Will you take the mRNA Vaccine Immediately When Available?

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Do you plan on taking either the Moderna or Pfizer mRNA vaccine immediately when available?

  • Yes

    Votes: 170 77.6%

  • No

    Votes: 49 22.4%
  • Total voters
    219
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AMEHigh said:
The society of maternal fetal medicine has released their statement on the Covid vaccine. Essentially they’re saying pregnant healthcare and essential workers should get the vaccines that are released and for everyone else they can’t specifically say to get it since they weren’t included in trials but they think it will be safe and recommend they start including pregnant people in trials. They’re saying to counsel patients that the theoretical risk of a mrna vaccine is likely low.

www.smfm.org

404: Page or Resource Not Found | SMFM.org - The Society for Maternal-Fetal Medicine

The SMFM is a Society of physicians and scientists who are dedicated to the optimization of pregnancy and perinatal outcomes.
www.smfm.org
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This is useful. Thank you.
Unfortunately, it seems like it is still a matter of rolling the dice.
 
La Cumbre Lines said:
The only time I was ever required to show proof of prior immunization (or antibody titers) was to enter medical school. I also don’t know if I could have refused at that time as I didn’t feel the need to.

I understand potentially not being allowed to fly on a plane with others if actively sick right now, but not sure I agree with demonstrating proof of immunization to fly.
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Sorry I thought you never required proof of immunization status to work at your hospital. I thought that was strange. I now realize I didn't read your post correctly.

Private business is different, they can do whatever the hell they want. If you want to fly from A to B and all carriers want official documentation that you have received a vaccine, then you either produce it, get one, or you don't fly.
 
La Cumbre Lines said:
I agree with many of the things you said. I read back over some posts and wanted to just add a few things for clarity and depth. Sorry for derailing the vaccine discussion a bit more.

I probably should have just said TB, as its airborne transmission is the most comparable, and its disease burden is the most silently high. I have a little experience with all 3 of those diseases as well as COVID-19. I’ve seen death from all of them. I think I subconsciously listed Malaria as I remember when we were semi-panicked about anyone coming from Africa with a fever automatically terrified it was Ebola. All the while we continued to forget about Malaria like we have often done. Scary things grab headlines and make us lose perspective. I included HIV, because I’ve had people close to me die from AIDS secondary to contaminated blood transfusions prior to there being available treatment. People with HIV at that time were treated like lepers with others afraid to touch them or even breath the air around them. I see that similar fearful expression now when people give someone with a cough a wary glance. Anyways, TB alone would have been the better argument as it relates to proof of testing prior to boarding a plane. I’ll admit too that I don’t really care about what an airline may or may not do in this regard. If passengers don’t feel safe they won’t fly and airlines’ business will suffer. Many people in first world countries are sadly barely aware of TB anymore even though it infects a decent percentage of the world’s population.

I still don’t agree with this. Maybe I don’t understand what you mean, or maybe it’s semantics. A huge number of people are afflicted by these 3 diseases. TB in particular has been around for forever. COVID-19 is much more likely to come and go.

I do agree with this. We shouldn’t ignore COVID-19. We should be conscious of it all.

If we didn’t experience sickness and death from COVID-19, then 2020 would have looked a lot different. When we experience these diseases personally it is more powerful than any random number or emotionless science. I’ve intubated hundreds of patients that I mostly forget, but I can remember a handful vividly years later. When a loved one dies whether it is from AIDS or COVID-19, that experience changes you. That’s why I think experience matters. We can see the data and form opinions, but when it strikes close to home the opinions garner strength through feeling.
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My thing is that, as Americans, even given the fairly low CFR we are much MUCH more likely to die of COVID than TB. Primarily because we have a literal cure for 99% of TB cases but also because the prevalence of TB is so low in this county.

Yes, TB worldwide is a huge problem and its pretty shameful that we don't care more about it, and yes it kills a pretty significant number of people worldwide as well BUT its just not a huge problem for Americans.
 
