone from zero to 1,850.

www.beckershospitalreview.com

It’s a valid point. Our hospital isn’t small by any means, but it’s independent not a part of a huge chain or system. We’ve dealt with staffing issues, and so rightly or wrongly our hospital leadership has held off on a mandate due to concern of worsening the staffing situation.

 

[Apollyon]

Perhaps. I don’t blame the 17 year olds though, and doubt they will blame themselves either.

You’re right that we can to some extent. However, to my knowledge, we as society historically haven’t all collectively looked at the big picture of medicine evaluating overall good because we are in our individual silos in place and time usually thinking something is better than nothing until grandpa with 15 medications rolls in the door after falling down altered. Sometimes we help, but not always. That’s why it’s an art and an evolving science. I don’t think we’ve every understood all the implications of what we do. Not necessarily arguing against trying to control nature, but it’s worth reflecting on and evaluating if only having partial control is beneficial if we have a limited understanding.

One day we’ll have a better understanding, just like we do now compared to the past. Maybe some day people will live to be 150-200 years old or forever without experiencing much disease. Maybe that same day the earth will become overpopulated and the climate destroyed. Maybe we’ll all live on other planets or space colonies. A lot is possible, but there are sometimes unintended consequences of even good intentions.

More of a rhetorical question just to provoke some critical analysis of medicine in general. The more I’m in medicine, the more skeptical I become of just how much benefit we provide. I think we often think that we are doing more good than we probably really are. We resuscitate a lot of people near the end of their lives where the outcome doesn’t change. I’m equally guilty. People on hospice without intervention can live longer. My questions are just as much for me as anyone else and seem unanswerable. My skepticism has served me well though. Apologies for the long philosophical explanation.

We will never without end live on other planets or moons. We are purpose built, through God or evolution, to live on this planet. Likewise, it's unlikely (although, I guess, not impossible) that we can live in our human bodies beyond about 120 years. More likely would be whole body prosthesis.

I am not discounting anything you said, at all. Just adding some space information.

 

[RustedFox]

We will never without end live on other planets or moons. We are purpose built, through God or evolution, to live on this planet. Likewise, it's unlikely (although, I guess, not impossible) that we can live in our human bodies beyond about 120 years. More likely would be whole body prosthesis.

I am not discounting anything you said, at all. Just adding some space information.

Apollyon and GeneralVeers discuss where it all went wrong. 2143, colorized.

 

[Old_Mil]

That's a lot of data studying a question that basically nobody is asking. For most people, infection with COVID-19 alpha provided protection against subsequent COVID-19 alpha infection. The current question is does prior infection with alpha provide robust protection against delta and if so, for how long?

"With a total of 835,792 Israelis known to have recovered from the virus, the 72 instances of reinfection amount to 0.0086% of people who were already infected with COVID."

“By contrast, Israelis who were vaccinated were 6.72 times more likely to get infected after the shot than after natural infection, with over 3,000 of the 5,193,499, or 0.0578%, of Israelis who were vaccinated getting infected in the latest wave.”

So yes, real time data seems to indicate that not only is natural immunity superior to vaccination when it comes to protecting against the 'delta variant', but far superior.

Also, your last sentence is wildly irresponsible.

You may consider it wildly irresponsible, I don't. My point isn't that "everyone should try to get natural immunity."

Once again, treat the patient that is in front of you. You may think that it is acceptable practice to place patients who are at minimal to no risk of a disease at risk for serious side effects, I do not.

With regards to the anecdote above, granny and grandpa should have gotten the shot. The kids shouldn't. That's what would have changed the outcome, not vaccinating the kids... Because as we all know, our CDC director has admitted that the vaccine doesn't prevent transmission.

 

[dchristismi]

The more I’m in medicine, the more skeptical I become of just how much benefit we provide. I think we often think that we are doing more good than we probably really are. We resuscitate a lot of people near the end of their lives where the outcome doesn’t change.

1000x this. Which is a good part of why I made my specialty change.

 

[thegenius]

"With a total of 835,792 Israelis known to have recovered from the virus, the 72 instances of reinfection amount to 0.0086% of people who were already infected with COVID."

“By contrast, Israelis who were vaccinated were 6.72 times more likely to get infected after the shot than after natural infection, with over 3,000 of the 5,193,499, or 0.0578%, of Israelis who were vaccinated getting infected in the latest wave.”

So yes, real time data seems to indicate that not only is natural immunity superior to vaccination when it comes to protecting against the 'delta variant', but far superior.


You may consider it wildly irresponsible, I don't. My point isn't that "everyone should try to get natural immunity."

Once again, treat the patient that is in front of you. You may think that it is acceptable practice to place patients who are at minimal to no risk of a disease at risk for serious side effects, I do not.

With regards to the anecdote above, granny and grandpa should have gotten the shot. The kids shouldn't. That's what would have changed the outcome, not vaccinating the kids... Because as we all know, our CDC director has admitted that the vaccine doesn't prevent transmission.

Don't care too much about re-infection because that is going to happen. Every single person on this planet will get COVID at some point. It's inevitable.

