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Post by ragan on May 17, 2021 22:29:44 GMT -6
Heheh. I'm certainly not reporting anything. What's to report? Some people are comfortable with frank discussion and differing views being directly addressed and some people aren't (which is of course fine, there's no requirement to read this particular thread). For my part, I think everyone's been pretty damn civil.
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Post by teejay on May 18, 2021 10:49:01 GMT -6
Just texted with a friend of mine. I've known and played tennis with him for years. Haven't seen him on the courts in a while and asked him what's up. He said, and I quote: "I still have a bum arm, complication from the COVID shot believe it or not. Appears I may have to have some kind of surgery." He's a very healthy guy and has never had an arm problem before.
Whatever you want to believe or promote about the vaccines being "safe", the reality is we are far short of evidence of what this is doing and will potentially do to people, especially over the long-term. No one has knowledge of the side-effects or health impact these may have in the future, especially for our younger population. This is the classic case of "we don't know what we don't know". Yet, we have quickly gone from targeting/protecting those we know are the most vulnerable to fear-induced/near-coerced mass vaccination...now including children who are scientifically shown to be least impacted/vulnerable...without regard for the initial "science" of who really needs it, nor the extremely high recovery rate and natural antibodies of those who contract it. Not to mention the beginnings of discrimination we're starting to see against those who don't wish to submit themselves to experimental vaccines.
We have no clue how long the vaccines will "protect" someone, and it is already proven that getting the vaccine does not stop everyone from contracting the virus. If discrimination is imposed going forward, at least it should be based on what is concrete...which is whether or not someone has the antibodies, not just that they had a shot.
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Post by matt@IAA on May 18, 2021 13:14:56 GMT -6
Couple of thoughts on that 1. All vaccines, like all medicine, have potential side effects. Even something as innocuous as Advil can cause internal bleeding. Medicine should always be weighed in a cost-benefit. This vaccine has side effects like any other, but they're rare. That vaccines have side effects doesn't make them unsafe or a bad idea. Any vaccine or injection can cause shoulder injury from the injection itself. Here's two resources on that. www.ismp.org/resources/prevent-shoulder-injuries-during-covid-19-vaccinationsccandh.com/vaccines-and-shoulder-injuries/2. mRNA has a half life in the body of a couple of hours. Whatever is happening from the mRNA injection is over in a week. 3. COVID also has rare side effects. The rare side effects from COVID (like GBS and blood clots) are more common than the rare side effects of the vaccine. The reality is ultimately you have a high chance of getting COVID if you do not get the vaccine. 4. Children and young adults on average have incredibly mild cases of COVID and don't seem to contribute to spread. I don't believe we should be vaccinating kids for two reasons: cost-benefit isn't there if the disease risks become near-parity with vaccine side effect risk, and also every vaccine has an opportunity cost. The world needs vaccines right now for the vulnerable populations, and American kids are basically a risky waste of vaccines that could be going to people who actually need them. 5. Ultimately herd immunity is part of any vaccination strategy, so mass vaccination is always the goal. The only way this ends is if enough people either get it and recover (or die, sadly) or are vaccinated against it. 6. We don't know how long vaccines protect someone because we haven't been giving them vaccines for long enough to say with certainty. Certainty comes from observation. So far we know that the Pfizer and Moderna vaccines provide protection for at least six months. The reason it's "at least" is because that's as long as we've been following volunteers in the clinical trials. It may be similar to the flu, where a combination of new variants that mutate seasonally and naturally waning immunity require boosters. But we don't know, because vaccines range from only a few months like the flu to once in your life like measles. No one really knows yet, and that's ok. 7. This vaccine was never intended to prevent everyone from contracting the virus. However, it does reduce the likelihood of getting the virus by 90%+ and brings the risk of hospitalization and death to near zero. Also - it's sad that it needs to be said but yeah, there's no excuse for treating people with anything other than kindness and respect regardless of what they think about masks, or vaccines, or whatever. People should relax a bit, because the in-your-face and hypernegative approach just makes people dig in.
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Post by ehrenebbage on May 18, 2021 13:42:02 GMT -6
4. Children and young adults on average have incredibly mild cases of COVID and don't seem to contribute to spread. I don't believe we should be vaccinating kids for two reasons: cost-benefit isn't there if the disease risks become near-parity with vaccine side effect risk, and also every vaccine has an opportunity cost. The world needs vaccines right now for the vulnerable populations, and American kids are basically a risky waste of vaccines that could be going to people who actually need them. Really appreciate how well you communicate. Clear, concise, and seemingly based on the best info you can find. #4 raised questions for me. - Seems like the degree to which children spread COVID is still unclear. - Is the disease risk actually equal to or lesser than the vaccine side effect risk, or are you just posing a hypothetical? - Agreed that the world needs vaccines for vulnerable populations, but there are political and industry factors which are limiting supply in other regions...maybe those should be addressed first.
