Still more on vaccination
Apr. 5th, 2021 09:00 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
lyornI am very annoyed.
I got my first dose of Astra Zeneca on Feb 28, and took it reasonably well.
I should get the second dose on May 2nd, and I would be very happy and relieved and I would be doing the happy dance and buy overpriced chocolate to celebrate, if that should happen.
It seems, however, that it won't. Instead (insert polemic warning) I, and ten thousand of others who are at high or very high risk of getting Covid-19 in a very bad way, or having Covid-19, should they get it, delay urgent life-saving treatments for weeks or months, have been volunteered (on April 1st, of all days, but not an April Fool's joke, more's the pity) to act as a test group for a so far untested vaccination scheme of "first dose AZ, second mRNA (or whatever)". Note: Second. Not first of a new basic immunisation with *two* doses of an mRNA vaccine.
The very same government agency that has decided to do so is writing in their FAQ, right below "oh, by the way, we are switching the following groups to an untried vaccination scheme" that they haven't the foggiest if said untried vaccination scheme is safe or efficient.
It's efficient, though, to do this study on people likely to die should this new scheme turn out to be neither safe nor efficient. Dying is such a convincing and easily measured end point.
There isn't enough WTF in the world.
If you have not followed the German/EU shenanigans about the Oxford/AstraZeneca vaccine, you might be confused about why they are even considering this.
If you have, you might be aware that there is sufficient reason to assume a risk of a bad complication after an AZ vaccination, which occurs more often in women than in men and more often in younger women than in in older ones. The complication, while possibly lethal if unrecognized and untreated, has (by now) known symptoms, a mechanism that is understood reasonably well, tests which show that it's happening, and a treatment.
It has also a risk of occurring which is about 1:100.000 among the most at-risk group of younger women.
The risk for a younger (than 60) woman with a bad Covid prognosis to get infected and die is higher -- probably by orders of magnitude. And there is still no good treatment for COVID-19.
What the everloving fuck are those guys on?
I have actually sent a mail to the government agency in question, askingwhat the fuck they were on if they might explain in their FAQ the rationale for these decisions, because it looked very confusing to a lay person.
I got my first dose of Astra Zeneca on Feb 28, and took it reasonably well.
I should get the second dose on May 2nd, and I would be very happy and relieved and I would be doing the happy dance and buy overpriced chocolate to celebrate, if that should happen.
It seems, however, that it won't. Instead (insert polemic warning) I, and ten thousand of others who are at high or very high risk of getting Covid-19 in a very bad way, or having Covid-19, should they get it, delay urgent life-saving treatments for weeks or months, have been volunteered (on April 1st, of all days, but not an April Fool's joke, more's the pity) to act as a test group for a so far untested vaccination scheme of "first dose AZ, second mRNA (or whatever)". Note: Second. Not first of a new basic immunisation with *two* doses of an mRNA vaccine.
The very same government agency that has decided to do so is writing in their FAQ, right below "oh, by the way, we are switching the following groups to an untried vaccination scheme" that they haven't the foggiest if said untried vaccination scheme is safe or efficient.
It's efficient, though, to do this study on people likely to die should this new scheme turn out to be neither safe nor efficient. Dying is such a convincing and easily measured end point.
There isn't enough WTF in the world.
If you have not followed the German/EU shenanigans about the Oxford/AstraZeneca vaccine, you might be confused about why they are even considering this.
If you have, you might be aware that there is sufficient reason to assume a risk of a bad complication after an AZ vaccination, which occurs more often in women than in men and more often in younger women than in in older ones. The complication, while possibly lethal if unrecognized and untreated, has (by now) known symptoms, a mechanism that is understood reasonably well, tests which show that it's happening, and a treatment.
It has also a risk of occurring which is about 1:100.000 among the most at-risk group of younger women.
The risk for a younger (than 60) woman with a bad Covid prognosis to get infected and die is higher -- probably by orders of magnitude. And there is still no good treatment for COVID-19.
What the everloving fuck are those guys on?
