Re: No.

1

My sister got her jab on the first day with no waiting. She was glad, but she was also afraid that it was because other people at the hospital were refusing.


Posted by: Moby Hick | Link to this comment | 12-31-20 9:04 AM
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A lot of these areas are more properly considered suburban or exurban, but it's still shocking, yes. (Even one public hospital worker is quoted!)

I feel like we've got a toxic mix of antivaxxism and relatively reasonable race/ethnicity-based skepticism of the medical establishment combining into this skepticism becoming a default even among disengaged people.

Trump threatening to fire the FDA head if he didn't move up approval of the vaccine a few weeks ago can't have helped either.


Posted by: Minivet | Link to this comment | 12-31-20 9:11 AM
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Isn't the Republican part of California just going fucknuts anyway? Festering resentment and no leadership with no incentive to do anything but try to out Q the other fucker.


Posted by: Moby Hick | Link to this comment | 12-31-20 9:11 AM
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Because I have never been to Riverside and have not been to the state of California in almost two decades, I'm in a good place to understand it through a process of pure reason.


Posted by: Moby Hick | Link to this comment | 12-31-20 9:13 AM
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Not just the suburbs.

https://www.firehouse.com/safety-health/news/21165341/poll-more-than-half-of-fdny-firefighters-will-refuse-vaccine

"The 55 percent doesn't surprise me. They're called the Bravest, not the Smartest," the FDNY member said.

Posted by: gswift | Link to this comment | 12-31-20 9:16 AM
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Idiots refusing the vaccine means I can get it sooner.


Posted by: Spike | Link to this comment | 12-31-20 9:30 AM
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Josh Marshall (paywalled):

I think we fool ourselves, are less than honest with ourselves, if we treat COVID vaccine hesitance or resistance as just a new version of the anti-vaccine activism we've seen for the last couple decades. It's clearly connected to that phenomenon and is fueled by the climate of doubt it has created. But this is a new vaccine and (in the case of the Pfizer and Moderna vaccines) uses a novel vaccine approach. Being wary of going first in such a case is simply not the same as refusing vaccines which have been administered literally billions of times and have track records of short term and long term safety going back decades.

But reading into the piece you see hints of the larger crisis of public trust which runs like a through line through our civic life. One intensive care nurse who has taken the vaccine but understands his colleagues' wariness tells the Times his co-workers have "lost faith in big pharma and even the CDC."

It won't impact my willingness and desire to get vaccinated. But I will tell you that the last year has really torched my faith in the CDC as an institution as well.


Posted by: apostropher | Link to this comment | 12-31-20 9:38 AM
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The "traditional" antivaxx stuff defied any easy left/right categorization, but strongly tended to be a UMC phenomenon. So this definitely seems like something new. Nurses and Fire Fighters were not in the traditional antivaxx demographic.

The CDC's reputation has been damaged to such an extent that they should probably rename the agency.


Posted by: AcademicLurker | Link to this comment | 12-31-20 9:45 AM
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Isn't the Republican part of California just going fucknuts anyway?

There are barely any Republican parts of California anymore - Riverside County went 53-44 for Biden - but the miasma remains, yes. I think it's even worse in Bakersfield.

Red Bluff in the article is in a deep red county.


Posted by: Minivet | Link to this comment | 12-31-20 9:46 AM
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Centre For Disease Control? British things still code as "smart" here.


Posted by: Moby Hick | Link to this comment | 12-31-20 9:47 AM
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I understand the loss of faith of institutions, but fuck those people. I would push an orphan down a flight of stairs to get the vaccine early, and the people who are first in line and declining the vaccine should stick a gun in their mouths and pull the trigger, so that they're out of my way.


Posted by: Walt Someguy | Link to this comment | 12-31-20 9:48 AM
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7: Rochelle Walensky, Biden's Nominee for CDC director is an infectious disease doc and is friggin fantastic.


Posted by: Bostoniangirl | Link to this comment | 12-31-20 9:54 AM
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I'm hoping that by the time it comes around to me that it'll be a one time shot, instead of the one where you have to get a second shot in 3 weeks.

I do wonder, though, how many of the front line people saying no aren't really front line, so feel like they can continue to manage the risk a while longer, or already had the coronavirus, and don't feel an immediate pressure. There could well be enough subtlety to take the crazification portion here down to that of the general population.


Posted by: CharleyCarp | Link to this comment | 12-31-20 10:02 AM
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My cousin's husband who is a gerontologist in NYC and my boss's husband who works in a nursing home in Columbus both already got the vaccine, so I think things can't be going as badly as it seems from the news.

