Will you get a vaccine?

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    Votes: 34 12.1%

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I've read your posts in the hyponatremia thread, don't come in here telling us about medicine 101.
 
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MeaCulpa

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I've read your posts in the hyponatremia thread, don't come in here telling us about medicine 101.
This is extremely vague. I presented a case and asked questions. My asking for opinions on a relatively complex anesthetic scenario is a sign of weakness? What should I do instead? Pretend I have all the answers like the people here? No thanks, I will continue to ask questions, if that to you is a sign of weakness, when I try to fill any defecits in my knowledge, then you know what? Go back into your echo chamber.
 
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vector2

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This is extremely vague. I presented a case and asked questions. My asking for opinions on a relatively complex anesthetic scenario is a sign of weakness? What should I do instead? Pretend I have all the answers like the people here? No thanks, I will continue to ask questions, if that to you is a sign of weakness, when I try to fill any defecits in my knowledge, then you know what? Go back into your echo chamber.

Just out of curiosity, you’re pro-vaccination for the ones that have decades of data like MMR, tdap, hep b, varicella, influenza, etc, right?
 
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MeaCulpa

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Just out of curiosity, you’re pro-vaccination for the ones that have decades of data like MMR, tdap, hep b, varicella, influenza, etc, right?
Of course. This has little to do with vaccines in general per se. It has to do with the fact the safety in this novel vaccine is unknown. The fact that prior vaccines for SARS has been not only ineffective but made people worse off in the long term.
 
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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?

Actually this is indeed an all or nothing decision. There exists a dichotomy. Your choices are 1) to get vaccinated or 2) to NOT get vaccinated. There is no such thing as a little vaccinated or "just a little bit" unvaccinated. We have several months of data on several hundred thousand people across the world at this point. At this point we are indeed cautiously optimistic.

The problem is that you are looking for 10 year data on this topic, but alas you will have to wait 10 years for that to come out. In the meantime asymptomatic carriers continue to spread this virus. Your request for "time and process" is the equivalent of recruiters looking for computer programmers with 5 years of experience in <insert new coding language here>. Only problem is that the language was only developed 1 year ago...
 

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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.

Ugh.....
 
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Southpaw

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This is extremely vague. I presented a case and asked questions. My asking for opinions on a relatively complex anesthetic scenario is a sign of weakness? What should I do instead? Pretend I have all the answers like the people here? No thanks, I will continue to ask questions, if that to you is a sign of weakness, when I try to fill any defecits in my knowledge, then you know what? Go back into your echo chamber.

The case you presented and the questions you asked undermine your education as a physician if that’s in fact what you are.
 
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Southpaw

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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?

There’s much gray to medicine and life in general. Rarely do we have all the answers. We often simply do the best we can given our education, experience, and ability to apply common sense solutions to common problems. However, on vaccination it is definitely all or nothing. Or at least extremely high majority or nothing.
 
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SXMMD

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Actually this is indeed an all or nothing decision. There exists a dichotomy. Your choices are 1) to get vaccinated or 2) to NOT get vaccinated. There is no such thing as a little vaccinated or "just a little bit" unvaccinated. We have several months of data on several hundred thousand people across the world at this point. At this point we are indeed cautiously optimistic.

The problem is that you are looking for 10 year data on this topic, but alas you will have to wait 10 years for that to come out. In the meantime asymptomatic carriers continue to spread this virus. Your request for "time and process" is the equivalent of recruiters looking for computer programmers with 5 years of experience in <insert new coding language here>. Only problem is that the language was only developed 1 year ago...
You’re misinterpreting what I’m saying. The place where there is a binary decision is to get vaccinated or not to get vaccinated. We don’t disagree on that. We agree even that the risk of unknowns from vaccine is likely less harmful from the consequences of COVID.

Where we disagree is the idea that this vaccine is as safe and efficacious as it is promoted based on available data. It may well be that longitudinal data will support these claims in the future. Pretending available data supports that position today is over zealousness. This is far from settled science.

