Will you get a vaccine?

  • Yes

    Votes: 247 87.9%
  • No

    Votes: 34 12.1%

  • Total voters
    281

MeaCulpa

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Wouldn’t all of those side effects have been caught by Pfizers trial that ended in October and had 20,000 people getting the vaccine? I’m not sure I ever heard of hidden long term vaccine effects (except for Wakefield’s debacle)
You should read about the vaccine developed for SARS-COV1
 

MeaCulpa

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Bad move for anyone who's seen what covid can do to people
Smart move. I am young and healthy, my risk is exceptionally low. Versus a vaccine with no long term data, and a history of serious issues with previous SARS-COV vaccine trials which I am sure you are already aware of.
 
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MeaCulpa

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Bad move for anyone who's seen what covid can do to people
I think the lack of scientific knowledge regarding COVID and mainly its “Darwinian genesis” (!), places you (and all of us) to a huge disadvantage; judging people about their decision is not smart; indicates at least ignorance. Please don’t take this personally. It’s not your fault, it’s what we have been fed with this entire time.
 
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MeaCulpa

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To be quite honest, I am shocked, truly shocked at the rapidity in which my partners and it appears that the majority of posters here have adopted the belief that this vaccine is inherently safe with very little short or long term risk associated. How would any of you be able to make a reasoned determination of the long term safety of this vaccine?
 
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BLADEMDA

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Smart move. I am young and healthy, my risk is exceptionally low. Versus a vaccine with no long term data, and a history of serious issues with previous SARS-COV vaccine trials which I am sure you are already aware of.

I suspect 30-40% of Americans will do exactly as you have done and NOT get the mRNA vaccine. I hope this doesn't mean we can't resume normal activities by summer. I am so looking forward to a return to normal in 2021.
 

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COVID-19 vaccine developers respond to new strain​

Pfizer, Moderna and AstraZeneca suggest their respective vaccines should remain effective​


As a new strain of the novel coronavirus takes hold in the UK, a number of vaccine developers have responded to the news with comments regarding the efficacy of their respective vaccines against the variant.
During a press conference, BioNTech chief executive officer Ugur Sahin – whose Pfizer-partnered vaccine has been approved in the US, UK and EU – said he’s ‘confident’ that the vaccine will continue to work against the new variant.
Sahin added that the company could also modify the vaccine if it fails to protect against the new strain, by updating small sections of the messenger RNA (mRNA) used within the Pfizer/BioNTech vaccine.
“The beauty of the messenger RNA technology is that we can directly start to engineer a vaccine, which completely mimics this new mutation,” Sahin commented.
Meanwhile, Moderna told Bloomberg that it expect that its mRNA-based vaccine is likely to be effective against the new strain. Moderna has already tested its vaccine against previous strains and expects that it 'would be protective against the variants of the SARS-CoV-2 virus recently described in the UK'.
“We will be performing additional tests of the vaccine in the coming weeks to confirm this expectation,” the company added.
British pharma company AstraZeneca also told Reuters that its COVID-19 vaccine, AZD1222, should be effective against the new strain
 
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Look, everything has risks and benefits. Having seen hospitals flooded with hundreds of new covid admissions daily as well as multiple previously young and healthy people end up on ecmo and then dead, I will take my chances with the vaccine that has already been tested on tens of thousands of people rather than a disease that I know causes significant morbidity and mortality.
 
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MeaCulpa

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I suspect 30-40% of Americans will do exactly as you have done and NOT get the mRNA vaccine. I hope this doesn't mean we can't resume normal activities by summer. I am so looking forward to a return to normal in 2021.
With the WHO changing the definition of herd immunity and Fauci now stating that herd immunity will only happen once 90% of the population is vaccinated, I am having a hard time understanding how we will reach the goalpost of 90% herd immunity. There is likely going to be mandates in the near future, which is extremely concerning to me that the government may have the power to demand medical therapy of unknown risk.

