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The Myth of "Good" and "Bad" Covid Vaccines

Jambalaya

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A must-read, for people who are concerned about differences between the three Covid vaccines. The source, Stat News, is reputable. I fell prey to this exact perception when I got my J&J vaccine, before realizing I didn't have anything to worry about. The three vaccines are pretty much identical in their success rates of preventing severe illness, hospitalization, and death.

https://www.statnews.com/2021/02/17...ns-overlook-facts-and-could-breed-resentment/

The myth of ‘good’ and ‘bad’ Covid vaccines: Why false perceptions overlook facts, and could breed resentment​


Mike Ryan, the World Health Organization’s health emergencies director, had a conversation recently with his mother, the kind that lots of public health people are having these days, much to their dismay. Ryan’s mother was concerned about one of the Covid-19 vaccines in use in Ireland, where she lives. The one made by AstraZeneca.


Clinical trials had shown the vaccine offered protection against the disease, but less than the vaccine made by Moderna or the one made by Pfizer and BioNTech. Ryan’s mother was worried the vaccine might not be good enough.


Ryan, never one to mince words, decided it was time for a come-to-Jesus chat with his 80-year-old mother. “Whatever vaccine they show up with, you take it,” he told her. “Because that is the best decision you can make on that day for your health.”


That’s a message Ryan and other public health officials are trying to deliver to everyone — but it’s not necessarily one that is being well-received. News coverage and social media posts about clinical trial results are creating a hierarchy of Covid vaccines in the minds of much of the public: “good vaccines” and “bad vaccines.” The former you might try to seek out; the latter might even prompt you to step out of line.


That, health officials say, is a problem.


The concern isn’t just that people will get picky about which vaccine they want, slowing down the task of inoculating enough of the population to blunt the impact of Covid-19. Public health experts also worry a simplified narrative overlooks essential facts — say, that AstraZeneca’s and Johnson & Johnson’s vaccines were being tested in clinical trials after variants of the SARS-CoV-2 virus started to circulate widely, likely reducing their efficacy more than was the case with Pfizer’s and Moderna’s vaccines, the first to be cleared.


The vaccines perceived to be less effective also happen to be ones that may be the best option in rural America or in low-income countries because they don’t require the ultra-cold freezers and complex delivery systems more commonly found in or near major cities.


“I worried that we’re going to have that kind of consumer-driven ‘Oh, is it Moderna? Great! Is it [Johnson & Johnson]? No, thank you, I’ll wait,’” said Alison Buttenheim, an associate professor of nursing and health policy at the University of Pennsylvania, whose research focuses on vaccine acceptance. “That’s just going to delay getting to the coverage that we want to get to.”


In truth, the phenomenon is already playing out, even among some who understand the caveats around when the studies were conducted and the operational benefits of these easier-to-deploy vaccines. STAT asked Emory University immunologist Rafi Ahmed if he would specify a preference should his mother ask for advice about Covid vaccines. Ahmed replied without hesitation: He’d tell her to get one of the messengerRNA, or mRNA, vaccines made by Pfizer or Moderna. “It’s human nature,” he insisted. “It’s common sense.”


Experts say that the problem is likely to worsen with the authorization of more vaccines, each with varying efficacy, dosing regimens (one dose or two), and dose intervals (21 days, 28 days, up to 12 weeks in some cases and places). They also say there are only limited messaging strategies to do something about it.


“I think, right now, the message really has to be that the vaccines that are authorized for use are authorized for use because they will provide significant protection against Covid-19 illness. And if you’re not vaccinated, you have no protection against Covid-19 illness,” said Glen Nowak, director of the Center for Health and Risk Communication at Grady College of Journalism and Mass Communication in Athens, Ga.


Kasisomayajula “Vish” Viswanath, a professor of health communication at the Harvard T.H. Chan School of Public Health, said he is deeply concerned that decisions about where to use some of the vaccines that appear less effective will be viewed through a lens of racial or socio-economic inequality, even if the reasons to offer those vaccines in certain settings make sense from a public health point of view and gets vaccine to those places faster.


“This is going to explode in the near future, I think,” Viswanath warned.

This is not a problem that people in public health anticipated. Virtually no one, after all, expected Pfizer and Moderna, the first vaccine makers to produce clinical trial results, to report such stunning efficacy data, at roughly 95%. Seasoned vaccine researchers —with decades of experience in the often-frustrating field of vaccine development — broke into gleeful giggles when talking about the mRNA vaccines.