I’m not arguing against vaccination. I’m arguing against mindless zealotry and uncritical acceptance of early data as definitive proof. I am arguing for cautious optimism and critical evaluation of the process rather than uncritical acceptance or fearful rejection of the data. Like southpaw mentioned above, there is gray area here and though we have to make a binary decision we can acknowledge the gray without calling each other conspiracy theorists
 
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SXMMD

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Shouldn't we all be hesitant about any treatment that has very little evidence short or long term to support its mass use? This is medicine 101.
Personally just generally concerned about the abridged process, less so the route of delivery. I’m actually pretty excited about mRNA vaccines in genera, sounds like a pretty cool way to go about vaccine development
 
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Southpaw

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Again vague. You are being petty for the sake or being petty. You obviously have a lot riding on your image.

I asked what would be peoples anesthetic preference in the setting of an urgent c section in a patient with profound hyponatremia.

Go for it, give me your petty reasons as to why this was a poor case.

Sounds like I'm being petty about the petty of my pettiness. Is that overly petty? You're right, I have a lot riding here on my online anonymous image.

I found myself thinking what @SaltyDog posted in that thread, FWIW.

As far as this thread goes, it's looking more and more dumpster fireish. So I'll not contribute my part to it any longer.
 

MeaCulpa

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Sounds like I'm being petty about the petty of my pettiness. Is that overly petty? You're right, I have a lot riding here on my online anonymous image.

I found myself thinking what @SaltyDog posted in that thread, FWIW.

As far as this thread goes, it's looking more and more dumpster fireish. So I'll not contribute my part to it any longer.
Again being vague. A scholar such as yourself that can make accusations such as this "The case you presented and the questions you asked undermine your education as a physician if that’s in fact what you are.", should be able to lay out your case. So why don't you lay out your case instead of scurrying away? Referencing someone else's statement shouldn't suffice. Layout your specific reasoning to claim that the questions I asked undermine my education as a physician. Come on Aristotle, lets hear your evidence.
 
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BLADEMDA

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Actually this is indeed an all or nothing decision. There exists a dichotomy. Your choices are 1) to get vaccinated or 2) to NOT get vaccinated. There is no such thing as a little vaccinated or "just a little bit" unvaccinated. We have several months of data on several hundred thousand people across the world at this point. At this point we are indeed cautiously optimistic.

The problem is that you are looking for 10 year data on this topic, but alas you will have to wait 10 years for that to come out. In the meantime asymptomatic carriers continue to spread this virus. Your request for "time and process" is the equivalent of recruiters looking for computer programmers with 5 years of experience in <insert new coding language here>. Only problem is that the language was only developed 1 year ago...

No. I'm more hesitant about the second dose of a mRNA vaccine than the first. I've even thought about skipping it. In the end, I will get the second shot but with concern of real side-effects which may sideline me for several days. I think that these side-effects will become much more known by the lay person as we all get our second shots.


Pfizer vaccine side effects


Pfizer's analysis indicates that about 25% to 50% of patients experienced some degree of side effects, while 10% to 15% had a more serious reaction.


"I had chills, nausea, a headache, some fatigue, and that just kind of got worse and worse as the night went on," said Kristen Choi, a nursing professor at UCLA. On Dec. 7, she published a first hand account in the Journal of the American Medical Association, of the symptoms she experienced after her second injection in a Phase 3 Pfizer trial, including a 104.9 degree fever
 
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MeaCulpa

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Sounds like I'm being petty about the petty of my pettiness. Is that overly petty? You're right, I have a lot riding here on my online anonymous image.

I found myself thinking what @SaltyDog posted in that thread, FWIW.

As far as this thread goes, it's looking more and more dumpster fireish. So I'll not contribute my part to it any longer.
I will be the direct one, I am not concerned with making an example of anyone.

You directed me to address @Saltydogs questions pertaining to my Hyponatremia and Urgent C/S thread, as his questions seemed to indicate an undermining of education as a physician.

Saltydog wanted to know why I would question the role of a spinal anesthetic in a hyponatremic patient.

My reasoning is this, hyponatremia is a direct cause of cerebral swelling as fluid goes from an area of high to an area of low concentration. It is known that hyponatremia can lead to cerebral edema. Cerebral edema can lead to elevated ICP.