La Cumbre Lines said:
I also agree with most of this. Remember though that a cure is different than a mostly effective treatment. There are plenty of cases of patients with reactivation of the same TB years later following adequate treatment. MDR TB has become a major problem as well.
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Semantics. A cure doesn't have to be 100% effective to still be a cure.
 
thegenius said:
You don’t require proof of other vaccines? I remember during the cert process I had to get titers for hepatitis and measles / mumps, and had to get a booster for one of those.

I don’t know if I could have refused, but perhaps I could have.
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Yes you could have refused. you essentially sign an admin equivalent of an AMA form.

Make no mistake, requiring proof of vaccines is about protecting the hospital. Not you.
 
Should hospitals mandate vaccines and is it even legal for them to mandate that physicians need to have certain vaccinations??
 
@HoosierdaddyO
Should hospitals mandate vaccines? Yes.
Is it even legal for them to mandate that physicians need to have certain vaccinations?? I'm not sure, but seeing as we don't assume people have a positive right to be employed, I suspect it's not illegal unless it would constitute discrimination based on religion.
 
thegenius said:
There were two cases of possible autoimmune pathology in the trials using the mRNA vaccines. One person developed MS, another person developed transverse myelitis. I think both were deemed not to be caused by the vaccine, although how anyone can tell is beyond me.
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I think the case of TM was found to be in the control/placebo group. I didn't read about the MS case.
 
La Cumbre Lines said:
The only time I was ever required to show proof of prior immunization (or antibody titers) was to enter medical school. I also don’t know if I could have refused at that time as I didn’t feel the need to.

I understand potentially not being allowed to fly on a plane with others if actively sick right now, but not sure I agree with demonstrating proof of immunization to fly.
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Why not? Flying is a privilege, not a right. Do you think vaccination should be required for any activities at all? Like a flu shot at work?
 
HoosierdaddyO said:
Should hospitals mandate vaccines and is it even legal for them to mandate that physicians need to have certain vaccinations??
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Most hospitals require flu vaccination. They are a private business- they can require this, as it doesn't appear to violate any civil rights law, and they certainly have precedent with flu vaccines.
 
miacomet said:
Most hospitals require flu vaccination. They are a private business- they can require this, as it doesn't appear to violate any civil rights law, and they certainly have precedent with flu vaccines.
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I agree with you and do think hospitals are in their rights to mandate such vaccination. However, I do think it is worthwhile to point out that it's not necessarily as easy as saying they are private businesses so they can do what they want. (I know you are not saying this.) For example, we could craft a scenario where a vaccine is 51% effective, has a greater risk profile, is potentially dangerous to the fetus, etc. and then I think we would not be comfortable with hospitals enforcing such a vaccine across the board (such as to pregnant women or other such populations). I even think religious exemptions should be considered and possibly respected, not unconditionally and not across the board... but if reasonably possible.
It's all a balancing game.
 
GeneralVeers said:
Before this thread I would have considered taking the mRNA vaccine as I hadn't really researched it. Now, after reading this thread it sounds like they are injecting Borg Nano-probes into our bodies.....
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The new mRNA vaccines are by no means traditional. As was mentioned earlier, mRNA tech has only been used for Ebola and Dengue. The DengueVax caused national uproar in the Philippines.
The same major pharmaceutical corporations who tell physicians pain is the fifth vital sign are the ones asking for government protection for any adverse outcomes from the new vaccines, and we are talking about forcing all providers to take this after it hasn’t even been one year?



I’m all in support of prioritizing at risk persons and health care workers; they should be first in line to receive these new therapeutics if they want them. We also deserve to have a right of first refusal, pending further safety studies.
 
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Angry Birds said:
I agree with you and do think hospitals are in their rights to mandate such vaccination. However, I do think it is worthwhile to point out that it's not necessarily as easy as saying they are private businesses so they can do what they want. (I know you are not saying this.) For example, we could craft a scenario where a vaccine is 51% effective, has a greater risk profile, is potentially dangerous to the fetus, etc. and then I think we would not be comfortable with hospitals enforcing such a vaccine across the board (such as to pregnant women or other such populations). I even think religious exemptions should be considered and possibly respected, not unconditionally and not across the board... but if reasonably possible.
It's all a balancing game.
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it should be legal for hospitals to mandate vaccines for their employees.

but would they make a new covid vaccine mandatory upon release? Doubt it. That opens them up to massive massive liability and easy lawsuits if any bad vaccine effects are found out after the fact in the future. Especially when pharma companies have deals from gov granting them immunity from lawsuits. Lawyers have no other money to get except from those who force employees to covid vaccinate.
 