Care most about how vaccination affects your risk of contracting serious morbidity or death, which needs to be stratified by age. There is nothing you have shown to suggest natural is better than vaccine immunity at contracting serious morbidity or death. The problem with the Israeli data above is it doesn't account for confounding behavioral factors like 1) if you've been infected in the past you are more likely to modify your behavior going forward to prevent reinfection in the future (a sensible conclusion) 2) vaccinated people more likely to engage in risky behavior because they think they are protected (a reasonable conclusion), and 3) vaccinated people by absolute numbers skew younger and take on more risk (that data exists but I don't have it).

You can present data, and yet you have dozens and dozens of ER doctors on this board telling you routinely that HERE IN AMERICA (not in Israel), at least 4 out of every 5 people we admit these days with COVID are not vaccinated.

I suppose if there is definitive evidence that the vaccine does not reduce transmission and the literal risks of COVID infection are the same as getting the vaccine in young patients, I might change my opinion on that. (Frankly...I think as we gather more evidence we will find that vaccines do reduce transmission but we can't establish that yet.)

You have a very interesting way of wording things to your benefit:
"place patients who are at minimal to no risk of a disease at risk for serious side effects"

Like myocarditis? Reminds me of that study they did at Ohio State University early on where they MRIed about 40 student athletes and about 2/3 had MRI evidence of myocarditis. But few if any actually had any symptoms.


Just remember. As of July 2021, 335 kids 17 and under have died from COVID. How many have died from the vaccine?

 

[doctalaughs]

You may think that it is acceptable practice to place patients who are at minimal to no risk of a disease at risk for serious side effects, I do not.

Most everything in your post is reasonable except this statement- which clearly false.

Even patients that are at “minimal” risk have that risk reduced by orders of magnitude for morbidity/death by vaccination. And there is no question that risk of covid19 in these populations >>>> risk of vaccination.

It’s math.

 

[1DeletedAccount]

And there is no question that risk of covid19 in these populations >>>> risk of vaccination.

It’s math.

Meh. It’s just as much fear mongering and sensationalism.

I’ve changed my opinion over time that the vaccine is unlikely to cause much harm for the majority of people (although we often don’t know, what we don’t know).

I have though taken care of someone who developed ITP and died from bleeding within 2 weeks of the vaccine. People and studies can say that the rate of ITP is the same as the background, but I still think there is perhaps causality for a ‘healthy’ person (albeit older) who never had autoimmune disease or thrombocytopenia to suddenly develop post immunization petechiae, ITP, bleeding complications and death. Something might always provoke ITP in general and we have just dismissed it as an infrequent occurrence, but not unexpected to see. Sure, side effects appear rare, and COVID-19 is currently everywhere (often undiagnosed because mild symptoms aren’t tested and the tests are far from great), but there seems to be a crowd that likes to readily dismiss immunization side effects immediately with the mantra regarding the collective good. I don’t think that’s a great messaging strategy to an uneducated population. I think validating concerns and recognizing the possibility that medicine isn’t perfect goes further.

The risk in terms of serious morbidity and mortality of COVID-19 to children, teenagers and younger adults is still very small. Decreasing a very small number to a very small number is still a very small number.

 

[doctalaughs]

I have though taken care of someone who developed ITP and died from bleeding within 2 weeks of the vaccine. People and studies can say that the rate of ITP is the same as the background, but I still think there is perhaps causality for a ‘healthy’ person (albeit older) who never had autoimmune disease or thrombocytopenia to suddenly develop post immunization petechiae, ITP, bleeding complications and death.

So you are suggesting we should take anecdotes over large multi-center multi-country studies enrolling hundreds of thousands (now millions) to provide advice?

 

[1DeletedAccount]

So you are suggesting we should take anecdotes over large multi-center multi-country studies enrolling hundreds of thousands (now millions) to provide advice?

I’ve learned from my patients and practicing medicine over time gaining experience and wisdom. I don’t discount that.

 

[1DeletedAccount]

Every single person on this planet will get COVID at some point. It's inevitable.

Agree. I feel though that many physicians don’t really see it this way, and most in the lay public see COVID-19 as something that’s not common, would be surprised to come down with, and think they can avoid. Even those immunized often tell me, “It can’t be COVID because I’m immunized,” when I recommend testing.

Care most about how vaccination affects your risk of contracting serious morbidity or death, which needs to be stratified by age.

Also agree. I’m curious though, if the vaccine isn’t shown to offer significant benefit for lower age groups, and doesn’t affect spread, are people going to be understanding and accepting of these individuals choosing not to be vaccinated? I know it’s not the flu, but we seemed to have a slight tolerance for those in lower risk groups choosing to pass on a yearly influenza shot.

 

[southerndoc]

Meh. It’s just as much fear mongering and sensationalism.

I’ve changed my opinion over time that the vaccine is unlikely to cause much harm for the majority of people (although we often don’t know, what we don’t know).