 
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BLADEMDA

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On December 16, 2020, the EEOC updated its ongoing COVID-19 guidance with questions-and-answers specifically addressing mandatory COVID-19 vaccination policy issues. The short version of this guidance is that employers can implement and enforce mandatory COVID-19 vaccination policies for employees, with certain exceptions and caveats. Here are the key takeaways:
  1. Employers can require that employees receive the COVID-19 vaccine (once it is available) as a condition of returning to, or remaining in, the workplace.
  2. However, employers must attempt to accommodate employees who, due to medical disabilities or sincerely-held religious beliefs, decline or refuse to receive the vaccine.
  3. If an employer determines, based on objective evidence, that the presence of an unvaccinated employee (i.e., one who declines or refuses to be vaccinated against COVID-19 for disability or religious reasons) presents a direct threat to the health and safety of persons in the workplace that cannot be reduced or eliminated through a reasonable accommodation, the employer can exclude the employee from the workplace.
  4. When the employer excludes an unvaccinated employee from the workplace due to the perceived direct threat presented by his or her presence in the workplace, the employer may not automatically terminate the employee, but instead must assess whether other accommodations, such as remote work, can be provided.
The guidance offers more details.
  • Administration of a COVID-19 vaccine by an employer, or by a third-party with which the employer has contracted to provide vaccinations to employees, such as an outside health care clinic or similar provider, is not a “medical examination” for purposes of the Americans with Disabilities Act (ADA) because the employer is not seeking information about the employee’s current health status. The guidance further clarifies that administering the vaccine or requiring employees to provide proof of vaccination does not implicate the Genetic Information Non-Discrimination Act (GINA) because an employee’s genetic information is not being used to make employment decisions and no genetic information is being acquired by the employer or disclosed by the employee.
  • Even though administration of the vaccine is not a “medical examination” under the ADA (if it were, the employer would have to demonstrate job-relatedness and business necessity before conducting the examination), the guidance notes that, according to the US Centers for Disease Control and Prevention (CDC), health care providers should ask certain pre-vaccination screening questions to ensure there is no medical reason for a person not to receive the vaccine. These questions (as opposed to the administration of the vaccine itself) may constitute a “medical examination” under the ADA because they could inquire into a person’s disability status. Accordingly, if an employer is going to require that employees answer pre-vaccination screening questions that are disability-related, the employer must be able to demonstrate that the questions are job-related and consistent with business necessity, which can be shown if the employer has a reasonable basis to believe, based on objective evidence, that an employee who does not answer the questions – and therefore does not receive the COVID-19 vaccine – presents a direct threat to his/her own health or safety or that of others. The guidance further notes that these pre-vaccination screening questions could implicate GINA to the extent they elicit disability-related information, but notes that it is unclear at this time what potential genetic conditions will be included in the screening checklists for vaccine contraindications.
  • Although asking pre-vaccination screening questions may be a disability-related inquiry, asking or even requiring employees to show proof they received a COVID-19 vaccine is not a prohibited inquiry under the ADA because it is not likely to elicit information about an employee’s disability status. However, the guidance cautions that if an employee indicates he or she did not receive the vaccine, an employer should be careful not to ask why they did not receive it, because that could be a prohibited disability-related inquiry unless the employer can show that its questioning was job related and consistent with business necessity. Employers who ask employees to provide proof of vaccination also should exercise caution to ensure that the information the employee provides does not disclose any medical information beyond proof of vaccination.
  • The ADA permits employers to exclude employees from the workplace who present a direct threat to the health or safety of persons in the workplace. Therefore, an employer can require that employees be vaccinated to reduce that threat. However, some employees may be unable to receive the vaccine due to medical conditions constituting a disability. In that case, before excluding that employee from the workplace, the employer must demonstrate that the unvaccinated employee presents a significant risk of substantial harm to health or safety that cannot be eliminated or reduced through reasonable accommodations. In other words, the employer must attempt to accommodate an employee who cannot receive the vaccine due to a disability unless there is no reasonable way to do so. Employers must assess four factors in making this determination: 1) the duration of the risk presented by the unvaccinated employee; 2) the nature and severity of the potential harm presented by the unvaccinated employee’s presence in the workplace; 3) the likelihood that harm will occur; and 4) how imminent that harm is to others in the workplace. Only after conducting this analysis and concluding that the disabled employee cannot be reasonably accommodated can the employer exclude the employee from the workplace. That does not mean that the employer may terminate the employee’s employment. Rather, it means that the employer will need to assess if other accommodations can be provided to permit the employee to continue working, such as permitting the employee to work, or continue to work, remotely, or having the employee work in another location on-site where the threat is reduced or eliminated.
  • Employers also must accommodate employees whose sincerely-held religious beliefs prevent them from receiving the COVID-19 vaccine, unless doing so would present an undue hardship to the employer. If that is the case, the employer can exclude the employee from the workplace, but, as with disabled employees, cannot automatically terminate the employee and must determine if any other accommodations can be provided to permit the employee to continue working.
Given the skepticism expressed by many concerning the safety of the COVID-19 vaccine, employers undoubtedly will confront vaccination-related issues, whether they implement mandatory vaccination policies or not. We’ll continue to monitor and report on developments in this area.
© Copyright 2020 Squire Patton Boggs (US) LLPNational Law Review, Volume X, Number 351
 

DoctwoB

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I don’t get your issue. There was a theoretical concern that pre exposure to a vaccine could worsen the cytokine storm picture of severe COVID, somewhat like in prior Dengue vaccine. Reasonable concern? Sure.

But now we have real data, that the vaccine prevents infection, and in people who get infected, prevents severe infection. So that turned out, at least for the mRNA vaccine, to be an unfounded fear.
 
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Yes I have. The data is based on 8,000 patients of which 170 developed COVID, of which 8 were given the vaccine. So yes I’ve reviewed the study.
Are you reading the same study?

A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6).
 
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MeaCulpa

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Are you reading the same study?

