COVID-19 treatment and vaccine update thread

[Default]

Thanks for posting on the J&J/Moderna booster mixing. Now to see if my job qualifies me for getting one.

[Daehawk]

Dont any plans to mix mine. Going to just try and get Pfizer like before.

[paulbaxter]

An acquaintance of mine just hit her one year mark with long COVID. I havent kept up much with her, but it was sad seeing what's been going on with her. Here's part of what she wrote.

Most days I still feel like shit, mostly inflammatory related crap. Today my ears, teeth, jaw, and glands hurt in addition to a severe headache. My sinuses are bothering me and I am irritable and struggling to focus. My memory is impaired. For a year, normal activities and exercise has been completely out of reach - when I try to ease my way back in, it takes days to recover from severe joint pain and exhaustion. I try to do the things I love like hiking and dancing. I just can't. My chest tightens, my legs shake and buckle. Then I cry bc I just want to be back to normal. My sense of taste and smell has been completely out of whack for a year - not gone anymore, but altered in a super bad way - most fruit tastes rotten, coffee and other loves taste and smell like cigarettes and poop. Garlic and onion smells and tastes like rank BO. Phantom smells. I rarely go to even the safest social events I want to attend, bc I feel like shit.

[Default]

Dont any plans to mix mine. Going to just try and get Pfizer like before.

I didn't have an option.

[Smoove_B]

Mix and match is coming:

The Food and Drug Administration is planning to allow Americans to receive a different Covid-19 vaccine as a booster than the one they initially received, a move that could reduce the appeal of the Johnson & Johnson vaccine and provide flexibility to doctors and other vaccinators.

The government would not recommend one shot over another, and it might note that using the same vaccine as a booster when possible is preferable, people familiar with the agency’s planning said. But vaccine providers could use their discretion to offer a different brand, a freedom that state health officials have been requesting for weeks.

The approach was foreshadowed on Friday, when researchers presented the findings of a federally funded “mix and match” study to an expert committee that advises the Food and Drug Administration. The study found that recipients of Johnson & Johnson’s single-dose shot who received a Moderna booster saw their antibody levels rise 76-fold in 15 days, compared with only a fourfold increase after an extra dose of Johnson & Johnson.

[ImLawBoy]

Positive case in my daughter's class! Yippee!

So her class is now quarantining for 10 days with remote learning, but her twin in the other second grade class is still at school. Meanwhile we're trying to keep her separated from her big brother, who is scheduled for major surgery in 2 weeks.

The good news is that she's not showing any symptoms right now. We'll get her tested soon (may use a home test if we start seeing anything suspicious), but hopefully this won't amount to much for us.

We did a home test on Saturday that came out negative. I just took her for a lab test, also negative. I haven't heard of any other positives from either her class or the school, so that's good. At this point, she'll go back to school on Monday.

[El Guapo]

My brother's son (12) tested positive on Monday. He's fully vaccinated, and sounds like he has mild symptoms. He's severely autistic (which sounds weird to say, but I'm not sure how else to say it), so my understanding is that partly as a result my brother and his wife have a hard time getting him to keep his mask up, which probably didn't help. Sounds like he's doing ok, at least.

[FishPants]

Well somehow Ontario seems to have it's shit together, and we are near the bottom of the pack in all of north america (here's a great resource updated daily that compares all states and provinces.

I'm starting to believe this may be the end of the road of the virus in Ontario with our population at 83.7% fully vaxxed (of 12+). This is near 2 weeks post thanksgiving here as well, and full hockey game attendance, concerts open etc (all with vax passport requirements). Who knew, vaccines actually work!

[gbasden]

He's severely autistic (which sounds weird to say, but I'm not sure how else to say it),

That sounds like a totally reasonable way to say it. My son is autistic, but doesn't exhibit a lot of the classic symptoms of autism. I would expect someone who is severely autistic to need additional assistance with daily living and show more physical symptoms.

[Kraken]

He's severely autistic (which sounds weird to say, but I'm not sure how else to say it),

That sounds like a totally reasonable way to say it. My son is autistic, but doesn't exhibit a lot of the classic symptoms of autism. I would expect someone who is severely autistic to need additional assistance with daily living and show more physical symptoms.

