Covid Vaccine

JVBT, ASN · Jan 11, 2021

12 hours ago, TheMoonisMyLantern said:

Biden's decision makes me nervous as well. In the beginning of the vaccine rollout Pfizer and Moderna said it was critical that a second dose was received in 3-4 weeks of the first dose. Now they're saying Oh you can wait up to 12 weeks and it'll be just fine! If they studied the vaccine being administered at 3-4 weeks how can it be just fine to speculate that going up to 12 weeks will be just as effective? One article I read had an immunologist say that theoretically giving 12 weeks between injections could boost effectiveness, but I just don't think it's a good idea to deviate from how the vaccine was studied.

Not just how the vaccine was studied, but how it was approved. This is not yet a supply problem. It is a distribution, administration, marketing, communications problem. Solve that first, then we'll talk. But better not to mess at all with the schedule. Might a lot of partially vaccinated individuals lead to a significant mutation? It might, given what they're now saying about convalescent plasma's role in that.

MunoRN, RN · Jan 11, 2021

On 1/8/2021 at 11:08 AM, JVBT said:

https://www.washingtonpost.com/nation/2021/01/08/coronavirus-covid-live-updates-us/

Biden says he will release nearly all available coronavirus vaccine before second doses are administered

The Author is a phsyician and supposedly has experience in Public Health, but her position here is non-sensical.

First, increasing the distribution of vaccines doesn't make it less likely people will be able to get their second dose, it makes it more likely.

Currently, it's up to organizations (hospitals, clinics, etc) to ensure they have or will have sufficient doses available to provide second doses on time. If they are administering first doses without having sufficient doses on hand for the second dose, but are relying on expected deliveries of additional doses, then increasing the chance that those doses will arrive as expected doesn't make it less likely that people will get the second dose, it makes it more likely.

MeganMN · Jan 28, 2021

I have read and read this forum throughout this pandemic. I identified with many posts, learned from others, and have been deeply offended by some as well. I hesitated even posting in this topic because it seems so inflammatory. At the end of the day, we are almost all weary and tired of this 'new normal'. We are all also doing the best we can given the circumstances.

It really makes me sad that people are resorting to name calling and attacking each other for differences of opinion. At work, on this forum, in the news, and all around me, I see people excited about the vaccine, getting the vaccine, and often (not always) attacking people who do not want to get it. At work, there is bullying occuring, anger, hostility, etc.

For the most part, we have all played our part in civic duty by wearing masks, social distancing, and trying to prevent our own part in the spread of this awful virus. But I deeply respect each and every person's right to decide if they want to take part in an experimental vaccine. We all want this to be over...but we all have to decide for ourselves if we want to get a vaccine that is, as of yet, experimental. I can tell you that I spend hours pouring over research articles. I speak with other colleagues. I do my homework. Just because I have declined to get the Moderna or Pfizer vaccine doesn't mean that I am an 'idiot's or a 'moron' or that I am believing in false science. It means I am cautious, and skeptical, and need time to make an informed decision. I have seen vaccine injury. It has made me cautious and not just trust blindly, but question everything.

Generally speaking, if someone wishes to convince someone else to do something, it is easier and more productive to seek out the reasons for the other persons viewpoint, and have a dialogue, not attack the person's character. I have been open and honest if someone genuinely asks me about my hesitancy to have the vaccine. I had a physician spend an hour with the ICU nurses on a slower day and give us information in a non threatening, conversational way. That conversation did more to convince me to think more about the vaccine than any of the belittling, condescending, offensive language I have heard here and elsewhere. Personal attacks do nothing to increase the person's trust in you or your position. Genuine dialogue and an interest in hearing my viewpoint DID help.

I do have what I feel are valid concerns about the vaccine. I also have concerns about getting Covid. They are equally as intense for me and it is not an easy decision for me regardless of what I finally end up doing! It is actually quite agonizing and neither decision (to get vaccinated or NOT get vaccinated) is going to be easy or ease my anxiety.

I am including some links to articles that explain the benefits and risks of the mrna vaccines , as well as the adenovirus vaccines (Johnson and Johnson).

My main concerns at this point are more related to the potential long term conplications. I have personally decided , at this point, to wait and see and continue my current course of minimizing risk to getting the actual virus as well. I may change my mind. But please be civil and respect my (and everyone 's) ability to decide!