A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6).
“A review of unblinded reactogenicity data from the final analysis which consisted of a randomized subset of at least 8,000 participants 18 years and older in the phase 2/3 study demonstrates that the vaccine was well tolerated”
 
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LimpSpatula

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I’m not going to keep posting. This is stupid. It serves me zero purpose.
“A review of unblinded reactogenicity data from the final analysis which consisted of a randomized subset of at least 8,000 participants 18 years and older in the phase 2/3 study demonstrates that the vaccine was well tolerated”
It is stupid. You don’t have to explain your fear of vaccinations to people on the internet. You’re also arguing a very moot point as reactogenicity is available for over 1 million people now. I’m sure the less than 10 people who developed severe allergic reactions were less hysterical than you. Cheers.
 
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BLADEMDA

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When we read his/her concerns about the covid 19 vaccine it reflects FEAR of the unknown among tens of millions of Americans. I would NOT dismiss the fear or concerns because there is still so much we don't know yet.

As we all get the second dose of mRNA covid 19 vaccines let's post any issues we see or hear about. Thanks.
 
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Long before COVID-19, scientists understood the transmission cycle and immunity of the four other coronaviruses that are very common causes of respiratory infections in humans. Like other respiratory viruses, such as influenza and RSV, immunity to coronaviruses is also very short-lived – up to nine months at the longest. This why these viruses are considered seasonal and we see spikes in cases every year because the “herd” never develops enough immunity.

Thanks to new research from renowned virologists and epidemiologists, we now know that natural immunity to the SARS-CoV-2 virus lasts only three to nine months. The reproductive number for COVID-19 is between 2-3. That means that in order to achieve herd immunity to COVID-19, 70 percent of the population would have be to infected every nine months! In other words, it’s impossible to achieve herd immunity to COVID-19 through widespread
transmission.

Blade, don’t you think that there is some retained Tcell immunity after an infection? That a secondary infection won’t have the same significant reaction that a first one did? That is where most of the problems are in the younger populations, an immune response that is so inflammatory it creates problems.
I’m thinking that in ten years or so we won’t be vaccinating for this. That we all will have been exposed enough or have enough vaccinations that this morphs into another common cold similar to the other coronaviruses out there. Maybe wishful thinking but I also don’t think that this will linger as a deadly threat for a generation.
 

LimpSpatula

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When we read his/her concerns about the covid 19 vaccine it reflects FEAR of the unknown among tens of millions of Americans. I would NOT dismiss the fear or concerns because there is still so much we don't know yet.

As we all get the second dose of mRNA covid 19 vaccines let's post any issues we see or hear about. Thanks.
Ya of course, which I did. That doesn't mean we should allow people to make baseless claims or call people idiots for not being as scared, which is what happened. And that's exactly why doctors/politicians should be setting the example by taking the vaccine. How can you expect people to take a vaccine their doctor won't even take? We're in this position because less educated, frightened people had no direction and were manipulated by a narcissist who is our President for next couple weeks. Now's a good time to get a handle on this thing given we're at the worst it's been. It's not the time to be giving merit to paranoia.
 
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I am not against all vaccines. However, it is not my duty to the general population as doctor to willingly submit to medical interventions that do not have a clear history of safety.
The assumption that this vaccine is safe is baseless. There are reasons the first SARS-COV has never had a vaccine produced even though it was known that this virus most likely would re-emerge. I have clearly presented not my case but the case presented back in 2005 when vaccines were being developed for SARS-COV. Were any of you aware of the issues back in 2005? Did any of you read the concerns that the AAMC had in regarding producing a rushed vaccine back in March? What have all these concerns evaporated? If so why? Your claim that one million doses have been administered so it puts any and all concerns to bed and as doctors we should just willingly get this vaccine and shut up.
It’s a baseless appeal to authority and falling in line that is based on zero evidence and zero common sense. Common sense says that my risk if I do contract this virus is extremely small. I have a greater risk of dying in a traffic accident or from an MI. Two, the risks associated with this vaccine have not been fleshed out. You have absolutely no justification in saying that. All sound medical expertise prior to the past few months have relied on years of data in being able to conclude that a vaccine is relatively safe in a population. Vaccines for this virus have raised concerns for infections with mutated strains in the future. So if a person that is vaccinated is infected with a mutate strain, the infection will be quite significant. 8 people in the vaccinated group ended up with COVID. We have zero evidence of what their response will be if they are infected with the mutated strain from England or South Africa. If it makes you feel better to get the vaccine get it. The reason I am upset is because I don’t want it. My decision is based on rational reasoning. I’ve been researching this is depth since early 2020. That is why I am well aware of all the issue. Two, you all make a blanket claim that this vaccine is safe. That does scare me. Why? Because you cannot make that claim because you don’t have that evidence, yet you do. That means administrators will also make that type of claim as will bureaucrats, and it is baseless. There seems to be cult like thinking emerging surrounding this issue. “Just do it. Everyone e else is. Help the others.” Yet your claims of safety are not based in truth but based on faith. I don’t want the vaccine. It shouldnt be forced upon me. And there isn’t solid evidence that the risk benefit ratio tilts towards any benefit but weighs heavily in favor of a massive risk to me.
I've read a few of your replies. The challenge as I see it is that you and others who think like you are looking for something that does not exist. Complete and absolute safety from harm never existed prior and will not exist moving forward. There isn't two options here: 1) The safe choice and 2) The unsafe choice. That of course would be easy. The choice (for the majority of us) is to take the vaccine and risk the side effect of the vaccine vs not take the vaccine and risk the weird long lasting side effects of COVID that those that survive it continue to suffer from. What complicates this is that you are a physician and therefore a potential vector for transmission to your patients. It is anti-intellectual at best and dangerous at its worst.

