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The COVID Vaccination Thread (1 Viewer)

Scott Merryfield

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I would think smokers who lie (and are at significant risk from the habit) would be discovered easily enough once they need very substantial care (whether due to that habit or something else). And the insurance company can probably just deny whatever coverage based on the fraudulent assertion/agreement.

A (habitual) smoker is probably better off being honest than not or risk having his/her coverage rejected/denied when he/she needs it most...

_Man_
You are probably right. As a lifelong non-smoker, it's never been an issue for me, so it was just a curiosity.
 

BobO'Link

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Do insurance companies have full access to doctor's records? I'd think that people would be more honest with a doctor or the medical paperwork when asked if they smoke than they would be with their insurance company. No doubt the insurance companies have made a science out of looking at what ailments hit tobacco users so maybe when someone has certain problems they look at medical records to see if they're smoking?
To receive a "wellness checkup" discount my insurance company requires a verification of tobacco use status. The ones I've done are a sponge-like device you put in your mouth and fully saturate with saliva. They test that for presence of tobacco products (it'll also detect if you've vaped). The results are put on a form you have to send to the insurance company as part of their verification for that discount. I don't know if anyone's been denied that discount if they are a smoker as no one I work with uses tobacco products of any kind.

But - yes, insurance companies have access to your medical records. You can lie about smoking but there are absolutely signs in treatment/illnesses that indicate someone's likely a tobacco user.
 

Josh Steinberg

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I just have to sign an affidavit every year attesting that I don’t use tobacco. If it’s discovered that I have been lying, the penalty is that I will be retroactively charged the tobacco user rate for the period I was lying, and/or lose health coverage through my employer entirely and/or face termination of employment. Those seem like strong incentives to be honest.
 

Carlo_M

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I can't link to an article, because it was part of a NY Times daily morning briefing email I signed up for, but apparently they're now saying after having looked at the data to date, the actual chance of a breakthrough infection are closer to 1 in 5,000 on average. The odds are obviously much higher in low vaccinated areas, and could be as low as 1 in 10,000 in high vaccinated places (they mentioned Los Angeles as the latter which makes me feel much better).
 

ManW_TheUncool

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I can't link to an article, because it was part of a NY Times daily morning briefing email I signed up for, but apparently they're now saying after having looked at the data to date, the actual chance of a breakthrough infection are closer to 1 in 5,000 on average. The odds are obviously much higher in low vaccinated areas, and could be as low as 1 in 10,000 in high vaccinated places (they mentioned Los Angeles as the latter which makes me feel much better).

Not sure what exactly that means. Also, I'm a little confused by how those odds are stated. Maybe a little more context might help as well...

Ultimately, is that good news or bad news (and by how much)?

_Man_
 

Malcolm R

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That still seems to work out to 0.02% and 0.01% respectively, which is still much lower than the 8-10% that would be expected with a vaccine that's 90-92% effective. Not sure if "odds" as stated above correlate directly to percentages? I've never really understood odds, stated as such.

1 in 100 would be 1%.
 

Carlo_M

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Not sure what exactly that means. Also, I'm a little confused by how those odds are stated. Maybe a little more context might help as well...

Ultimately, is that good news or bad news (and by how much)?

_Man_

Ok, let's see if copy and paste is email-to-forum friendly...

Good morning. We explain the exaggerated fears about breakthrough infections.​
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A teenager receives her first dose of the Pfizer vaccine in Troy, Mich.Emily Elconin for The New York Times​

One in 5,000​

The C.D.C. reported a terrifying fact in July: Vaccinated people with the Delta variant of the Covid virus carried roughly the same viral load in their noses and throats as unvaccinated people.​
The news seemed to suggest that even the vaccinated were highly vulnerable to getting infected and passing the virus to others. Sure enough, stories about vaccinated people getting Covid — so-called breakthrough infections — were all around this summer: at a party in Provincetown, Mass.; among the Chicago Cubs; on Capitol Hill. Delta seemed as if it might be changing everything.​
In recent weeks, however, more data has become available, and it suggests that the true picture is less alarming. Yes, Delta has increased the chances of getting Covid for almost everyone. But if you’re vaccinated, a Covid infection is still uncommon, and those high viral loads are not as worrisome as they initially sounded.​
How small are the chances of the average vaccinated American contracting Covid? Probably about one in 5,000 per day, and even lower for people who take precautions or live in a highly vaccinated community.​

