I think you’re mixing up two different fractions, there. The fraction of doses that have been given to nursing homes will go down as time goes on, because most people aren’t in nursing homes. Don’t look at the fraction of doses given to people in nursing homes; look at the fraction of people in nursing homes given doses.
I don’t think so. They seem to be saying nursing homes were given x doses and they used 1/3x.
Are they including staff with that number? We have a low rate of staff who took the vaccine and a high percentage of patients.
FigNorton is correct. And that I noticed it didn’t say if they were including only residents in the stats or residents and staff; unfortunately, I can’t find that particular NH NPR page at the moment to check (since it definitely had a bunch of fine print I didn’t scrutinize), just articles decrying the stats. I’ll see if I can try find it tomorrow on the other computer since I’m almost sure I bookmarked it.
Whaaaaaat???!?! This is dangerously wrong!
In almost all cases, the issue with booster shots is that they are taken too close together, not too far apart. eg: In this meta-study, the authors looked at a study of patients taking the HPV vaccine as a 3 dose, 2 doses 6 months apart, 2 doses 2 months apart and 1 dose. The incidence of HPV were 0.4%, 0.8%, 1.3% and 1.1%. In other words, taking 2 doses 2 months apart was worse than even 1 dose!
The originally recommended schedule of the HPV vaccines was to administer 2 priming doses (at one or 2 months interval) and a single booster dose at 6 months. A single priming dose is likely to be adequate for such a vigorously immunogenic vaccine, especially in adolescent populations with high immune-competence. The memory B-cells require at least 4–6 months to mature and differentiate into high-affinity B-cells. The booster dose at 6 months can efficiently reactivate the memory B-cells to give a long lasting protection. It is therefore important to maintain the spacing between the doses of the vaccine to at least 6 months, if 2 doses are administered. Studies have documented optimal B-cell induction after 2 doses of HPV vaccine administered at an interval of 6 months in adolescent girls (9–13 years)
With the MMR vaccine, this study shows that the timing of the booster shot does not matter at all within a range of 6 months to 5 years. The current 5 year recommendation is purely to ease administrative burden. The only recommendation is that the second shot not be taken within 28 days of the first.
Current practice calls for the administration of 2 doses of MMR, the first after the first birthday (12 to 15 months) and the second at school entry (4 to 6 years). The recommendation for the second dose at this age range is based on administrative considerations. MMR can be administered at an earlier age as long as the interval between the doses is 28 days or longer.
If you take a look at the WHO Recommendations for Interrupted or Delayed Routine Immunization, the default recommendation is for a delayed booster shot is to resume without repeating the previous dose. The only two vaccines that they recommend starting over are one type of Cholera and Typhoid vaccine and even then, only if the delay is more than 21 days. The minimum intervals between doses of any vaccine on that list are at least 4 weeks , with many in the months to years range.
The reason why the COVID booster shot was set at 3 weeks was purely to make the trials go faster. Based on everything we know about immunology, extending the span between shots is extremely unlikely to make it less effective and highly likely to make it more effective. As we gather more data, if COVID is like every other vaccine, the optimal spacing between shots is likely to be in the months range, not the weeks range.
There’s a slight asterisk in this model in that you are slightly less protected in the duration between your first and second shot and since COVID is currently an ongoing pandemic, there’s a slight chance you may catch it during this period which might justify shortening the time window in the short term. However, the reason is because your chances of catching COVID are several thousand times greater than any of the other diseases we currently vaccinate for, not some absurd theory that your immune system “assumes” it was a harmless protein.
I cannot believe I had to spend an hour debunking this dangerous nonsense and you should be ashamed of yourself for pretending to have expertise you absolutely do not have.
Isn’t it also true that they didn’t widely test any other span of time between shots? If so, it’s hard to say this time frame that just happens to work is best practice when there’s been nothing to compare it to yet.
Yes, hence why all the drug companies are careful to say there is “no evidence” efficacy is the same with a longer interval because they don’t want to be held liable even though they know damn well it probably will have no negative effects.
Found the link: Explore the Data: Tracking COVID-19 in New Hampshire | New Hampshire Public Radio
While it’s nice to see there’s been improvement over the past week, long-term care is still by far the congregate setting in NH that has vaccinated the least - note that the pharmacy partnership program covers all but 980 of the 34,140 New Hampshire residents living in long-term care settings. Of the 26,325 doses that have arrived at the ltc facilities doors (according to the footnotes) thus far they’ve made it into only 12,439 arms. Well, 12,072 arms given 367 2nd doses have been given.
