General COVID-19 Vaccine Discussion

[Flashback]

Plus our vaccines are pretty much perfect, aren’t they? Given I’ve either got or recovered from it at the moment (depending on which country you’re in - amazing how that makes a difference) I can say the worst symptom was maybe a sore throat that I may have imagined when trying to justify how horrible it’s supposed to be.

We’ve gone from world ending, lock every country up pandemic to not even a scratchy throat. I’d say the vaccines are pretty damn good. What more do we want? Are we back on that eradication/covid zero train again?

That's not the case for all, though. My sister recently had COVID (was triple jabbed) and was rather ill.... more than just a scratchy throat.

 

[drron]

And whilst we have thought of our own safety in the West Africa is reaping the price of our solitary focus.

In Malawi, where polio vaccine coverage is high – above 90% in most districts – rates during the pandemic fell by 2%, according to Janet Kayita, WHO Malawi head. She said the child who was paralysed had one dose of the polio vaccine at birth, but not the other doses needed for full protection.

Even in Israel they have not followed up with full vaccination for polio and the disease has happened there as well.

Vaccine-derived polio, a form of the disease stemming from incomplete vaccination coverage, is more widespread globally, and recent outbreaks have sparked concerns about how the coronavirus pandemic may have hit vaccination coverage.

Israel is battling an outbreak of vaccine-derived polio, its first since the 1980s, after a case was discovered in Jerusalem last week. Almost 12,000 children have since been vaccinated.

Ukraine reported its first vaccine-derived polio case in five years last year, but urgent efforts to curb the outbreak were halted after the Russian invasion on Feb. 24.

'Dangerous moment:' huge effort begins to curb polio after Malawi case

The world is at a 'dangerous moment' in the fight against diseases like polio, a senior World Health Organization official said, as efforts begin to immunize 23 million children across five African countries after an outbreak in Malawi.

www.reuters.com

It was not as if we weren't told.

COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO, UNICEF data shows​

23 million children missed out on basic childhood vaccines through routine health services in 2020, the highest number since 2009 and 3.7 million more than in 2019​

15 July 2021

COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO, UNICEF data shows

23 million children missed out on basic childhood vaccines through routine health services in 2020, the highest number since 2009 and 3.7 million more than in 2019

www.unicef.org

 

[Lynda2475]

Fail to see the connection between aussies having a 3rd covid vaccine dose and africians failing to get their polio vaccination, its not like polio vaccinations were diverted away from Africa to Australia. The two are unrelated imo.

But I agree that too many other health initiatives have suffered i.e. routine cancer screening and elective surgeries because of a total over raction to covid in the west.

 

[N860CR]

That's not the case for all, though. My sister recently had COVID (was triple jabbed) and was rather ill.... more than just a scratchy throat.

It does seem to be the case for the vast majority, though. It’s not all that different to the flu vaccine. Some will obviously get a bit unwell.

I think we’ve someone managed to get our expectations a little high. Maybe one day we’ll have a vaccine that turns a covid infection into rainbows shining out of your nostrils, but it’s not happening overnight. Especially given so much of the world hasn’t even received the current vaccination.

 

[Pushka]

Received our first notification today of a major SA client requiring a booster to be allowed onsite.

 

[drron]

I am starting to get concerned about the "evidence" for a 4th shot.
The initial study of the 4th shot in HCW in Israel wasn't great for effectiveness against breakthrough infection. It only was significant for over 60s,

https://www.nejm.org/doi/full/10.1056/NEJMc2202542?query=featured_coronavirus

https://www.nejm.org/doi/suppl/10.1056/NEJMc2202542/suppl_file/nejmc2202542_appendix.pdf

Now if a new drug is trialled and the results don't reach statistical signicance that drug basically needs new larger trials or is forgotten.
Well the Israelis went with a new larger trial which did show effectiveness and on that basis the CDC has approved a 4th dose at least 4 months after the third dose,

https://dgalerts.docguide.com/ncov-home/article/fda-authorises-second-booster-dose-of-2-covid-19-vaccines-for-older-and-immunocompromised-individuals-1

However you will note that larger study was of 700000 Israelis 600000 of them over 60. Talk about selecting your study patients to get the result you wanted.
What concerns me is that this didn't worry the CDC Why is it so? Is it because Pfizer and Moderna are US businesses? I mean they approved the US adenovirus vector vaccine but not the UK based one even though side effects basically the same and the UK product was cheaper and studied in far greater numbers.