For a brief heady period, it seemed like the gods had taken pity on humankind. The Food and Drug Administration quickly issued emergency use authorizations for the two vaccines. Experts including Anthony Fauci, the nation’s leading vaccine official, were predicting multiple vaccines were almost certain to be effective, because they targeted the same protein on the SARS-2 virus.


Then reality set in. The first data on the AstraZeneca vaccine, released in late November, suggested the protection induced by the British-made vaccine was more moderate, somewhere around 62%, depending on the interval between doses.


More recently, clinical trials of two other vaccines have produced results — the Novavax recombinant protein vaccine, based on testing in Britain and South Africa, and Johnson & Johnson’s potential game-changer, a one-dose vaccine.


The Novavax vaccine was nearly 90% effective, except in South Africa, where in the face of a widely circulating variant it was about 60% effective. The efficacy of the J&J vaccine was 66%, though that varied a bit by geography too.


If results of the trials of these vaccines had been the first to be released, the world would have been popping champagne corks. But because the data came after the wildly positive results seen from Pfizer and Moderna, enthusiasm has been muted.


Anna Durbin, a vaccine researcher from Johns Hopkins Bloomberg School of Public Health, noted that most of the trials have focused on the vaccines’ ability to prevent any symptomatic infection — and by that measure there are some differences among the vaccines.


But Durbin, who is running one of the sites for AstraZeneca’s U.S. trial, said many of the infections being detected in the clinical trials are so mild they are only being noticed because trial volunteers are monitored so closely. A report of a sore throat can lead to a Covid test; if it’s positive, that’s a case. By that measure, the differences between vaccines may not prove to be quite as meaningful.


Durbin emphasized that what the world needs is vaccines to prevent severe disease, hospitalizations, and deaths due to Covid. On that front, all of the vaccines tested so far seem to be quite effective.


“I believe that in all the clinical trials that have been done so far, with the seven or eight candidates that we know about, there has been no case of a death or a severe disease with hospitalization occurring in the vaccine group, regardless of which vaccine,” Soumya Swaminathan, the WHO’s chief scientist, said at a press conference last week. “So I think that is clear it is protecting against severe disease.”


That point, however, is getting lost in conversations about the vaccines among ordinary people. So, too, is the fact that the AstraZeneca, Novavax, and J&J vaccines are less expensive than the mRNA vaccines, making them more affordable in developing countries.


The J&J vaccine has another advantage in that is administered in a single dose, which would make vaccinating homeless people much less complicated, to say nothing of people who might otherwise struggle to get time off work to get a two-dose vaccine.


The J&J vaccine is likely going to be the third authorized for use in the U.S.; the FDA’s advisory committee meets to consider it on Feb. 26 and it is widely expected to be authorized by the agency for emergency use within days.


That, experts say, is when the challenge of messaging will likely get harder.


“To me, one of the trickiest things about this is that we are likely to end up with a vaccine — the J&J — that is showing somewhat less effectiveness than these amazing first two that came out of the gate and is also most appropriate for rural settings, low-resource settings, settings without really great freezers,” said Buttenheim.


“And while it would be great … to say, ‘Let’s use J&J in settings where it’s going to be most feasible and appropriate,’ once it’s thought of as the less well-performing vaccine, then it’s like ‘Great, send the [expletive] vaccine to the poor people,’” she said. “There is no easy solution to that. I think from a behavioral science standpoint, the fact that we are anchoring from these 95% effective vaccines is tough.”


The J&J vaccine rollout will be a harbinger of bigger problems to come, Viswanath worries.


“If certain groups in the system get certain kinds of vaccines with differential efficacy, all hell will break loose,” he warned.


Black and Latino Americans have suffered disproportionally higher rates of infection in the pandemic, and are getting vaccinated at lower rates so far than white Americans. “If there is a kind of a differential allocation, even if the reasons are good, that will definitely explode into allegations of racism and mistrust,” Viswanath said. “We already have a lot of mistrust in the system.”


To forestall this, public health officials will need to be fully upfront about which vaccine is being used where and why, Viswanath said. Nowak agreed: “I think transparency is going to be essential. Honesty is going to be essential.”


“The message that what we’re doing is guided by the desire to get as many people vaccinated and protected from Covid-19 illness as fast as possible is the underlying driving motivation,” Nowak said.


Ryan, the WHO official, believes being able and willing to show that vaccine is being allocated through a process that is based on operational needs will help.


“People don’t like it when it’s black-box decision-making,” he said. “Because then they can add the conspiracy theory to it. ‘Ah, you see, the reason why they’re doing that is they don’t like people in rural areas.’ And I can imagine in the U.S. how that might play.”

