adssx
#41
This is not only about unvaxxed people here but people with 1 dose vs 2 or 2 vs 3 etc. It’s true that the more vaxxed you are the more likely you are to be Covid conscious and therefore to get tested whenever you have the slightest symptom of a cold. So it there might be confounders here. We should read the whole paper to understand what that means.
This other paper published in the very serious NEJM also points to a modest and quickly decreasing protection even against death: Durability of XBB.1.5 Vaccines against Omicron Subvariants
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Davin8r
#42
Ok but that’s accurate according to my understanding. Cuts infection risk 30-50% for several months, cuts risk of hospitalization/death for longer. Cutting hospitalization/death by 70% and gradually decreasing to still almost 50% protection at 5 months is still worth it to me.
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@KarlT Absolutely brilliant response. Agree with you 100%. We understand this in a way very few people can have a perspective of, truly being in the environment where we see all this happen. This experience is real, and we understand, as we see and experience what the risk/benefit is of all this. The literature often confuses and doesn’t actually speak to what is happening - in addition to lagging behind.
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Cuts something by … I doubt the data … by 30-50% of infection. What about death? Disability? I’ve seen one new case of “long covid” in the last 12 months. Not so sure that is the top concern.
Again, at risk, vaccinate, but don’t think it is going to do much good, or harm right now based on what we see on the cutting edge with those who are actually dealing with this, diagnosing, treating, hospitalizing folks. We have a pretty good sense of what is going on. @KarlT is absolutely on point … the literature fails in so many ways. There also is a bias in what is published.
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Davin8r
#46
COVID infection is an incredibly rare event? Not in the USA, unfortunately.
I trust the data more than I trust anecdotes, even when I see them in the clinic myself. That’s the whole reason we do scientific studies in the first place rather than just basing our practice on the limited samples of patients we see every day. As Dr. Greger would say, “You don’t know until you…put it to the test.”
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Signed up for booster next week.
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amuser
#48
‘… don’t recommend vaccination for Covid except in high risk groups’
Is >60yo a high risk group? I would think so.
What is the benefit/risk ratio for this high risk group?
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AnUser
#49
Skipping the new shot is “a hazardous way to go,” because even if your last infection was mild, your next might be worse or leave you with symptoms of long COVID, said Dr. Robert Hopkins Jr. of the National Foundation for Infectious Diseases.
Dr. Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, recommends the updated COVID vaccines for high-risk groups.
“I believe the vaccines remain effective at decreasing risks of severe disease and long COVID, and should especially be considered in high-risk groups, including those with chronic diseases and the elderly,” he told Fox News Digital.
…
While the side effects of the vaccine have been “highly publicized,” Siegel stated that the risks of the virus — including myocarditis and brain fog — are far greater, and the vaccine decreases those risks.
@KarlT So Fox News is far left now like Eric Topol?
Have you reviewed the FDA approval published on Aug 22, and the studies they cite?
Not everything is lunatics and their ilk on X/Twitter and Facebook.
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Tim
#50
Covid is a devious little creature, highly resistant to broad generalizations.
Infection is common, death or disability currently with ongoing cases is rare.
I’d recommend listening to specialists like myself who are on the receiving end of all this. ER Physicians know what is happening in the community like virtually no one else, whether it be infection, drugs, trauma, new gang in town … we see it all. It’s not anecdotes … but I do note that individuals increasingly don’t appreciate true expertise, and consider a google search to be superior. Much of my reason for stopping practicing in the current environment and moving to concierge longevity medicine.
We are the site where 100% of admissions for covid occur from. @KarlT works in the ER, and I work in high volume urban and rural ER’s (plus in my own primary/longevity practice). Simply telling you the experience in a high volume ER setting in an area where we have lots of covid infections.
Anyway, this is not a political issue for me, I could care less about the craziness on each side - but in practicality, this is currently a cold for most individuals … it wasn’t at the beginning of this mess.