I have though taken care of someone who developed ITP and died from bleeding within 2 weeks of the vaccine. People and studies can say that the rate of ITP is the same as the background, but I still think there is perhaps causality for a ‘healthy’ person (albeit older) who never had autoimmune disease or thrombocytopenia to suddenly develop post immunization petechiae, ITP, bleeding complications and death. Something might always provoke ITP in general and we have just dismissed it as an infrequent occurrence, but not unexpected to see. Sure, side effects appear rare, and COVID-19 is currently everywhere (often undiagnosed because mild symptoms aren’t tested and the tests are far from great), but there seems to be a crowd that likes to readily dismiss immunization side effects immediately with the mantra regarding the collective good. I don’t think that’s a great messaging strategy to an uneducated population. I think validating concerns and recognizing the possibility that medicine isn’t perfect goes further.

The risk in terms of serious morbidity and mortality of COVID-19 to children, teenagers and younger adults is still very small. Decreasing a very small number to a very small number is still a very small number.

Had an anti-vaxxer last week who developed ITP and died. His refusal to get the vaccine ultimately led to his death, even though he didn't get COVID. That's essentially what you're saying. His case was random just like your case.

I drive over speed bumps all the time. If I have a STEMI immediately after driving over one, it doesn't mean that the speed bump caused my STEMI.

 

[1DeletedAccount]

Had an anti-vaxxer last week who developed ITP and died. His refusal to get the vaccine ultimately led to his death, even though he didn't get COVID. That's essentially what you're saying. His case was random just like your case.

I drive over speed bumps all the time. If I have a STEMI immediately after driving over one, it doesn't mean that the speed bump caused my STEMI.

If he didn’t get COVID, why did his choice not to get the vaccine have anything to do with his death? Or is this a made up analogy? I don’t find it equivalent.

It did if you have really bad exertional angina (I hope you don’t, nor that you have a STEMI).

You seem to suggest that we confidently know the causality of ITP. I’m not so certain.

I don’t think my case was random. Neither did he. Neither did his family. Neither did staff. Neither did other physicians that took care of him. I’m ok with taking an unpopular view on this forum regarding this case.

 

[deleted836128]

Okay, so 335 kids 17 and under have died of COVID. 335. And we don’t know for sure if they died OF COVID or simply WITH COVID. Sounds like a population that shouldn’t get the stab until there are fewer unknowns.

 

[deleted1114045]

Okay, so 335 kids 17 and under have died of COVID. 335. And we don’t know for sure if they died OF COVID or simply WITH COVID. Sounds like a population that shouldn’t get the stab until there are fewer unknowns.

Are you implying that pediatricians are incompetently filling out the cause of death as COVID or involved in some new world order conspiracy to falsely elevate pediatric deaths from COVID? Cancer doesn’t usually cause death directly either. People die of malnutrition, dehydration, sepsis, PE, etc. However, it would be disingenuous to say that cancer wasn’t the cause of death in the vast majority of cases. If you are afraid of giving children the vaccine, you should be petrified of allowing them to get full blown COVID. I’ll take some spike protein in my kids deltoid over viremia in every organ of their body. The COVID vaccine is pissing in the immunologic ocean compared to the disease itself. As children get exposed to fewer and fewer wild-type coronaviruses, their immunity will wane and they will get worsened morbidity and mortality to COVID. Those being admitted are getting younger and younger. This trend will continue.

 

[Birdstrike]

I vaccinated my kids against COVID much like I vaccinated them against chicken pox. I didn’t think either disease is likely to kill them, due to the minuscule risk. But I still didn’t want them getting either, dealing with an illness (however mild), spreading it, having to miss school, quarantine, etc. Both COVID and the vaccine are statistically a near zero risk for my kids. But getting vaxxed allows them to have more freedom. And it might allow them to have one less viral respiratory infection.

Most myocarditis cases in kids resolve as do most cases of COVID, in kids.

 

[1DeletedAccount]

I vaccinated my kids against COVID much like I vaccinated them against chicken pox. I didn’t think either disease is likely to kill them, due to the minuscule risk. But I still didn’t want them getting either, dealing with an illness (however mild), spreading it, having to miss school, quarantine, etc. Both COVID and the vaccine are statistically a near zero risk for my kids. But getting vaxxed allows them to have more freedom. And it might allow them to have one less viral respiratory infection.

Most myocarditis cases in kids resolve as do most cases of COVID, in kids.

That’s fair, reasoned and understandable. I struggle with trusting emergently authorized interventions over the natural response to an evolutionary process, but am in agreement that I want children to have the best path forward. I’m uncertain that medicine offers the best protection in general, but I’m also uncertain with all aspects of parenting (don’t tell my kid(s).

 

[Southpaw]

Okay, so 335 kids 17 and under have died of COVID. 335. And we don’t know for sure if they died OF COVID or simply WITH COVID. Sounds like a population that shouldn’t get the stab until there are fewer unknowns.

this is a massively irresponsible statement. The AAP and the CDC are recommending the vaccine for kids 12 and older.

how many kids have died or have even been hospitalized with vaccine side effects? My guess is that number is much, much closer to 0 than 335.

 

[Birdstrike]

this is a massively irresponsible statement. The AAP and the CDC are recommending the vaccine for kids 12 and older.

how many kids have died or have even been hospitalized with vaccine side effects? My guess is that number is much, much closer to 0 than 335.