The other issue, like we're having at my hospital, is logistics. They can't mandate getting something if they don't have enough of it to go around in the first place.
 
La Cumbre Lines said:
You may have missed it. I also said:


No. As of now I don't feel vaccines should be mandated. My feelings aren't set in stone though. Are you going to force a vaccine upon someone who doesn't want it? If they refuse, are you going to incarcerate them? A hospital I have worked at has threatened in the past to discontinue hospital privileges if not immunized against influenza. I'm not sure if they would take this step or not, but the trade off is unemployment. That wasn't a trade off I was willing to risk. If private businesses want to do that then they have that right. I don't agree with it, but they are able to do that. There is no protection in the constitution as far as I'm aware that is being discriminated against. I don't agree with a governmental mandate requiring mass immunization. I certainly understand the argument regarding individual vs. societal protection and don't really want to have that debate. I think vaccines should be voluntary. I think people should want to take them on their merits and safety. Not because they are forced. I'm not a libertarian, but I agree with their views on individual freedom as it relates to mandated medical treatment. I have concerns regarding newer vaccine technology (feels like the wrong word choice?) and rushed development. I think those are fair and widespread concerns.
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They are all voluntary, although in some places one loses certain privileges, such as employment or public school.
 
La Cumbre Lines said:
In my opinion if it is truly voluntary then it shouldn't result in the loss of privileges. That doesn't feel fully voluntary. To play devil’s advocate, should you still be required to pay local property taxes towards public schooling if you instead decide to homeschool your children because you don't agree with 'voluntary' immunization that is required for your children to attend? Just so you know, I'd immunize my kids, send them to school and pay property taxes. I'm just making the case that in my opinion it isn't really voluntary in the full sense of the word if you still are required to pay local property taxes for services such as public schooling you aren't allowed to access because of making a 'voluntary' choice. In the same vein, I'd like to keep working as an EP. If hospitals state they require influenza immunization or you will lose your credentials, then I don't really have a choice. I need to keep working. Asking me to find another hospital that doesn't require immunization or change to a field outside of medicine at this point in my career isn't really practical. Like I've previously said, I receive the influenza immunization every year. I might still even if it wasn't 'required.' I just don't agree with the idea that you have a choice, but if you don't voluntarily comply then you lose something significant.
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I suppose the thought is that you lose privileges because you are endangering others, like a drunk driver losing his license.

What things should we lose privileges for, and what things shouldn't we?

Should someone have to have a medical license to practice medicine?
How about board certification; is that a fair requirement for a hospital to impose?

My point is that there are many, many things for which we lose privileges; why would not vaccinating (thereby endangering others) not be on the list?
 
Angry Birds said:
I agree with you and do think hospitals are in their rights to mandate such vaccination. However, I do think it is worthwhile to point out that it's not necessarily as easy as saying they are private businesses so they can do what they want. (I know you are not saying this.) For example, we could craft a scenario where a vaccine is 51% effective, has a greater risk profile, is potentially dangerous to the fetus, etc. and then I think we would not be comfortable with hospitals enforcing such a vaccine across the board (such as to pregnant women or other such populations). I even think religious exemptions should be considered and possibly respected, not unconditionally and not across the board... but if reasonably possible.
It's all a balancing game.
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Fair point, but I doubt that a hospital would decide to require a 51% effective vaccine. And if one did, I wouldn't want to work there.
 
La Cumbre Lines said:
The only time I was ever required to show proof of prior immunization (or antibody titers) was to enter medical school. I also don’t know if I could have refused at that time as I didn’t feel the need to.