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Comorbidities are everything here - age is a huge factor, but obesity, diabetes, inactivity … poor t cell immunity. In my current state of health if I were 20 years older (I’m 56 now) I’d not bother taking a vaccine - add some comorbidities - absolutely. But then you’re at risk of death from all manner of things at an elevated risk.
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AnUser
#53
I’ll be having both the updated 2024-2025 covid vaccine, and the flu vaccine. Easy decision.
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I prefer an educated immune system and will get another Covid vaccination (5 so far both Pfizer and Moderna) when it becomes available.
Same for seasonal flu.
Had my shingles and pneumococcal vaccines. And every childhood vaccine.
When the cancer vaccines become available I will get those as well.
And we are still in the top 100 in the RO!!!
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Davin8r
#55
But @KarlT said that vaccine boosters “won’t stop an infection” (when in fact they can) and dismissed anyone with differing opinions as “political”. If that’s an expert opinion, I’d rather trust Google. How would HE know if an infection had been stopped by a vaccine? After all, you only see the sick people in the ER, not the ones who never caught it because they got a booster. This is why scientific studies are done – so we can carefully and methodically examine rates of infections in boosted vs unboosted populations.
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@Davin8r first thing - you are great … and understand where you are coming from. You’d have a different perspective if in the midst of things in real time, rather than seeing literature that represent how things were a year ago or more; and often with some biases.
My experience early on was vaccine status was helpful - as we’ve gone forward with this, it has been less of a factor. But again, see lots of covid, see little critical disease from covid. It is much to do about little right now. 2020 … absolutely terrifying. The euphoria from getting pfizer #1 on December 19 and 20 days later vaccine #2 … as first in the line of priority.
It simply isn’t that type of problem anymore. It has evolved - the literature lags behind.
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amuser
#57
flu vaccine. Easy decision.
Good chance it’s useless, but why not. https://archive.fo/Xz6pZ
The results were also so unexpected that many experts simply refused to believe them. Jackson’s papers were turned down for publication in the top-ranked medical journals. One flu expert who reviewed her studies for the Journal of the American Medical Association wrote, “To accept these results would be to say that the earth is flat!” When the papers were finally published in 2006, in the less prominent International Journal of Epidemiology, they were largely ignored by doctors and public-health officials. “The answer I got,” says Jackson, “was not the right answer.”
KarlT
#58
Even if vaccinated, you will still get infected. You will have antibodies from the vaccine for 2-4 months which will immediately fight off the virus until you t cells fire up. You may not even feel sick but the virus is in you and you can transmit it to someone else.
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KarlT
#59
The FDA’s number is based on cases for the entire population. That data does very little for an individual. If you’re a 70 yo woman your risk of myocarditis is essentially zero, and you may benefit from the vaccine. But if you’re a 19 yo man, myocarditis risk is 1 in 8-12,000. That’s still small, but it should be zero because 19 yo men should be required to get vaccinated because their benefit is very small.
The risk of myocarditis is significantly higher with the Moderna vaccine. As much as 5x than from getting COVID.
And lastly, the risk of myocarditis from a COVID infection is likely exaggerated as the denominator is unknown.
As far as the CDC and FDA, both agencies can no longer be fully trusted as they are now controlled by politicians and pharmaceutical companies.
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KarlT
#60
And, so you don’t think @DrFraser is alone in his experience, I too have not admitted, or seen any patient be admitted because of Covid in well over a year. Here again, the data is misleading. If a patient gets admitted for any reason if they test positive for Covid, they may get counted as a Covid admission.
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Davin8r
#61
The virus has evolved to become much more contagious, but are you saying it also has become less virulent? If so, I haven’t seen anything about that. My understanding is that short-term hospitalizations and deaths are so much lower now thanks to the fact that nearly everyone has had at least one past infection and/or one or more vaccines. Since I’ve never had the infection (as far as I know), I’m relying on the vacc (and the portable HEPA filters that I keep in my patient exam rooms). I do have a stash of metformin ready to go, just in case.
My main concern is potential long-term effects of the virus on cardiovascular and neurological health, even in the absence of “long COVID” symptoms. Just too many unknowns there.
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