I agree that kids over 12 should get vaccinated. But if you’re going to say it’s “massively irresponsible” to have a discussion about the risks and benefits, then why isn’t it “massively irresponsible” that the FDA and CDC aren’t letting 11 and 10 year olds get vaccinated?

The physiologic differences between ages 10, 11 and 12 are irrelevant. So why is it not “massively irresponsible” that they’re making parents wait?

So they can have some meetings?

So they can fill out some paper work?

We know with near 100% certainty they’re going to approve it for younger kids

Why are you so harsh for a poster in SDN with no power to affect the situation, but you have all the understanding for the FDA and CDC, who are, by your logic, being “massively irresponsible” in depriving 9, 10 and 11 years, the exact same treatment form the exact same disease?

100% they will approve it for younger kids, but are denying them the treatment.

Why is that okay?

 

[Southpaw]

I agree that kids over 12 should get vaccinated. But if you’re going to say it’s “massively irresponsible” to have a discussion about the risks and benefits, then why isn’t it “massively irresponsible” that the FDA and CDC aren’t letting 11 and 10 year olds get vaccinated?

The physiologic differences between ages 10, 11 and 12 are irrelevant. So why is it not “massively irresponsible” that they’re making parents wait?

So they can have some meetings?

So they can fill out some paper work?

We know with near 100% certainty they’re going to approve it for younger kids

Why are you so harsh for a poster in SDN with no power to affect the situation, but you have all the understanding for the FDA and CDC, who are, by your logic, being “massively irresponsible” in depriving 9, 10 and 11 years, the exact same treatment form the exact same disease?

100% they will approve it for younger kids, but are denying them the treatment.

Why is that okay?

the irresponsibility is the poster making an assumption that those 335 didn’t die from covid. It’s buying into more conspiracy theory nonsense that covid isn’t responsible, they just happen to have it at the time when their body failed from, say, overwhelming sepsis and multi organ failure, but it gets chalked up to covid. It’s no different than the FoxNews pundits claiming covid deaths are inflated as covid wasn’t the direct cause, they just happened to have it when they died.

for the rest of your post, approval is based on age group studies. Like, actual evidence. And that’s how it should work. By your logic the second it was approved in adults then all age groups should’ve been approved because we’re the same in the end, right? Kids are just little adults. I imagine you’d have a hard time convincing the AAP and the CDC of that.

 

[d2305]

this is a massively irresponsible statement. The AAP and the CDC are recommending the vaccine for kids 12 and older.

how many kids have died or have even been hospitalized with vaccine side effects? My guess is that number is much, much closer to 0 than 335.

The CDC makes the number hard to find.

 

[Birdstrike]

Kids are just little adults. I imagine you’d have a hard time convincing the AAP and the CDC of that.

I'm in favor of everyone eligible getting vaccinated.

And I didn't say "kids are just little adults." I said 10 and 11 year olds are exceedingly similar to 12 year olds. You still haven't explained why it's "massively irresponsible" to have a discussion about vaccinations in 12 year olds, but not "massively irresponsible" for the CDC to deny vaccinations to 10 and 11 year olds. They can give emergency use authorization any time they want. Which is exactly what the approval for ages ages 12 + is. Your answer that "because studies have always been done that way" doesn't reconcile the situation for me. Nothing related to COVID is being "done the way it's always been done." Is it dire that all kids are vaccinated immediately, or not? If you think it's dire, then at least be consistent and get on the FDA and CDC about it. 9,10 and 11 year olds can get it and spread it just as much as 12 year olds, and you and I know, with 100% certainty they're going to be approved. But somehow it's okay to wait months and months and months with no criticism when there's literally zero chance it won't be approved?

I'm in favor of everyone eligible getting vaccinated.

 

[Southpaw]

I'm in favor of everyone eligible getting vaccinated.

And I didn't say "kids are just little adults." I said 10 and 11 year olds are exceedingly similar to 12 year olds. You still haven't explained why it's "massively irresponsible" to have a discussion about vaccinations in 12 year olds, but not "massively irresponsible" for the CDC to deny vaccinations to 10 and 11 year olds. They can give emergency use authorization any time they want. Which is exactly what the approval for ages ages 12 + is. Your answer that "because studies have always been done that way" doesn't reconcile the situation for me. Nothing related to COVID is being "done the way it's always been done." Is it dire that all kids are vaccinated immediately, or not? If you think it's dire, then at least be consistent and get on the FDA and CDC about it. 9,10 and 11 year olds can get it and spread it just as much as 12 year olds, and you and I know, with 100% certainty they're going to be approved. But somehow it's okay to wait months and months and months with no criticism when there's literally zero chance it won't be approved?

I'm in favor of everyone eligible getting vaccinated.

I never made a claim of massive irresponsibility with regard to vaccination and age group. You seem really hung up on age groups and who gets vaccinated and who doesn’t. To be honest I don’t care much about that as I’m fairly trusting of the system and believe the experts are doing the best they can with the available data. And they’re obtaining new data as quickly as they can.