CNS herniation occurs if there is a change in the pressure gradient within the CNS compartment sufficient to cause movement of CNS tissue out of its normal position. This can involve brain, spinal cord, and nerve root tissue, often with devastating and fatal consequences. In these cases, an abnormal pressure gradient already exists, and it is the further transient lowering of pressure, as a result of CSF withdrawal from an LP, which allows the raised pressure compartment above the LP to move along the pressure gradient and consequently move CNS tissue. This is in contrast to states of uniformly raised intracranial pressure within the whole CNS compartment, such as in idiopathic intracranial hypertension (IIH), where no internal pressure gradient has developed so is it is safe to perform an LP.


Studies have been performed to identify features that may indicate states where a pressure gradient has developed, and therefore guard against performing LP, such as, an age over 60 years, an immunocompromised patient, previous CNS disease, any recent seizures, reduced consciousness, papilloedema, or an abnormal neurological examination.

Parturients with intracranial lesions are often assumed to have increased intracranial pressure, even in the absence of clinical and radiographic signs. The risk of herniation after an inadvertent dural puncture is frequently cited as a contraindication to neuraxial anesthesia.
 
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BLADEMDA

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Stories like these are the reason I will suck it up and get the second shot. I am still going to make sure I have a few days off after getting the second dose.

 

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the risk of my dying or being severely ill is less than 0.009%, and that is for all comers in my age group, which includes obese and people suffering concomitant illnesses. I am exceptionally healthy therefore my risk is significantly lower than 0.009%

Out of curiosity, how are you calculating this 0.009%? You mean if you contact covid19, or are you somehow multiplying in your population risk of getting it times risk of morbidity?

Everything (reputable) I’ve read shows higher rates of morbidity/morality, except maybe children.

Please link source. Because while there are certainly unknowns about the vaccines, even a risk of even 0.3% is a much different decision than than 0.009% (you are saying your risk of any serious outcome after contracting covid19 is less than 1 in 10,000)
 

MeaCulpa

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Out of curiosity, how are you calculating this 0.009%? You mean if you contact covid19, or are you somehow multiplying in your population risk of getting it times risk of morbidity?

Everything (reputable) I’ve read shows higher rates of morbidity/morality, except maybe children.

Please link source. Because while there are certainly unknowns about the vaccines, even a risk of even 0.3% is a much different decision than than 0.009% (you are saying your risk of any serious outcome after contracting covid19 is less than 1 in 10,000)
 
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MeaCulpa

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Out of curiosity, how are you calculating this 0.009%? You mean if you contact covid19, or are you somehow multiplying in your population risk of getting it times risk of morbidity?

Everything (reputable) I’ve read shows higher rates of morbidity/morality, except maybe children.

Please link source. Because while there are certainly unknowns about the vaccines, even a risk of even 0.3% is a much different decision than than 0.009% (you are saying your risk of any serious outcome after contracting covid19 is less than 1 in 10,000)
 

AMEHigh

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Shouldn't we all be hesitant about any treatment that has very little evidence short or long term to support its mass use? This is medicine 101.

I was asking a genuine question because a lot of people in general have been focusing on mrna, so I was wondering if it was specific to mrna concerns or were people ok with the other vaccines?

But anyway to answer your question, we’re in a pandemic that’s killing a lot of people daily. Yes in an ideal situation we wouldn’t be in a pandemic, we would’ve seen this coming and could’ve magically been testing the vaccine on people 5 years ago and have robust data now. But that’s not our reality.

But since we don’t and With the evidence we have now, covid itself seems like a bigger immediate threat to our population and well-being, vaccinate away. I’m actually in a vaccine trial myself so yes I decided that the science seemed ok enough to me to take a small risk to help advance science for others.

Of course I understand if people have questions but all the data we have now says the vaccine is safe (safer than Covid because no one can predict exactly how Covid will affect someone) and during a pandemic that is killing millions of people it’s not practical to wait 5 years for longer term data.