From:

https://www.nature.com/articles/nrd.2017.243?utm_medium=affiliate&utm_source=commission_junction&utm_campaign=3_nsn6445_deeplink_PID9237743&utm_content=deeplink#Sec17

Quote

91. Potential safety concerns that are likely to be evaluated in future preclinical and clinical studies include local and systemic inflammation, the biodistribution and persistence of expressed immunogen, stimulation of auto-reactive antibodies and potential toxic effects of any non-native nucleotides and delivery system components. A possible concern could be that some mRNA-based vaccine platforms54,166 induce potent type I interferon responses, which have been associated not only with inflammation but also potentially with autoimmunity167,168. Thus, identification of individuals at an increased risk of autoimmune reactions before mRNA vaccination may allow reasonable precautions to be taken. Another potential safety issue could derive from the presence of extracellular RNA during mRNA vaccination. Extracellular naked RNA has been shown to increase the permeability of tightly packed endothelial cells and may thus contribute to oedema169. Another study showed that extracellular RNA promoted blood coagulation and pathological thrombus formation170.

Another article discussing previous issues with Moderna 's track record 2017)

https://www.statnews.com/2017/01/10/moderna-trouble-mrna/

An optimistic article about effectiveness:

https://www.bmj.com/content/371/bmj.m4347

An article describing pearls and pitfalls of adenovirus delivery vaccines (johnson&johnson)delivery

https://cen.acs.org/pharmaceuticals/vaccines/Adenoviral-vectors-new-COVID-19/98/i19

SansNom · Jan 28, 2021

5 hours ago, MeganMN said:

My main concerns at this point are more related to the potential long term conplications. I have personally decided , at this point, to wait and see and continue my current course of minimizing risk to getting the actual virus as well. I may change my mind. But please be civil and respect my (and everyone 's) ability to decide!

I too hesitated for a few weeks due to similar reasoning, and then decided to go ahead and get it because I realized I would be waiting a really long time (probably years) if I was actually trying to wait and see all the possible long term effects.

I respect this reasoning though. The reasoning I have real issues with and am having shorter and shorter patience with are the kind propagated by conspiracy and far right sites. Ones about causing infertility, inserting microchips, mind control, and other things that have zero evidence or science backing them but people are still believing.

I try to be civil because I agree with you that insulting people rarely gets you anywhere, but many of the people who believe that kind of stuff really aren't trying to find factual answers, they're just catering to fear and trying to prove a point.

OhHaiMark · Jan 28, 2021

7 hours ago, MeganMN said:

I do have what I feel are valid concerns about the vaccine. I also have concerns about getting Covid. They are equally as intense for me and it is not an easy decision for me regardless of what I finally end up doing! It is actually quite agonizing and neither decision (to get vaccinated or NOT get vaccinated) is going to be easy or ease my anxiety.

WOW, great job writing this comment ? I feel the same as you do. I work with the public. At this point, I am waiting too. I have not gotten COVID yet, which I attribute part to luck and part to careful diligence.

I think what your comment very eloquently details is a hypocrisy that many people, in social media and in the news media, have approached the other side with. People that are hesitant are stereotyped, then subsequently attacked. Never mind the fact that me declining the vaccine gives someone else, perhaps someone more at risk of severe complications, the opportunity to receive it. Never mind that there are major questions as far as ethics (see comments from the WHO director) about the distribution of this vaccine. Those are whole other separate conversations, but they reflect the fraught nature of this rollout.

This is all to say, I appreciate this comment and you for taking time to write it, because IMO it reflects the feelings of many people who currently are vaccine-hesitant.

TheMoonisMyLantern, LPN, RN · Jan 28, 2021

I admit that in years gone by I was very militantly pro-vaccine for everything, especially measles and flu. I felt like people in healthcare should get them or get out. I don't believe this anymore, I learned that my opinion was too extreme. I took the covid vaccine, and I urge patients and co-workers to do the same, the current risk versus benefit based on what we know justifies vaccination. HOWEVER, I respect and understand some of the fears related to the vaccine, long term effects, mistrust towards government, pharmaceutical companies, I don't blame people from being scared. I don't think we should shame people into vaccination, we should allow people to make an informed decision. In my area the vaccine has been very popular, which I'm glad. I think the majority of people will take the vaccine.

Off topic, the Brazil variant is probably going to kill us all anyway so vaccination is moot point.

JenTheSchoolRN, BSN, RN · Jan 28, 2021

1 hour ago, OhHaiMark said:

This is all to say, I appreciate this comment and you for taking time to write it, because IMO it reflects the feelings of many people who currently are vaccine-hesitant.

I like the phrasing of "vaccine-hesitant." That is very different from anti-vaccine as well. This is a new vaccine. I was beyond ready for dose #1, but respect and understand folks that aren't. I've had conversations with both of these camps.

I think as a health care provider it is not up to me to make my patient's (or colleague's) choices. It is up to me to provide scientific information and opportunity, support, and answer any questions, also be upfront with honesty so that their choice is an informed one. When folks ask me "but what are the long term effects?" I have to say "we aren't sure yet. This is what we know thus far."

Also, listening is so important. For some folks I've talked with, they have shared they appreciate that I'm willing to listen to their hesitation without judgement.