Or maybe one in 10,000​

The estimates here are based on statistics from three places that have reported detailed data on Covid infections by vaccination status: Utah; Virginia; and King County, which includes Seattle, in Washington state. All three are consistent with the idea that about one in 5,000 vaccinated Americans have tested positive for Covid each day in recent weeks.​
The chances are surely higher in the places with the worst Covid outbreaks, like the Southeast. And in places with many fewer cases — like the Northeast, as well as the Chicago, Los Angeles and San Francisco areas — the chances are lower, probably less than 1 in 10,000. That’s what the Seattle data shows, for example. (These numbers don’t include undiagnosed cases, which are often so mild that people do not notice them and do not pass the virus to anyone else.)​
Here’s one way to think about a one-in-10,000 daily chance: It would take more than three months for the combined risk to reach just 1 percent.​
“There’s been a lot of miscommunication about what the risks really are to vaccinated people, and how vaccinated people should be thinking about their lives,” as Dr. Ashish Jha of Brown University told my colleague Tara Parker-Pope. (I recommend Tara’s recent Q. and A. on breakthrough infections.)​
For the unvaccinated, of course, the chances of infection are far higher, as Dr. Jeffrey Duchin, the top public-health official in Seattle, has noted. Those chances have also risen much more since Delta began spreading:​
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Source: Washington State Department of Health​
Another way to understand the situation is to compare each state’s vaccination rate with its recent daily Covid infection rate. The infection rates in the least vaccinated states are about four times as high as in the most vaccinated states:​
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Data as of Sept. 2; cases are the 7-day daily average.The New York Times​
If the entire country had received shots at the same rate as the Northeast or California, the current Delta wave would be a small fraction of its current size. Delta is a problem. Vaccine hesitancy is a bigger problem.​

The science, in brief​

These numbers help show why the talking point about viral loads was problematic. It was one of those statements that managed to be both true and misleading. Even when the size of the viral loads are similar, the virus behaves differently in the noses and throats of the vaccinated and the unvaccinated.​
In an unvaccinated person, a viral load is akin to an enemy army facing little resistance. In a vaccinated person, the human immune system launches a powerful response and tends to prevail quickly — often before the host body gets sick or infects others. That the viral loads were initially similar in size can end up being irrelevant.​
I will confess to one bit of hesitation about walking you through the data on breakthrough infections: It’s not clear how much we should be worrying about them. For the vaccinated, Covid resembles the flu and usually a mild one. Society does not ground to a halt over the flu.​
In Britain, many people have become comfortable with the current Covid risks. The vaccines make serious illness rare in adults, and the risks to young children are so low that Britain may never recommend that most receive the vaccine. Letting the virus continue to dominate life, on the other hand, has large costs.​
“There’s a feeling that finally we can breathe; we can start trying to get back what we’ve lost,” Devi Sridhar, the head of the global public health program at the University of Edinburgh, told The Times.​
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Theater employees checking vaccination cards as people returned to Broadway last week.Jutharat Pinyodoonyachet for The New York Times​
I know that many Americans feel differently. Our level of Covid anxiety is higher, especially in communities that lean to the left politically. And there is no “correct” response to Covid. Different people respond to risk differently.​
But at least one part of the American anxiety does seem to have become disconnected from the facts in recent weeks: the effectiveness of the vaccines. In a new ABC News/Washington Post poll, nearly half of adults judged their “risk of getting sick from the coronavirus” as either moderate or high — even though 75 percent of adults have received at least one shot.​
In reality, the risks of getting any version of the virus remain small for the vaccinated, and the risks of getting badly sick remain minuscule.​
In Seattle on an average recent day, about one out of every one million vaccinated residents have been admitted to a hospital with Covid symptoms. That risk is so close to zero that the human mind can’t easily process it. My best attempt is to say that the Covid risks for most vaccinated people are of the same order of magnitude as risks that people unthinkingly accept every day, like riding in a vehicle.​