 

[Pushka]

I am starting to get concerned about the "evidence" for a 4th shot.
The initial study of the 4th shot in HCW in Israel wasn't great for effectiveness against breakthrough infection. It only was significant for over 60s,

https://www.nejm.org/doi/full/10.1056/NEJMc2202542?query=featured_coronavirus

https://www.nejm.org/doi/suppl/10.1056/NEJMc2202542/suppl_file/nejmc2202542_appendix.pdf

Now if a new drug is trialled and the results don't reach statistical signicance that drug basically needs new larger trials or is forgotten.
Well the Israelis went with a new larger trial which did show effectiveness and on that basis the CDC has approved a 4th dose at least 4 months after the third dose,

https://dgalerts.docguide.com/ncov-home/article/fda-authorises-second-booster-dose-of-2-covid-19-vaccines-for-older-and-immunocompromised-individuals-1

However you will note that larger study was of 700000 Israelis 600000 of them over 60. Talk about selecting your study patients to get the result you wanted.
What concerns me is that this didn't worry the CDC Why is it so? Is it because Pfizer and Moderna are US businesses? I mean they approved the US adenovirus vector vaccine but not the UK based one even though side effects basically the same and the UK product was cheaper and studied in far greater numbers.

But isn't it that the fourth shot is simply only effective for over '60's? Both studies showed that. And that's the only age group approved.

 

[drron]

But isn't it that the fourth shot is simply only effective for over '60's? Both studies showed that. And that's the only age group approved.

The CDC says 50 and over plus immunocompromised who basically are the most in need.

 

[mviy]

Well I plan to have a fourth late May/early June to maximise my protection for international trips over the following few months.

 

[Lynda2475]

But isn't it that the fourth shot is simply only effective for over '60's? Both studies showed that. And that's the only age group approved.

Exactly under 60s arent allowed to get a 4th dose in Australia unless imuno compromoised (and then for them its 3 doses to be considered fully vacinated, so the 4th dose is actually just their first booster).

My parents will be 4 months post booster in last week of April (2 AZ and 1 Pfizer so far), Ive made them book into GP to agree whetehr they should do flu shot last week of April, then 4th covid dose in mid may or vice versa; and to talk about which vaccine.

 

[Pushka]

Exactly under 60s arent allowed to get a 4th dose in Australia unless imuno compromoised (and then for them its 3 doses to be considered fully vacinated, so the 4th dose is actually just their first booster).

My parents will be 4 months post booster in last week of April (2 AZ and 1 Pfizer so far), Ive made them book into GP to agree whetehr they should do flu shot last week of April, then 4th covid dose in mid may or vice versa; and to talk about which vaccine.

I’ve had the flu shot and am due for 4th booster (age) after April 9. Travelling to UK mid May. No brainer.

 

[Lynda2475]

So despite some here arguing against the need for 3rd dose/booster SA have released real world statistics showing that actual death rate is 3* higher in unvaccinated as it is for those with 3 doses:

"Our local SA data shows that adults who are triple-vaccinated have the most protection against severe impacts of COVID-19, including a very low risk of death at 0.05 per cent.

"Adults who are partially vaccinated (one or two doses) have double the chance of dying if they contract the disease and adults who are completely unvaccinated have triple the chance of dying, compared to those with three doses."

'Triple the chance of dying': New SA Health data reveals COVID-19 risk for unvaccinated

Unvaccinated people are more than three times as likely to die from COVID-19 than are those with three doses, according to new data released by South Australian health authorities.

www.abc.net.au

 

[kangarooflyer88]

So despite some here arguing against the need for 3rd dose/booster SA have released real world statistics showing that actual death rate is 3* higher in unvaccinated as it is for those with 3 doses:

"Our local SA data shows that adults who are triple-vaccinated have the most protection against severe impacts of COVID-19, including a very low risk of death at 0.05 per cent.

"Adults who are partially vaccinated (one or two doses) have double the chance of dying if they contract the disease and adults who are completely unvaccinated have triple the chance of dying, compared to those with three doses."

'Triple the chance of dying': New SA Health data reveals COVID-19 risk for unvaccinated

Unvaccinated people are more than three times as likely to die from COVID-19 than are those with three doses, according to new data released by South Australian health authorities.

www.abc.net.au

What about those who have received four doses of the COVID vaccine such as will be yours truly in a couple of hours?

-RooFlyer88

 

[mviy]

What about those who have received four doses of the COVID vaccine such as will be yours truly in a couple of hours?