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Post by matt@IAA on May 18, 2021 15:12:29 GMT -6
- Seems like the degree to which children spread COVID is still unclear. Everything is unclear, all the time hahaha. But it *seems like* they don't contribute significantly to spread on a macro level. Schools haven't been the source of big community spread, and outbreaks at school tend to be among the staff rather than students. www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/transmission_k_12_schools.htmlThis study looked at rates before and after schools opening in Israel and it seems like the very young (less than 9) especially don't contribute to spread. jamanetwork.com/journals/jamanetworkopen/fullarticle/2778940?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=042621- Is the disease risk actually equal to or lesser than the vaccine side effect risk, or are you just posing a hypothetical? Well the risk of fatality for a child due to COVID in the United States is incredibly low. In the entire country for children under the age of 18 there have been a total of 287 deaths from COVID19. That's comparable to the risk from seasonal flu (which includes the fact that many children receive flu shots, so COVID is less lethal than seasonal flu for kids - thank God!). It seems like the single highest risk from the vaccine is anaphylaxis (which is not unique to this vaccine). The rate is 2-10 cases per million doses (in adults) depending on the vaccine, and its riskier if you have a history of allergy. But, they also monitor for it when giving shots so it isn't a death sentence. It also isn't the only side effect. The published ballpark IFR for kids is something like 10 per million cases. There's not much upside to be had, especially compared to an adult. - Agreed that the world needs vaccines for vulnerable populations, but there are political and industry factors which are limiting supply in other regions...maybe those should be addressed first. Eh, for example the US has said they'll be sending vaccines to Canada and Mexico, but only a paltry 1.5 and 2.5 million. That number could be much higher, and with our economic ties and travel, it's a win-win.
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Post by ehrenebbage on May 19, 2021 7:45:47 GMT -6
Gotcha. Thanks!
Such an interesting time. It's a pressure cooker situation and we all respond to pressure in different ways. As a dad to two young children it's definitely pushing my protective instinct buttons.
Kids can't make these decisions for themselves, and they can't manage the outcomes of the decisions that are made for them. It's similar for various segments of the population who are vulnerable and don't have the resources to adapt to changing circumstances on short notice. It's an incredibly difficult public policy challenge.
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Post by teejay on May 19, 2021 11:09:30 GMT -6
New Research Suggests Number of Kids Hospitalized for COVID Is Overcounted"The implications of the findings of these two studies are enormously important, as reports of pediatric hospitalizations have regularly made headlines over the past year, greatly affecting public perceptions about risks to children." "The hospitalization numbers for children were already extremely low relative to adults — at the pandemic’s peak this winter, it was roughly ten times lower than for 18-to-49-year-olds and 77 times lower than those age 65 and up. But cutting the pediatric numbers by nearly half is a striking difference, making the actual rates vanishingly small." "Pediatric hospitalization figures for COVID-19 also influence policy on school openings and guidelines, camp recommendations, and other political decisions. Gandhi and Beck’s commentary noted, “Children have suffered tremendously due to policies that have kept schools and recreational facilities closed to them, and the burden has been greatest on children who are low-income and English-language learners.”" "Moreover, the findings arrive as parents have begun vaccinating children under the expedited “emergency-use authorization” against a virus that, these findings suggest, poses a dramatically lower incidence of pediatric hospitalizations than the data have shown thus far. Stefan Baral, an infectious-diseases epidemiologist and physician at Johns Hopkins, wrote in the British Medical Journal about the risk-benefit calculus of vaccinating children against a disease that poses a “very low likelihood of severe outcomes” to them, which, he argued, means it does not meet the definition of an “emergency.”" (emphasis mine)
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Post by Tbone81 on May 19, 2021 11:25:28 GMT -6
You know, I have no doubt that some 17-18 year olds have suffered from Covid (albeit in low numbers), but every pediatric case I've read about, at least of children 10 and younger, has been kids who had serious medical issues and who happened to ALSO have covid. And with these specific cases I've read about, it wasn't like their comorbidities caused them to die from covid, rather their comorbidities killed them and they just happened to test positive for COVID too.
I can remember two cases of premature infants dying from complications of birth who tested positive for covid hours before they died. They clearly died from complications of their prematurity yet the news headlines read "Infant Dies From Covid".