My best friends' granddaughter is going on 7 years old and has never spoken or eaten solid food. They've never offered a label for that, but she's my benchmark for "severely autistic."

[dbt1949]

It's odd but when I was a kid there were no "anti-vaxers" except for Christian Scientists.
I wonder when people started to change.

[Max Peck]

It's odd but when I was a kid there were no "anti-vaxers" except for Christian Scientists.
I wonder when people started to change.

As I understand it, the surge in anti-vax activism largely traces back to Andrew Wakefield's paper that falsely linked the MMR vaccine with autism.

[Blackhawk]

So, Andrew Wakefield is arguably responsible for hundreds of thousands of unnecessary deaths.

It makes me wish I was Christian, just so I could believe there would be consequences.

[Smoove_B]

If anyone would like to watch a most-excellent documentary on the subject - one that likely needs another update (it's been updated 2x since it was released almost a decade ago), check out The Vaccine War.

You might even see some people you know (not just Dr. Jenny McCarthy!).

But yes, the Wakefield paper is likely the event that started the current trajectory - namely in how it attracted celebrities and politicians to the cause, amplifying the (incorrect) message.

[Kraken]

It's odd but when I was a kid there were no "anti-vaxers" except for Christian Scientists.
I wonder when people started to change.

A 1901 smallpox epidemic, a charismatic quack, and the rise of anti-vax propaganda in Boston (Might be paywalled...I'm a subscriber so IDK)

The relevant bit:

From the time smallpox inoculations were pioneered in Boston in 1721 by Dr. Zabdiel Boylston and preacher Cotton Mather — who first learned of the practice from a West African man named Onesimus whom he enslaved — they had proven controversial. Even by 1901, opposition remained stiff among an entrenched minority of Bostonians.

Anti-vaccination activists in Boston responded to mandatory inoculations with a brochure entitled “Vaccination Is the Curse of Childhood.” It falsely claimed that the vaccines caused smallpox instead of preventing it, and maintained that the only real way to prevent infection was “good drainage, good ventilation, pure water and healthy food.” Anti-vaccinationists, as they were called, branded compulsory vaccination an infringement on their civil rights. And they implored parents to write to a Beacon Street address to receive physician-signed certificates that indicated their children were “unfit subjects for vaccination,” and should be exempt from the state requirement to show proof of vaccination to attend public school.

By January 1902, more than 80 percent of the city’s 586,000 residents had been vaccinated, but that still didn’t appear to be enough to reach herd immunity. Durgin grew increasingly frustrated by the tens of thousands of unvaccinated Bostonians who allowed the epidemic to linger. The number of cases in Massachusetts had grown from around 100 in 1900 to 773 in 1901, with 97 deaths. The new year ahead held the threat of even more.

The smallpox outbreak had become an epidemic of the unvaccinated, with those not inoculated accounting for 9 out of every 10 cases in Boston’s so-called pesthouses. “I have no patience with those who say vaccination is useless and harmful,” Durgin told The Boston Post. “I wish the smallpox would get into their ranks instead of among innocent people.”

It's a very interesting story, but too long to paste the whole thing in here. Point being that anti-vaxxers have always been with us.

[Smoove_B]

It's a very interesting story, but too long to paste the whole thing in here. Point being that anti-vaxxers have always been with us.

They have. The difference now is their ability to monetize the movement and take advantage of social media.

In other news:

A very brief guide to mixing boosters, in descending order of antibodies:

3 shots of Moderna = Best
Pfizer → Moderna = Next best
Moderna → Pfizer = Also very good!
J&J → Moderna = Do it
J&J → Pfizer = Yes
J&J → J&J = Get Moderna or Pfizer instead

[Isgrimnur]

Poor J&J. I sure hope that multinational corporation can survive this horrible break.

[RunningMn9]

Why doesn’t that list include three shots of Pfizer juice? How does that compare to three shots of Moderna juice?

[Smoove_B]

Why doesn’t that list include three shots of Pfizer juice? How does that compare to three shots of Moderna juice?

Not as good.

The combos above produce the highest levels of protection, ranked in order highest to lowest.

I'm guessing 3 Pfizer shots is #4 on that list, which is why they were recommending Pfizer people should get a Moderna.