The bottom line​

Delta really has changed the course of the pandemic. It is far more contagious than earlier versions of the virus and calls for precautions that were not necessary a couple of months ago, like wearing masks in some indoor situations.​
But even with Delta, the overall risks for the vaccinated remain extremely small. As Dr. Monica Gandhi, an infectious-disease specialist at the University of California, San Francisco, wrote on Friday, “The messaging over the last month in the U.S. has basically served to terrify the vaccinated and make unvaccinated eligible adults doubt the effectiveness of the vaccines.” Neither of those views is warranted.​
What about children? I’ll dig into that question in a coming newsletter.​
 

Carlo_M

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Huh, that worked out better than expected...yay forum software lol.

I think that table is pretty telling in Seattle about 0.9 out of 10,000 vaccinated vs. 9 out of 10,000 for unvaccinated. They've never claimed that it's perfect, but if that number holds up, that means you are 10X less likely to get COVID if you're vaccinated, even with the Delta variant. And not only that, but your outcomes are more optimistic with only about one in a million vaccinated in Seattle having to go to a hospital. Even if that's an outlier and it's 5 times worse, that's still 5 in a million chance of needing to be hospitalized. That's what the vaccine was built to do: give you the best chance at surviving this pandemic without having its most serious outcomes.
 

DaveF

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I can't link to an article, because it was part of a NY Times daily morning briefing email I signed up for, but apparently they're now saying after having looked at the data to date, the actual chance of a breakthrough infection are closer to 1 in 5,000 on average. The odds are obviously much higher in low vaccinated areas, and could be as low as 1 in 10,000 in high vaccinated places (they mentioned Los Angeles as the latter which makes me feel much better).
That’s a per day estimate. It’s about 1 in 14 chance annualized: (1-5000)^365.
If my stats are right, which is not my mathematical strength.

what’s that mean compared to any other risks in life? <shrug>
 
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DaveF

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Virginia Department of Health (which I think is one of the sources in the NYT summary) has some simple, clear graphs on area cases. The simple takeaway is being vaccinated makes you 10x less likely to get sick, be hospitalized, or die from COVID-19.

This is good news. But it’s not as amazingly great as I thought it should be, and I’m confused by that. And I don’t know any experts who can explain it to me. :)

 
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Josh Steinberg

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Probably the truth is closer to the unfortunate idea that we don’t really know. CDC stopped collecting breakthrough data in May, and large areas of the country are under testing. Hospitals aren’t uniformly collecting data for which patients are vaccinated or when that vaccination was given out or what other factors there might be (like what conditions a patient might have or when they were vaccinated).

I don’t mean this as fearmongering - the vaccine is an extraordinary success. But we’re missing tons of data that would have been very helpful for epidemiologists and virologists to have.
 

Bill_S_25

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With all the data posted on breakthrough infections I'm confused on the push for boosters.

Another situation that confuses me is all the mandates don't take into account natural immunity. I've read many studies claiming it is very effective but find little numbers on how many recovered have become reinfected.
 

Mark Booth

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The articles I've read indicate that natural immunity (having actually been infected with the virus and recovered) is the strongest immunity against THE SAME STRAIN. Whereas, the vaccine offers better broad immunity against all of the strains.

In other words, if you were infected with the Beta variant and recovered, your body would probably do well against reinfection by Beta. But, it might not do as well (as the vaccine) against infection with Delta.

Pfizer's testing indicated a 5-10 times increase in neutralization titers after a 3rd dose of its vaccine. Thus, it is likely (but not completely proven) that a 3rd dose will REDUCE the number of breakthrough infections.

Further, Pfizer is working on a booster dose that specifically addresses the full spike protein of the Delta variant. Clinical trials started in August.

Mark
 

Carlo_M

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I feel like this is a detail that the "but the vaccinated people can catch it too so what's the point" crowd is missing.
That’s only part of what they’re missing. They’re also missing the part that the vast majority of those who were vaccinated and test positive rarely need hospitalization/ventilators and almost never die from it. The vast majority of people in hospitals are unvaccinated despite now half or more of Americans being vaccinated. If it was “pointless to get vaccinated” we’d expect much closer to 50/50 numbers. But it’s like over 90% unvaxxed taking up hospital beds.
 

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