From what I've seen working in the Hospital (and my specialty is Neonates for what its worth) the risk to children 16 and under is virtually zero. Feel free to take that with a grain of salt as its just my experience and not necessarily statistically meaningful.
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Post by matt@IAA on May 19, 2021 11:41:34 GMT -6
teejay completely agree about the kids not meeting the standard of the FDA emergency use provisions. COVID19 doesn't seem to fall into that category for children.
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Post by ericn on May 19, 2021 13:00:39 GMT -6
Was the vaccine designed to work for everybody but the Yankees? I heard the Yanks got their Vaccines from the Red Sox team doctor!!! Gee Doc, now if only there was only this class of drugs known for increasing how far one could hit a ball while ironically shrinking there balls. Drugs that long term use of is known for screwing up ones immune system. Because most jobs in baseball are never filled with players who didn’t quite have it.
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Post by ericn on May 19, 2021 13:04:03 GMT -6
New Research Suggests Number of Kids Hospitalized for COVID Is Overcounted"The implications of the findings of these two studies are enormously important, as reports of pediatric hospitalizations have regularly made headlines over the past year, greatly affecting public perceptions about risks to children." "The hospitalization numbers for children were already extremely low relative to adults — at the pandemic’s peak this winter, it was roughly ten times lower than for 18-to-49-year-olds and 77 times lower than those age 65 and up. But cutting the pediatric numbers by nearly half is a striking difference, making the actual rates vanishingly small." "Pediatric hospitalization figures for COVID-19 also influence policy on school openings and guidelines, camp recommendations, and other political decisions. Gandhi and Beck’s commentary noted, “Children have suffered tremendously due to policies that have kept schools and recreational facilities closed to them, and the burden has been greatest on children who are low-income and English-language learners.”" "Moreover, the findings arrive as parents have begun vaccinating children under the expedited “emergency-use authorization” against a virus that, these findings suggest, poses a dramatically lower incidence of pediatric hospitalizations than the data have shown thus far. Stefan Baral, an infectious-diseases epidemiologist and physician at Johns Hopkins, wrote in the British Medical Journal about the risk-benefit calculus of vaccinating children against a disease that poses a “very low likelihood of severe outcomes” to them, which, he argued, means it does not meet the definition of an “emergency.”" (emphasis mine) The thing was kids were getting really really sick, so it was seamed better to admit than street, yes the first rule of medicine is not do no harm, it’s cover your ass.
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Post by Tbone81 on May 19, 2021 13:12:20 GMT -6
New Research Suggests Number of Kids Hospitalized for COVID Is Overcounted"The implications of the findings of these two studies are enormously important, as reports of pediatric hospitalizations have regularly made headlines over the past year, greatly affecting public perceptions about risks to children." "The hospitalization numbers for children were already extremely low relative to adults — at the pandemic’s peak this winter, it was roughly ten times lower than for 18-to-49-year-olds and 77 times lower than those age 65 and up. But cutting the pediatric numbers by nearly half is a striking difference, making the actual rates vanishingly small." "Pediatric hospitalization figures for COVID-19 also influence policy on school openings and guidelines, camp recommendations, and other political decisions. Gandhi and Beck’s commentary noted, “Children have suffered tremendously due to policies that have kept schools and recreational facilities closed to them, and the burden has been greatest on children who are low-income and English-language learners.”" "Moreover, the findings arrive as parents have begun vaccinating children under the expedited “emergency-use authorization” against a virus that, these findings suggest, poses a dramatically lower incidence of pediatric hospitalizations than the data have shown thus far. Stefan Baral, an infectious-diseases epidemiologist and physician at Johns Hopkins, wrote in the British Medical Journal about the risk-benefit calculus of vaccinating children against a disease that poses a “very low likelihood of severe outcomes” to them, which, he argued, means it does not meet the definition of an “emergency.”" (emphasis mine) The thing was kids were getting really really sick, so it was seamed better to admit than street, yes the first rule of medicine is not do no harm, it’s cover your ass. Hey Eric, care to elaborate? I haven't seen any evidence of kids getting really sick from Covid. I'm wondering what your experience has been.
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Post by ericn on May 19, 2021 13:14:50 GMT -6
teejay completely agree about the kids not meeting the standard of the FDA emergency use provisions. COVID19 doesn't seem to fall into that category for children. This from a friend at TX children’s : it’s not that they were or are seeing a ton of sick kids, it’s just that the kids we do see are really really bad. They live, but we have to do a lot for that to happen and with the effects we are seeing with adult long haulers we will only with time know the lasting effects on kids. Plus you have to add in the idea of non symptomatic transmission, even if the kid isn’t sick, he could transmit it to adults. The other thing is those studies represent a space in time as far as how this virus morphs at some point the virus will adapt and realize the young makes great hosts.