Meanwhile my 88-year old mom in Israel is scheduled to get her vaccination on Saturday.


Posted by: peep | Link to this comment | 12-31-20 10:14 AM
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I'm curious as to how many staff at my mom's home have gotten vaccinated, but there's really no good way to ask.


Posted by: Moby Hick | Link to this comment | 12-31-20 10:18 AM
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I was composing a long response to this post, but 7 says pretty much all of it, and much more concisely than I could have. These vaccines use a brand-new process, and their development and trials have been very quick and highly politicized. Trump threatened to fire the head of the FDA if he didn't clear the Pfizer vaccine that day, and voila, at the end of the day it was done. Of course people are nervous.

I'll get the vaccine when it's made available to me, but by the time I have the opportunity (months from now) I'll have the benefit of a lot more information about the efficacy and safety of these vaccines over time. It would be scarier to be first in line. The nurse quoted in the article notes, correctly, that these vaccines haven't been tested on pregnant women. In three months, she won't be pregnant anymore, and we'll have more data about vaccine reactions. Maybe in the same situation you would go ahead, but the fact that she's decided to wait three months doesn't mean that she's an idiot, or that she should go kill herself. Jfc, you guys.


Posted by: jms | Link to this comment | 12-31-20 10:32 AM
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The cynical "less for anti-vaxxers, more for me" stance doesn't even make sense with this vaccine, does it? 90-odd percent efficacy (maybe less with mutations) is very well and good, but it doesn't actually make you invulnerable; the whole point is you need it at the population level.


Posted by: lourdes kayak | Link to this comment | 12-31-20 10:39 AM
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I think 90% efficacy is pretty high as far as these things go.


Posted by: Moby Hick | Link to this comment | 12-31-20 10:41 AM
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There were reports on Twitter that the Republican Governor of Ohio, who has apparently been pretty good on the virus for a Republican, expressed similar concerns in his state.

My brother-in-law (wife's brother), a nurse at a nursing home in urban Upstate New York with pre-existing conditions, has expressed a lot of concern over the vaccine because of issues with a vaccine in the 1970s leading to Guillian-Barre. Never mind that there were so few cases and that was 44 years ago. Pretty sure he'll get the vaccine (wife has done good work trying to walk him through the evidence) when he has an opportunity to in a few weeks, though. There have been deaths in his nursing home. My sister-in-law (wife's sister), a teacher in rural Upstate, has also expressed concerns, but she's surrounded by a clique that hasn't been safe in the slightest. There have been cases at her school. They live close to my parents-in-law and we constantly worry about their safety, but they're going to do what they're going to do.

So much disappointment.


Posted by: dalriata | Link to this comment | 12-31-20 10:44 AM
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Ohio: https://thehill.com/homenews/state-watch/532198-ohio-gov-60-percent-of-nursing-home-staff-elected-not-to-take-covid-19


Posted by: heebie | Link to this comment | 12-31-20 10:48 AM
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My brother got the Moderna a few days ago.
It's 90% preventing infections but 99+% preventing severe cases. I don't mind having a cold but I do mind having a cold that has a 1% chance of killing you and a 5% chance of giving you a heart condition.


Posted by: SP | Link to this comment | 12-31-20 11:01 AM
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[haven't read thread]. I was shocked that a friend who is an ICU nurse (married to a professor) said she was not going to get the vaccine. I still can't believe it. She has doubts about it. Her husband, a philosopher, is definitely conservative-ish, but got off that train when Trump appeared. They are both immigrants from Germany. I don't know how to explain it unless some part of the conservative propaganda machine is part of the atmosphere/background/social scene they're in. They live in a more upscale neighborhood than we do and may have more neighbors in the dentists-for-Trump demographic.


Posted by: chill | Link to this comment | 12-31-20 11:25 AM
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21: I have a question about that. Some of the athletes who had cardiac issues (temporary/permanent?) were asymptomatuc cases. We only know about most of them, because the athletes were closely followed and got scans and the like. How do we know the vaccines would prevent that kind of thing? Of course, I'll get vaccinated, but I won't feel entirely safe.


Posted by: Bostoniangirl | Link to this comment | 12-31-20 11:36 AM
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One interesting thing I've noticed from reading about past epidemics (not reassuring, exactly, but interesting) is that while the diseases themselves vary a lot, the patterns of public response show really consistent tendencies over time, especially distrust of authorities, skepticism about the reality/danger of the disease, wariness of new prevention/treatment options, etc. A lot of this stuff feels new because we haven't had a truly devastating worldwide pandemic like this in 100 years, but it's always been lurking just under the surface.