END
 

Karl_K

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They are equal only if you discount a higher chance of getting sick at all.
For someone in good health j&j is good enough but all the spin in the world dont change facts.
 

Jambalaya

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Karl, the way I read it is that J&J is not as good as Pfizer at preventing mild illness from Covid, but it IS as good at preventing severe disease, hospitalization, and death, and that these two things are true for everyone regardless of beginning health status.

Stat News is independent. I don't think they have any reason to spin anything.
 

Jambalaya

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Karl, just out of interest, have you had your vaccine yet?

I just read another article, and I think I understand a little more. The J&J vaccine didn't record data for mild cases of covid in its trial. It only measured the success of the vaccine in preventing moderate to severe covid, and there were no hospitalizations or deaths in its trials, which were large. Pfizer and Moderna recorded every tiny symptom. So it could be that the J&J prevents mild illness, but we don't know.

This is what I just read: https://www.statnews.com/2021/02/02...eloped-by-pfizer-moderna-and-johnson-johnson/

Regardless, all three vaccines are very good at protecting against getting covid badly, and that's what we need. Maybe later there will be chances to choose which vaccine we get, and I'm sure there will be boosters for all three. (There's already talk of that for all of them.)
 
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Karl_K

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Karl, the way I read it is that J&J is not as good as Pfizer at preventing mild illness from Covid, but it IS as good at preventing severe disease, hospitalization, and death, and that these two things are true for everyone regardless of beginning health status.

That is somewhat true but the spin is the last part that its just as good for everyone.
There are people that even a mild case of covid could potentially kill them and for them the j&j is not the right one to get. Just my opinion after reading everything out there.
 

Karl_K

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Karl, just out of interest, have you had your vaccine yet?
Yes, Pfizer second dose on Saturday I would have rejected j&j.
That page is basicaly the same information that's has been on the cdc website for a while.
 

Jambalaya

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I'm glad you got your vaccine, Karl, and that it was Pfizer. It seems like a really good vaccine. I probably would have chosen that one too, if there was a choice. Maybe I will in the future, if it's possible. Good luck for Saturday!
 

Karl_K

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Whats kinda messed up is results like the j&j would have been seen as awesome in the past but the Pfizer and Moderna reset the benchmarks much higher.
A bunch of the younger people in my family who have to get it for school are mostly getting the j&j.
Im good with that.
 

kenny

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Our culture is SOOOO dumbed down now. :nono:

Only stupid people accept myths as facts.
Screw them.

Listen to the WHO, CDC, IOW our best legitimate medicine and science.
There! problem solved. :dance:
 
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missy

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Our culture is SOOOO dumbed down now. :nono:

Only stupid people accept myths as facts.
Screw them.

Listen to the WHO, CDC, IOW our best legitimate medicine and science.
There! problem solved. :dance:

I've recently been made aware that there are groups of people out there who believe in Urine Therapy. They "age" and drink their own urine because they believe it helps them heal all sorts of ailments. :sick: So uh... when's that meteor supposed to hit Earth?

Yup. No limit to stupidity.


geniusvsstupidity.jpg
 

kenny

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Oh, another thing I recently learned is some people also drink Turpentine. Yet many of those same people refuse to take the COVID vaccine. :wall:

Let them turpentine drinkers die.
Bye Bye. :wavey:
Don't let the door hitcha.

But by refusing this vaccine those fragging Einsteins are helping others to die! :angryfire:
I like freedom too, but not when it's really freedom to harm others.

I just read 41% of republicans don't plan to get the vaccine. :doh::doh::doh:
REALLY!?! :-o:-o:-o

Shirley I hope that this - as those people love to say - is more libtard faux news.
Thanks a lot, all you lovely people! :nono::nono::nono:

 
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seaurchin

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I think those in authority who work so hard to dangerously trick, confuse and manipulate people should get the full consequences of the law for it, whether they’re government officials or news outlet executives.

While people who refuse to listen to reason and stubbornly cling to that whole network of dangerous (to us all) lies drive me nuts, the truth is half the population has below average education and half the population has below average intelligence. And that is exactly the demographic the fascists are targeting with the goal of destroying our democracy. We live in very dangerous times.
 

YadaYadaYada

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I would just like to point out for those directly or indirectly labeling those who refuse a COVID vaccine as stupid or of low intelligence, there is a very real reason for mistrust for one group in particular.