I have actually sent a mail to the government agency in question, asking
(no subject)
Date: 2021-04-05 07:44 pm (UTC)(no subject)
Date: 2021-04-06 02:28 pm (UTC)Because it's either stupid or evil off the scale. And any sufficiently advanced stupidity, as they say...
(no subject)
Date: 2021-04-05 11:12 pm (UTC)(no subject)
Date: 2021-04-06 02:26 pm (UTC)Three days ago I planned to apply to my GP for my second dose of AZ some time in May, and refuse whatever the vaccination center has been told to do, but as days go by I fear that this option might be closed by May. What then? Stay in seclusion? Buy black market?
I can run in circles screaming just fine. I do not want the Robert-Koch-Institute to do that.
(no subject)
Date: 2021-04-07 10:17 am (UTC)(no subject)
Date: 2021-04-08 10:38 am (UTC)Instead I have written to the RKI (no answer yet, not that I am expecting much), and to the NDR Corona Podcast, and it seems that I wasn't the only one doing the latter!
The podcast talked about it in their latest edition (#83) -- also about why a "heterologous vaccination scheme" has not been studied yet, despite a desire to do so: Non-approved usage of a drug + risky = lots of regulation and effort involved. (Weird, isn't it? Doing it as part of a study is regulated, prescribing it to people who cannot give informed consent for lack of available information is just peachy. I am still convinced that either I or a lot of experts are just off their rocker.)
Also, they are hoping for a study from the UK soon. Ms Ciesek thinks that it will probably work out OK, because as far as known, it did people who have had Covid-19 and gotten a single dose vaccination later. I might even work better.
Hendrik Streeck seems as baffled about "we don't know anything, so we recommend it" as me, if less panicked, while the STIKO guy (of course) still thinks it a brilliant idea because one cannot know how risky a second dose of AZ is. I still cannot follow that risk evaluation.
But at least it's getting discussed now, and more important, studied.
If it works equally well or better, then I'm all for it. But until then I go with what is tested and approved for use, if possible.
Also: There isn't enough chocolate in the world for this.
(no subject)
Date: 2021-04-08 11:01 am (UTC)If it works equally well or better, then I'm all for it. But until then I go with what is tested and approved for use, if possible.
THIS, OMG.
*sends virtual chocolate*
(no subject)
Date: 2021-04-09 07:57 am (UTC)to act as a test group for a so far untested vaccination scheme of "first dose AZ, second mRNA (or whatever)".
So... this is an experiment being conducted on people without their consent, yes? How is this legal? Don't you have human rights in the EU?
(no subject)
Date: 2021-04-09 06:56 pm (UTC)Phrasing this as "having been volunteered to act as a test group" is me being polemic, in an attempt to do justice to the amount of WTFBBQ going on in my brain. So, the following is also strongly affected by me being angry, confused and sarcastic.
It's not actually a study. There had been interest in studying mixed vaccinations, because "sooner or later this is going to happen", but rules and regulations and ethics requirements on this kind of study (off-label use of a drug, potential harm) are very stringent. It's not the kind of thing a clinic can just do and see what happens, but a major project. So, no studies. (I read that studies have been done in the UK. Aren't we lucky. Results are expected some time before a significant number of the group of high-risk under-60s actually gets their second jab.)
It's a recommendation, given by the highest level scientific givers-of-recommendations in matters of public health in Germany, the guys whose recommendations become regulation. And as it's not a study, there will be no extensive info for the participants of risks, no observation during and after, no antibody checking, no careful listing of age, gender, pre-existing conditions to generate scientifically useful information. And as it's not a study, but a recommendation, no regulations beyond "jabs to be given by doctors only, vaccines have to be approved, vaccinee has to sign information/consent form". I wonder what that consent form will say.
At least there is (for now, says my panicky brain) an opt-out. One can contact one's GP (or in some federal states of Germany, go to a clinic) and say, "I am under sixty, I have gotten a first dose of AZ, and I want my second one to be AZ, and I'm more than willing to accept a friggin' risk of 1:100.000 for brain blood clots". If that wasn't possible, I'm quite sure that people *would* sue. And looking at the stance the courts are taking in all things Covid, have a good chance to win.