All that being said, I'd need a big brain to suss out the actual benefits of mixing and matching based on specific demographics and ultimate levels of protection conferred. It might be relatively small percentages and if I had to guess, the benefits are greatest for those at the highest risk levels.

It's ok if you're not on team Moderna like me. I'll still hang out with you. Eventually.

I think it's likely more important for the J&J crew to get another shot ASAP rather than most people getting a 3rd shot of anything. And if J&J people are getting a second shot (and they should be), they should be given Moderna if possible.

EDIT: Yeah, here you go - I mean, 96% is pretty impressive. Not Moderna impressive, but pretty good.

Wow, a Pfizer booster shot results in 96% efficacy against *infection*, relative to *already double-vaccinated people*, and *during the Delta wave*.

So a booster gives more protection against Delta than the two-shot regimen gave against original covid.

[Kraken]

It's a very interesting story, but too long to paste the whole thing in here. Point being that anti-vaxxers have always been with us.

They have. The difference now is their ability to monetize the movement and take advantage of social media.

Allow me to quote most of the rest of the linked story for the benefit of all who were stymied by the paywall. Our villain, Dr. Immanuel Pfeiffer, was the flamboyant leader of the anti-vax crowd and a shameless self-promoter.

The contents of his 48-page monthly magazine, Our Home Rights, were as eclectic as the editor himself. It carried advertisements from magnetic healers and psychics and regular columns on astrology and women’s rights, as well as the evils of saloons, eating meat, and the American tax code. Pfeiffer saved his strongest opinions to rail against the smallpox vaccine. He assailed compulsory vaccinations as a violation of civil liberties and thought smallpox to be not nearly as contagious or debilitating as health officials claimed.

The pages of Our Home Rights reeked of misinformation about the vaccine. Not only did Pfeiffer claim that it offered no protection, but he considered vaccination more dangerous than smallpox itself, which he attributed to bad hygiene and intemperate habits. He told readers that the syphilitic hands of cow milkers were the original source of the vaccine material and claimed doctors were solely vaccinating patients to enrich themselves. He printed gory tales of Bostonians who suffered serious illness after receiving the vaccination, including a 2-year-old who died from septic abscesses on her shoulder and a young department store worker whose arm had to be amputated.

The protagonist of our story, Dr. Samuel Durgin, was the local Fauci of his day.

In the fall of 1901, Durgin mobilized a massive response to the smallpox epidemic that included free vaccinations at locations around the city. Under an 1855 state law that gave local health boards the power to force people to be inoculated, hundreds of doctors went door-to-door. Anyone who refused could face a 15-day jail sentence or $5 fine, the equivalent of roughly $160 today. Durgin wasn’t shy about employing heavy-handed tactics. He dispatched “virus squads” to rooming houses, where police officers pinned down occupants so that physicians could administer vaccines. One man received his vaccine, as well as stitches for a gash on his head left by a police officer’s club.

Even as his all-out campaign began to show results, Durgin believed that some of his fellow Bostonians were traitors to the cause. That antagonism would lead to one of the country’s earliest vaccine fights.
...
Exasperated by the anti-vaccination campaigners, Durgin made an unprecedented decision: He would call their collective bluff with a high-stakes dare to willingly expose themselves to smallpox.

“If there are among the adult and leading members of the antivaccinationists any who would like an opportunity to show the people their sincerity in what they profess,” he announced in The Boston Globe, “I will make arrangements by which that belief may be tested . . . by exposure to smallpox without vaccination.”

“I do not believe there is a man or woman among them who will volunteer to take an exposure to smallpox,” Durgin continued. He couldn’t have expected anyone to take him up on his offer. But he didn’t count on Dr. Immanuel Pfeiffer.

Pfeiffer contracted smallpox, made a great show of spreading it around, disappeared, nearly died, then recovered.

PFEIFFER SURVIVED his bout of smallpox, and so did his crusade. After five weeks of quarantine, the doctor emerged to pronounce himself “as strongly opposed as ever to vaccination.” In fact, he continued to question the necessity of vaccines since none of the other family members isolating alongside him contracted smallpox before they were vaccinated. When he resumed publication of Our Home Rights, he described neighbors who became sick after they rushed to get their shots based on what had happened to him.