I understand potentially not being allowed to fly on a plane with others if actively sick right now, but not sure I agree with demonstrating proof of immunization to fly.
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Proof of immunization to fly already happens.
You have to provide proof of yellow fever vaccine if coming and going from certain countries.
I once got stuck in Ethiopia because of this, I won’t go in to the long details, but yes airlines are very strict about certain rules because then they have to pay fines if they don’t comply.
 
La Cumbre Lines said:
You didn’t answer my question. Should you still have to pay local property taxes in my devil’s advocate scenario?

Your examples of a medical license and board certification aren’t equivalent arguments in my opinion. Those are qualifications verifying your ability to competently perform the job.

Surprise, like many vaccine discussions the debate just ended up going right to individual vs. societal rights.
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I don't see the property tax question as equivalent at all. I also think property taxes are a bad way to fund schooling.
I think not infecting patients is a prerequisite to being a good physician!
 
La Cumbre Lines said:
I agree that I don’t think property taxes are the best method for funding schools.

I didn't ask if it was equivalent. I asked if those not immunized should still have to pay taxes for services they don't receive. If you would say yes, then effectively you are attempting to disincentivize their choices through taxing those not immunized by precluding their ability to receive the services they help pay for. If you support that opinion, then my followup question would be: Do you support a tax on those not receiving an immunization against COVID-19. If so, I suspect you would be in the minority in that view given many in society say they wouldn't or are unsure if they would receive an immunization at this point. All of those people likely wouldn't support a tax. This is relevant, because it is somewhat comparable to the original individual mandate in the ACA. Rhetorically, can you try to force (or heavily incentivize if we need to get lost in the semantics) people to buy insurance through a fine/tax/mandate? Also rhetorically, can you force/incentivize people to receive a vaccine through a fine/tax/mandate?

You seem to imply that those not receiving immunizations are intentionally infecting patients and therefore are bad physicians. That comes across as self-righteous to me.
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Don't give the government ideas. Taxing people who don't get a COVID vaccine is essentially coercion (as was the ACA mandate). If they do that, then it opens the door for all sorts of coercive taxes on people. Taxes for obesity, medication non-compliance, eating junk food, or other behaviors that the government finds socially unacceptable will be next.
 
Don't give the government ideas. Taxing people who don't get a COVID vaccine is essentially coercion (as was the ACA mandate). If they do that, then it opens the door for all sorts of coercive taxes on people. Taxes for obesity, medication non-compliance, eating junk food, or other behaviors that the government finds socially unacceptable will be next.
 
La Cumbre Lines said:
I agree that I don’t think property taxes are the best method for funding schools.

I didn't ask if it was equivalent. I asked if those not immunized should still have to pay taxes for services they don't receive. If you would say yes, then effectively you are attempting to disincentivize their choices through taxing those not immunized by precluding their ability to receive the services they help pay for. If you support that opinion, then my followup question would be: Do you support a tax on those not receiving an immunization against COVID-19. If so, I suspect you would be in the minority in that view given many in society say they wouldn't or are unsure if they would receive an immunization at this point. All of those people likely wouldn't support a tax. This is relevant, because it is somewhat comparable to the original individual mandate in the ACA. Rhetorically, can you try to force (or heavily incentivize if we need to get lost in the semantics) people to buy insurance through a fine/tax/mandate? Also rhetorically, can you force/incentivize people to receive a vaccine through a fine/tax/mandate?

You seem to imply that those not receiving immunizations are intentionally infecting patients and therefore are bad physicians. That comes across as self-righteous to me.
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I think they may unintentionally be infecting patients. Therefore, they should get the vaccine or refrain from patient care.
 
La Cumbre Lines said:
Masks are reported to be extremely effective. I wear one every shift. So there is no possible way I could infect a patient if we are both wearing them.

I think all physicians should refrain from patient care for forever. We could give someone a hospital acquired infection at any time. That just can’t happen.
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It's true masks are effective. If you are wearing a procedural mask, though, you still run the risk of infecting a patient. I don't know anywhere that is supplying N-95s in the manner they are supposed to be used- single use, one per patient encounter. So we still run the risk of infecting patients, or getting infected ourselves. If you are using N-95s as they were designed to be used, more power to you.