Posted by: teofilo | Link to this comment | 12-31-20 11:41 AM
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I'll have the benefit of a lot more information about the efficacy and safety of these vaccines over time.

For me (someone who will be in one of the early waves) a mitigating factor is that loads of the initial rollout has been to oldsters with underlying conditions and shitty immune systems. It hasn't killed a single one of them and hospitalizations have been super rare.


Posted by: gswift | Link to this comment | 12-31-20 11:48 AM
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Swinging by to say belated happy New Year, but this is here, so.
7, 13, 16, make good points.
Don't have links handy but IIRC various polls across the OECD show vaccine hesitance around 30-40%. US cases in this thread don't seem wildly higher.
Standing to be corrected: front-line healthcare workers aren't necessarily scientifically literate at all. Charles Stross said of NHS nurses he worked with that roughly 1/3 were as smart and as necessary as MDs, another 1/3 merely competent, and 1/3 so stupid their work could be more safely done by machines. 50% vaccine rejection sounds consistent with that.
Health workers are also uniquely acquainted with the many fuckups of medicine, including things like IIRC hospital infections being the leading cause of death in rich-world hospitals. Granular data across richer and poorer countries could be interesting there; similarly US versus other rich countries. Also similarly, the passage of whole generations since the great midcentury vaccination campaigns has led to a lot of forgotten expertise. In that connection, many poor countries have done notably well containing covid, using as they themselves have pointed out methods they literally learned from the CDC.
More (but not entirely) US-specific: over the past year online anti-vax groups have essentially been assimilated by q/a/n/o/n, which has in turn largely assimilated red America.
All of which is a long way of saying, I was really surprised that the OP link surprises anyone.
Partially pwned on preview by 24, which is fascinating.


Posted by: Mossy Character | Link to this comment | 12-31-20 11:58 AM
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24:. I think we might have been under the impression that we made some progress.


Posted by: peep | Link to this comment | 12-31-20 11:59 AM
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Hey, Mossy, great to hear from you! But I know you're just here to show off because you're so far ahead of us in 2021.


Posted by: peep | Link to this comment | 12-31-20 12:01 PM
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Mossy!


Posted by: teofilo | Link to this comment | 12-31-20 12:03 PM
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And so rudely goddamn healthy I won't qualify for a vaccine until approximately 2026.


Posted by: Mossy Character | Link to this comment | 12-31-20 12:04 PM
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27: Progress since 1346, that is.


Posted by: peep | Link to this comment | 12-31-20 12:05 PM
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Mossy! Happy new year.


Posted by: Moby Hick | Link to this comment | 12-31-20 12:06 PM
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The trends up here are more promising, btw, despite the fact that Alaska had a vastly disproportionate number of the mysterious severe reactions early on (which may well have just been random chance). Vaccine uptake has been high and the vaccination rate so far is the third-highest in the US.


Posted by: teofilo | Link to this comment | 12-31-20 12:09 PM
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31: Sadly, this may be an area where progress is very difficult to make and especially sustain.


Posted by: teofilo | Link to this comment | 12-31-20 12:10 PM
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Which is not to say effective response is impossible, although the US certainly hasn't been a model of it. As Mossy notes many poor countries have done quite well at containing it, which may in part be because the standard policy response measures to a new epidemic disease with no prevention or cure are literally medieval in origin and don't require much in the way of technology or resources. They do require a lot of social solidarity and political will, though, both of which are in short supply these days.


Posted by: teofilo | Link to this comment | 12-31-20 12:15 PM
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23- Trials will continue to monitor for other disease symptoms. So far I haven't heard of any reports in either treatment or control arms.
Fuck the fucking psycho who intentionally destroyed 500+ doses. Not technically treason when your enemy is a virus, but if someone were caught sabotaging tanks or planes or supplies in a real war they'd be in jail for a long long time.


Posted by: SP | Link to this comment | 12-31-20 12:20 PM
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Or a short short time, before dawn.


Posted by: | Link to this comment | 12-31-20 12:22 PM
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If we had a functioning government, vaccine education would have been part of Operation Warp Speed.

As it is, not only are people refusing it, but doses are being distributed per organization, so those leftover doses aren't going to the elderly or health and essential workers, but to administrative staff at various hospitals and clinics.


