While reducing the risk of infection obviously reduces the risk of PASC, the very high degree of sterilizing immunity achieved right after the second (third?) shot doesn't last very long. Protection vs. symptomatic COVID-19 is more persistent, but small comfort given findings of long COVID symptoms following asymptomatic infections.
Reports of PASC sufferers feeling better following vaccination are interesting, but they could just as plausibly be explained by a placebo effect as either of the mechanisms proposed by Prof. Iwasaki. (On the other hand, this study and the handful of others like it do seem to show that vaccinations doesn't often make long-haulers feel *worse*, which is good.)
In any case, we desperately need some answers when it comes to long COVID. If we're going to "live with" COVID-19 as an endemic disease, then we need to figure out how to prevent it from disabling large numbers of people. The world's social welfare systems can no more sustain such a surge than hospitals can one of severe acute cases.
This is a fantastic question and could have made this more clear. because there were two groups (breakthrough among partially vaccinated and breakthrough among fully vaccinated) there were two comparison groups of unvaccinated. so 10.7% among one group of unvaccinated and 11.4% among the second group of unvaccinated. but 10.7 isn’t statically different than 11.4. so the story is the same on that end
So why isn't anyone talking about a timeline for under 5s or providing a reason outside of vaccine hesitancy why doctors can't vaccinate off label? We've got babies who have never met their extended family or seen an adult without a mask on and no one seems to care enough even to provide an end date to this living nightmare.
The Pfizer vaccine for kids under 5 is in trials now. Initial data should be reported before the end of the year, final data in the first half of next year. It's taking longer than initially projected because the FDA requested expanded safety monitoring.
Yes, I am aware of that. I also think that it's ethically problematic. It's like a house being on fire and making the babies wait in a back room because the adult sized fire suits haven't been tested on children yet.
Literally billions of people have had this vaccine. This type of vaccine has been around since the 1990s. Millions of people are dead, with many millions (probably billions) left with long term, potentially life long, health issues while we deny a safe, effective, 30 year old vaccine to a population where about half of them can't even wear the minimal protection of a mask. So, as a parent to a baby born the first day of lockdown and a 3 year old, my options are to throw my babies out into a world where no one wears a mask and our vaccine rates are terrifyingly low, or continue to keep them at home while I try not to get fired at my job because working with 2 toddlers is basically impossible. They don't get to meet their family, they miss their second holiday season in a row, and their parents have been doing this alone without even a single hour break for the last 20 months. All they know is adults in masks, way too much TV, and 2 parents who are so beyond traumatized by this extended extreme stress that I can't even type this without crying.
So please, tell me again to be patient and how everything is totally ok as I look at the next 9-12 months stretching out in front of me like a black hole. Tell me that it's not absolutely morally disgusting to deny parents the ability to protect their children. There is no scientific rationale at all for doctors to refuse to vaccinate off label. Withholding this vaccine is more harmful to children and their parents than any side effect.
The first human trials for mRNA vaccines were in the 2010s, and none were approved before the pandemic. So, no, they haven't been around since the 1990s.
They have, of course, proven remarkably safe and effective in adults and older children in the first year of their widespread use. However, it doesn't necessarily follow that the same will be true when it's given to younger kids.
Pfizer found in the earliest pediatric trials that if it gave young children the same 30 mcg dose it gives to adults and teens, it tended to elicit pretty bad side effects. That's why kids 5-11 get 10 mcg, and kids 2-4 are getting 3 mcg. But they need to be sure that these lower doses produce an antibody response comparable to that seen in adults, which takes time. We don't want to subject kids to severe pain, but we also don't want to give them something that won't actually do much to protect them from COVID.
It's also necessary to make sure that the vaccine isn't causing any serious problems in the weeks or months after kids receive it. There could be adverse events that are too rare in older populations for monitoring to pick up, but more common for young children. It could also be that known adverse events in older populations, like myocarditis, have a more severe presentation in young children. And if any of these do turn out to be problems, doctors who prescribe off-label could be legally liable.
I have a toddler, too, so I know what you're going through. And I think it's absolutely true that parents and children have been inexcusably relegated to an afterthought in much pandemic decision-making. But there's little use, I think, in getting frustrated over things we can't control, however warranted that frustration may be.
Dr. Jetelina retweeted a pediatrician who said "The evidence is clear: the risk of covid-19 myocarditis & long-haul covid-19 outweigh the risk of vaccine associated myocarditis."
I will absolutely not stop yelling everywhere I can about the fact that we are denying a vaccine to a population that largely can't even wear a mask. There is no harm from the mRNA vaccine, which is processed and out of our systems within a week or so, that is not greater than the potential for harm from contracting covid. I would gladly have my kid feel like garbage for a day and then have protection, even non optimal, from covid.
In other words--you have been presented with 2 bowls of skittles. In one bowl, 50% or more has skittles that can kill or make you very ill. In the other bowl, .01% of the skittles can kill or make you very ill. Which bowl are you handing to your kid?
Kids aged 12-15 in the Pfizer trial produced almost twice as many antibodies as adults receiving the same dose of the same vaccine, so it's not clear that they'll need boosters on the same schedule. As for 16-17 -- that's around where myocarditis risk peaks, and I'm sure they want to wait and see what that risk looks like for boosters in older recipients first.
I think the jury is still out on this one. Another large study, based on medical records rather than self-reporting, found no difference PASC between vaccinated and unvaccinated individuals: https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v1.full.pdf. And another, based on VA records, found some reduced risk in vaccinated individuals, but far less than the ~50% reduction touted in the Lancet study: https://www.researchsquare.com/article/rs-1062160/v1.
While reducing the risk of infection obviously reduces the risk of PASC, the very high degree of sterilizing immunity achieved right after the second (third?) shot doesn't last very long. Protection vs. symptomatic COVID-19 is more persistent, but small comfort given findings of long COVID symptoms following asymptomatic infections.