That has nothing to do with my response to @ERCATs post.

 

[DeadCactus]

I’ve learned from my patients and practicing medicine over time gaining experience and wisdom. I don’t discount that.

You can go Pepperidge Farm all you want, but using an anecdotal experience as a counterargument to a massive randomized controlled studies data is more leeches and trephination than Sir William Osler.

 

[Birdstrike]

I never made a claim of massive irresponsibility with regard to vaccination and age group. You seem really hung up on age groups and who gets vaccinated and who doesn’t. To be honest I don’t care much about that as I’m fairly trusting of the system and believe the experts are doing the best they can with the available data. And they’re obtaining new data as quickly if they can.

That has nothing to do with my response to @ERCATs post.

I happen to agree with you that kids should get vaccinated and disagree with ERCAT's post saying they shouldn't. I'm just saying let's cut out the overwrought rhetoric of accusing people of being "massively irresponsible" for an SDN post, when we all know the considerations regarding COVID and the vaccination in kids, are very different than in adults.

The FDA and CDC obviously agree, which is why they're taking their sweet old time in approving it for all kids, and seem quite content to keep tens of millions of kids unvaccinated, for many months.

 

[thegenius]

Okay, so 335 kids 17 and under have died of COVID. 335. And we don’t know for sure if they died OF COVID or simply WITH COVID. Sounds like a population that shouldn’t get the stab until there are fewer unknowns.

No….they died of COVID. It’s not like they had dead bowel and a coincidentally had a positive COVID test.

the risks of the vaccine are always overstated on this forum.

 

[thegenius]

this is a massively irresponsible statement. The AAP and the CDC are recommending the vaccine for kids 12 and older.

how many kids have died or have even been hospitalized with vaccine side effects? My guess is that number is much, much closer to 0 than 335.

no kid has died from the vaccine

 

[erdoc00]

no kid has died from the vaccine

I think its impressive how people can die 1 month after covid and their death is attributed to covid but teenagers and 20 year olds can have sudden unexplained death days after vaccination "bUT tHERES nO eViDeNCE ThE vACCIne iS To bLAmE!!!"

This is on the level of claiming covid is a hoax.

 

[BoardingDoc]

I think its impressive how people can die 1 month after covid and their death is attributed to covid but teenagers and 20 year olds can have sudden unexplained death days after vaccination "bUT tHERES nO eViDeNCE ThE vACCIne iS To bLAmE!!!"

This is on the level of claiming covid is a hoax.

COVID-19 Vaccine Safety in Adolescents Aged 12–17 Years ...

This report describes COVID-19 vaccine safety among U.S. adolesc...

www.cdc.gov

Any reported death in this age group which has a temporal correlation to covid vaccination is being reviewed. They are specifically looking into whether the vaccine has some causative relationship. Thus far, none has been found.

You can either believe that
A: The vaccine appears to be safe
B: The vaccine is not safe and the CDC is grossly incompetent at their job - personal take: this is unlikely
C: The vaccine is not safe and the CDC is deliberately hiding this. - Personal take: that tinfoil hat sure looks dapper.

 

[Southpaw]

I think its impressive how people can die 1 month after covid and their death is attributed to covid but teenagers and 20 year olds can have sudden unexplained death days after vaccination "bUT tHERES nO eViDeNCE ThE vACCIne iS To bLAmE!!!"

This is on the level of claiming covid is a hoax.

Is the implication here that physicians who sign death certificates are involved in a conspiracy to both inflate the number of COVID deaths when they really aren't COVID-related, and also to hide the truth about the vaccine which you believe has directly killed adolescents? That's how I read your post. If that's how you meant it don't you think it's worthwhile to provide some non-politically biased information or evidence to support these claims?

 

[erdoc00]

COVID-19 Vaccine Safety in Adolescents Aged 12–17 Years ...

This report describes COVID-19 vaccine safety among U.S. adolesc...

www.cdc.gov

Any reported death in this age group which has a temporal correlation to covid vaccination is being reviewed. They are specifically looking into whether the vaccine has some causative relationship. Thus far, none has been found.

You can either believe that
A: The vaccine appears to be safe
B: The vaccine is not safe and the CDC is grossly incompetent at their job - personal take: this is unlikely
C: The vaccine is not safe and the CDC is deliberately hiding this. - Personal take: that tinfoil hat sure looks dapper.

From your source: "CDC reviewed 14 reports of death after vaccination. Among the decedents, four were aged 12–15 years and 10 were aged 16–17 years. All death reports were reviewed by CDC physicians; impressions regarding cause of death were pulmonary embolism (two), suicide (two), intracranial hemorrhage (two), heart failure (one), hemophagocytic lymphohistiocytosis and disseminated Mycobacterium chelonae infection (one), and unknown or pending further records (six)."

Is there a control for comparison?

 

[1DeletedAccount]

You can go Pepperidge Farm all you want, but using an anecdotal experience as a counterargument to a massive randomized controlled studies data is more leeches and trephination than Sir William Osler.

I used leeches once in residency. I also assisted neurosurgery with trephination in the form of a burr hole during medical school. I hope Osler would be proud, although I cheated on the second one with imaging instead of my diagnostic skills.