Medicine 101 (ok maybe 201 once you start actually treating people) is mostly about weighing risks vs benefits, and this is just another example of that.
 
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AMEHigh

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Personally just generally concerned about the abridged process, less so the route of delivery. I’m actually pretty excited about mRNA vaccines in genera, sounds like a pretty cool way to go about vaccine development

I will say that I’ve definitely learned a lot of the trial process along the way, especially being a trial participant and it doesn’t seem so much abridged, but a lot of red tape was cut out. Obviously we can’t do anything about not having 5 year data, especially during a pandemic.

The fact that China gave the world the dna for Covid right away seems pretty unprecedented in regards to cooperation. Then, countries decided to put money behind the vaccine before it was proven effecacious, which speeds up the process of enrolling people, all the money it takes to manufacture, etc. Then, I was also told that the consent process also used to be a lot more cumbersome and like rest of the world it was ok’d to send consent forms via email, which wasn’t allowed before. I was sent my consent form via email and read it over before my appointment and then read it again the day of my appointment (I think before you might have had to have a separate consent appointment but don’t quote me on that).

Also, and this just might be a guess on my part, there was a huge push to get people registered to be a part of the trials. I’m going to guess that it typically takes a lot longer to recruit tens of thousands of people to participate when people aren’t scared of an imminent threat.

So anyway, it doesn’t seem like any safety steps were cut. I’ve felt 100% safe during the trial and everyone I’ve interacted with from the nurses to the doctors have been 100% honest and said my safety is the most important thing. So I really feel as though no safety cuts were taken overall. If anything, they know the world is watching and want to be extra cautious.
 
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MeaCulpa

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I was asking a genuine question because a lot of people in general have been focusing on mrna, so I was wondering if it was specific to mrna concerns or were people ok with the other vaccines?

But anyway to answer your question, we’re in a pandemic that’s killing a lot of people daily. Yes in an ideal situation we wouldn’t be in a pandemic, we would’ve seen this coming and could’ve magically been testing the vaccine on people 5 years ago and have robust data now. But that’s not our reality.

But since we don’t and With the evidence we have now, covid itself seems like a bigger immediate threat to our population and well-being, vaccinate away. I’m actually in a vaccine trial myself so yes I decided that the science seemed ok enough to me to take a small risk to help advance science for others.

Of course I understand if people have questions but all the data we have now says the vaccine is safe (safer than Covid because no one can predict exactly how Covid will affect someone) and during a pandemic that is killing millions of people it’s not practical to wait 5 years for longer term data.

Medicine 101 (ok maybe 201 once you start actually treating people) is mostly about weighing risks vs benefits, and this is just another example of that.
Actually, you have this backwards. We have data on how covid will affect populations. We have a very reasoned answer to outcomes based on age and comorbidities. Of course one never knows how one will react in the course of any illness but we do have meaningful data based on age and comorbidity.
Again we did see this coming. There were vaccine trials in 2005 for the first SARS-COV and there were issues in developing that vaccine. You state all the data we have now regarding the vaccine is not concerning. The data we have now is extremely limited. The risks and outcomes surrounding this vaccine are an unknown. I am not sure why people insist on repeating the same untruths over and over in this discussion, as if those untruths will somehow make it more real. We don’t have any long term data. Zero. To claim we know this vaccine is safe long term is an absolute fallacy.
 

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Actually, you have this backwards. We have data on how covid will affect populations. We have a very reasoned answer to outcomes based on age and comorbidities. Of course one never knows how one will react in the course of any illness but we do have meaningful data based on age and comorbidity.
Again we did see this coming. There were vaccine trials in 2005 for the first SARS-COV and there were issues in developing that vaccine. You state all the data we have now regarding the vaccine is not concerning. The data we have now is extremely limited. The risks and outcomes surrounding this vaccine are an unknown. I am not sure why people insist on repeating the same untruths over and over in this discussion, as if those untruths will somehow make it more real. We don’t have any long term data. Zero. To claim we know this vaccine is safe long term is an absolute fallacy.
Maybe I missed it, but when and who made that claim?
 