A bigger concern of mine is that hospitals and the public really, really don't like masks (my system banned elastomerics because scary/Darth Vader) and that they will soon be discouraging masking.
 
miacomet said:
my system banned elastomerics because scary/Darth Vader
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That's a real shame. I work at one hospital where everyone (techs, nurses, radiology, physicians, NPs, PAs) was issued P100 half face masks, face shields, and glasses. They're worn for almost every patient and there is no pushback staff want to gown even for low(er) risk encounters. These were fit tested and cleaning supplies are provided. There haven't been any complaints and staff are much safer (I think). Every patient gets a mask too.
 
MechEDoc said:
That's a real shame. I work at one hospital where everyone (techs, nurses, radiology, physicians, NPs, PAs) was issued P100 half face masks, face shields, and glasses. They're worn for almost every patient and there is no pushback staff want to gown even for low(er) risk encounters. These were fit tested and cleaning supplies are provided. There haven't been any complaints and staff are much safer (I think). Every patient gets a mask too.
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We are only allowed procedural masks for any and all patient encounters unless it's an "aerosolizing procedure" in which case we are allowed a PAPR. So patients cough all over us when all we have are procedural masks.
 
La Cumbre Lines said:
Does anyone really feel significantly safer depending upon whether or not they wear a surgical mask, N95, face shield, PAPR, combination of several methods, or turn themselves into a bubble boy/girl? I don’t personally find myself feeling remotely any more protected no matter what I use and assume I may or may not become ill. I trust my general focus on health and believe that helps me more than any mask ever will. I’ve continued the same practice just like I always have done in the ED and abroad with exposure to many infectious diseases. Currently, I usually just wear a regular surgical mask for patient encounters even if COVID-19 positive and even though I have ready access to other better PPE options. I’ve seen so many people become infected including those religious about PPE. I still fully believe that we all are going to live the reality of 2019 which roared into the ‘20s. Just like when I’ve ever been exposed to other viral illness in the ED, I’ve found my immunity built up and kept marching on. I know several of you won’t like this post, but please just take a second to consider before dismissing outright.
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Wasted effort on your part. These people are terrified and will continue to be terrified of this virus. I hope they wear their N95s and PAPRs to Costco, when dining out and through their daily lives as well. Can't risk exposure to this thing under any circumstances!
 
La Cumbre Lines said:
Does anyone really feel significantly safer depending upon whether or not they wear a surgical mask, N95, face shield, PAPR, combination of several methods, or turn themselves into a bubble boy/girl? I don’t personally find myself feeling remotely any more protected no matter what I use and assume I may or may not become ill. I trust my general focus on health and believe that helps me more than any mask ever will. I’ve continued the same practice just like I always have done in the ED and abroad with exposure to many infectious diseases. Currently, I usually just wear a regular surgical mask for patient encounters even if COVID-19 positive and even though I have ready access to other better PPE options. I’ve seen so many people become infected including those religious about PPE. I still fully believe that we all are going to live the reality of 2019 which roared into the ‘20s. Just like when I’ve ever been exposed to other viral illness in the ED, I’ve found my immunity built up and kept marching on. I know several of you won’t like this post, but please just take a second to consider before dismissing outright.
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Your post is somewhat confusing. Your opening suggests that you don't think that wearing additional PPE will decrease your chance of contracting COVID from a patient. I don't agree with that statement, and yes, I feel like I'm less likely to get COVID if I'm wearing an N95 + faceshield while in a room with a COVID+ patient than if I were in there with only a surgical mask.

The last part of your comment though seems to imply that it isn't so much that you don't think that PPE prevents infections, it's that you don't care if you get COVID as you see this as being a likely benign infection for you. Presuming you're young and healthy, yeah, I agree. You'll probably be fine. I would also probably be fine if I got it as I'm also in the young and healthy camp.

My mentality is less "I can't afford to get this disease!" and more, "if I put this mask on, I'm less likely to get infected and subsequently infect my family." I don't personally see the latter as being in any way onerous, so that's what I do.
 