Studies are often wrong and subsequently disproven. Maintaining skepticism is important. My original primary point was that ending your argument with “it’s math” won’t convince anyone in the same way just telling people “it’s science” will either. Science is messy. Findings are right, then wrong, then refined to try to get to the truth. Sometimes there is some truth right in front of you. Osler chose to believe that.

 

[Arcan57]

I happen to agree with you that kids should get vaccinated and disagree with ERCAT's post saying they shouldn't. I'm just saying let's cut out the overwrought rhetoric of accusing people of being "massively irresponsible" for an SDN post, when we all know the considerations regarding COVID and the vaccination in kids, are very different than in adults.

The FDA and CDC obviously agree, which is why they're taking their sweet old time in approving it for all kids, and seem quite content to keep tens of millions of kids unvaccinated, for many months.

The FDA works with the data they are given. I doubt they're "content" so much as there's not an overwhelming burden of disease in 0-12 yo that justifies extending emergency use authorization in a population that wasn't part of the initial study. I'm sure Pfizer has been trying to balance being first to market with this age group vs. making sure i's are dotted and t's crossed so it doesn't get rejected and cost them market share during the resubmission process.

But there's a big difference between not YOLO'ing what are likely distinct age groups and saying 17 yo's shouldn't get vaccinated. I agree with your point about 10-12 yrs being physiologically similar, although pre-pubertal/pubertal as defined by age is pretty dodgy when puberty can be anywhere from 8-13 in girls (9-14 in boys). And personally I'm frustrated because my 10 yo getting vaccinated will represent a paradigm shift in how I'd view COVID risk at a non-abstract level.

Maybe the source of concern is fundamentally different, but it's hard to see this rash of posters regurgitating up the same arguments all over again. And even with a vaccine that was 10-100x less safe than what we currently have, our society as a whole would be healthier and more stable if vaccinations rates were higher. It's painful to be reminded that there's a significant minority of our own profession that's undermining that effort. If there's any group of American physicians that's fought COVID at great personal cost, it's EM. We've seen our pay crater, we've born the brunt of staff losses and massive overcrowding, the emotional toll of preventable death and disability, the loss of colleagues, and the inescapable reality that we're propping up a system that's fundamentally flawed and unsustainable. It seems like we should be able to get our s%$# together about trying to at least mitigate as much of the pandemic as we can before splintering back into our "every doc for themselves" silos.

 

[erdoc00]

Is the implication here that physicians who sign death certificates are involved in a conspiracy to both inflate COVID deaths when they really aren't COVID-related, and also to hide the truth about the vaccine which you believe has directly killed adolescents? That's how I read your post. If that's how you meant it don't you think it's worthwhile to provide some non-politically biased information or evidence to support these claims?

Its not a conspiracy that the CARES Act set out increased Medicare payments for COVID care.

By documenting a positive COVID result, the hospitals were reimbursed 20% more than typical Medicare rates.

So any covid positive case would qualify for this regardless of the reason for admission. It doesn't necessary have to be fraudulent but there is certainly an incentive to make sure to capture this money.

But I was not referring to any of this with my post. My point was that deaths within 30 of covid were counted as covid deaths without a requirmement to "prove" that covid was the cause of death. But when it comes to deaths within several weeks of the vaccine, now all of a sudden unless there is definitive and absolute proof at the cellular level that the vaccine was the cause, then its dismissed as spurious.

The double standard is my problem. We should be scientists and investigate. The only way we can make definitive scientific claims is by investing. We need to be doing autopsies and actual post-mortem analysis. Not doing data dives on observational reports.

 

[erdoc00]

The FDA works with the data they are given. I doubt they're "content" so much as there's not an overwhelming burden of disease in 0-12 yo that justifies extending emergency use authorization in a population that wasn't part of the initial study. I'm sure Pfizer has been trying to balance being first to market with this age group vs. making sure i's are dotted and t's crossed so it doesn't get rejected and cost them market share during the resubmission process.

But there's a big difference between not YOLO'ing what are likely distinct age groups and saying 17 yo's shouldn't get vaccinated. I agree with your point about 10-12 yrs being physiologically similar, although pre-pubertal/pubertal as defined by age is pretty dodgy when puberty can be anywhere from 8-13 in girls (9-14 in boys). And personally I'm frustrated because my 10 yo getting vaccinated will represent a paradigm shift in how I'd view COVID risk at a non-abstract level.

Maybe the source of concern is fundamentally different, but it's hard to see this rash of posters regurgitating up the same arguments all over again. And even with a vaccine that was 10-100x less safe than what we currently have, our society as a whole would be healthier and more stable if vaccinations rates were higher. It's painful to be reminded that there's a significant minority of our own profession that's undermining that effort. If there's any group of American physicians that's fought COVID at great personal cost, it's EM. We've seen our pay crater, we've born the brunt of staff losses and massive overcrowding, the emotional toll of preventable death and disability, the loss of colleagues, and the inescapable reality that we're propping up a system that's fundamentally flawed and unsustainable. It seems like we should be able to get our s%$# together about trying to at least mitigate as much of the pandemic as we can before splintering back into our "every doc for themselves" silos.