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AMEHigh

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Actually, you have this backwards. We have data on how covid will affect populations. We have a very reasoned answer to outcomes based on age and comorbidities. Of course one never knows how one will react in the course of any illness but we do have meaningful data based on age and comorbidity.
Again we did see this coming. There were vaccine trials in 2005 for the first SARS-COV and there were issues in developing that vaccine. You state all the data we have now regarding the vaccine is not concerning. The data we have now is extremely limited. The risks and outcomes surrounding this vaccine are an unknown. I am not sure why people insist on repeating the same untruths over and over in this discussion, as if those untruths will somehow make it more real. We don’t have any long term data. Zero. To claim we know this vaccine is safe long term is an absolute fallacy.

Sorry if my post wasn’t clear. I was specifically saying no we don’t have long term data about the vaccine since this specific Covid strain has only been around for about 1 year. So I don’t think I was repeating anything false. You are correct we don’t have long term data. We also don’t have long term data about the threat of Covid itself, since again this strain has been around for approximately 1 year. Hence, my last sentence in regards to weighing risks vs benefits, that is what medicine and being a good physician is all about. Our jobs would be a lot easier if every medical decision we had to make was binary with 100% of the evidence pointing toward 1 option being the right, safest, easiest, least painful, least expensive, etc choice 100% of the time.
 
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MeaCulpa

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Maybe I missed it, but when and who made that claim?
There have been a number of posts claiming that the risk benefit ratio tilts heavily in favor of benefit for the vaccine
 

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And how can you say we have long term data about how Covid will affect populations?

Are you saying that scientists have been lying and this strain has been around for decades infecting people and they’ve been studying the affects?
 

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There have been a number of posts claiming that the risk benefit ratio tilts heavily in favor of benefit for the vaccine

Yes but who falsely said we have long term data about covid? You said multiple people falsely made that claim. I read the posts and where did multiple people say we have long term Covid data?
 
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How about the tie the 2G pp stimulus to the vaccine? Anyone who voluntarily wants the vaccine can get 2G for it. People who don't want it don't have to get it. Numbers will probably reach herd immunity levels.
 

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How about the tie the 2G pp stimulus to the vaccine? Anyone who voluntarily wants the vaccine can get 2G for it. People who don't want it don't have to get it. Numbers will probably reach herd immunity levels.
Like I’ve said before, there is absolutely zero evidence to suggest that receiving the vaccine is in any way beneficial in preventing transmission.

  • The World Health Organization's chief scientist, Dr. Soumya Swaminathan, has urged people to be cautious with their behavior even after receiving a COVID-19 vaccine.
  • Swaminathan told a Monday briefing there was not yet enough evidence from vaccine trials "to be confident that it's going to prevent people from actually getting the infection and therefore being able to pass it on."
  • She added that at least for now, even people who had received the vaccine should still quarantine when traveling to countries with lower coronavirus transmission rates.
  • Vaccine researchers in the US are trying to determine whether vaccines can stop the virus from spreading or are effective only at preventing symptomatic cases of COVID-19.”
 
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vector2

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Check the post right below you. The poster is claiming for the population as a whole the benefits outweigh the risks. That is an impossible claim to make at this point.

On a population basis, given the fact that 330+ thousand people have died and the economic cost is going to reach in the trillions, the overall risk:benefit definitely favors the vaccine- given the likelihood that the vaccine kills fewer than 330+ thousand people d/t side effects in the long run and doesn't cost the economy trillions.

I'm assuming there are some morbidity/mortality/economic cost numbers where the risk to benefit of not knowing the long-term effects of an effective vaccine still favors getting the population vaccinated. I just wonder what those figures are for you.
 
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dhb

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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.
I'm pro vaccination but i can agree with a lot of the points raised here.
Overall i believe (but yes it's just a belief) that injecting a little bit of chopped up protein is very benign when you consider all the crap we submit our bodies to.
Hygiene vaccination and penicilline have saved a hell of a lot more lives that an Miller 2 or a Mac 3.
 