And to answer the question asked earlier, to the paper cited in the footnotes shows it is just patients in the totals being stated in the nhpr chart
My wife’s assisted living facility, all residents over 80, just got scheduled to receive their vaccine next week. They got their first Covid case in a resident last weekend and the 2nd staff member (my wife) at the same time. If they weren’t doing the weekly testing, they would have found neither as both had no symptoms.
Thank you for informing me of the “dangerous nonsense” in my prior post and the degree of shame I should shoulder as my burden. You will perhaps extend the same courtesy to researchers at BioNTech and Pfizer who expressed a similar concern regarding the delay of booster shots and the unknown impact upon efficacy. They will no doubt regard your sagacious message with all of the merit that it is due. I am gratified to hear that this apparently gave you a good cardiovascular workout and the attendant benefits to your personal health.
You are correct that the booster intervals for the Pfizer and Moderna vaccines (21 days and 28 days respectively) were likely selected as the minimum safe interval to prevent the vaccine-associated Arthus reaction. The CDC also notes that there is no maximum interval on application of the booster associated with either of the mRNA vaccines. However, it is not true that all vaccines have equal or better efficacy with a longer interval between the initial vaccination and a booster. The trivalent oral polio vaccine in particular has a quantifiable reduction in effectiveness if the booster schedule is significantly delayed. This is for an interval exceeding four years, but the point remains that immune response is just not something that can be estimated de novo and hence the need to adhere to evidence-based dosing protocols to the extent possible.
The push to distribute the ‘reserve’ vaccines scheduled for booster shots in order to provide some degree of inoculation for a larger segment of the population would appear to be driven by political expediency rather than well-founded scientific expertise. While Moncef Slaoui, the former GlaxoSmithKline executive and Trump Administration appointee who deftly championed the United States “Warp Speed” initiative to its effective and well-coordinate effort to distribute vaccines to the states with clear guidance on how to schedule vaccinations, is in favor of this notion, Dr. Anthony Fauci–an actual physician-scientist who has worked in public health and infectious disease for nearly four decades, not only as a noted researcher and an able administrator but also as an editor and author on the ubiquitous Harrison’s series of handbooks on internal medicine and infectious disease–has registered his significant concern of deviating from the protocol established by the clinical trials, or in his own words:
Regardless of emotions about following or not the vaccination protocols, delaying vaccination means that the full level of protected by the vaccine will not be provided to the inoculated population, which are generally the most exposed and vulnerable demographics (e.g. medical personnel treating COVID-19 patients, the elderly, and people with underlying conditions). The degree of protection that partial immunity offers to those populations with high viral load exposure or underlying conditions is unknown but it should be evident that they are the priority for the best possible protection while other sections of the population can take non-medical protections (e.g. physical distancing, mask wearing, avoiding large gatherings and poorly ventilated spaces, et cetera) to prevent spread of contagion.
There is also the issue that partial inoculation to the ~50% level demonstrated by single dose vaccination is insufficient in and of itself to achieve the necessary level of protection to achieve the heard immunity threshold, so if vaccine production cannot be accelerated to provide necessary two doses for a large portion of the population expeditiously, we will not be able to reduce effective transmissibility to the extent that it would be possible to reopen up the economy at large, e.g. safe indoor dining, large gatherings, et cetera. So the notion of distributing the booster doses as initial vaccinations in order to get back to a fully open economy is very to be self-defeating.
As for doing so to address the increase in infections stemming from the holiday gatherings, that would be closing the barn door after the horses have done run away. Using the vaccines in the way they were intended and tested in clinical trials while looking to increase production and approve more vaccine candidates is the scientifically valid way to proceed.
Thank you, again, for your concern about my “dangerous wrong” post and general lack of competence. As I have not made any pretense of being an expert in immunology and vaccine development and am merely a reasonable well-read layperson with a shelf of microbiology and infectious disease texts who endeavors to keep up with research and make observations consistent with leading experts in the field, any constructive criticism and corrective information is appreciated. I’m also glad I could give you reason for such an energetic workout.
Warmest regards,
Stranger
I’m well aware of the many public health officials who have come out on the record not advising for delaying the second shot and I’m aware of the myriad considerations they have to make (including ones I explicitly pointed out in my post), many of which don’t have to do with public health or immunology. I’m certainly not aware of any public health official whose state reason was anything similar to:
Which is not talking about the current vaccine but about historical vaccines for which, when asked for a cite, you wave it off with a blithe
When called on it, you try to pull an example out of your ass
And you somehow manage to dig up a paper from 1978 which shows that booster intervals up to 4 years are fine which isn’t remotely in the same universe as “protective immunity that will fade in a few months”. I assumed if your point was so obvious as to be included in textbooks, you could find a more compelling example than this.