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Post by ericn on May 19, 2021 13:17:30 GMT -6
The thing was kids were getting really really sick, so it was seamed better to admit than street, yes the first rule of medicine is not do no harm, it’s cover your ass. Hey Eric, care to elaborate? I haven't seen any evidence of kids getting really sick from Covid. I'm wondering what your experience has been. Early on there was a number of kids who were having major respiratory issues who were testing positive via PCR. They had given it, it’s own diagnostic that now escapes me.
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Post by ericn on May 19, 2021 13:20:20 GMT -6
You know, I have no doubt that some 17-18 year olds have suffered from Covid (albeit in low numbers), but every pediatric case I've read about, at least of children 10 and younger, has been kids who had serious medical issues and who happened to ALSO have covid. And with these specific cases I've read about, it wasn't like their comorbidities caused them to die from covid, rather their comorbidities killed them and they just happened to test positive for COVID too. I can remember two cases of premature infants dying from complications of birth who tested positive for covid hours before they died. They clearly died from complications of their prematurity yet the news headlines read "Infant Dies From Covid". From what I've seen working in the Hospital (and my specialty is Neonates for what its worth) the risk to children 16 and under is virtually zero. Feel free to take that with a grain of salt as its just my experience and not necessarily statistically meaningful. The thing is how many kids ( and adults have these co morbidites but haven’t been diagnosed?
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Post by Tbone81 on May 19, 2021 14:35:59 GMT -6
teejay completely agree about the kids not meeting the standard of the FDA emergency use provisions. COVID19 doesn't seem to fall into that category for children. Plus you have to add in the idea of non symptomatic transmission, even if the kid isn’t sick, he could transmit it to adults. The other thing is those studies represent a space in time as far as how this virus morphs at some point the virus will adapt and realize the young makes great hosts. Non-symptomatic transmission is real, but in practical terms exceedingly rare. It's questionable weather you're actually "infected" if you don't have symptoms. In prior pandemics, like SARS, MERS etc, being symptomatic was required for a positive diagnosis. We kinda threw that out the window with COVID. Pre-symtomatic transmission, however, is an entirely different thing.
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Post by Tbone81 on May 19, 2021 14:42:41 GMT -6
You know, I have no doubt that some 17-18 year olds have suffered from Covid (albeit in low numbers), but every pediatric case I've read about, at least of children 10 and younger, has been kids who had serious medical issues and who happened to ALSO have covid. And with these specific cases I've read about, it wasn't like their comorbidities caused them to die from covid, rather their comorbidities killed them and they just happened to test positive for COVID too. I can remember two cases of premature infants dying from complications of birth who tested positive for covid hours before they died. They clearly died from complications of their prematurity yet the news headlines read "Infant Dies From Covid". From what I've seen working in the Hospital (and my specialty is Neonates for what its worth) the risk to children 16 and under is virtually zero. Feel free to take that with a grain of salt as its just my experience and not necessarily statistically meaningful. The thing is how many kids ( and adults have these co morbidites but haven’t been diagnosed? In this specific context their co-morbidities are clearly and easily diagnosed. But "co-morbidity" really isn't a great word to describe what I'm talking about. I'm referring to premature newborns (one case was a 26 week neonate) with clear maternal and fetal risk factors, at high risk for death and/or serious medical complications that died but happened to test positive for Covid literally hours before they died. In these cases COVID was completely inconsequential. We see neonates from time to time that get COVID from the process of child birth itself (being infected from their mothers), but I've yet to see one single case where the neonate was harmed from COVID.
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Post by Tbone81 on May 19, 2021 14:50:24 GMT -6
Hey Eric, care to elaborate? I haven't seen any evidence of kids getting really sick from Covid. I'm wondering what your experience has been. Early on there was a number of kids who were having major respiratory issues who were testing positive via PCR. They had given it, it’s own diagnostic that now escapes me. That's interesting. I'll have to look into that. I remember early on hearing some news about a influx with kids with Systemic Inflammatory Response Syndrome that they thought might be COVID. This was early on when testing wasn't widely available. The news died down and I never heard anything else about it. But we (NICU and PICU departments) do regularly communicate with the bigger area Childrens Hospitals as well as national pediatric/neonatal medical organizations, and to my knowledge haven't heard much of anything.