Pfeiffer also insisted that his own case was none too serious, which he baldly presented as evidence that public health officials exaggerated the disease’s potency. “I laughed and told jokes and played games most of the time, and the disease of small-pox, dreadful as it is said to be, never caused me pain for one minute,” he boasted. He insisted that he had contracted smallpox because he had been overworked, not because he had been unvaccinated.
...
Anti-vaccination propaganda, however, was here to stay. In 1926, a proposed state mandate to require vaccination for private school students was stopped by anti-vaccination activists. The holding power of their dangerous message was something the Massachusetts Board of Health had warned about years earlier, at the end of the Pfeiffer affair. “Boston is practically a hot-bed of the anti-vaccine heresy,” the board reported in 1903. “Although the vaccine house is built upon a rock, and is not likely to fall, the noisy storm has frightened many of our people into a dangerous neglect or opposition to vaccinal protection.”

So he may not have had social media and national reach, but his playbook is still in use 120 years later by those who do.

[FishPants]

Lol so now mixing is acceptable because America says so? I'm kind of getting tired of this political moving target bullshit - but at least I don't have to worry if work drags me south of the border in the new year.

Things are looking good here, assuming kids can get vaccinated here soon (the request is made, some people are saying it could be a couple of weeks before we approve 5+ on Pfizer) - I think it's more likely sometime mid/late November... Still it would be great to see kids with a single shot at least before Christmas.

Apparently the feds here quietly removed the "non essential travel advisory"; which means travel insurance is back into play (I'm sure with a rider for only fully vaxxed people). Looking at the deals in Greece right now for next summer, the price is about half of what we booked a few years back before my mom passed away (travel insurance covered that as it was right before departure)... This is some place Amy and I have wanted to travel since our honeymoon, and every time we booked it some shit hit the fan and we didn't go.. At this point we figure we might as well book it, and save any of these new variants causing a major issue - just go. She's flown close enough to the sun for both of us to realize time is very finite.

The next question is do we bring our kids along (fully vaxxed as well) or leave them here with the inlaws and dogs! Things are looking up, I hope it keeps on this trajectory, it's been a long ten years of stress - the last two were the cherry on top. Nice to look forward to something again.

[Defiant]

What booster should I get?

[malchior]

A very brief guide to mixing boosters, in descending order of antibodies:

3 shots of Moderna = Best
Pfizer → Moderna = Next best
Moderna → Pfizer = Also very good!
J&J → Moderna = Do it
J&J → Pfizer = Yes
J&J → J&J = Get Moderna or Pfizer instead

I really appreciate the Atlantic. Great coverage always and you can't impeach their integrity either. It also points at the weird weave of our society. This coverage has grants from the guy arguably behind the biggest font of anti-vax propaganda and an organization of the same pedigree as one of the vaccines. Strange times.

The Atlantic’s COVID-19 coverage is supported by grants from the Chan Zuckerberg Initiative and the Robert Wood Johnson Foundation.

[Unagi]

I guess J&J should just stick to shampoo.

[Smoove_B]

I guess J&J should just stick to shampoo.

Here's the thing, it was pretty much unspoken common knowledge that at no point did we expect the J&J shot to be a single "one and done" offering. It did what it was supposed to do - elevated immunity quickly during the Spring of 2021 and helped us out of the tailspin we were in.

The problem is how long it's taken to get that booster approved. Again, considering we (public health/virologists/immunologists/researchers) knew a single shot wasn't going to cut it, why wasn't the approval process for a J&J booster accelerated?

Where it's fuzzy is for Moderna and Pfizer. There was hope that having the two shots would offer long-lasting protection, but there were plenty of people in the know the indicated the spacing between the first and second shots was too close to reasonably expect that. So here again, we traded speed (and faster protection) for long term durability.

From a practical sense, I'm not sure the decision should have been any different (how they were all rolled out), but it does seem like maybe getting the boosters approved sooner would have been a better plan. And of course, expanding access to younger folks as well.

[Defiant]

Having J&J be a one shot vaccine, even not of as strong benefit and being less long lasting, probably also helped get people vaccinated for whom scheduling two shots (in a specific scheduling) would have been much harder. Plus, it probably got people to vaccinate who are paranoid about the mRNA vaccines.

[malchior]

I guess J&J should just stick to shampoo.