40 year old software engineer working from home refusing to get the vaccine = personal choice
40 year old ER physician refusing to get the vaccine = bad example, irrational, and a walking danger to the stream of patients who have no choice but to come in contact with you

Eventually masks will go away and life will return to normal. Stop endangering your patients.
 
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MeaCulpa

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I've read a few of your replies. The challenge as I see it is that you and others who think like you are looking for something that does not exist. Complete and absolute safety from harm never existed prior and will not exist moving forward. There isn't two options here: 1) The safe choice and 2) The unsafe choice. That of course would be easy. The choice (for the majority of us) is to take the vaccine and risk the side effect of the vaccine vs not take the vaccine and risk the weird long lasting side effects of COVID that those that survive it continue to suffer from. What complicates this is that you are a physician and therefore a potential vector for transmission to your patients. It is anti-intellectual at best and dangerous at its worst.

40 year old software engineer working from home refusing to get the vaccine = personal choice
40 year old ER physician refusing to get the vaccine = bad example, irrational, and a walking danger to the stream of patients who have no choice but to come in contact with you

Eventually masks will go away and life will return to normal. Stop endangering your patients.
There is absolutely no evidence that this vaccine prevents transmission of the virus. How do you know that no long term or short term risks exist? You don’t. The issue here is that this shouldn’t be thought of as a vaccine. Calling it a vaccine has its own prejudices. It’s in effect a drug. If a company developed an extremely rushed drug for a disease that had extremely low mortality for me and did not assure anyone that it would prevent me spreading the disease even if I took the drug, then I wouldn’t get the drug. How could you justifiably then argue that a novel drug that was developed over the course of a few months was inherently safe and anyone who questioned this faith in the drugs safety was questioning weird potential issues. This is pure insanity. If a novel anesthetic came out I wouldn’t be the first to use it on myself. I would wait. Especially if it came out without proper vetting. It’s bad practice. Do what you want. Again you say I am placing others at risk. Stop using this cult like thinking to try and force me to get this. You have zero evidence other than your deluded mind to claim I am putting others at risk.
 

MeaCulpa

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If the CDC distributes an untested coronavirus vaccine this Fall, it would be the largest drug trial in history—with all of the risks and none of the safeguards.

“Approving a vaccine without testing would be like climbing into a plane that has never been tested,” said Tony Moody, MD, director of the Duke Collaborative Influenza Vaccine Innovation Centers. “It might work, but failure could be catastrophic.”


What happened with the last vaccine rush​

On March 24, 1976, in response to a swine flu outbreak, President Gerald Ford askedCongress for $135 million for “each and every American to receive an inoculation.”

How badly did the Swine Flu campaign of 1976 go? Well, one of the drug companies made two million doses of the wrong Swine Flu vaccine, vaccines weren’t exactly effective for people under 24, and insurance companies said, no way, they didn’t want to be liable for the science experiment of putting this vaccine into 120 million bodies.

By December, the Swine Flu vaccination program was suspended when people started to develop Guillain-Barré Syndrome, a rare neurological condition whose risk was seven times higher in people who got the vaccine and which paralyzed more than 500 people and killed at least 25.


What else can go wrong when vaccines are rushed​

“Vaccines are some of the safest medical products in the world, but there can be serious side effects in some instances that are often only revealed by very large trials,” said Kate Langwig, Ph.D., an infectious disease ecologist at Virginia Tech.

One of the other possible side effects is known as vaccine enhancement, the very rare case when the body makes antibodies in response to a vaccine but the antibodies help a second infection get into cells, something that has been seen in dengue fever. “The vaccine, far from preventing Covid-19, might turn out to make a patient’s disease worse,” said Nir Eyal, D.Phil., a bioethics professor at Rutgers University.

We do not know whether a coronavirus vaccine might cause vaccine enhancement, but we need to. In 1966, a vaccine trial against respiratory syncytial virus, a disease that many infants get, caused more than 80 percent of infants and children who received the vaccine to be hospitalized and killed two.