Reports of PASC sufferers feeling better following vaccination are interesting, but they could just as plausibly be explained by a placebo effect as either of the mechanisms proposed by Prof. Iwasaki. (On the other hand, this study and the handful of others like it do seem to show that vaccinations doesn't often make long-haulers feel *worse*, which is good.)
In any case, we desperately need some answers when it comes to long COVID. If we're going to "live with" COVID-19 as an endemic disease, then we need to figure out how to prevent it from disabling large numbers of people. The world's social welfare systems can no more sustain such a surge than hospitals can one of severe acute cases.
Just a quick question--why is the percentage of unvaccinated different in these two bullets (under the "Second Study" heading)?
* The rate of long COVID19 among partially vaccinated breakthrough cases was the same as the rate of long COVID19 among unvaccinated (9.2% vs 10.7%).
* The rate of long COVID19 among fully vaccinated breakthrough cases was lower than the rate of long COVID19 among unvaccinated (5.2% vs. 11.4%).
This is a fantastic question and could have made this more clear. because there were two groups (breakthrough among partially vaccinated and breakthrough among fully vaccinated) there were two comparison groups of unvaccinated. so 10.7% among one group of unvaccinated and 11.4% among the second group of unvaccinated. but 10.7 isn’t statically different than 11.4. so the story is the same on that end
So, we're ok with under 5s just getting long covid?
Im not sure who “we” are, but i’m certainly not okay with that!
So why isn't anyone talking about a timeline for under 5s or providing a reason outside of vaccine hesitancy why doctors can't vaccinate off label? We've got babies who have never met their extended family or seen an adult without a mask on and no one seems to care enough even to provide an end date to this living nightmare.
The Pfizer vaccine for kids under 5 is in trials now. Initial data should be reported before the end of the year, final data in the first half of next year. It's taking longer than initially projected because the FDA requested expanded safety monitoring.
Yes, I am aware of that. I also think that it's ethically problematic. It's like a house being on fire and making the babies wait in a back room because the adult sized fire suits haven't been tested on children yet.
Literally billions of people have had this vaccine. This type of vaccine has been around since the 1990s. Millions of people are dead, with many millions (probably billions) left with long term, potentially life long, health issues while we deny a safe, effective, 30 year old vaccine to a population where about half of them can't even wear the minimal protection of a mask. So, as a parent to a baby born the first day of lockdown and a 3 year old, my options are to throw my babies out into a world where no one wears a mask and our vaccine rates are terrifyingly low, or continue to keep them at home while I try not to get fired at my job because working with 2 toddlers is basically impossible. They don't get to meet their family, they miss their second holiday season in a row, and their parents have been doing this alone without even a single hour break for the last 20 months. All they know is adults in masks, way too much TV, and 2 parents who are so beyond traumatized by this extended extreme stress that I can't even type this without crying.
So please, tell me again to be patient and how everything is totally ok as I look at the next 9-12 months stretching out in front of me like a black hole. Tell me that it's not absolutely morally disgusting to deny parents the ability to protect their children. There is no scientific rationale at all for doctors to refuse to vaccinate off label. Withholding this vaccine is more harmful to children and their parents than any side effect.
The first human trials for mRNA vaccines were in the 2010s, and none were approved before the pandemic. So, no, they haven't been around since the 1990s.
They have, of course, proven remarkably safe and effective in adults and older children in the first year of their widespread use. However, it doesn't necessarily follow that the same will be true when it's given to younger kids.
Pfizer found in the earliest pediatric trials that if it gave young children the same 30 mcg dose it gives to adults and teens, it tended to elicit pretty bad side effects. That's why kids 5-11 get 10 mcg, and kids 2-4 are getting 3 mcg. But they need to be sure that these lower doses produce an antibody response comparable to that seen in adults, which takes time. We don't want to subject kids to severe pain, but we also don't want to give them something that won't actually do much to protect them from COVID.
It's also necessary to make sure that the vaccine isn't causing any serious problems in the weeks or months after kids receive it. There could be adverse events that are too rare in older populations for monitoring to pick up, but more common for young children. It could also be that known adverse events in older populations, like myocarditis, have a more severe presentation in young children. And if any of these do turn out to be problems, doctors who prescribe off-label could be legally liable.
I have a toddler, too, so I know what you're going through. And I think it's absolutely true that parents and children have been inexcusably relegated to an afterthought in much pandemic decision-making. But there's little use, I think, in getting frustrated over things we can't control, however warranted that frustration may be.
Dr. Jetelina retweeted a pediatrician who said "The evidence is clear: the risk of covid-19 myocarditis & long-haul covid-19 outweigh the risk of vaccine associated myocarditis."
I will absolutely not stop yelling everywhere I can about the fact that we are denying a vaccine to a population that largely can't even wear a mask. There is no harm from the mRNA vaccine, which is processed and out of our systems within a week or so, that is not greater than the potential for harm from contracting covid. I would gladly have my kid feel like garbage for a day and then have protection, even non optimal, from covid.
In other words--you have been presented with 2 bowls of skittles. In one bowl, 50% or more has skittles that can kill or make you very ill. In the other bowl, .01% of the skittles can kill or make you very ill. Which bowl are you handing to your kid?
Or under 18 (or 16-17) - - many of which DO need boosters already. And schools aren’t seemingly concerned about long Covid at all.
Kids aged 12-15 in the Pfizer trial produced almost twice as many antibodies as adults receiving the same dose of the same vaccine, so it's not clear that they'll need boosters on the same schedule. As for 16-17 -- that's around where myocarditis risk peaks, and I'm sure they want to wait and see what that risk looks like for boosters in older recipients first.