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Southpaw

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I'm pro vaccination but i can agree with a lot of the points raised here.
Overall i believe (but yes it's just a belief) that injecting a little bit of chopped up protein is very benign when you consider all the crap we submit our bodies to.
Hygiene vaccination and penicilline have saved a hell of a lot more lives that an Miller 2 or a Mac 3.

It’s fine to question the vaccine. It’s just difficult believe someone has been face to face with bad Covid (that our icus are full of right now), then look at the vaccine data for prevention and transmission, and think that for the entire population the vaccine is more dangerous than the disease. Matter of fact it’s unscientific.

How will we obtain long term data on vaccination? By tracking the disease and how the population responds to covid post-vaccination. There’s no other way.
 
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chocomorsel

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It’s fine to question the vaccine. It’s just difficult believe someone has been face to face with bad Covid (that our icus are full of right now), then look at the vaccine data for prevention and transmission, and think that for the entire population the vaccine is more dangerous than the disease. Matter of fact it’s unscientific.

How will we obtain long term data on vaccination? By tracking the disease and how the population responds to covid post-vaccination. There’s no other way.
I think something is completely off with this person. Like something is missing. The elevator/lift does not go all the way to the penthouse/top floor.
 
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MeaCulpa

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Let me reiterate for the majority of the population the risk benefit is simply not been proven. Sure if you are in a higher risk population, such as elderly, obese etc, then it could tilt in favor of the vaccine. But to claim that we understand the risk of the vaccine to be less than the risk of covid is simply untrue. Science is a materialist philosophy that relies on observation. The only observation available is the past. The past attempts at a vaccine have been wrought with failure for SARS. That is what I am saying. It isn’t a controversial stance.
 

Southpaw

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Let me reiterate for the majority of the population the risk benefit is simply not been proven.

Can’t get past first sentence.

Covid in the US - 19 million cases, 335k dead.

Vaccine - mild arm soreness and maybe a headache. 95% effective. Extreme low number of bad side effects.

You’re right, this decision is really tough....
 
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vector2

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The immediate risk of COVID on a population level is that it definitely could kill another 300k people.

The immediate risk of the vaccine is arm soreness and flu symptoms.

Unless the long term risk of the vaccine is 300k vaccine related deaths (or a zombie apocalypse) the risk:benefit on a population level favors the vaccine.

The end
 
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vector2

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We don't know the long term risk, the vaccine could affect a much broader population in an adverse way. Therefore it would be prudent to vaccinate those at highest risk.

We dont have a crystal ball that says the sun is going to rise tomorrow either. But we can make educated guesses based on the constituents and the mechanism of action of the vaccine what the effects will be.

You should acknowledge that the odds of the vaccine causing, in the long term, severe morbidity or mortality anywhere close to COVID let alone worse than COVID are essentially zero.
 
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pgg

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Let me reiterate, the majority of deaths have been in subpopulations.
The risk of the virus is not just about you or me catching it and dying.

It's also about the risk of longer term effects after recovery. We know these aren't rare.

It's also about the risk of transmission to more vulnerable types of patients.


What you keep citing as a reason to not get vaccinated is the possibility of serious vaccine side effects that are delayed in onset many months post-administration. Or side effects that manifest quickly but are so rare that they didn't happen in phase 3 trials.

You're in a small minority of physicians who weigh those risks as greater than individual covid morbidity + additional population morbidity/mortality by choosing to be a vector.
 
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cchoukal

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The way I'm thinking about it, we know pretty well the short-term side effects in the 0.1%-1% range. There are enough patients that events in this range of prevalence would show up. Things that are more like 0.01%-the one-in-a-million-rare-awful-thing can't be known until millions more vaccines are given. But we already know that having a severe or fatal case of COVID is well over 0.1% (300K+ have died and, obviously well above that number have had severe or complicated courses, out of a population of 330M). And this is all short term because the pandemic is here NOW. So we're comparing the risk of something unseen (so would have to be in the 0.01%-really rare group) against the KNOWN, much higher risk of the disease.

