COVID-19 vaccines: medical concerns and recommendations

[blues]

The patients are told.

That's good to hear. Thanks for that.

[Hambo]

That's good to hear. Thanks for that.

A quick read of the article that was posted:

The Centers for Medicare and Medicaid Service (CMS), which oversees the regulatory process for US labs, requires genome-sequencing tests to be federally approved before their results can be disclosed to doctors or patients. These are the tests that pick up on variants, but right now, there's little incentive for the labs to do the work to validate those tests.

The system my wife works for is not sending tests out to a lab like the ones mentioned in the article. They want to know, they're paying for it, they get the results and can share them.

Of course the article has a clickbait title designed to make everyone think they can't be told. In truth, it really doesn't matter which one you have, staff is treating your symptoms as best they can.

[blues]

A quick read of the article that was posted:



The system my wife works for is not sending tests out to a lab like the ones mentioned in the article. They want to know, they're paying for it, they get the results and can share them.

Of course the article has a clickbait title designed to make everyone think they can't be told. In truth, it really doesn't matter which one you have, staff is treating your symptoms as best they can.

Still, a man wants to know he only has Gonorrhea when he feared he might have syphilis.

[0ddl0t]

Scratching my head here…. If the labs aren’t allowed to release the variant, how are “we” certain that the Delta variant is so prevalent?

They can't release the data to you or your doctor. They can release it to state or local public health and they can also release general info like "80% of cases this week were Delta."

[Hambo]

Still, a man wants to know he only has Gonorrhea when he feared he might have syphilis.

You would know more about that than I do.

[blues]

You would know more about that than I do.

Clearly.

[RoyGBiv]

If only I had this foresight with my investment decisions. Now, the big question is do I want to double down and get the dose that they have me scheduled for in three weeks--which they believe will be my second dose but which will really be my forth dose? Will this put me ahead of the curve before they decide that you really need a series of two boosters? Will this further boost my immunity and make me the Omega man? Or will this put me in the hospital and give them a novel case of someone who took 4 doses to study?

At about 51 hours after getting the 3rd dose I was feeling completely back to normal other than a tender arm. This was easier than my second dose which had me feeling sick for a number of days and seemed to take at least 5 days before I felt unsick and longer than that before I didn't feel abnormally tired.

A 4th dose so close to a booster that is reported to be very effective seems unnecessary, bordering on overdose.

Not a Dr. Only my unqualified intuition.

[pangloss]

Scratching my head here…. If the labs aren’t allowed to release the variant, how are “we” certain that the Delta variant is so prevalent?

As far as I know, it's the same test for both viruses, which means that most people will never know for sure what virus they got. The lab down the hall from me is sequencing virus. I can't remember how many per week--maybe a hundred. I've seen some of their data, and I talk with that colleague pretty frequently. Delta is definitely real. We had a local variant pop up, which I was afraid was going to be a super delta. Fortunately it wasn't.

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[GyroF-16]

As far as I know, it's the same test for both viruses, which means that most people will never know for sure what virus they got. The lab down the hall from me is sequencing virus. I can't remember how many per week--maybe a hundred. I've seen some of their data, and I talk with that colleague pretty frequently. Delta is definitely real. We had a local variant pop up, which I was afraid was going to be a super delta. Fortunately it wasn't.

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Thanks - I’m certainly not skeptical that Delta exists. Just wondering if there was an actual count of Delta numbers, or an assumption that the recent surge was due to Delta.

[pangloss]

If the index vaccination ended up affecting primarily clinical disease but doesn't affect asymptomatic and community transmission as much, as we are told in light of delta surge all day every day now, why would we expect the same booster to decrease the transmission to unvaccinated?

I know it is unfair for me to ask you this in light of all uncertainty, and I hope you got a good night's rest.

My personal interpretation of what has happened so far (and I am really just one step above an amateur in immunity and virology) is that the vaccination indeed reduced both community spread and clinical disease - when the vaccine was tailored against the predominant variant. I understand that by boosting now we will get an additional humoral response which will cross react against the delta to some extent. To me it would be akin to getting a flu vaccine made on the basis of viruses predominant a year before. Maybe this is the best we can do but I wish we could do better.

I think that the currently available vaccines definitely help reduce community transmission. Last week my state was the world leader in new cases per capita and we have an abysmally low vaccination rate. Vermont, that has the highest vaccination rate, is not overrun with COVID patients. Getting a third immunization now will give me a big jump in antibody levels. A reasonable percentage of those antibodies will recognize the delta variant. As time passes and antibody levels drop, my susceptibility to Delta would increase again. However, by that point, community transmission will be much lower, so it won't be as much of danger. The molecular changes between the alpha and delta variants aren't nearly as significant and the potential changes in flu from year to year. The receptor binding domain of the spike protein of Delta differs from the Alpha strain at just three amino acids. In any case, the vaccine efficacy is a combination of the titer of the antibodies and how well they recognize the virus. I can game my titers right now with a third vaccination, but I can't do anything about how well the vaccine matches the virus in circulation. When SARS-CoV emerged in the early 2000s, most of the amino acid changes occurred in the first year after emergence. SARS-CoV-2 is obviously a much more successful virus, but I think the window will start to close soon on the potential for new variants. Worldwide, we've administered 5 billion doses of vaccine and had 215 million cases.

Thanks - I’m certainly not skeptical that Delta exists. Just wondering if there was an actual count of Delta numbers, or an assumption that the recent surge was due to Delta.

Got it. It's based on sampling, so not an actual count but not an assumption either.