“To put this into perspective, the typical length of making a vaccine is fifteen to twenty years,” said Paul Offit, MD, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Offit’s laboratory developed a vaccine for rotavirus, a disease that kills infants. That process began in the 1980s and wasn’t completed until 2006. The first scientific papers behind the HPV vaccine, for example, were published in the early 1990s, but the vaccine wasn’t licensed until 2006.

An untested vaccine may also prove a deadly distraction. “An ineffective vaccine could create a false sense of security and perhaps reduce the emphasis on social distancing, mask wearing, hand hygiene,” said Atul Malhotra, MD, a pulmonologist at the UC San Diego School of Medicine.


Other issues with inadequately tested vaccines​

Even worse, an untested vaccine may have consequences far beyond the present pandemic. Even today, one poll shows that only 57% of people would take a coronavirus vaccine. (Some experts argue that we need 55 to 82% to develop herd immunity.)

If we don’t get the vaccine right the first time, there may not be enough public trust for a next time. “Vaccines are a lot like social distancing. They are most effective if we work cooperatively and get a lot of people to take them,” said Langwig. “If we erode the public’s trust through the use of unsafe or ineffective vaccines, we may be less likely to convince people to be vaccinated in the future.”

“You don't want to scare people off, because vaccines are our way out of this,” said Dr. Offit.

So, how will you be able to see through the fog of the vaccine war and know when a vaccine is safe to take? “Data,” said Dr. Moody, “to see if the vaccine did not cause serious side effects in those who got it, and that those who got the vaccine had a lower rate of disease, hospitalization, death, or any other metric that means it worked. And we really, really want to see that people who got the vaccine did not do worse than those who did not.
 

MeaCulpa

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No my job as a doctor is not to rush and get a vaccine of unknown safety simply to assure the local population that it is safe. That is flat out wrong and dangerous. Would you jump into an untested plane just to show others, “look I’m an aviation professional and I’m recklessly jumping into this plane. It’s ok, any fear is unjustified, just weirdos who are scared”
If you plane crashes and burns it ruins the image of all aviation professionals. Not just yours. And youre dead or crippled.
 
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a) No one is forcing you to do anything.
b) You're quoting articles where a few dozen people died. Over 300,000 people have died from the direct effects of covid and counting. We are well on our way to 400,000 and the holidays aren't even over yet. That's just in this country.
c) No one is saying that the vaccine is absolutely safe. Just that there are risks and benefits and the benefits seem to outweigh the risks.

The strangest thing is that you are so sure that there are minimal risks of you getting coronavirus and associated morbidity/mortality but that thinking doesn't seem to apply to the vaccine.
 
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LimpSpatula

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No one is forcing me? Then why the bizarre thinking, that I should be getting the vaccine out of concern for others, that is completely unfounded? Why did the WHO recently change their definition of herd immunity to include only vaccinated individuals (which this drug has never been proven to create) and now the definition of herd immunity includes 90% of vaccinated individuals in order to arrive at herd immunity? About 56% of the population wants to be vaccinated, which is a far cry from 90%. There is going to be a mass push to get back to "normal". The only route according to the experts is to get 90% of the population vaccinated. The writing is on the wall. Its obvious the message has penetrated even the supposedly highly educated as you all are falling in step with ridiculous claims about safety which are completely unfounded. There is going to be a push to vaccinate everyone.
And then our Reptilian overlords will be able to have complete control of us with our new microchips. Resistance is futile.

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Mea Culpa does raise some reasonable points about aspects of the vaccine that are unknowns. As far as I know we don’t have animal models that we have tested vaccination and virus challenge on. How can we be 100% confident that there won’t be enhanced immune response to reinfection? How confident can we be in vaccine effectiveness and efficacy when we aren’t even clear how this thing is spreading as virulently as it is with masking/ social distancing? Are you confident that exposure risk in test and placebo groups are similar enough that the data is reliable? Why are so many young relatively healthy people getting severe disease? Is our understanding of the pathophysiology of this thing strong enough to explain why people get severe or critical illness? Or who is at risk for post acute complications? If not, how can we have iron clad confidence in the efficacy data of these vaccines in placebo and subject groups?

with that said, the data we do have I think does offer a glimmer of hope and the cost benefit analysis laid out is clear- risk the unknowns of the vaccine with promising early data, or risk the unknowns of your personal risk of catching COVID and developing severe disease with post acute complications.

I am getting my vaccination this week. I’m just not as confident that this thing is the magic bullet that some appear to think it is. Hopefully (probably even) I’m wrong and overly pessimistic. Still, a degree of caution is not unwarranted or unreasonable I think.

Lancet article raising academic concerns/ exploring challenges regarding COVID 19 vaccine development and measurement of efficacy

 
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BLADEMDA

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No my job as a doctor is not to rush and get a vaccine of unknown safety simply to assure the local population that it is safe. That is flat out wrong and dangerous. Would you jump into an untested plane just to show others, “look I’m an aviation professional and I’m recklessly jumping into this plane. It’s ok, any fear is unjustified, just weirdos who are scared”
If you plane crashes and burns it ruins the image of all aviation professionals. Not just yours. And youre dead or crippled.