It's true, though, that long-term effects simply can't be known. What I have observed from my perch in the ICU and from seemingly countless hours of doom-scrolling is that, given the behavior of large numbers of Americans, there will BE no long-term anything without large numbers of people taking this vaccine. In this way, whatever long-term side effects of the vaccine may be, they appear to be the only option in controlling this disease. Sure, it's POSSIBLE that public health measures alone could do it, but we've already proven that we don't have what it takes to do that.

Full disclosure: I was vaccinated last Thursday.
 
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coffeebythelake

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Let me reiterate for the majority of the population the risk benefit is simply not been proven. Sure if you are in a higher risk population, such as elderly, obese etc, then it could tilt in favor of the vaccine. But to claim that we understand the risk of the vaccine to be less than the risk of covid is simply untrue. Science is a materialist philosophy that relies on observation. The only observation available is the past. The past attempts at a vaccine have been wrought with failure for SARS. That is what I am saying. It isn’t a controversial stance.

Are you against vaccines in general? Or specifically the COVID vaccine

While you are among the minority of physicians who feel this way about the COVID vaccine, it is not a small minority who is unsure. There are a number of physicians in my department that have also expressed hesitancy about the COVID vaccine, for similar reasons you've elucidated. After all we have been dealing with COVID for many months now. So really it should be framed as the risk/benefit of continuing current practice of wearing our N95/PPE vs that plus vaccination.

I was among the first group to get the COVID vaccine. While N95 is protective it is not 100% effective, and when the prevalence in general population gets so high, its only a matter of time you would get it somewhere/somehow.
 
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I just want to say that it's not like I trust the pharmaceutical companies blindly. I saw how they pushed hydroxychloroquine, remdesivir and all sorts of other nonsense just to make ridiculous profits off of the pandemic. I'm aware of vioxx and other scandals that have plagued them throughout the years and I'm sure the rest of you are too. But I still got the vaccine and I'm grateful for all the work that went into it.
 
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Neopolymath

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SDN in 2010:
- How to be PP Slick
- AANA is Crazy
- How do I pick fellowship?
- Is this a good PP contract?

SDN in 2020:
- Physicians acting crazy about Trump
- Physicians fervently denying a vaccine

Wtf happened to some of you? Were you always crazy and now feel safe to let it out post 2016?
 
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pgg

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SDN in 2010:
- How to be PP Slick
- AANA is Crazy
- How do I pick fellowship?
- Is this a good PP contract?
There are threads for all four of these subjects on the first page of the forum, right now. :)


SDN in 2020:
- Physicians acting crazy about Trump
- Physicians fervently denying a vaccine

Wtf happened to some of you? Were you always crazy and now feel safe to let it out post 2016?
In 2010 we had physicians acting crazy about Obama and there wasn't a swine flu vaccine to deny. :)
 
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doctalaughs

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Like I’ve said before, there is absolutely zero evidence to suggest that receiving the vaccine is in any way beneficial in preventing transmission.

  • The World Health Organization's chief scientist, Dr. Soumya Swaminathan, has urged people to be cautious with their behavior even after receiving a COVID-19 vaccine.
  • Swaminathan told a Monday briefing there was not yet enough evidence from vaccine trials "to be confident that it's going to prevent people from actually getting the infection and therefore being able to pass it on."
  • She added that at least for now, even people who had received the vaccine should still quarantine when traveling to countries with lower coronavirus transmission rates.
  • Vaccine researchers in the US are trying to determine whether vaccines can stop the virus from spreading or are effective only at preventing symptomatic cases of COVID-19.”

Sure there’s no proof yet, but history and understanding of immunology would suggest it does in some way at least lower transmission significantly. You can argue that mRNA vaccines are somehow different, I guess, but really they end up creating proteins that our immune system recognizes— same as all vaccines.

Regarding your stance, Ignoring morbidity completely, if your personal mortality risk is truly 0.09% (which is lower than probably 95% of physicians on here) I suppose I can understand an individual decision to hold off for now and wait.

On a population level it’s not a hard decision though. What is your personal risk cutoff of covid19 to actually face the “unknown” risks of the vaccine? 0.3%? 0.5%? 2%?

There are ALOT of obese people (or Even males or people over 30) that have a much higher relative risk than your stated risk.
 
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