Personally, I'm excited to get dose #2 of the Moderna ahead of the rest of my teachers (I'm a school nurse) because I can be the willing guinea pig here. Helps me be even more equipped to answer questions.

allnurses Guide · Jan 28, 2021

On 12/23/2020 at 8:46 PM, SansNom said:

This is definitely a concerning statistic.

My only question regarding this V-safe source in your link is that it's a "smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination" (https://www.CDC.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html). From what I can tell, the data it collects is based on people receiving the vaccine and then bothering to register and set up an account.

When I got my vaccine, I was never told about V-safe, and so I definitely didn't register for it and I doubt anyone else in my facilities did either. I'm guessing my facilities are not the only ones nationwide who weren't pushing this system, and even if they did of course everyone's not going to bother participating. I've never heard of it until I started looking into your link, and I suspect that the majority of people getting the vaccine are not registering and reporting their vaccine experience. Could also explain why the last data is from 5 days ago........

So it just makes me wonder how reliable it is as an accurate reflection of the whole. Was anyone else reading this who got the vaccine told about V-safe?

I am just now reading through this thread but just wanted to pipe up that my institution IS giving out the info on VSafe and has been from the beginning. I used it for both of my doses.

allnurses Guide · Jan 28, 2021

I have given over 1000 doses of the vaccine at this point. Most people are excited to get it, a few are pretty hesitant. I had an open and honest conversation with an educated person of color yesterday at my station, who had come to get the vaccine, but felt unsure and had questions they wanted answered prior to the injection. My appointment with them took twice as long, but in the end they took the vaccine and thanked me profusely for having an open and honest conversation about what we do know and what we do not know about both Covid and the vaccines we are giving.

Particularly for minority populations, who have been impacted in greater numbers and who have an understandable mistrust of our medical community in general, I think sharing of information and invitation to question is vital. I am not going to blame a single soul for wanting to wait or for being hesitant about this vaccine. The only way we are going to get the information out there and keep this thing from being even more politicized than it already has been in the past year, is by being nonjudgmental and working to foster trusting relationships while people work through the trauma we have been through collectively.

JVBT, ASN · Jan 28, 2021

I appreciate the hesitancy and I admire the efforts of the educators expressed here. One thing that might be good to hear from those postponing the vaccine or outright refusing it, is how they envision contributing to the alleviation of the crisis - continued masking, regular testing? etc. It is not the same, but certainly better than nothing. I would appreciate (but do not expect) an acknowledgement of the benefits of vaccines to the public at large. Especially now with the variants (Brazil, South Africa) that make infection in previously Covid19 infected people quite possible based on what I'm reading today.

At work, I say nothing to those who are hesitating to get the vaccine unless asked by the person, and my message is almost always, talk to your doctor if they have doubts, since frequently the doubts have to do with a pre-existing condition. Otherwise, I am generally expressing excitement at our staff and patient vaccinations - with no focus on the person not getting vaccinated - and how this is a good thing.

OhHaiMark · Jan 28, 2021

I think it is a little premature to say "it's not the same" as a vaccine as far as "contribution", since it isn't known with certainty if individuals who receive the mRNA shots will be able to still pass the virus on. This issue is further compounded by the question of efficacy against variants, especially the Brazilian one another poster mentioned.

As far as my personal efforts, I have been masking from the beginning, and distancing as well. I avoid areas where people don't mask, and those individual people. I live in the hardest-hit area of my city, and we are fortunate to have free testing, which I am taking advantage of more and more often.

I hate to be a pessimist, but I don't see a vaccine being the solution most people seem to hope for. I read several months ago in the (NY Times op-ED I think) that it was likely COVID would become an endemic disease and any successful vaccine would be more akin to a flu shot, and require updating due to the type of virus that it is. That is another reason I am hesitant...if the vaccines have to be updated over the long-term anyway, I am less willing to take something experimental and prefer to wait for more data. The flu shot on the other hand, I get because it's been around for a long time and deemed safe, even if not always very effective.

OhHaiMark · Jan 28, 2021

4 hours ago, TheMoonisMyLantern said:

I admit that in years gone by I was very militantly pro-vaccine for everything, especially measles and flu. I felt like people in healthcare should get them or get out. I don't believe this anymore, I learned that my opinion was too extreme. I took the covid vaccine, and I urge patients and co-workers to do the same, the current risk versus benefit based on what we know justifies vaccination. HOWEVER, I respect and understand some of the fears related to the vaccine, long term effects, mistrust towards government, pharmaceutical companies, I don't blame people from being scared. I don't think we should shame people into vaccination, we should allow people to make an informed decision. In my area the vaccine has been very popular, which I'm glad. I think the majority of people will take the vaccine.

Off topic, the Brazil variant is probably going to kill us all anyway so vaccination is moot point.

Yikes, I read about Manaus after I read your comment, and the situation there is very sad and alarming.