Posted by: ogged | Link to this comment | 12-31-20 12:31 PM
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Mossy!


Posted by: | Link to this comment | 12-31-20 12:57 PM
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39 is me


Posted by: Barry Freed | Link to this comment | 12-31-20 12:58 PM
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I wonder if it would be good to have standby waitlists - people sign up with the county health department or maybe a local hospital, input their job or other risk factors, and then you have a bunch of people who can be notified to come in quickly when there's expiring vaccine and not enough people to take them.

A problem with this is the people figuring out vaccine prioritization are only identifying one or two tiers at a time, so you can't sort out by priority a table of random people who sign up, even if they provide all the relevant information.


Posted by: Minivet | Link to this comment | 12-31-20 2:01 PM
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36: Your comment was the first I'd heard of the destruction of doses. Without evidence that the vaccine ha terilizing immunity or prevents transmission, I won't feel comfortable that it prevents the subtle, longer lasting problems, but preventing death is enough reason to take it.


Posted by: Bostoniangirl | Link to this comment | 12-31-20 2:30 PM
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24: the patterns of public response show really consistent tendencies over time, especially distrust of authorities, skepticism about the reality/danger of the disease, wariness of new prevention/treatment options, etc.

I was curious about the death of a collateral ancestor (3x great-uncle), who died of cholera in 1851 (in rural Ontario); so I looked up cholera epidemics in Canada, and found this (a boilerplate account, but based on real research):

During epidemics, individual towns attempted to quarantine themselves against the disease. When quarantine failed to stop the disease, public health measures were taken by towns and provincial and colonial governments. The response to cholera encouraged governments to act to protect the health of Canadians and to provide for the sick. Not all the actions were popular and in some areas riots ensued, with crowds burning the cholera hospitals.

I guess today's 'let's deliberately destroy 500 doses of the COVID-19 vaccine' is yesterday's 'let's burn down the cholera hospital'...

The vaccine resistance is still shocking, though, and profoundly depressing.


Posted by: Just Plain Jane | Link to this comment | 12-31-20 3:24 PM
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Someone pointed out that the Tuskegee experiment is used as shorthand for distrust of the medical profession, but it was withholding a known effective treatment, not trying unproven medicines on unconsenting patients.


Posted by: SP | Link to this comment | 12-31-20 3:59 PM
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Remember in one of the recent Ebola outbreaks, militias attacked Ebola hospitals? We're too civilized to ever do anything like that.

I'll come in again...


Posted by: CHETAN R MURTHY | Link to this comment | 12-31-20 4:01 PM
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Yeah, but Tuskegee isn't one episode that people are generalizing from. People of color have stories and experiences aplenty.


Posted by: Minivet | Link to this comment | 12-31-20 4:08 PM
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To work in medical research, you need to know about Nazis, the Belmont Report, the Tuskegee experiment, HIPAA, and not to leave patient records on the fax machine.


Posted by: Moby Hick | Link to this comment | 12-31-20 4:13 PM
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46: There is substantial evidence that Black patients cared for by Black doctors and nurses have better outcomes. The one that really nails the case closed, is that Black babies cared for by Black doctors have better outcomes. So it's not about compliance or communication or whatnot.

One can imagine that faced with an overwhelmingly white medical system, a lot of Black people have serious (and well-founded) trust issues.


Posted by: CHETAN R MURTHY | Link to this comment | 12-31-20 4:15 PM
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I think it's reasonable to be concerned about the vaccine. Trump politicized the shit out of it, and he's been a bad actor and wrong about everything. It wasn't tested adequately on people of color (according to my friends who know about these things), and it isn't cleared for pregnant women or kids. It also seems correct that it is good to take it, but I can see that one need not be reflexively against vaccines in order to be a little worried about being a guinea pig. Or thinking, I'm a nurse, I have PPE now, I'm actually pretty low risk, I'd rather mine go to Grandpa Joe, etc.

I'm also a little more sanguine about the prospects after reading an interview with Peter Salk who recalled that something like 50% of people said they wouldn't take the polio vaccine when it was discovered. ("99.3% of kids are fine! Kids can get paralyzed riding bikes, let's ban bikes! The Russians put fluoride in the vaccine" -- one imagines.) In the end, nearly everyone did. So I suspect a lot of people will come around in two months when there aren't severe reactions in the elderly or Gates Foundation zombies. The Q people are unreachable, but we don't need them to get back to normal.