Its not your place or anyone else's places to tell people what they are or are not going to do.

70% of covid admissions are in obese people. Are you going to fat shame everyone now and start lobbying the government to mandate meal plans and exercise?

And I thought you guys wanted to be as busy as possible. How many docs were bitching last year as volumes were down. Remember too all the "dont get mad at the non-emergencies, these are great payors."

You guys have made your bed, so lay in it. Emergency medicine is a dumpster fire right now and many of you were complicit in allowing this to happen. And btw, its about to get a lot worse as more of us walk off the job. I hope everyone's self-righteous authoritarianism can carry them through the upcoming ****show.

 

[Arcan57]

Its not a conspiracy that the CARES Act set out increased Medicare payments for COVID care.

By documenting a positive COVID result, the hospitals were reimbursed 20% more than typical Medicare rates.

So any covid positive case would qualify for this regardless of the reason for admission. It doesn't necessary have to be fraudulent but there is certainly an incentive to make sure to capture this money.

But I was not referring to any of this with my post. My point was that deaths within 30 of covid were counted as covid deaths without a requirmement to "prove" that covid was the cause of death. But when it comes to deaths within several weeks of the vaccine, now all of a sudden unless there is definitive and absolute proof at the cellular level that the vaccine was the cause, then its dismissed as spurious.

The double standard is my problem. We should be scientists and investigate. The only way we can make definitive scientific claims is by investing. We need to be doing autopsies and actual post-mortem analysis. Not doing data dives on observational reports.

Your first example, the one you talk about not talking about, is textbook conspiracy theory.

Your second example builds off the fog of doubt created by the first. It provides a motive ($$$) than demands a level of proof that is definitively unobtainable in order for a response to be a valid rebuttal. While it would be a boondoggle for the pathologists, there's neither enough pathologists to be even grossing 600k cadavers nor the lab capacity to run detailed testing to "prove" causality. You've seen autopsy reports on medical patients, how often is it anything more than "patient has evidence of a bunch of chronic diseases and likely died from one of them"? It's not like there's a COVVAXDEATH-256 titer we could run, or else we probably would have done it while they were alive.

 

[MechEDoc]

Yea, we should just disregard that over half of all deaths reported to VAERS occur in just two novel vaccines that have been on the market for less than a year. Totally nothing to be concerned about. "bUT wE CAN'T dO aUToPsIEs oN eVeRyBody!!"

Ugh, are you off your meds?

 

[Birdstrike]

70% of covid admissions are in obese people.

It's been known for over a year and a half that obesity massively increased one's risk of death from COVID. There hasn't been nearly enough public health push to get people to hurry up and lose weight, not as theoretically possible thing to do, but as an immediate survival need. At one pound per week, 18 years (78 months) is enough time to safely lose over 75 lbs. But in a "magic pill" "patient satisfaction" world, no one even attempts to make the effort.

Get the vaccine and end your obesity and you've probably reduced your covid death risk a thousandfold.

 

[Birdstrike]

The FDA works with the data they are given. I doubt they're "content" so much as there's not an overwhelming burden of disease in 0-12 yo that justifies extending emergency use authorization in a population that wasn't part of the initial study. I'm sure Pfizer has been trying to balance being first to market with this age group vs. making sure i's are dotted and t's crossed so it doesn't get rejected and cost them market share during the resubmission process.

But there's a big difference between not YOLO'ing what are likely distinct age groups and saying 17 yo's shouldn't get vaccinated. I agree with your point about 10-12 yrs being physiologically similar, although pre-pubertal/pubertal as defined by age is pretty dodgy when puberty can be anywhere from 8-13 in girls (9-14 in boys). And personally I'm frustrated because my 10 yo getting vaccinated will represent a paradigm shift in how I'd view COVID risk at a non-abstract level.

Maybe the source of concern is fundamentally different, but it's hard to see this rash of posters regurgitating up the same arguments all over again. And even with a vaccine that was 10-100x less safe than what we currently have, our society as a whole would be healthier and more stable if vaccinations rates were higher. It's painful to be reminded that there's a significant minority of our own profession that's undermining that effort. If there's any group of American physicians that's fought COVID at great personal cost, it's EM. We've seen our pay crater, we've born the brunt of staff losses and massive overcrowding, the emotional toll of preventable death and disability, the loss of colleagues, and the inescapable reality that we're propping up a system that's fundamentally flawed and unsustainable. It seems like we should be able to get our s%$# together about trying to at least mitigate as much of the pandemic as we can before splintering back into our "every doc for themselves" silos.

I agree 100% in that I'm pro-vaccine, like you. It think the "risk" of taking the COVID vaccine is no greater than the risk of the MMR, Hep B and other vaccines we've all taken, which is to say it's so low, it essentially rounds down to zero. I don't get what this big deal is, either. 2 of 4 vaccinated members of my household got delta variant and recovered with only moderate cold/mild flu-like symptoms. I can only assume it would've been worse if we weren't vaccinated.