I appreciate your posts. I find your points have a lot of merit. I disagree with your conclusion but respect your decision. There is still so much we don't know about Covid 19 and if the vaccines will be both effective and safe in the LONG RUN.

If I was under age 40 and without any co-morbidities (which I am not) then decision to take an mRNA based vaccine would not be an easy one for me.
I would likely take it to protect others more than myself (the under age 40 self) but even then is there solid evidence behind that decision?
 
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the decision to vaccinate yourself isn't just about you. it's about disease spread and the safety of the community at large. it's why many health systems mandate the flu vaccine. while i respect the decision of health systems not to require the covid vaccine, i admit to being surprised by it. if you're a physician, unless you're testing yourself routinely (which no one is doing) you have no idea to know if you've been or will be an asymptomatic carrier of covid. we should all be common sense smart enough to know that as physicians we have been and will continue to interact with the older/sicker of our population. it is not a stretch at all to conclude some among the physician population who choose not to vaccinate themselves will make their patients and co-workers sick.

the politics of this all isn't lost on me. the same people who wan't to 'hip hip hooray' that loser Trump for Operation Warp Speed are the same people who don't want to vaccinate themselves against the pandemic they didn't want to lock down for and they're the same people who believe a legally held election was stolen. it all touches on distrust, conspiracy theories, and just pure craziness. and the sheer number of people who wholeheartedly or even somewhat buy into all of this nonsense continues to both surprise and disgust me.
 
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SXMMD

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the decision to vaccinate yourself isn't just about you. it's about disease spread and the safety of the community at large. it's why many health systems mandate the flu vaccine. while i respect the decision of health systems not to require the covid vaccine, i admit to being surprised by it. if you're a physician, unless you're testing yourself routinely (which no one is doing) you have no idea to know if you've been or will be an asymptomatic carrier of covid. we should all be common sense smart enough to know that as physicians we have been and will continue to interact with the older/sicker of our population. it is not a stretch at all to conclude some among the physician population who choose not to vaccinate themselves will make their patients and co-workers sick.

the politics of this all isn't lost on me. the same people who wan't to 'hip hip hooray' that loser Trump for Operation Warp Speed are the same people who don't want to vaccinate themselves against the pandemic they didn't want to lock down for and they're the same people who believe a legally held election was stolen. it all touches on distrust, conspiracy theories, and just pure craziness. and the sheer number of people who wholeheartedly or even somewhat buy into all of this nonsense continues to both surprise and disgust me.
I don’t share your confidence in the efficacy and safety of the vaccine based on available literature- I am hopeful, but the data is simply insufficient to have that level of confidence. I agree with the principles you are advocating in your post- but those principles stand on an assumption that this vaccine is safe (long term) and efficacious, both claims which are not adequately proven right now.
There is room for optimism based on available data, but this rush to paint people considering a more cautious approach based on the limitations of available data as part of the right wing tin foil hat cohort is a little over the top. It reminds me of the rush to use HCQ earlier on during the pandemic- based on promising in vitro studies that ultimately didn’t pan out in clinical practice. How much harm did we do then?

Can we take an approach of measured optimism while recognizing there are some limits to our knowledge right now or is that too much to ask?
 

Southpaw

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I don’t share your confidence in the efficacy and safety of the vaccine based on available literature- I am hopeful, but the data is simply insufficient to have that level of confidence. I agree with the principles you are advocating in your post- but those principles stand on an assumption that this vaccine is safe (long term) and efficacious, both claims which are not adequately proven right now.
There is room for optimism based on available data, but this rush to paint people considering a more cautious approach based on the limitations of available data as part of the right wing tin foil hat cohort is a little over the top. It reminds me of the rush to use HCQ earlier on during the pandemic- based on promising in vitro studies that ultimately didn’t pan out in clinical practice. How much harm did we do then?

Can we take an approach of measured optimism while recognizing there are some limits to our knowledge right now or is that too much to ask?

How will you get long term safety data for this vaccine? By looking at the willing, that's how. There's simply no other way. I respect your decision to obstain from vaccination, but all we know right now about the vaccine and the disease shifts benefit > risk clearly in the favor of vaccination when you consider the population at whole.
 
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Guillemot

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I agree that the safest route is to get neither the vaccine nor COVID19. Just cloister yourself off in Antarctica for the next decade and you should be good.
 
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chocomorsel

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I agree that the safest route is to get neither the vaccine nor COVID19. Just cloister yourself off in Antarctica for the next decade and you should be good.
I think I saw a newsflash that this thing has now hit all seven continents. Not even the polar bears are safe. Do polar bears live in Antarctica?
 
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abolt18

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I think I saw a newsflash that this thing has now hit all seven continents. Not even the polar bears are safe. Do polar bears live in Antarctica?
Other hemisphere.
 
