Coronavirus: Vaccines

[Tiredretiredlawyer]

This is why I've missed you, Sam!!!!!!!

[Kendra]

US employees of United Airlines have until Sept. 27 to either get vaccinated or to apply for an exemption.

The exempt workers will either be reassigned or go on temporary leave until it's safe, "but they won't be in front of customers after Sept. 27," CEO Scott Kirby says.

[MN-Skeptic]

An excellent twitter thread about a large Midwest company which mandated vaccinations. In an effort to understand why folks weren't vaccinated, the CEO talked to the unvaccinated. It turned out that the majority of them had minor excuses and now, at this point, 95% of the workforce is vaccinated. About 5% of the workforce are of the "Freedom!" variety and will probably leave the company.

[Foggy]

Wow, that's awesome, MN-Skeptic.

[Slim Cognito]

My hair has always been poker straight. I put it up in a pony tail at the beginning of the pandemic, to keep me from constantly brushing it out of my face, and only take it down to wash it or sleep. Last week I decided to trim it and, lo and behold, I suddenly have curls like The Dude. (One friend called it Farrah Fawcett hair but that's a bit lofty.)

I looked it up and it's a not that unusual side effect of aging, because exposure to radiation and chemo don't apply to me. Also, gray hair tends to be curlier and that's coming in bigly these days. (I also quit coloring it red at the beginning of the pandemic.)

But my plan is to tell everyone who notices that it's from the vaccine. Depending on their reaction, I may fess up.

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the dude.jpg (52.22 KiB) Viewed 1028 times

[AndyinPA]

[Volkonski]

[Volkonski]

[Volkonski]

[Volkonski]

Still a chance third shot might be approved for us folks.

[filly]

Interesting! Fauci was on just the other night and said when the FDA saw *all* the data, he believed they would be compelled to approve the booster, based on the data. I wonder what he's seen that so many of the FDA folks did not?

[Volkonski]

[filly]

That's good because you could have a rush of people from 63-65 hitting Rite-Aid for a third shot.

Meanwhile:

[Volkonski]

[Volkonski]

[AndyinPA]

Just curious. I haven't seen anything about Moderna. I had Moderna. If I get a booster, is getting Pfizer okay, or do I wait until Moderna is approved for a booster? I know Moderna is behind as it was approved and used later.

[MN-Skeptic]

Just curious. I haven't seen anything about Moderna. I had Moderna. If I get a booster, is getting Pfizer okay, or do I wait until Moderna is approved for a booster? I know Moderna is behind as it was approved and used later.

I don't think they've addressed that yet, but, since there are so many of us who did get the Moderna vaccinations, I'm sure they will be issuing a recommendation for us, whether to wait for the Moderna approval or to get the current Pfizer booster.

[Luke]

Well how about this, really interesting article. Had no idea so many common meds use fetal cell lines. Another excuse bites the dust. https://arstechnica.com/science/2021/09 ... exemption/

OrlyLicious @Orly_licious 5m
#COVID #AntiVaxxers claiming #ReligiousExemptions: Fetal cell lines were also used for Tylenol, Pepto Bismol, Aspirin, Tums, Lipitor, Motrin, Ibuprofen, Maalox, Ex-Lax, Benadryl, Sudafed, Preparation H, Claritin, Zoloft & Azithromycin. Be consistent.

[Sam the Centipede]

Just curious. I haven't seen anything about Moderna. I had Moderna. If I get a booster, is getting Pfizer okay, or do I wait until Moderna is approved for a booster? I know Moderna is behind as it was approved and used later.

It is very ok. Any of the vaccines used in the US or Europe will work well as a booster after any other vaccine. A booster dose of a vaccine acts by presenting the immune system again with the apparent threat to which it previously mounted a response, in this case the spike protein.

There's none of the earlier vaccine left in your body, you're not topping up a reserve of vaccine or something like that. The booster persuades your memory B-cells and memory T-cells to continue and enhance their activity against the apparent threat.

[AndyinPA]

Just curious. I haven't seen anything about Moderna. I had Moderna. If I get a booster, is getting Pfizer okay, or do I wait until Moderna is approved for a booster? I know Moderna is behind as it was approved and used later.

It is very ok. Any of the vaccines used in the US or Europe will work well as a booster after any other vaccine. A booster dose of a vaccine acts by presenting the immune system again with the apparent threat to which it previously mounted a response, in this case the spike protein.

There's none of the earlier vaccine left in your body, you're not topping up a reserve of vaccine or something like that. The booster persuades your memory B-cells and memory T-cells to continue and enhance their activity against the apparent threat.

Thank you.

[Lani]

The UK primarily gave AstraZeneca, but for the booster shots, it's using Pfizer and Moderna.

[Sam the Centipede]

Still on third doses, mainly for those who love precision (hurrah!) or are annoying pedants (boo!). A few pointettes…

Third doses are becoming established policy in several countries: USA, UK, Austria, France, Germany, Israel, Norway, Sweden amongst them. I think their policies are all similar, and some/most/all are recommending mRNA vaccines for this.

I think (but can't be bothered to check) that I have been sloppy in my use of terminology. This is a third dose of a primary course of immunisation, not technically a booster.

The FHI (Folkehelseinstituttet, the Institute of Public Health) in Norway neatly describes the difference: Personer med nedsatt immunforsvar anbefales en tredje vaksinedose :

The recommendation of an additional vaccine dose [i.e. a third dose] for patients with severely weakened immune systems differs from what is called a "booster dose", which is a refresher vaccine to those who have had a response to the vaccine. Although some countries such as Israel and the United States have offered a refresher to large sections of the population, the knowledge base for this is still very limited. There is a need for more knowledge here.

