Calgarypuck Forums - The Unofficial Calgary Flames Fan Community - View Single Post - Coronavirus All Purpose Thread: moving on?

opendoor · 07-20-2022, 12:49 PM

Yeah, one needs to only look at the original timelines bandied about for updating vaccines (6-12 weeks) to see how you might basically be waiting for vaporware if you're waiting for an updated vaccine based on what's happened since. I recall people who were becoming eligible for 3rd doses in January talking about waiting until March for the updated vaccine. But now we're looking at almost a year from identifying BA.1 to a vaccine being rolled out, and it's already far from ideal given the drift that has happened since.

And the stats are pretty clear. Based on UK/Israeli data, a 3rd dose of the original vaccine drops the hospitalization risk for Omicron by about 6x vs. 2 doses. And a 4th dose drops it about 3-4x vs. a waning 3rd dose (though we don't have longer term data on that). So anyone with any real hospitalization risk (i.e. people over 40, anyone with comorbidities) should probably stick to the recommended schedule (6 months after prior dose or 3-6 months after latest infection).

At the same time, you do have to balance the risk reduction with potential side effects. mRNA vaccines unfortunately do carry small risks and seem to be less well tolerated than other types of vaccines. From what I understand, evidence is suggesting that people who had bad side effects with earlier doses are more likely to have them with later doses (and vice versa for people who didn't). So I wouldn't necessarily blame a younger person who had 3 doses and had bad side effects from shying away from a 4th dose at this point.

All that said, it's also important to remember when you see low effectiveness numbers for vaccines these days, the control group (unvaccinated people who've never been infected) basically doesn't exist anymore, and where they do are nearly impossible to identify. Vaccine efficacy is normally expressed as the risk reduction compared to an immunologically naive person. But when a bunch of people with prior infections are randomly thrown into the unvaccinated group, it will tend to depress effectiveness numbers even while protection remains the same. For instance, if we took protection from prior infection as being equivalent to vaccination, and 75% of the unvaccinated group had a prior infection, then all of the sudden something like 75-80% effectiveness for vaccines will show up as 20% effectiveness because 75% of the control group have significant protection. And the same applies to hospitalization data. The risk reduction looks much smaller than it really is because there is significant immunity among the unvaccinated group.

07-20-2022, 12:49 PM	#646
opendoor Franchise Player Join Date: Apr 2007 Exp:	Yeah, one needs to only look at the original timelines bandied about for updating vaccines (6-12 weeks) to see how you might basically be waiting for vaporware if you're waiting for an updated vaccine based on what's happened since. I recall people who were becoming eligible for 3rd doses in January talking about waiting until March for the updated vaccine. But now we're looking at almost a year from identifying BA.1 to a vaccine being rolled out, and it's already far from ideal given the drift that has happened since. And the stats are pretty clear. Based on UK/Israeli data, a 3rd dose of the original vaccine drops the hospitalization risk for Omicron by about 6x vs. 2 doses. And a 4th dose drops it about 3-4x vs. a waning 3rd dose (though we don't have longer term data on that). So anyone with any real hospitalization risk (i.e. people over 40, anyone with comorbidities) should probably stick to the recommended schedule (6 months after prior dose or 3-6 months after latest infection). At the same time, you do have to balance the risk reduction with potential side effects. mRNA vaccines unfortunately do carry small risks and seem to be less well tolerated than other types of vaccines. From what I understand, evidence is suggesting that people who had bad side effects with earlier doses are more likely to have them with later doses (and vice versa for people who didn't). So I wouldn't necessarily blame a younger person who had 3 doses and had bad side effects from shying away from a 4th dose at this point. All that said, it's also important to remember when you see low effectiveness numbers for vaccines these days, the control group (unvaccinated people who've never been infected) basically doesn't exist anymore, and where they do are nearly impossible to identify. Vaccine efficacy is normally expressed as the risk reduction compared to an immunologically naive person. But when a bunch of people with prior infections are randomly thrown into the unvaccinated group, it will tend to depress effectiveness numbers even while protection remains the same. For instance, if we took protection from prior infection as being equivalent to vaccination, and 75% of the unvaccinated group had a prior infection, then all of the sudden something like 75-80% effectiveness for vaccines will show up as 20% effectiveness because 75% of the control group have significant protection. And the same applies to hospitalization data. The risk reduction looks much smaller than it really is because there is significant immunity among the unvaccinated group.