Many younger people vaccinated for epidemologial reasos that I have talked with are actually glad to get their second jab from a "better" vaccine. They are quite sure that nothing bad will happen. After all, people have recovered from COVID-19, and got a vaccination later, and they are doing just fine. (Are they? Has anyone checked and compared? This is not only about safety. It's about effectiveness.) And the combination might even do better. (Yeah. *might* being the operative word here. Because we don't f**ing know.)
Grrr. I'm still going BSoD over this. But at least now the Easter Holidays are over and discussion is taking place.
I am actually *not* hoping for a shitstorm. There has been too much screaming and hyperbole and drama, and too little coherence already. I want to know if *I* am being absurd, or if the public health agency is. And most of all I want evidence.
(no subject)
Date: 2021-04-10 05:19 am (UTC)I want to know if *I* am being absurd, or if the public health agency is. And most of all I want evidence.
I don't think it's an either-or proposition. I think maybe neither is being absurd. You're not wrong to want more evidence, but it doesn't seem like that exists, and so decisions have to be made in the absence of that evidence.
I think the calculus is that asking people (those younger people who had the one AZ shot before it was found to have that risk) to take a known risk of stroke when there's an alternative vaccination path that doesn't seems reckless. While it's possible that there's a bad interaction between AZ and a mRNA follow-up, it seems the more likely bad outcome is that they simply fail to have the compounding effect getting two of the same shots attains, in which case, one is left with all the protection of one of the two different shots one gets, presumably the greater of the two. The mRNA shots seem to have an efficacy of around 80% with a single dose, IIRC; I don't know for AZ.
(no subject)
Date: 2021-04-10 10:15 pm (UTC)I guess my perspective differs from that of the majority of the affected group. Estimated 80% of those who got an AZ jab early are medical personnel and care workers. (Because the elderly got Pfizer/BioNTech instead). So, when the health agency thinks about the affected group, they are thinking about 35 yo healthy nurses, doctors, carers and therapists, not about 50 yos with serious illness. So it is safety that's on top of their minds, not effectiveness.
But I feel that for me, personally, the risk of low effectiveness far outweighs a 1:100.000 safety risk. (I am jaded on this risk, having taken drugs with a much worse safety profile over the course of the last two years.)
My worry now is that the minority group I belong to might just get overlooked and I'll be stuck with Schrodinger's immunisation: I won't know if I am immune until a positive PCR test shows I wasn't. And I *so* do not need more FUD in my life. (AFAIK, AZ fades after 12 weeks if no second shot is given. I do not have this info for the mRNAs, health agency goes with "not known, but more than 6 weeks.")
I wish they would recommend that members of the affected group can chooses how they want to continue instead of just being told what will be done to them (unless they wiggle out by convincing their GP to go against top-level recommendation). OTOH, it's not as if there is much choice given to anyone, because, pandemic. On the third hand (I'm borrowing paws from the cat), "'mixed' is an experimental treatment, that needs special consent". And on the fourth hand, everyone is free *not* to get vaccinated, which does not help at all.
Well. The only uplifting thing about this whole rotten stupid miserable pandemic is that it's probably been the biggest boost to science since the race for the moon. There *will* be results. And as I do not assume that the people in charge are actively evil, recommendations will be updated according to results.
Sigh. I have spent 15 month in a state of suspended panic. I need to get off the panic train sometime.
(no subject)
Date: 2021-04-12 04:08 am (UTC)[...] But I feel that for me, personally, the risk of low effectiveness far outweighs a 1:100.000 safety risk. (I am jaded on this risk, having taken drugs with a much worse safety profile over the course of the last two years.)
I think that's excellent reasoning, and I think you should definitely take it up with your GP.
I do not have this info for the mRNAs, health agency goes with "not known, but more than 6 weeks."
Canada has apparently gone for the "stick everyone once" with the mRNA vaxes, putting off second shots for (I'm hearing) something like four months. I have no further info on this.