Promising New Coronavirus Vaccine

[TechTalk]

I believe the point Slobodan was making was that doctors should not be making public policy.

They don't. They only provide advice and recommendations. Policy makers decide what to do with the advice they receive. So, you can relax and breath easy now.

Oh, and the other things that doctors do is advance the understanding, treatment, and prevention of diseases, as well as take care of you when you're sick.

[faberryman]

In case it is not clear, I am speechless that you consider it "perfectly normal" to beat someone up because of their personality.

I agree. It was a poor choice of words. I should have said "entirely predictable".

[faberryman]

It seems to reasonable people that the risks don't justify stopping the vaccine, even just pausing it "for days or weeks" as Fauci said.

Who are these reasonable people you are talking about?

Apparently not you.

I don't know how you arrived at that conclusion. I haven't said whether I thought pausing the vaccine was a good idea or a bad idea.

So again I ask. Who are these reasonable people you are talking about?

[James Clark]

Appeal to authority, again.

And before I hear again that Wikipedia is an authority on the Appeal to Authority fallacy (i.e., that it is not a fallacy if the authority is real), let me clarify something (bold mine):

Of course, and no one argued such.   But that doesn't mean that anyone's opinion on anything is equally valid.   

[TechTalk]

As usual, you're putting words in my mouth that I never said.

Go back and look at the post to which you're referring. Do you see that "?" at the end of the sentence? That "?" means that it is a question as opposed to a statement or quote. He is asking you if that's what you believe. Understand?

He isn't "putting words in [your] mouth that [you] never said". Perhaps you're trying to ease a guilty conscience.

[TechTalk]

Of course, and no one argued such.   But that doesn't mean that anyone's opinion on anything is equally valid.

That helps to confirm my decisions not to ask a plumber to examine my teeth or ask my dentist about sewer line drainage issues. I suppose advice from authority does have some place in life.

[Alan Klein]

It was a bad decision.

[Slobodan Blagojevic]

That helps to confirm my decisions not to ask a plumber to examine my teeth or ask my dentist about sewer line drainage issues. I suppose advice from authority does have some place in life.

No, not the cross authority as in your example (plumber > teeth, etc.). But even when my dentist advised me to do something, the final decision is mine. I had one particularly aggressive in upselling, who had offices of his daughter and son-in-law (two separate offices) in the same building, practicing different dental specializations, and he always tried to sell their services too. I listened, but I ultimately declined or accepted the advice.

As for plumbers, after paying two or three times up to $300 for their services, next time I went to Lowe and rented the snake-cable machine and did it myself.

So, yes, advice from authority does have some place in life. But the ultimate decision should be mine. I have nothing against Dr. Fauci telling me to use three mask layers... just that I am not going to do so.

[Slobodan Blagojevic]

... Given the respect I have for your intelligence, I'm surprised that you would describe them the way you have above....

That was a rhetorical and hyperbolic sarcasm  

[chez]

No, not the cross authority as in your example (plumber > teeth, etc.). But even when my dentist advised me to do something, the final decision is mine. I had one particularly aggressive in upselling, who had offices of his daughter and son-in-law (two separate offices) in the same building, practicing different dental specializations, and he always tried to sell their services too. I listened, but I ultimately declined or accepted the advice.

As for plumbers, after paying two or three times up to $300 for their services, next time I went to Lowe and rented the snake-cable machine and did it myself.

So, yes, advice from authority does have some place in life. But the ultimate decision should be mine. I have nothing against Dr. Fauci telling me to use three mask layers... just that I am not going to do so.

Yes, but your bad teeth have zero affect on anyone else, thus the decision is all yours. Now when something could affect others, then it’s not quite that simple, like smoking in planes or driving drunk can have severe affects on others, so those decisions are taken out of your hands...like they should be.

[TechTalk]

That was a rhetorical and hyperbolic sarcasm

Thanks. That's a reasonable reply. I should have realized, but you do have a way of stating things rather emphatically—not to say that's always a bad thing mind you. 

[Chris Kern]

The Advisory Committee on Immunization Practices of the U.S. Centers for Disease Control and Prevention met this afternoon, and the participants reportedly concluded that additional information would be necessary before they could ratify, revoke, or amend the federal government's recommendation that providers temporarily suspend use of the Johnson & Johnson coronavirus vaccine.

As far as I have been able to determine, most states are following the federal recommendation, and filling all existing appointments for their residents with one of the two approved mRNA vaccines.