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dannyboy1

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the decision to vaccinate yourself isn't just about you. it's about disease spread and the safety of the community at large. it's why many health systems mandate the flu vaccine. while i respect the decision of health systems not to require the covid vaccine, i admit to being surprised by it. if you're a physician, unless you're testing yourself routinely (which no one is doing) you have no idea to know if you've been or will be an asymptomatic carrier of covid. we should all be common sense smart enough to know that as physicians we have been and will continue to interact with the older/sicker of our population. it is not a stretch at all to conclude some among the physician population who choose not to vaccinate themselves will make their patients and co-workers sick.
They can’t mandate it. It is not even FDA approved, just EUA. Before getting my vaccine I had to sign something acknowledging this and a release that I will not sue the hospital. No way they could legally mandate it at this point...
 

SXMMD

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How will you get long term safety data for this vaccine? By looking at the willing, that's how. There's simply no other way. I respect your decision to obstain from vaccination, but all we know right now about the vaccine and the disease shifts benefit > risk clearly in the favor of vaccination when you consider the population at whole.
I am not abstaining from vaccination. I’m still not sold on the excess optimism that isn’t supported by the data but the risk benefit analysis didn’t look good for catching COVID either. My point is that this isn’t an all or nothing discussion here. There is room for caution without painting the cautious as tin foil hatters. Yes, some are excessive in their worry, but there IS room for some objective analysis too.

bt dubs you get vaccine safety data for COVID the same way you get it for any other vaccine- time and process. The anxiety for many is that we are shortchanging both. The question that I’m not smart enough to answer is- are our protocols and data robust enough, and is the situation dire enough, to pilot an abridged process right now?
 
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vector2

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An anecdote........A text I got from my wife today about a family friend :

"Hey B got his X-ray results, no pneumonia but they see scarring. He wants to know if that will go away. He says he still sob but does feel a little better"

For reference, B is 40 years old, nonsmoker, nondrinker, no comorbidities, has a fairly active blue collar job. Contracted COVID 6 weeks ago and is just now getting over it. His wife had it in April and she barely knew she had it.

Told him there's a chance if his initial disease was bad enough the scarring (fibroproliferative changes) may be permanent but regardless his functional status is *probably* going to get better as he convalesces more over the next month or so.

Short of the longterm effects from the mRNA vaccines being some kind of cancer or heart failure, there is almost no doubt in my mind that the risk:benefit favors the vaccine.
 
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MeaCulpa

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How will you get long term safety data for this vaccine? By looking at the willing, that's how. There's simply no other way. I respect your decision to obstain from vaccination, but all we know right now about the vaccine and the disease shifts benefit > risk clearly in the favor of vaccination when you consider the population at whole.
Based on what? You have zero data to make this assertion. What data do you have to come to your conclusion? Absolutely none. Its frustrating the amount of people who comment with such determination and with such eagerness as if they are expert, and have absolutely nothing to back their assertions. These are the same people deriding others as tinfoil hat wearers. The amount of projection here is unbelievable.
 
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The AstraZeneca vaccine is likely to be approved in the U.K. next week.

It uses the adenovirus and DNA. Are people hesitant about how this vaccine as well? Or is it more specifically the mRNA in the Pfizer and Moderna vaccines?
 

MeaCulpa

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the decision to vaccinate yourself isn't just about you. it's about disease spread and the safety of the community at large. it's why many health systems mandate the flu vaccine. while i respect the decision of health systems not to require the covid vaccine, i admit to being surprised by it. if you're a physician, unless you're testing yourself routinely (which no one is doing) you have no idea to know if you've been or will be an asymptomatic carrier of covid. we should all be common sense smart enough to know that as physicians we have been and will continue to interact with the older/sicker of our population. it is not a stretch at all to conclude some among the physician population who choose not to vaccinate themselves will make their patients and co-workers sick.

the politics of this all isn't lost on me. the same people who wan't to 'hip hip hooray' that loser Trump for Operation Warp Speed are the same people who don't want to vaccinate themselves against the pandemic they didn't want to lock down for and they're the same people who believe a legally held election was stolen. it all touches on distrust, conspiracy theories, and just pure craziness. and the sheer number of people who wholeheartedly or even somewhat buy into all of this nonsense continues to both surprise and disgust me.
Exactly my point. This is the type of thinking that is dangerous. "You need to get the vaccine, because youre killing your patients" Based on what evidence? You make a lot of assumptions based on zero evidence. I am not killing anyone by not being vaccinated, and you have zero idea the long term effects of this drug, let alone the short term effects, if this drug prevents asymptomatic spread in those who take the drug, and how long this drug protects the person who takes it. You make a lot of assumptions and pontificate as if you are the holder of these truths. You aren't. You are in no better position than any of us. We are all wading through this, and for you to stand up and pretend like you know better than anyone else is not based at all in fact or in you knowing that this drug is the cure all.