I’m referring to black Americans, they are one demographic that is skeptical and more likely to refuse. Not because they are stupid or of low intelligence or lack critical thinking skills, because they have been subjected by our government to absolutely horrific and inhumane medical experimentations. The very government that conducted these trials and now wants them to roll up their sleeves for what they might consider to be another questionable medical intervention.
 

seaurchin

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I agree with that, Yada, and did not mean that anyone who doesn't want the vaccine or who has a differing viewpoint on anything else has lower intelligence by definition. I am speaking in general terms of a sickening tactic used by some in charge to an alarming degree in recent years.

There is a ton of deliberate disinformation out there these days on many topics and they know a certain percentage of the population will believe it just because the political leader they favor said it or just because it was stated on the news outlet they watch.

The point I was trying to make was that those in authority positions who are deliberately spreading these dangerous lies for their own ends should be the ones punished, rather than those who believe their leaders, because everyone does not have the same ability to sort it out on their own. Sorry, should have been more clear.
 
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seaurchin

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Here is the CDC link. It says the blood clotting is rare but severe and the blood clots occurred in women from 18-48. There were 6 reports of it out of 6.8 million doses, and one of the women died. Out of an abundance of caution, the CDC and FDA recommend pausing the J and J vaccine while they look into it.
 
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kipari

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We've had 31 patients with blood clots in Germany with the Astra Zeneca vaccine, 29 of which women, all under 60 , 9 dead out of 2.7 million doses given.

I remember people getting upset by Germany and subsequently the EU suspending the vaccine to look into this.
I bet the picture would have been different if it was mainly politician aged men who were affected
...
Europe has suspended vaccination of under 60- y/o olds with AZ.
 

seaurchin

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I have a hard time understanding what the statistics they give us mean. For ex., how do the numbers they give compare to deaths from Covid-19 in unvaccinated people in that same demographic. Or what percentage of women in that age group get or die from blood clots aside from the vaccine. Etcetera. Though I guess they did give the gist of it, which is that they recommend pausing the J&J vaccine while they look into it.
 
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YadaYadaYada

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I’m a 42 year old female with a previous clot event. I can’t take any kind of hormones as a result. I wonder if they were thoroughly screening people before administering the J&J shot, particularly at pop-up clinics and vax-a-thon events, I wonder how thorough the screening process is to identify people at risk of a blood clot.

Can anyone speak to the screening process before getting a COVID vaccine?
 

elizat

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I’m a 42 year old female with a previous clot event. I can’t take any kind of hormones as a result. I wonder if they were thoroughly screening people before administering the J&J shot, particularly at pop-up clinics and vax-a-thon events, I wonder how thorough the screening process is to identify people at risk of a blood clot.

Can anyone speak to the screening process before getting a COVID vaccine?

We did the first shot at a pop-up/mass site.

The questions they asked for us:

1. Do you have any allergies? If you gave them the name of something, they just wrote it down and didn't say anything.
2. Are you pregnant or nursing?
3. Do you currently have any symptoms of Covid?

They did not do any post monitoring at our site. They did the shot in the car, and then you move to the next station which took about 2 minutes and then they asked if everyone felt okay so far and then they told you to leave. If they would have had people stay for monitoring the line would have been completely backed up, which is why I think they didn't do monitoring.
 

chrono

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@YadaYadaYada
Where I took my vaccination, we had to sit and be monitored for 15 minutes before we are released. I remember having to complete some health questionnaire but don't recall if it asked anything specifically about clots.
 

YadaYadaYada

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@chrono, I should know this since you are a long time PS’er but are you in the U.S.? I’m just curious if screening outside the states is any more or less thorough.
 

seaurchin

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And then we’d also need to keep in mind that this is all taking place against a deadly and highly contagious illness.
 

YadaYadaYada

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Btw @Jambalaya sorry if my question has derailed your thread! Not my intention at all.
 

elizat

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@chrono, I should know this since you are a long time PS’er but are you in the U.S.? I’m just curious if screening outside the states is any more or less thorough.

My thought is that if you are going to get the vaccine with your history, I would have it done at your doctor's office.

I think it would just be safer. About 4 hours after the first shot for me I ended up with what I do believe was an allergic reaction, so even monitoring at the site would not have helped, but I think if you have a history of issues that are a concern for the vaccine that your doctor is the best bet.
 

YadaYadaYada

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@seaurchin I appreciate the urgency of the vaccination process but there also needs to be a thorough screening process to identify individuals at risk of a clot or other potentially deadly reaction.

For example, I don’t think it unreasonable to screen for blood clot risk. Perhaps folks that have had a blood clot would be better served by visiting their own doctor who can better advise them of their individual risk of a clot vs COVID.
 
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