I am not versed on all vaccines so it’s entirely possible there are one or two out there that function bizarrely in the way you stated but even then, I am extremely doubtful, I’ve never encountered a single explaination for vaccines that sounds remotely like “the immune system ‘assumes’ that it wasn’t a real threat and doesn’t develop long term response in order to prevent allergic response to what could just be a harmless protein”
If you can find an immunology textbook written in the last 20 years that specifically states that this is a common way that vaccines work, I will completely recant my statement.
But the plain fact of the matter is that for almost all extant vaccines, the primary public health messaging is that booster shots shouldn’t be taken too close together. To the extent that they emphasize timeliness for the next dose, it’s primarily to make sure people actually show up. Almost all of them are not overly concerned about delaying the booster and the advice is to just continue where you left off.
What happened is you wrote a bunch of smart sounding nonsense that sounds superficially plausible to a layperson but lives in a completely different universe to the very basics of how vaccines work.
Hopefully well before that TPTB will look to those outposts of civilisation where a considerable measure of success has been achieved. Through a mixture of luck, geography, social responsibility and learning from the evolving science we can now sit back and watch the progress of one of the world’s largest series of in vivo experiments into vaccine efficacy.
Elsewise it would seem to be a case of “welcome our Antipodean Overlords”
“But–and I am only saying this because I care–there are a lot of decaffeinated brands on the market today that are just as tasty as the real thing.”
Stranger
Moderating
Let’s avoid personal sniping in this forum. No warnings issued.
Colibri
QZ Moderator
I understand the good intentions behind your argument, but there’s an important point you haven’t considered: it’s not that some protection is better than none; it’s that there’s little evidence the first dose provides much protection beyond the first few weeks:
See this Scientific American article:
In the trials, the Pfizer vaccine provided partial immunity about two weeks after the first dose, with an efficacy of 82 percent. But there are no data on whether protection lasts longer than three weeks, when the second dose was given.
And this from the British Medical Journal:
Pfizer and BioNTech themselves have already urged caution on the grounds that their data ends at day 21, and “there is no data to demonstrate that protection after the first dose is sustained after 21 days”. It’s possible that the protection people seem to have will suddenly drop off after that point – in fact, this wouldn’t be surprising based on the way the immune system usually works.
[all bolding mine]
So we’re not talking about twice as many people having a pretty good level of immunity; we’re talking about the strong possibility that people having had only one dose will have very little immunity 4 weeks later, while that one dose is still being distributed.
I’ve considered it, but I’ve concluded it’s more important to get shots into as many people’s arms as possible.
I understand the concerns that the single dose might be less effective in terms of providing 95% percent inoculation against the virus in those who receive the vaccine.
The flip side is that there is growing evidence that the vaccine is preventing severe COVID-19 cases, and if that holds, and if we have strong evidence (even if it’s not airtight evidence at this point) that a single dose is preventing people from hospitalization…I want that damn dose. I want others to have it as well.
We would then still have to keep in place the same social distancing and mask wearing to prevent the actual spread of the virus. But the vaccine has to be thought of not as a magic pill, which is what I think a lot of people want to view it as, but it instead needs to be regarded as another highly important layer of protection.
I doubt this is the last version of the vaccine that we will see. The virus will mutate in response to vaccines, and the vaccines themselves will have to be adapted in the future anyway, like the flu vaccine.
I’m sorry (really), but as we keep trying to tell you, the immune system doesn’t work like that. Here’s a quick-and-dirty explanation that will show you why you are, most regrettably, wrong:
You get one dose of a vaccine. Your body’s B cells rush in. B cells make antibodies, but they die in only a few weeks. Think of them as elite warriors who strike fast but die before they can secure the borders: at first, your body will have lots of antibodies, but as those antibodies die off, you lose that protection.
You get the second dose of the vaccine. That triggers the arrival of certain T cells that DO confer long-term immunity. Think of them as the troops that don’t respond to the first alarm, but when they do arrive, they’re there for good–or at least for long periods.
As the second link says, “Most vaccines require booster doses to work.” Note: not to give us better immunity, but to work.
I get your frustration and applaud your determination. Unfortunately, neither changes the way our immune systems work.
Hope this helps.
Getting shots into as many arms as possible does no good after a month. Do two shots into person A, then move onto two shots into person B, then 2 into person C…
Listen, the protection GOES AWAY, AFAWK, after a month or so. It isn’t merely ‘less effective’, it stops being effective meaningfully.
It’s science, not math.
Do you have a cite for B cells dying so quickly? Lots of vaccines don’t even use booster shots or have them years apart. Old people have been found to have B cells from the Spanish flu.
And don’t get this confudence in the vaccine being useless in a month. Where are you people getting this?