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Post-pandemic adjustments: Air exchange rates
#11
(06-06-2021, 03:17 PM)ChrisGreene Wrote:
Quote:That's great news!  Right now I don't have any contact with teens or even young (20ish) adults so I had no idea how it might vaccination might be viewed.  Furthermore, since I know you do a lot (all?) of your work in disadvantaged areas, this is encouraging that we aren't having a "We don't trust the establishment" reaction.


Perhaps someone treats his clients with respect and has gained their trust?

I find it really offensive when people say things like "why are they so stupid?" I know that it is based in anger because the speaker feels that these people are putting them at risk. Being called stupid when you are not does not convince one to get a vaccination. Even the Washington Post seems to imply something is wrong if someone does not get vaccinated. If a person does not get the vaccine due to political affiliation, that is sad. If the person performs a risk assessment and decides to decline, we have to accept it. 

My favorite coronavirus podcast, Das Coronavirus Update, had a guest speaker. The podcast is remarkably apolitical and features very well respected experts. The EU (EMA) recently recommended authorization of an mRNA (Pfizer/Biontech, called "Comirnaty" over there) vaccine for 12+. The guest speaker works at the government agency that makes recommendations. He said that Germany would not recommend it for 12-15 year olds. His cited reasons include risks from the vaccine:
  • myocarditis and pericarditis,
  • cerebral venous sinus thrombosis,
  • lack of long term observations.
So this confused me. The first risk may come from one vaccine, the second from AZ or JJ which was not part of the recommendation. (The interview was conducted virtually and he had less than perfect enunciation and equipment. Perhaps they authorized AZ as well.) He also said that there was no safety study, just a study on the effectiveness of the vaccine. The numbers were so low, 1100 in each of the placebo and test group, that even relatively high incidence short term effects could go unnoticed. He noted that the observation period ranged from 1 to 2 months. He said that MIS-C was an important side effect from the disease, but was treatable and expected to lead to good outcomes.  He noted that Germany, a country of 83 million had 2 deaths of people in this age group. Both were at the end stage of a different, terminal disease. He noted that more kids in this group end up in ICU than expected, but there is a bias to put kids in ICU earlier due to emotional impact of kids that are sick. (Lots of paraphrasing here). I was disappointed that he did not mention the long covid risk. He did mention that doctors could still give vaccinations to this age group based upon individual circumstances (co-morbidities, the need to protect immunocomprimised family members, etc.)

I think it is refreshing to hear a health official state that "safe" means "safe from short term effects". Part of the calculus here is that the risks of covid are lower for this age group and using a vaccine with unknown risks may or may not help overall. Do no harm. I do not feel that the CDC messaging is honest about the unlikely possibility of long term effects and that this will degrade trust. The guest speaker said that they were looking at the situation from what is best for the kids, not general public health. That is a tough balance. The US is on the public health side, from what I gather. 

The interviewer asked, when the unvaccinated kid gets covid and gives it to their 40 year old parent, then what? His answer reflects the state of vaccination in Germany: You have to start to vaccinate the 40+ before thinking of vaccinating the kids with the exception of co-morbidities. 

In summary, if I had kids between 12 and 15 I would go obsessive trying to learn the pros and cons, make a list, and then go to the doctor. I would not walk up to a clinic with them today and just get a shot. Yes, there is a balance between individual health and public health with vaccines, but the risks remain unclear.
Weighing the risks and benefits of the vaccine in children is not straightforward, I admit. There does appear to be a lot of myocarditis in young adults and teens infected with Covid, and it likely dwarfs the numbers which occur with the vaccine. As we see more and more variants of the virus we may run into even worse outcomes, so that should be considered. We do know that the public health benefits to the vaccine are great. So far, the mRNA vaccines have worked quite well against every variant. 

I would compare it to oral polio vaccine. 2 out of 1 million individuals contracted polio from the vaccine. That vaccine has wiped polio from the face of the earth with the exception of a few dozen cases a year on the Afghanistan-Pakistan border each year. There are some cases of oral vaccine initiated disease in Nigeria each year but that will shortly die out with a new killed virus vaccine being used there. Less than 1% of polio infections result in paralysis. There are a lot of parallels with Covid there. The negative outcomes from that infection were not common looking at percentages, but catastrophic and quite visible when they occurred. People tolerated the risk of the vaccine because the vaccine was so effective. Now we use the injectable polio vaccine. Safer and less effective, but we don't need the oral vaccine here anymore. 

I would definitely get my kids vaccinated at that age. My kids are a bit older (in their 20's), though. They wanted the vaccine ASAP, and got it the first day they were eligible. My daughter wanted it so that she wouldn't get her parents sick if she visited, and my son wanted it so he could see his friends. Slightly different motivations!
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#12
Statistic from Stanford conference I attended today:

Odds of a cardiovascular event from a Covid-19 vaccine: 1 in 1,000,000.
Odds of a cardiovascular event from wild Covid-19: 165,000 in 1,000,000.
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#13
Akiddoc, can I ask a clarifying question?   

For the odds of a cardiac event from COVID, is that stating if you get COVID then there are the odds you state?
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