Now, please take that with another grain of salt. My boss is always trying to get me to attend the those meetings, and I rarely do lol. Its a case of "hey we want you take on tons more responsibility, but pay you the same."
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Post by ericn on May 19, 2021 16:40:06 GMT -6
Plus you have to add in the idea of non symptomatic transmission, even if the kid isn’t sick, he could transmit it to adults. The other thing is those studies represent a space in time as far as how this virus morphs at some point the virus will adapt and realize the young makes great hosts. Non-symptomatic transmission is real, but in practical terms exceedingly rare. It's questionable weather you're actually "infected" if you don't have symptoms. In prior pandemics, like SARS, MERS etc, being symptomatic was required for a positive diagnosis. We kinda threw that out the window with COVID. Pre-symtomatic transmission, however, is an entirely different thing.
Yeah the hard and unless your testing everybody all the time really hard to say where that line is, but in this case it seams non symptomatic transmission is a generally excepted reality by most.
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Post by ericn on May 19, 2021 16:45:44 GMT -6
Early on there was a number of kids who were having major respiratory issues who were testing positive via PCR. They had given it, it’s own diagnostic that now escapes me. That's interesting. I'll have to look into that. I remember early on hearing some news about a influx with kids with Systemic Inflammatory Response Syndrome that they thought might be COVID. This was early on when testing wasn't widely available. The news died down and I never heard anything else about it. But we (NICU and PICU departments) do regularly communicate with the bigger area Childrens Hospitals as well as national pediatric/neonatal medical organizations, and to my knowledge haven't heard much of anything.
Now, please take that with another grain of salt. My boss is always trying to get me to attend the those meetings, and I rarely do lol. Its a case of "hey we want you take on tons more responsibility, but pay you the same."
You sit right in the middle of probably the biggest gray zone in this, newborns and premature baby’s. That invisible line between what is mom’s response and what is the child’s. Also hats off to you because most of us couldn’t do it, there is nothing worse than seeing a baby have to deal with any of this. In fact I couldn’t deal with Shriners patients knowing that 3/4 of our young burn victims were either victims of abuse or neglect. Really hard to look at parents knowing that.
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Post by dmo on May 19, 2021 17:18:53 GMT -6
The concern in pediatrics is for MIS-C - Multisystem Inflammatory Syndrome in Children. It's relatively rare but definitely real, has been a concern among the EM community for a while. Here's the CDC link for those interested. Don't think we have a true sense of actual occurrence rate since as noted so many kids are asymptomatic - so very hard to compare risk of vaccine vice MIS-C currently.
Todd,
There have been issues where folks are injecting the vaccine too high on the arm and causing structural damage to the shoulder joint (SIRVA). Can happen with any vaccine that's not properly administered, does not seem to be directly related to Covid vaccine itself. Not sure if this is what your friend has but sounds likely.
I've decided to mostly stay out of this discussion now - at this point I'm just another guy not smart enough to get into vet school (for the record, I agree with Eric, vet med is harder than taking care of people)
Bill
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Post by ericn on May 19, 2021 19:47:06 GMT -6
The concern in pediatrics is for MIS-C - Multisystem Inflammatory Syndrome in Children. It's relatively rare but definitely real, has been a concern among the EM community for a while. Here's the CDC link for those interested. Don't think we have a true sense of actual occurrence rate since as noted so many kids are asymptomatic - so very hard to compare risk of vaccine vice MIS-C currently.
Todd,
There have been issues where folks are injecting the vaccine too high on the arm and causing structural damage to the shoulder joint (SIRVA). Can happen with any vaccine that's not properly administered, does not seem to be directly related to Covid vaccine itself. Not sure if this is what your friend has but sounds likely.
I've decided to mostly stay out of this discussion now - at this point I'm just another guy not smart enough to get into vet school (for the record, I agree with Eric, vet med is harder than taking care of people)
Bill After the hospital pharmacy miss placed my insulin order today I wish I could just call my vet.
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Post by matt@IAA on May 20, 2021 12:36:01 GMT -6
Someone sent me this guy, second time I come across him. Really appreciate it, and this is a good video about vaccinating kids.
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Post by drbill on May 20, 2021 17:22:30 GMT -6
I must laugh. Mike Wallace, 60 minutes and the Swine Flu have been cancelled. (previous video I posted) Heaven forbid we learn from history. I'm sure it will pop up again somewhere else, but it does make the reasonable person wonder.....
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Post by matt@IAA on May 21, 2021 6:21:23 GMT -6
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