Here's the thing, it was pretty much unspoken common knowledge that at no point did we expect the J&J shot to be a single "one and done" offering. It did what it was supposed to do - elevated immunity quickly during the Spring of 2021 and helped us out of the tailspin we were in.

I also think it is probably important to get context right. From all I've read, the J&J vaccine was very protective. However, new technology has emerged that provided superior protection. It doesn't change that this was a race to get as many vaccines out the door in parallel as possible in an emergency. It seems unfair to look back and nitpick their relative choices. It is less about bad choices and more a learning opportunity.

The problem is how long it's taken to get that booster approved. Again, considering we (public health/virologists/immunologists/researchers) knew a single shot wasn't going to cut it, why wasn't the approval process for a J&J booster accelerated?

Indeed. I assume our responsiveness is heavily tied to bureaucracy and offsetting issues such as the one around hesitancy, right?

From a practical sense, I'm not sure the decision should have been any different (how they were all rolled out), but it does seem like maybe getting the boosters approved sooner would have been a better plan. And of course, expanding access to younger folks as well.

This is what I'm getting at above. They made choices a bit in the dark. It's done. My natural questions is will we learn from them and move on?

[Archinerd]

I have no regret taking the "first available" J&J shot.

[Smoove_B]

Having J&J be a one shot vaccine, even not of as strong benefit and being less long lasting, probably also helped get people vaccinated for whom scheduling two shots (in a specific scheduling) would have been much harder. Plus, it probably got people to vaccinate who are paranoid about the mRNA vaccines.

Absolutely - as I said, I'm not in any way suggesting it should have been done differently. It was an important offering. The problem was the messaging - that it was one and done. It should have been, it's one and done...for now but we're expecting you'll need another.

[Smoove_B]

I have no regret taking the "first available" J&J shot.

I wouldn't have regrets either. *ANY* of the vaccines are better than no vaccine, full stop. As I mentioned yesterday, I think our efforts right now should be focused on all the folks that received a single J&J shot in terms of priority for the next shot. After that, the high risk folks that received 2 of the others. And of course anyone still hesitant (legit) over the first any people still slipping between the cracks.

[LordMortis]

I have no regret taking the "first available" J&J shot.

I'd felt like I got the short straw but I wouldn't have hesitated and I wouldn't have regretted it. The alternative is proving to be crazy serious. Delta spread, hospitalization, death toll, and long COVID suffering hasn't proved to be a "a pandemic of the unvaccinated and the J&J injected."

[Unagi]

I have no regret taking the "first available" J&J shot.

I wouldn't have regrets either. *ANY* of the vaccines are better than no vaccine, full stop. As I mentioned yesterday, I think our efforts right now should be focused on all the folks that received a single J&J shot in terms of priority for the next shot. After that, the high risk folks that received 2 of the others. And of course anyone still hesitant (legit) over the first any people still slipping between the cracks.

Are we even in a position where we need to prioritize like that? I thought we had reached a point where we had access to more vaccine than we had arms that wanted them. I realize that the booster crowd will be an increase on the draw, but I just don't think we'll see a shortage.

[Smoove_B]

I should have been clearer - prioritize messaging and effort to reach those groups. Information (on the whole) still seems to be haphazard and inconsistent.

We're definitely not seeing a supply issue. For my own state, I believe the stats last week suggested ~80% of the people that were deemed eligible for a booster hadn't received it. That's...not good.

[El Guapo]

I guess J&J should just stick to shampoo.

Here's the thing, it was pretty much unspoken common knowledge that at no point did we expect the J&J shot to be a single "one and done" offering. It did what it was supposed to do - elevated immunity quickly during the Spring of 2021 and helped us out of the tailspin we were in.

The problem is how long it's taken to get that booster approved. Again, considering we (public health/virologists/immunologists/researchers) knew a single shot wasn't going to cut it, why wasn't the approval process for a J&J booster accelerated?

Where it's fuzzy is for Moderna and Pfizer. There was hope that having the two shots would offer long-lasting protection, but there were plenty of people in the know the indicated the spacing between the first and second shots was too close to reasonably expect that. So here again, we traded speed (and faster protection) for long term durability.

From a practical sense, I'm not sure the decision should have been any different (how they were all rolled out), but it does seem like maybe getting the boosters approved sooner would have been a better plan. And of course, expanding access to younger folks as well.