But from a persuasion standpoint, I think we'll win more converts being honest and straightforward, as opposed to being hyperbolic about risks and benefits, judgemental and shaming. That approach tends to connect people more emotionally to their position, they dig their heels in and view changing it as an outward sign of weakness. If the goal is to lash out and make people feel bad, it's effective. If it's to actually make a difference by changing minds, I think it's ineffective. That's just my opinion.

 

[deleted1114045]

MECHedDoc, I don't think the vaccine is killing people at a higher rate than the would be from the vaccine.

According to the VAERS website, 5,000 people have death as a side effect of the vaccine. However, this is correlation, Not causation. The real question is how many deaths would we have expected without people getting the vaccine in this cohort? Just in Heart disease deaths every year, 1600/million people die in the US every year. 189 million people Have got the Covid vaccine this year. 1600×189 = 302,400. So, based on the statistics, you would expect about 6000 people per week to die of heart disease. So, just in heart disease, you would expect exactly this number of deaths after getting any vaccine. Am I doing the math wrong? Even if the VAERS website is vastly undercounting the data, this is not an alarming number.

 

[Birdstrike]

Prevention of MISC is another good reason, perhaps the best reason, to give your kid the COVID vaccination.

 

[wholeheartedly]

If I see one more person who should really know better misinterpreting VAERs …

I was on our facility’s covid vaccine planning and implementation team and I was involved in assisting with two reports to VAERs. They have been very explicit that you are required to report x, z, y things if they occur (including hospitalization or death) regardless of what you suspect the cause to be. You are explicitly told NOT to report based on suspected causality. That means everything gets reported. If a guy gets vaccinated and 4 days later goes and gets wasted at the bar, crashes his car into a tree, and dies that gets reported. It’s a catch all signal detection system.

While they don’t review everything in VAERs, serious things are actually reviewed. We had two individuals hospitalized after vaccination. One was a nursing home resident who developed a fever, fatigue, confusion, and urinary frequency, within 12 hours of being vsccinated. Admitted, given abx for the UTI, improved and was discharged. Closer review of charting from the nursing home indicate symptom onset was actually before vaccination. After reporting to VAERs they requested the hospital send the patients chart and additional information.

In the other case the individual was vaccinated and 24 hours later suffered loss of consciousness and a seizure. Oh and had a whole lot of meth on board. Oh and had had this happen multiple times over the previous year. We submitted to VAERs and they again requested charts from us to review.

So while anything and everything is reported and it is only a signal detection system, things aren’t just being dumped there while someone watches for a signal spike. Someone is taking a closer look at the more serious reports.

/rant

 

[deleted836128]

If I see one more person who should really know better misinterpreting VAERs …

I was on our facility’s covid vaccine planning and implementation team and I was involved in assisting with two reports to VAERs. They have been very explicit that you are required to report x, z, y things if they occur (including hospitalization or death) regardless of what you suspect the cause to be. You are explicitly told NOT to report based on suspected causality. That means everything gets reported. If a guy gets vaccinated and 4 days later goes and gets wasted at the bar, crashes his car into a tree, and dies that gets reported. It’s a catch all signal detection system.

While they don’t review everything in VAERs, serious things are actually reviewed. We had two individuals hospitalized after vaccination. One was a nursing home resident who developed a fever, fatigue, confusion, and urinary frequency, within 12 hours of being vsccinated. Admitted, given abx for the UTI, improved and was discharged. Closer review of charting from the nursing home indicate symptom onset was actually before vaccination. After reporting to VAERs they requested the hospital send the patients chart and additional information.

In the other case the individual was vaccinated and 24 hours later suffered loss of consciousness and a seizure. Oh and had a whole lot of meth on board. Oh and had had this happen multiple times over the previous year. We submitted to VAERs and they again requested charts from us to review.

So while anything and everything is reported and it is only a signal detection system, things aren’t just being dumped there while someone watches for a signal spike. Someone is taking a closer look at the more serious reports.

/rant

Good for you, except that many are NOT reporting anything but serious events to VAERS...

 

[wholeheartedly]

Good for you, except that many are NOT reporting anything but serious events to VAERS...

My impression from my professional society is that most of them are making an earnest effort to report everything they know about that’s supposed to be reported. VAERs also isn’t the only reporting mechanism though. V-safe is also tracking mild to severe symptoms after vaccination. That’s a pretty huge data set. I’m still getting texts to log my status 8 months later. These were sensitive enough systems to catch “covid vaccine arm”

There’s also the vaccine safety data link, which is a system of 9 major health systems across the US doing active surveillance and research and looking in depth at possible causality for any possible adverse events.

There’s another network called CISA which is 7 medical research centers involved in clinical research on the vaccine and to serve as expeert consultants for individual cases.

Then the FDA also has the BEST system and the sentinel initiative which basically pull claims, EHR, and other data

CMS data is being evaluated and NHSN data requires adverse event submissions based on established definitions.

Plus there are things being done at the state level, within the military and VA, and tribal level.

Not everything is going to be caught, but this is definitely one of the most intensive monitoring programs we’ve had.