Posted by: Cala | Link to this comment | 12-31-20 4:24 PM
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What?


Posted by: Opinionated Jonas Salk and Peter Falk | Link to this comment | 12-31-20 4:27 PM
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It's his kid. Eleven when the vaccine was discovered.


Posted by: Cala | Link to this comment | 12-31-20 4:31 PM
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Well, I'm going to go watch Columbo anyway.


Posted by: Moby Hick | Link to this comment | 12-31-20 4:32 PM
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How is 20 even legal? Nursing home workers refusing are straight-up murderers.


Posted by: Unfoggetarian: "Pause endlessly, then go in" (9) | Link to this comment | 12-31-20 4:51 PM
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I think it's reasonable to be concerned about the vaccine. Trump politicized the shit out of it, and he's been a bad actor and wrong about everything.

But: people in countries where Trump is not a salient actor are not concerned about the vaccine. Which maybe suggests that it is unreasonable to be concerned about the vaccine, just because Trump, that scion of anti-science, said so?


Posted by: Just Plain Jane | Link to this comment | 12-31-20 4:52 PM
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20: if the vaccine stops disease but not infection or transmission, it is most definitely not.

54: Trump has said the vaccines were great, so if you don't trust Trump, you might be concerned. Also he told Azar he would be fired if an EUA wasn't issued fast enough.


Posted by: Bostoniangirl | Link to this comment | 12-31-20 5:25 PM
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Part 1 of 55 to 53.


Posted by: Bostoniangirl | Link to this comment | 12-31-20 5:25 PM
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But: people in countries where Trump is not a salient actor are not concerned about the vaccine.

26 suggested many in fact are, and after googling, here's some evidence (this survey was even before the success of vaccine development was announced).


Posted by: Minivet | Link to this comment | 12-31-20 5:30 PM
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Looking at the data released with that Nature article, those you might reasonably call resisters or hesitators - disagreeing completely or partially with the statement "I would follow my employer's recommendation to get a COVID-19 vaccine once the government has approved it as safe and effective" were as follows:

Europe:
Russia: 41%
Spain: 35%
Poland: 32%
France: 28%
Sweden: 26%
UK: 22%
Italy: 22%
Germany: 17%

Americas:
Ecuador: 47%
Brazil: 42%
Mexico: 33%
US: 25%
Canada: 17%

Asia:
Singapore: 24%
India: 19%
South Korea: 7%
China: 4%

Africa:
Nigeria: 32%
South Africa: 20%

So "gee, I don't know" for whatever reason seems pretty common, with the US not standing out. Of course people everywhere could be suspicious of the US's role.


Posted by: Minivet | Link to this comment | 12-31-20 5:52 PM
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Skipping much of this thread because I've had a few drinks (will try to read in a sec but I'm tired and it's been a year), but a pediatrician friend said his hospital (rural MI) did a poll that showed about 35% "Yes, immediately" and maybe 40% "Wait and see," plus 25% "No way, no how." At this point, we need not to waste doses. I give zero fucks about people who are hard nos, but the wait and see people should change pretty quickly if they see folks they know and respect getting theirs.

The CDC IS a goddamned tired fire, and the FDA pressure was a hideous own goal (the data were great, no pressure needed, but it make the whole thing look sketchy), but these vaccines are safe and effective. ~38,000 in the clinical trials. Zero severe cases for Moderna. ~95% efficacy. The Moderna trial was smarter in that they monitored for asymptomatic via testing as well as symptomatic like BioNTech - that's how we know it should prevent transmission and cardiac damage.

AFAICT, both are pretty much the same. Astra-Zeneca/Oxford will likely submit next, but I'm not confident in our ability to give annual boosters for this one for multiple years. Same for the Janssen technology.

At the Other Place, I've been celebrating, fact-checking, and arguing as hard as I can. The goalposts on really achieving herd immunity are somewhere between 70 and 85%, but every person we vaccinate is a step towards normalcy.

The government is fucking up distribution as badly as you might expect. At current rate, it will take TEN YEARS. Warp speed my ass. Same for the UK. We need shots in arms. I don't give a fuck if it's Joni Ernst at this point. Maybe she'll influence some of her asshole followers.

I didn't think this vaccine was going to be possible, to be honest. I didn't think the science was there. I though trials would take years and then fail. I am so proud of my colleagues who worked on this I can't even manage whole sentences without tearing up. I am calling it a moonshot with zero irony.


Posted by: ydnew | Link to this comment | 12-31-20 6:19 PM
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I'm already drunk. No worries.