-RooFlyer88

We'd be mainly relying on overseas data at this stage except for the immunocompromised, one would think. Comparing data between those who have had it versus those that have not needs to be done over a period of time.

 

[andye]

Worth remembering when comparing infection, hospitalisation and mortality rates that the undervaccinated, vaccinated and overvaccinated are different types of people

E.g
Unvaccinated are likely to be younger but also less likely to get a test
4-dosed are likely to have comorbidities or have cautious personalities
There is also the survivor effect-a reasonable proportion of frail unvaccinated will have already died

Makes the comparisons unwieldy and often leads to people picking data to confirm their own world-view

 

[Lynda2475]

What about those who have received four doses of the COVID vaccine such as will be yours truly in a couple of hours?

Not included in the data because virtually no one in Aus has had 4 doses to date, if any of this small hve dies assume would be counted under the 3 doses.

Worth remembering when comparing infection, hospitalisation and mortality rates that the undervaccinated, vaccinated and overvaccinated are different types of people

Sometimes but not always.

The under 5s (only age group not eligible for vaccination) are not counted as unvaccinated, but rather reported separately as ineligible and i think only 2 deaths in this group.

There are genuinely unvaccinated people in the over 12s who have chosen not to vaccinate and their mortality rate is higher than those with 1, 2 or 3 doses.

 

[drron]

So despite some here arguing against the need for 3rd dose/booster SA have released real world statistics showing that actual death rate is 3* higher in unvaccinated as it is for those with 3 doses:

"Our local SA data shows that adults who are triple-vaccinated have the most protection against severe impacts of COVID-19, including a very low risk of death at 0.05 per cent.

"Adults who are partially vaccinated (one or two doses) have double the chance of dying if they contract the disease and adults who are completely unvaccinated have triple the chance of dying, compared to those with three doses."

'Triple the chance of dying': New SA Health data reveals COVID-19 risk for unvaccinated

Unvaccinated people are more than three times as likely to die from COVID-19 than are those with three doses, according to new data released by South Australian health authorities.

www.abc.net.au

And 4-5 months later that effect is lost from US and Israeli studies. As well shows that not enough have had Covid in South Australia as the UK studies show that those unvaccinated but having had covid are very little different in risk to triple vaccinated. And indeed if they have had just 1 dose of vaccine plus natural infection have a lower risk than triple vaxxed and any extra doses have no extra effect.

 

[Lynda2475]

Well Dr Ron we can agree to disagree, I do not share your pessimism that boosters are ineffective. And I believe local real world evidence is more relevant than overseas studies wrt to how things pan out here. Despite rising cases our CFR is not increasing and this is due to high vaccination rate.

I know you are also not a fan of kids getting the jab but "a recent US study had found vaccinated children were much less likely to be diagnosed with the potentially deadly inflammatory disorder, which usually manifested within two to six weeks post-COVID" so another reason kiddies should get the jab even if they don't get that sick (noting kids don't get that sick from chicken pox either but that vaccine forms part of no jab no play policy).

2 weeks ago i attended the office on same day as a positive, I was only person in our hot desk area who did not subsequently get covid despite having my booster just under 4 months ago, which according to you should mean i have basically no protection left.

Now genetics may also be a factor, because my BIL had covid in January and yet my sister did not catch it despite sharing a bed during his infective period, and a bathroom during his iso period (obviously once diagnosed he needed to sleep in the spare room).

Prior to late December I only knew two people who had had covid (both in USA and had it early 2020, pre vaccination). In last 4 months many people I know of locally have had covid, but due to vaccination none have been seriously ill or hospitalized and none have died. Whilst vaccine may not prevent transmission it is doing its job by stopping vast majority from becoming seriously ill or dying. Almost all deaths have been in unvaccinated or those with serious underlying health condition (usually also of an advanced age), so i still support vaccination.

Remember Australia has had no excess deaths due to covid, deaths actually declined during the covid period.

 

[Pushka]

I can give several examples in the family and friends family where members have had three vaccines and very much within a two month window of the last one and they have developed Covid. I’ve had four and latest flu.

 

[VPS]

I can give several examples in the family and friends family where members have had three vaccines and very much within a two month window of the last one and they have developed Covid. I’ve had four and latest flu.

What did you have for your booster. I was going to try and search in a thread somewhere but it's easier to ask you

I've had AZ AZ and Pfizer and due for fourth booster in 2 weeks so not sure what to have. @drron - any comments?