The committee has published a number of interesting documents that were prepared for the participants in today's meeting, including a summary of Reports of cerebral venous sinus thrombosis with thrombocytopenia and a Work Group Interpretation of the currently available data and the policy options that the committee will consider.

My impression is that whatever recommendation the committee makes with respect to the Johnson & Johnson vaccine will likely influence a future decision regarding emergency use authorization in the United States of the Oxford-AstraZenica vaccine, about which similar concerns have been raised, but that's an inference based on the way the data were presented in the documents I've linked to above rather than anything that has been reliably reported yet.

[faberryman]

Thank you for the factual information.

[Robert Roaldi]

...  So due to their position, they become little tyrants deciding public policy that should be left to elected officials who respond to the public. 

The public should decide individually how we should live.  That's what freedom is all about. If we need to give up personal liberty at a time during a crisis, the next in line are elected officials who represent us, not experts, either scientific or economic.  We don't need a bunch of petty virologists or economists, meaning well I'm sure, who because of their ego, thinking they know what's best for everyone, to decide how we should live.  At least politicians, egotistical and petty as well,  respond somewhat to the public.

One day I'm sure you'll get over Fauci dissing Trump.

[TechTalk]

There have been a number of misrepresentations made today about what was done; what was said; and who said or did it; in regard to the J&J/Janssen vaccine. A couple of highlighted items in the CDC Reports of cerebral venous sinus thrombosis from the Vaccine Safety Team stand out. These were also contained in the CDC Health Alert published yesterday.

https://emergency.cdc.gov/han/2021/CDC Health Alert Network 00442

"CDC will convene an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday, April 14, 2021, to further review these cases and assess potential implications on vaccine policy. FDA will review that analysis as it also investigates these cases. Until that process is complete, CDC and FDA are recommending a pause in the use of the J&J COVID-19 vaccine out of an abundance of caution. The purpose of this Health Alert is, in part, to ensure that the healthcare provider community is aware of the potential for these adverse events and can provide proper management due to the unique treatment required with this type of blood clot."

In addition to the summary above, specific and important recommendations were made for evaluation, treatment, and reporting for clinicians caring for patients...

Recommendations

For Clinicians

1. Pause the use of the J&J COVID-19 vaccine until the ACIP is able to further review these CVST cases in the context of thrombocytopenia and assess their potential significance.

2. Maintain a high index of suspicion for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine, including severe headache, backache, new neurologic symptoms, severe abdominal pain, shortness of breath, leg swelling, petechiae (tiny red spots on the skin), or new or easy bruising. Obtain platelet counts and screen for evidence of immune thrombotic thrombocytopenia.

3. In patients with a thrombotic event and thrombocytopenia after the J&J COVID-19 vaccine, evaluate initially with a screening PF4 enzyme-linked immunosorbent (ELISA) assay as would be performed for autoimmune HIT. Consultation with a hematologist is strongly recommended.

4. Do not treat patients with thrombotic events and thrombocytopenia following receipt of J&J COVID-19 vaccine with heparin, unless HIT testing is negative.

5. If HIT testing is positive or unable to be performed in patient with thrombotic events and thrombocytopenia following receipt of J&J COVID-19 vaccine, non-heparin anticoagulants and high-dose intravenous immune globulin should be strongly considered.

6. Report adverse events to VAERS, including serious and life-threatening adverse events and deaths in patients following receipt of COVID-19 vaccines as required under the Emergency Use Authorizations for COVID-19 vaccines.

[LesPalenik]

Ontario reported 4,401 new cases of COVID-19 on Monday. The number of COVID-19 patients in intensive care units jumped to a record high of 612.

Health Minister Christine Elliott says the government is exploring its options to boost hospital capacity and staffing levels as variants of concern wreak havoc on the province. She said in a news conference on Monday that hospitals have been instructed to ramp down all surgeries “except the ones that are absolutely life-and-death matters.”
Ontario may have to turn to 'last resort' of triage protocol if ICU number surpasses 900. The cancellation of elective surgeries is “unfortunate, but sadly necessary right now,” Elliott said in the legislature.