Posted by: Moby Hick | Link to this comment | 12-31-20 6:23 PM
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We're just heating frozen appetizers and drinking.


Posted by: Moby Hick | Link to this comment | 12-31-20 6:24 PM
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And, in my case, trying to figure out when people will start dying of covid at a rate of 1,000 per day or lower again.


Posted by: Moby Hick | Link to this comment | 12-31-20 6:27 PM
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He sometimes eat the appetizers after they are heated.


Posted by: Moby Hick | Link to this comment | 12-31-20 6:32 PM
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49.1: It hasn't been cleared in kids because it's unethical to run trials in humans who can't give informed consent unless you have a good idea regarding safety of your new drug or vaccine. No ethical researcher would run safety trials in children. Trials in pregnant women are underway, but ACOG says they see no reason pregnant or breastfeeding women shouldn't be offered the vaccine.

I get being kind of skeptical if you aren't a specialist in the field. I get being skeptical of anything from the Trump administration. But this is the best, least ambiguous clinical data on an experimental treatment I have ever seen.


Posted by: ydnew | Link to this comment | 12-31-20 6:34 PM
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60/62: Thank goodness it's not just me. Old friends got married today (outside, distant!), and I couldn't resist a bit of celebration. I am betting the current disaster will start receding the third week of Jan and we'll be back at levels seen last summer in March/April.

Also, for what it's worth, my half-assed prediction is we'll see some real effect from vaccination when we hit 20% of the population. That covers health care workers, vulnerable seniors, and some front line workers.


Posted by: ydnew | Link to this comment | 12-31-20 6:40 PM
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49:

A few commentators have pointed out that even if the vaccine causes minimal severe reactions, some people will die of strokes/heart attacks/whatever just by chance shortly after being vaccinated. And their deaths will be used by anti-vaxxers to stir up panic.

Hasn't happened yet, but I wouldn't be surprised if it does.


Posted by: Ponder Stibbons | Link to this comment | 12-31-20 6:41 PM
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66: I keep seeing concern about Bell's palsy and allergic reactions elsewhere. It's impossible to say whether the Bell's is statistically significant. The severe allergic reactions are estimated to be roughly 1 per 1.3 million and do not overlap with other pre-existing severe allergies (eg nuts) such that the medical professional org for US allergists recommends vaccines for all (basically). And yeah, probably eventually someone will, by chance, have something awful happen and anti-vaxxers will latch on.

Overall, hardline vaccine refusal is fairly rare. In places we think of as having poor coverage, where measles outbreaks happen, vaccination rates are something like 85%. They're loud, but a tiny minority.


Posted by: ydnew | Link to this comment | 12-31-20 6:52 PM
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I wonder if Rupert Grint is the only person to appear two different series where a female character is named 'Hermoinie'.


Posted by: Moby Hick | Link to this comment | 12-31-20 7:19 PM
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ydnew, I think it was you who pointed out that most severe side effects appear in the first six months and then taper off, rather than suddenly popping up later, so since there's been nothing significant seen in the trials which started March, decent odds there's nothing yet to be identified. Thanks for that.


Posted by: Minivet | Link to this comment | 12-31-20 7:43 PM
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Balls-falling-off syndrome takes seven months to happen.


Posted by: Moby Hick | Link to this comment | 12-31-20 7:58 PM
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64: Oh, sure, I get that. I'm taking 'reasonable' not as 'has no defeasible reasons' but as 'not crazy.' 'Wait and see' isn't nuts if the person being polled is pregnant. I think most people will come around eventually, and I'm satisfied myself that the vaccine is safe.


Posted by: Cala | Link to this comment | 12-31-20 8:09 PM
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Since you can't get more pregnant, I guess they don't need to worry if it interferes with birth control.


Posted by: Moby Hick | Link to this comment | 12-31-20 8:41 PM
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Happy New Year, reprobates!


Posted by: peep | Link to this comment | 12-31-20 9:49 PM
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Happy new year to you also. Goodnight.


Posted by: Moby Hick | Link to this comment | 12-31-20 9:51 PM
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73: What time zone is Unfogged in? 2 hours and 11 minutes earlier than Columbus?

Who are these idiots making such a racket setting off fireworks and screeching?


Posted by: peep | Link to this comment | 12-31-20 9:51 PM
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I guess all these people would normally be at bars making idiots of themselves.


Posted by: peep | Link to this comment | 12-31-20 9:54 PM
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It's nearly always in slightly fucked Mountain Time here.