GeneralVeers said:
Wasted effort on your part. These people are terrified and will continue to be terrified of this virus. I hope they wear their N95s and PAPRs to Costco, when dining out and through their daily lives as well. Can't risk exposure to this thing under any circumstances!
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I mean, my hospital system requires procedural masks with potential flu patients, too, and there is decent data to back this up. I'm not super into febrile illness, so I follow the rules.

Much healthcare worker illness is community spread. There is decent data that a face shield really helps with a procedural mask, but if you don't care if you get Covid, then of course don't bother. It seems that they are finding more and more cognitive impairment in Covid survivors of all ages; I'd like to pass my recert so I'd prefer not to get sick.
 
miacomet said:
I agree. But it seems like many health systems have a standard of procedural mask plus face shield, no?
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Yes...is it not sufficient? The goal is not make it impossible to get an infection. The goal is to markedly reduce transmissibility in a relatively-cost effective manner.
 
thegenius said:
Yes...is it not sufficient? The goal is not make it impossible to get an infection. The goal is to markedly reduce transmissibility in a relatively-cost effective manner.
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That's a tough call. My health system also forbids personal PPE, which isn't reasonable.

Considering that prior to the pandemic the goal was to prevent infection completely, I'm not sure I agree, especially since elastomerics are not expensive and would prevent more infections. The fact that hospitals choose to sacrifice workers at all levels due to a misbegotten idea that elastomerics will decrease patient satisfaction- well, I'm not sure where to go with that.
 
miacomet said:
That's a tough call. My health system also forbids personal PPE, which isn't reasonable.
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This probably has everything to do with medical liability and lawyers. It's a world I don't live in.

miacomet said:
Considering that prior to the pandemic the goal was to prevent infection completely, I'm not sure I agree, especially since elastomerics are not expensive and would prevent more infections. The fact that hospitals choose to sacrifice workers at all levels due to a misbegotten idea that elastomerics will decrease patient satisfaction- well, I'm not sure where to go with that.
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Well I'm not going to get into the politics of wearing masks and the symbolism thereunto, and how hospitals want to market themselves and deal with patient complaints.

I've tried on one of those darth vader masks in the past and it was terribly uncomfortable. But I'm sure there are numerous models that are probably comfortable. Given that I (and you, and all of us) treat COVID on a daily basis for the past 9 months and I have not gotten sick yet should be general testament to the efficacy of using gloves, standard masking, donning and doffing PPE, etc.

Nothing is 100% effective. Not even the darth vader masks.

If I were on a hospital administrative committee I would put aside all complaints from patients about masks. Because the alternative would be a mass COVID-19 outbreak at a hospital and then the entire system has to shutdown. And what good is a shutdown hospital to a health care system in the middle of a pandemic.
 
GeneralVeers said:
Wasted effort on your part. These people are terrified and will continue to be terrified of this virus. I hope they wear their N95s and PAPRs to Costco, when dining out and through their daily lives as well. Can't risk exposure to this thing under any circumstances!
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I'm not "terrified".
I am concerned for the well being of others.
 
miacomet said:
I mean, my hospital system requires procedural masks with potential flu patients, too, and there is decent data to back this up. I'm not super into febrile illness, so I follow the rules.
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Fair enough. I do during flu season. I personally don't want to get sick with the flu (but I'm not scared of it).
miacomet said:
Much healthcare worker illness is community spread. There is decent data that a face shield really helps with a procedural mask, but if you don't care if you get Covid, then of course don't bother. It seems that they are finding more and more cognitive impairment in Covid survivors of all ages; I'd like to pass my recert so I'd prefer not to get sick.
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What are your numbers on cognitive impairment? I don't live my life in fear of low-chance theoreticals.
 
GeneralVeers said:
So you have locked yourself in your home and besides work go nowhere so that you can protect others? How long are you going to do that?
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It wouldn’t surprise me if this were the case, tbh. The Covid “fear porn” (as Dr Drew calls it) is an extremely powerful psychological tool.
 
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