For legally eagally folk who like others to be precise in their legal terminology, here's an opportunity to be precise in immunological terminology!

So the third dose is part of the primary course building up protection, a booster dose aims to rebuild that protection after it might have diminished with time.

On safety etc. of the third dose, the FHI (link above - it's a good little piece, run it through Google Translate if you can't understand the original):

No adverse reactions have been observed after the third dose in these patient groups [immunocompromised and elderly] other than those previously known after the first and second doses.

Most of the reasoning is (I believe) based on the level of circulating antibodies in the blood, which is relatively easy to measure, but immunologists are aware that it is not clear how well antibody levels are a good correlate or measure of protection, especially against severe disease.

Personal story, not Covid:

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I had measles as a kid in the days before measles vaccines. Because I have patient contact in some roles, I was required to be measles-immune, and there is nothing in my available medical records about that. The hospital's occupational health people wanted to do a blood test then offer me MMR vaccine if the test was negative. I refused the test on the basis that it would be looking for circulating antibodies, and the level in my blood after 4 or 5 decades, without the natural booster of being exposed to infected people, would be minimal, so I would expect a false negative result. I was confident I was immune, because the memory B-cells would be mooching around my body, sleepily doing the rounds, as they do with the long-lasting immunity from measles, but there wouldn't be many B-cells squirting out the antibodies. So I opted to cut out one visit and just have the MMR jabs, which would either (a) create immunity if I wasn't immune, or (b) act as a booster if I had prior immunity — both good results. The lack of any local reaction at the jab site weakly suggests (but doesn't prove) that I had immunity. Perhaps the blood test is sensitive enough to pick up my prior immunity, but I think I win either way with my "just give me a jab doc!" tactic. I also wasn't sure about my mumps status: I don't think I ever had it, but I think it was circulating while I was a babe-in-arms, and I might have been exposed while having some maternal protection (IgA antibodies in mother's milk), which could lead to permanent immunity, but I could just have been lucky.

Switching topic from three doses to one…

European countries are also moving towards immunizing 12-15 year olds with a single dose of vaccine. Why single? Because young bodies mount a strong immune response to one dose (the opposite of the weakened response in elderly folk) and because a single dose is less likely to provoke side-effects, from the FHI (this one is available in English at 12-15-year-olds will be offered coronavirus vaccination ):

A rare side effect in the form of inflammation of the heart, called myocarditis, has been reported after using mRNA vaccines, especially in younger people. The side effect mainly occurs after the second dose and is temporary, so most people recover within a month.

And we return to boosters…

Will they be needed? Rich countries will start using them out of caution and because their populations won't be happy with experts saying "lower antibody levels doesn't necessarily mean significantly reduced immunity to serious disease".

Anti-vaxxers claim that we don't know about long term side-effects of the vaccine. Well, no, we do, in that no vaccines have side-effects that don't manifest within, say, 6 to 8 weeks maximum. These are safe vaccines.

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For completeness, there are some longer-term immunological oddities on exposure to the same or other strains of a virus seen in dengue vaccines and the catastrophe of the 1960s RSV (respiratory syncitial virus) vaccine roll-out. But we can be fairly confident we're on safe ground with the SARS-CoV-2 vaccines. RSV haunts vaccine developers and is one cause of the extreme caution in developing vaccines for babies.

But what we cannot yet know is the long term trajectory of the immunity in different sectors of the population, because we haven't had enough time to see that; it's not yet a year since non-trials vaccinations started.

And that is also difficult to investigate. Why? Because we are moving from clinical trials, where the patients are well-researched and there are control groups, etc., and detailed analysis and supplementary investigation is possible, to observational studies on the wider population, and they are much, much more difficult. In observational studies there are many confounding variables, and it's difficult for epidemiologists to untangle them to identify the underlying patterns.

[dan1100]

Well how about this, really interesting article. Had no idea so many common meds use fetal cell lines. Another excuse bites the dust. https://arstechnica.com/science/2021/0 ... exemption/

OrlyLicious @Orly_licious 5m
#COVID #AntiVaxxers claiming #ReligiousExemptions: Fetal cell lines were also used for Tylenol, Pepto Bismol, Aspirin, Tums, Lipitor, Motrin, Ibuprofen, Maalox, Ex-Lax, Benadryl, Sudafed, Preparation H, Claritin, Zoloft & Azithromycin. Be consistent.

https://twitter.com/Orly_licious/status ... 878893575

If Sudafed is made from fetal cell lines, that means they are all going to have to give up crystal meth.

[Lani]

While I lived on the Big Island when Kilauea erupted, we relied on sudafed to help us cope with health problems. No one was concerned about fetal cells.

[RTH10260]

Just curious. I haven't seen anything about Moderna. I had Moderna. If I get a booster, is getting Pfizer okay, or do I wait until Moderna is approved for a booster? I know Moderna is behind as it was approved and used later.

My understanding is cause the Pfizer vaccine was the first on the market and intially used to vaccinate the seniors and high-risk people, those applications have reached the end of the first six months "guaranteed" to be most effective. Also too I understand that the Pfizer shot is seriously less effective against the Delta variant. All the reason to offer a booster to the first recipients. I guess once there is a fast, easy and cheap way to evaluate the remaining protection the boost can get applied selectively.