Posted by: Moby Hick | Link to this comment | 12-31-20 10:03 PM
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I can't sleep because of the fireworks.


Posted by: Moby Hick | Link to this comment | 12-31-20 10:03 PM
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There was considerable effort made to ensure minority representation in the trials. I'm not sure what your friend in 49 considers "adequate" but IIRC one of the big trials wasn't that far off from matching the US population. 40% total minorities, 10% black, 20% Hispanic.
I of course agree with ydnew on the science and its significance. A lot of people don't understand the technological and basic biological foundations that have been put in place over decades to enable a vaccine to be designed, synthesized, mass produced, and tested in under a year. Advances in sequencing and testing; lipid nanoparticle vectors; basic biology about what genetic bits are needed to make a protein express well; which protein to make and what slight changes to introduce to make it more stable and immunogenic; chemistry of nucleoside analogs to enable RNA delivery; and probably several dozen other things I don't understand. This is why every time John McCain or some other Republican asshole stands in Congress and says, "Dur hur we're paying scientists to infect worms with cholesterol blobs, couldn't they just eat more eggs?" it pisses me off.


Posted by: SP | Link to this comment | 12-31-20 10:13 PM
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Happy new year, reprobates.


Posted by: heebie | Link to this comment | 12-31-20 11:18 PM
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81

Happy New Year! I'm on another stakeout.


Posted by: teofilo | Link to this comment | 01- 1-21 2:17 AM
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Happy New Year!


Posted by: Barry Freed | Link to this comment | 01- 1-21 4:13 AM
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AFAICT, both are pretty much the same. Astra-Zeneca/Oxford will likely submit next, but I'm not confident in our ability to give annual boosters for this one for multiple years. Same for the Janssen technology.

Ydnew, Can you elaborate on that? Are you saying that the adenovirus-vectored vaccines might be problematic if we need periodic boosters? Is that because we will already have immunity to the Vector and won't produce antibodies to the spike.

You said the Moderna trial did asymptomatic screeening for infection. I had heard Astra/Oxford did that, but are you saying that Moderna did that too. How often?

* Autocorrect tried to change vector to Velcro.


Posted by: Bostoniangirl | Link to this comment | 01- 1-21 5:21 AM
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Happy New Year, imaginary friends.


Posted by: One of Many | Link to this comment | 01- 1-21 5:24 AM
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83.2: Yes, right. The immune response to the vector may become a problem - we may end up with dropping immunity to coronavirus but solid adenovirus immunity. Developers of adenovirus-based vaccines are careful to use ones that aren't already circulating in humans. I think it will work solidly for the first round of vaccinations, but I'm not sure how well it would hold up if we need to do frequent boosters. That said, I bet you could do boosters with a different vaccine type if needed. I think switching vectors isn't so practical at this point in the technology's lifetime.

83.3: Moderna did nasal swabs pre- and post-dose 1. The numbers are too small to confidently quantitate reduction in asymptomatic cases, but researchers found a 2/3 reduction in asymptomatic cases following the first dose.
https://www.fda.gov/media/144453/download

For what it's worth, one of the secondary trial endpoints is to determine vaccine protection against infection regardless of symptoms and severity, but I'm not sure how you get at asymptomatics without random testing of trial participants with no symptoms. You could rely on people bring tested for other reasons (like pre-surgery or something), but that would be a pretty small number. Then again, perhaps they'll do a stratification of efficacy vs symptom severity that would reasonably allow you to extrapolate protection.


Posted by: ydnew | Link to this comment | 01- 1-21 6:35 AM
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And 69, you're welcome. Immune systems are weird, but we've done enough vaccine trials to understand when problems will show up.

79: You forgot the money. So much money poured into this after years and years of painstaking basic research to get to the finished product. I think it's easy to overlook how much faster you can move if you can hire a ton of CROs, overlap phases in trials, and equip all your trial sites with the instrumentation needed. I underestimated how much of a difference that would make to the timelines.


Posted by: ydnew | Link to this comment | 01- 1-21 6:42 AM
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85: Weekly testing would have been great. I think there might be some studies of HCWs that will be doing that going forward.

I wish we would put money into the science of non pharmacological interventions - like filtration, ventilation and other ways to disinfect indoor air in public places.


Posted by: Bostoniangirl | Link to this comment | 01- 1-21 6:54 AM
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I hope I'm wrong, but I think Trump will still be in office at the end of this year.