Editorials

Asymptomatic transmission of covid-19​

BMJ 2020; 371 doi: Asymptomatic transmission of covid-19 (Published 21 December 2020)Cite this as: BMJ 2020;371:m4851


  1. Allyson M Pollock, professor of public health1,
  2. James Lancaster, independent researcher2
  3. Author affiliations
  4. Correspondence to: A M Pollock [email protected]
What we know, and what we don’t
The UK’s £100bn “Operation Moonshot” to roll out mass testing for covid-19 to cities and universities around the country raises two key questions. How infectious are people who test positive but have no symptoms? And, what is their contribution to transmission of live virus?
Unusually in disease management, a positive test result is the sole criterion for a covid-19 case. Normally, a test is a support for clinical diagnosis, not a substitute. This lack of clinical oversight means we know very little about the proportions of people with positive results who are truly asymptomatic throughout the course of their infection and the proportions who are paucisymptomatic (subclinical), presymptomatic (go on to develop symptoms later), or post-infection (with viral RNA fragments still detectable from an earlier infection).
Earlier estimates that 80% of infections are asymptomatic were too high and have since been revised down to between 17% and 20% of people with infections.12 Studies estimating this proportion are limited by heterogeneity in case definitions, incomplete symptom assessment, and inadequate retrospective and prospective follow-up of symptoms, however.3 Around 49% of people initially defined as asymptomatic go on to develop symptoms.45
It’s also unclear to what extent people with no symptoms transmit SARS-CoV-2. The only test for live virus is viral culture. PCR and lateral flow tests do not distinguish live virus. No test of infection or infectiousness is currently available for routine use.678 As things stand, a person who tests positive with any kind of test may or may not have an active infection with live virus, and may or may not be infectious.9
The relations between viral load, viral shedding, infection, infectiousness, and duration of infectiousness are not well understood. In a recent systematic review, no study was able to culture live virus from symptomatic participants after the ninth day of illness, despite persistently high viral loads in quantitative PCR diagnostic tests. However, cycle threshold (Ct) values from PCR tests are not direct measures of viral load and are subject to error.10
While viral load seems to be similar in people with and without symptoms, the presence of RNA does not necessarily represent transmissible live virus. The duration of viral RNA shedding (interval between first and last positive PCR result for any sample) is shorter in people who remain asymptomatic, so they are probably less infectious than people who develop symptoms.11
Viral culture studies suggest that people with SARS-CoV-2 can become infectious one to two days before the onset of symptoms and continue to be infectious up to seven days thereafter; viable virus is relatively short lived.7Symptomatic and presymptomatic transmission have a greater role in the spread of SARS-CoV-2 than truly asymptomatic transmission.121213
The transmission rates to contacts within a specific group (secondary attack rate) may be 3-25 times lower for people who are asymptomatic than for those with symptoms.1121415 A city-wide prevalence study of almost 10 million people in Wuhan found no evidence of asymptomatic transmission.16 Coughing, which is a prominent symptom of covid-19, may result in far more viral particles being shed than talking and breathing, so people with symptomatic infections are more contagious, irrespective of close contact.17 On the other hand, asymptomatic and presymptomatic people may have more contacts than symptomatic people (who are isolating), underlining the importance of hand washing and social distancing measures for everyone.

Missed opportunity​

By failing to integrate testing into clinical care, we have missed an important opportunity to better understand the role of asymptomatic infection in transmission. Given the variation in prevalence and testing strategies by region, the proportions of people with positive and negative test results should be published alongside the purpose of the testing strategy and the population tested (screening healthy populations in schools, universities, and health and social care, or testing people with symptoms). Government regulations on recording the age, ethnicity, sex, and place of residence of people with positive results must also be followed.18
Searching for people who are asymptomatic yet infectious is like searching for needles that appear and reappear transiently in haystacks, particularly when rates are falling.19 Mass testing risks the harmful diversion of scarce resources. A further concern is the use of inadequately evaluated tests as screening tools in healthy populations.20
The UK’s testing strategy needs to be reset in line with the Scientific Advisory Group for Emergencies’ recommendation that “Prioritising rapid testing of symptomatic people is likely to have a greater impact on identifying positive cases and reducing transmission than frequent testing of asymptomatic people in an outbreak area.”21
Testing should be reintegrated into clinical care with clinical and public health oversight and case definitions based on clinical diagnosis. Carefully designed prospective studies of cases and contacts are needed to estimate transmission rates by people with and without symptoms. These should include careful investigations of outbreaks—for example, testing all contacts of people with a clear history of exposure, especially in high risk environments such as nursing homes, prisons, and other institutional settings.
Coronavirus infection surveys by the Office for National Statistics22 and the REACT survey23 could be expanded to include clinical follow-up of participants combined with tests of viral load and viral cultures. The absence of strong evidence that asymptomatic people are a driver of transmission is another good reason for pausing the roll out of mass testing in schools, universities, and communities.


What do we know? Not a lot. So you claiming to know what is happening and how to react and shaming me or anyone else who chooses to not take this drug that is a complete unknown is completely unwarranted and reckless on your behalf.
 

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