What drives me a little nuts is that my recollection of the public messaging in spring / summer of 2021 was "the vaccines are all the same, so take the first one that you can get." My impression being that the first part was never really true but that people were insisting it was in order to help encourage people to get whatever was available. Or am I misremembering things?

[Smoove_B]

What drives me a little nuts is that my recollection of the public messaging in spring / summer of 2021 was "the vaccines are all the same, so take the first one that you can get." My impression being that the first part was never really true but that people were insisting it was in order to help encourage people to get whatever was available. Or am I misremembering things?

No, that was definitely the message. They are all the same in the sense that they all conferred excellent protection in the short term, dramatically reducing the risk of hospitalizations and death - they still do.

The monkey-wrench here is still the emergence and arrival of the Delta variant. In another universe where that didn't happen, I am not as sure that the push for a booster would have happened in the way that it did. It's still hotly debated in academic and research circles mainly because of what's happening elsewhere around the globe.

[RunningMn9]

EDIT: Yeah, here you go - I mean, 96% is pretty impressive. Not Moderna impressive, but pretty good.

I’m not sure you’re doing the math right there guy. We aren’t talking 96% efficacy. The way that’s written, if the original two shot dose of Pfizer juice made me 92% less likely to get infected (compared to some unvaxxed rube), I’m now 96% less likely to get infected, compared to the previously vaccinated me.

Compared to the unvaxxed rube, that would make me 99.7% less likely to get infected (against Delta no less) than the rube (which is better than two Moderna shots, but maybe not three Moderna shots).

But you don’t have three moderna shots, so like, I’m more invincible than you now.

[Smoove_B]

We aren’t talking 96% efficacy. The way that’s written, if the original two shot dose of Pfizer juice made me 92% less likely to get infected (compared to some unvaxxed rube), I’m now 96% less likely to get infected, compared to the previously vaccinated me.

I didn't look beyond the headline, so there you go.

But you don’t have three moderna shots, so like, I’m more invincible than you now.

Technically true, but I'm at near zero risk as I'm just about to complete my requirements to earn a second consecutive year of the Social Distancing Champion award.

But yes, I'm going to get my third Moderna ASAP.

[Smoove_B]

Saw this yesterday in the headlines and forgot to post it. I can't recall any other example of this occuring.

Sex of fetus influences immune response:

Pregnant people respond to COVID-19 differently depending on the sex of their unborn child, according to a study released yesterday (October 19) in Science Translational Medicine. Male placentas produced more proinflammatory genes and proteins than female placentas after the parent contracted COVID-19, and people gestating sons produced fewer antibodies following infection. They also passed fewer protective antibodies on to the fetus.

“What’s interesting about that is it means that the sex of the baby can dictate how the mother responds to a viral infection,” Akiko Iwasaki, a virologist and immunologist at Yale University who was not involved in the study, tells STAT. “We knew that maternal infection can significantly impact the fetus, but this means that there is cross-talk between the fetus and the mother. That’s exciting because it adds an extra layer to what we are used to thinking about.”

[LordMortis]

Technically true, but I'm at near zero risk as I'm just about to complete my requirements to earn a second consecutive year of the Social Distancing Champion award.

I've tapped out. After shot three I'm willing to go to an under attended restaurant for lunch and get in and out before they get busy. I don't linger, which mostly defeats the purpose of going out for a meal, but only mostly. I've been to two restaurants in October. I don't fear contracting the virus with my limited indoor non masked in non crowded environments engagements at this point so much as I fear becoming a carrier.

[Archinerd]

What drives me a little nuts is that my recollection of the public messaging in spring / summer of 2021 was "the vaccines are all the same, so take the first one that you can get." My impression being that the first part was never really true but that people were insisting it was in order to help encourage people to get whatever was available. Or am I misremembering things?

No, that was definitely the message. They are all the same in the sense that they all conferred excellent protection in the short term, dramatically reducing the risk of hospitalizations and death - they still do.

The monkey-wrench here is still the emergence and arrival of the Delta variant. In another universe where that didn't happen, I am not as sure that the push for a booster would have happened in the way that it did. It's still hotly debated in academic and research circles mainly because of what's happening elsewhere around the globe.

Don't forget ,we didn't yet realize just how many people there were who would refuse to get vaccinated.