Posted by: Roger the cabin boy | Link to this comment | 01- 1-21 10:12 AM
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Well at least this was the wrong thread which I'll count as a good start.


Posted by: | Link to this comment | 01- 1-21 10:13 AM
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It just gets worse. The guess they've given out as to motive for the pharmacist who deliberately spoiled vaccines is:

Police said that detectives believe he knew the spoiled doses would be useless and people who received them would mistakenly think they'd been vaccinated when they hadn't

On the plus side, he has been charged with three felonies, including reckless endangerment.


Posted by: Minivet | Link to this comment | 01- 1-21 11:21 AM
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True legal fact. If you cover the "p" on your pharmacy license before dispensing deliberately ruined medications, you can't be held accountable for fraud.


Posted by: Moby Hick | Link to this comment | 01- 1-21 1:16 PM
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91: There's even an album about it.


Posted by: One of Many | Link to this comment | 01- 1-21 8:11 PM
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79: Out of my wheelhouse, but as I understand it the worry is although Pfizer's group mirrored the demographics of the population, the 10% that's Black, etc., isn't a big enough with respect to the study for there to be confidence in the results of the study for minority populations. E.g., if there were 95000 people in the study, only 9500 were Black, and that's the number the objectors are saying is relevant and too low.


Posted by: Cala | Link to this comment | 01- 1-21 8:26 PM
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I think you can get the jab in the arm instead of the wheelhouse.


Posted by: Moby Hick | Link to this comment | 01- 1-21 8:51 PM
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Pirates are advised to get the jab in the wheelhouse in order to reduce Arrr Nought.

93: but unless there's a good reason to believe that the vaccine might not work on BAME patients, or might cause side effects that it doesn't cause in other groups, then that's no more worrying than any other small minority being represented only in small numbers. Probably only fifty or so people in Montana were in the study and so it is certainly true that we have no idea whether there are any specific dangers to Montanans.
And also this is kind of a Catch-22 - isn't it true that BAME people were underrepresented in the trial populations _because of their mistrust of health care_?


Posted by: ajay | Link to this comment | 01- 2-21 4:54 AM
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95: What I've heard is that Moderna was pretty good about this. I don't know as much about Pfizer. Astra Zeneca, on the other hand, was less good. It was also mostly younger people.


Posted by: Bostoniangirl | Link to this comment | 01- 2-21 5:25 AM
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I know NIAID were the ones giving tons of support to Moderna, and I doubt they'd underpower for statistical analysis on side effects in minorities. (A friend told me that three weeks ago was the first weekend that statisticians took off since February.) I will say that it's possible the exact numbers will shift with the rollout. I think the only number that's important is that in the experimental arm in trials, I believe there were no severe cases. If African Americans (or Hispanics) are much more likely to have severe cases (yes), then we might see a lower percentage. That said? It's still going to be really, really good, and it's a stupid thing to argue about with folks who won't get the nuance in a case where the other option is no vaccine. I'm no communications expert, but it seems like the clear message should be "safe and effective."

The AZ trial screwups were so severe, I am surprised regulators approved on an emergency basis in the UK. I was honestly expecting a delay in their application so they could actually get more data. I also think they've been less transparent.


Posted by: ydnew | Link to this comment | 01- 2-21 7:28 AM
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Oh, and ajay? For real, UK is going to single dose everything? I saw the analysis that suggests more people is better even assuming only 50% protection, but that decision indicates dire straits.


Posted by: ydnew | Link to this comment | 01- 2-21 7:52 AM
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Moderna for nothing and the sticks for free.


Posted by: Moby Hick | Link to this comment | 01- 2-21 8:03 AM
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heh.


Posted by: heebie | Link to this comment | 01- 3-21 7:06 PM
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Belatedly to 86: "I think it's easy to overlook how much faster you can move if you can hire a ton of CROs, overlap phases in trials, and equip all your trial sites with the instrumentation needed. I underestimated how much of a difference that would make to the timelines."

In places that don't ban analogies, I have compared the covid vaccine effort to the way that Indy car teams change tires. Not every set of tires can be changed that way, but some can, and in this case should.


Posted by: Doug | Link to this comment | 01- 4-21 3:11 AM
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191.last: There is no warm. There are no cockles. There is only Zuul.


Posted by: JP Stormcrow | Link to this comment | 01- 4-21 5:56 AM
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There is no wrong thread.


Posted by: JP Stormcrow | Link to this comment | 01- 4-21 5:57 AM
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