The province reported 4,401 new cases of COVID-19 on Monday - more than 1,280 in Toronto - and 15 new deaths due to the virus.

https://www.cp24.com/news/ontario-frantically-adding-icu-beds-to-hospitals-as-occupancy-due-to-covid-19-hits-record-high-1.5385128

[faberryman]

You know what is hilarious? A couple of weeks ago some of you guys were saying that no one in his right mind would take the J&J vaccine because it had a lower efficacy rating than the Pfizer and Moderna vaccines. Now that the CDC and FDA have recommended that the J&J vaccine be taken off the market temporarily until it can be determined if it causes blood clots in the brain, all of a sudden it is a national catastrophe. I don't know how it could be a national catastrophe if no one in his right mind was going to take it anyway. Seems like a non-event.

[Alan Klein]

One day I'm sure you'll get over Fauci dissing Trump.

I don't like Fauci for what he did thirty years ago and my feelings about it.  I forget the particular situation.  But he was in charge back then too. What I remember for these thirty years is that I got the feeling then he's a politician and I just didn't trust him since then.  That was long before Trump. I still feel the same way.   

[Alan Klein]

There have been a number of misrepresentations made today about what was done; what was said; and who said or did it; in regard to the J&J/Janssen vaccine. A couple of highlighted items in the CDC Reports of cerebral venous sinus thrombosis from the Vaccine Safety Team stand out. These were also contained in the CDC Health Alert published yesterday.

https://emergency.cdc.gov/han/2021/CDC Health Alert Network 00442

"CDC will convene an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday, April 14, 2021, to further review these cases and assess potential implications on vaccine policy. FDA will review that analysis as it also investigates these cases. Until that process is complete, CDC and FDA are recommending a pause in the use of the J&J COVID-19 vaccine out of an abundance of caution. The purpose of this Health Alert is, in part, to ensure that the healthcare provider community is aware of the potential for these adverse events and can provide proper management due to the unique treatment required with this type of blood clot."

In addition to the summary above, specific and important recommendations were made for evaluation, treatment, and reporting for clinicians caring for patients...

Recommendations

For Clinicians

1. Pause the use of the J&J COVID-19 vaccine until the ACIP is able to further review these CVST cases in the context of thrombocytopenia and assess their potential significance.

2. Maintain a high index of suspicion for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine, including severe headache, backache, new neurologic symptoms, severe abdominal pain, shortness of breath, leg swelling, petechiae (tiny red spots on the skin), or new or easy bruising. Obtain platelet counts and screen for evidence of immune thrombotic thrombocytopenia.

3. In patients with a thrombotic event and thrombocytopenia after the J&J COVID-19 vaccine, evaluate initially with a screening PF4 enzyme-linked immunosorbent (ELISA) assay as would be performed for autoimmune HIT. Consultation with a hematologist is strongly recommended.

4. Do not treat patients with thrombotic events and thrombocytopenia following receipt of J&J COVID-19 vaccine with heparin, unless HIT testing is negative.

5. If HIT testing is positive or unable to be performed in patient with thrombotic events and thrombocytopenia following receipt of J&J COVID-19 vaccine, non-heparin anticoagulants and high-dose intravenous immune globulin should be strongly considered.

6. Report adverse events to VAERS, including serious and life-threatening adverse events and deaths in patients following receipt of COVID-19 vaccines as required under the Emergency Use Authorizations for COVID-19 vaccines.

What misrepresentation has been made? The CDC stopped vaccinations using J&J.

[Alan Klein]

You know what is hilarious? A couple of weeks ago some of you guys were saying that no one in his right mind would take the J&J vaccine because it had a lower efficacy rating than the Pfizer and Moderna vaccines. Now that the CDC and FDA have recommended that it be taken off the market temporarily until it can be determined whether it causes blood clots in the brain, all of a sudden it is a national catastrophe. I don't know how it could be a national catastrophe if no one in his right mind was going to take it anyway, particularly now they now learn that it could cause blood clots in the brain. Seems like a non-event.

Your point just confirmed my argument back then.  I said I would wouldn't take J&J because it wasn't as effective as Moderna and Pfizer.  Others argued it was just as effective.  When I asked if people had a choice, who would take Johnson, no one said they would.  Now Johnson has even more problems.  So I'll ask the question again.  Who would take Johnson over the other two?

But none of this has anything to do with the current situation as to holding up vaccinations.  The new issue of one death doesn't justify stopping it in my opinion.  The CDC should have just allowed vaccinations to continue until they investigated it so millions of people could get some protection from Covid if they chose.  The one death doesn't change it s efficacy against Covid.