General COVID-19 Vaccine Discussion

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think the Feds called it as best they could ; backing AZ turned from triumph to disaster

Yep. While Morrison will be blamed for this, it's not like he sits in his office with a dartboard deciding on which vaccine we should order.

The reality is we've got a whole health apparatus who would have recommended the purchasing decisions, probably rubber stamped by the health minister.

I can fully understand why AZ was selected:
- cheaper (albeit the bigger cost is in distribution and jabbing)
- based on more classic and known vaccine technology
- could be manufactured in Australia by CSL
- less stringent chilling requirements enabling easier distribution

And as it turned out early Europe made AZ deliveries were blocked, and the US did the same thing with Pfizer, so the decision to pick something that could be manufactured locally was smart.

The problems are more twofold
- when the issues with AZ emerged, much of Pfizer was already spoken for, and there wasn't enough urgency within health to get more doses (eg. Using PM to push)
- allowing the strong demonization of AZ when we didn't have any other solution
 
when the issues with AZ emerged, much of Pfizer was already spoken for, and there wasn't enough urgency within health to get more doses (eg. Using PM to push)

Which was entirely avoidable, had we placed order when approached by Pfizer not over 3 months later, and if that initial order was for enough doses for everyone i.e Australia had over ordered like other countries, not only 30%.
 
Yep. While Morrison will be blamed for this, it's not like he sits in his office with a dartboard deciding on which vaccine we should order.

The reality is we've got a whole health apparatus who would have recommended the purchasing decisions, probably rubber stamped by the health minister.

I can fully understand why AZ was selected:
- cheaper (albeit the bigger cost is in distribution and jabbing)
- based on more classic and known vaccine technology
- could be manufactured in Australia by CSL
- less stringent chilling requirements enabling easier distribution

And as it turned out early Europe made AZ deliveries were blocked, and the US did the same thing with Pfizer, so the decision to pick something that could be manufactured locally was smart.

The problems are more twofold
- when the issues with AZ emerged, much of Pfizer was already spoken for, and there wasn't enough urgency within health to get more doses (eg. Using PM to push)
- allowing the strong demonization of AZ when we didn't have any other solution


Yes AZ could and should have been used more widely. I said in this thread a while back not using AZ more widely was a huge mistake.


Many mistakes since. ie Giving Pfizer to office workers who can work from home was a huge waste, and is an ongoing waste, of a scarce resource. It should have been restricted to priority groups, essential workers and public facing workers.
 
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OK thanks. So I will follow his example and seek Pfizer vaccinations.
There are plenty of other examples you can follow from him too, but I've no idea why you would.

Speaking to your GP instead of following the example of a politician would seem to be the most obvious decision one could ever make.
 
AZ wasn’t available at the time and this was before the media hijacked AZ.
AZ was approved February 16th. Doses available but not scheduled for rollout.

Scott Morrison vaccinated Feb 22nd.
 
Greg Hunt (the Federal Health Minister) and many others had Astrazeneca.

Considering the PM may suddenly need to travel overseas him taking a vaccine where he could be fully vaccinated sooner makes a lot of sense for his particular situation.
 
I will strictly deal with the issues raised and not make any thinly veiled attacks.


Yes, on that basis (suggest) the US CDC changed its advice and has been on a public information campaign since.

In my post, which has caused so much disquiet & attacks, I quoted an excerpt from The Age article. What The Age reported is/was 'new'.

Previously the worldwide understanding was that any CV vaccine saw significant lowering, across the board, of the viral load carried by infected fully vaccinated. Something you draw attention to in your post, ie; the history prior to the Delta variant.

Now, that the US (nothing to do with Australia) Centre for Disease Control feels there is sufficent evidence to warrant a change in approach for fully vaccinated people. Partly this may be due to their May 17th recommendation that fully vaccinated people in the US should no longer get tested for Covid. That has been reversed.

Covid-19: C.D.C. Reverses Testing Advice for Fully ...

https://www.nytimes.com › covid-delta-variant-vaccine

7 days ago — The C.D.C. now says fully vaccinated people should get tested ... If the results come back negative, they can stop wearing masks indoors.

Equally the CDC stopped recording breakthrough infections that did not require hospitalisation or resulted in death from April 30th, just when Delta was starting to appear. Bloomberg did a quick analysis, and remember this is after the CDC recommended fully vaccinated people not get tested for Covid anymore. What they found, from people who did not follow the official Govt advice, and went & got tested anyway:

www.bloomberg.com/news/articles/2021-07-30/cdc-scaled-back-hunt-for-breakthrough-cases-just-as-the-delta-variant-grew

Bloomberg gathered data from 35 states and identified 111,748 vaccine breakthrough cases through the end of July, more than 10 times the CDC’s end-of-April tally.

The figures being quoted for US breakthrough infections have been substantially understated since April.

These cases, not counted, are exactly the cases that present the highest risk as many will be asymptomatic due to the vaccine doing most of its job and preventing the fully vaccinated person from developing symptoms, let alone serious illness.

That does not prevent them from potentially being a superspreader, as explained by the CDC director on over 38 media appearances since.


So Apples with Oranges.
  • The time period covered is before the Delta variant took over.
  • This study reflects the old understanding of CV variants.
In early April, Delta represented just 0.1 percent of cases in the United States, according to the C.D.C. By early May, the variant accounted for 1.3 percent of cases, and by early June, that figure had jumped to 9.5 percent. The C.D.C. now estimates that the number has hit 82.2 percent.

In the time period of the study you reference the Delta variant made up less than 0.04% of cases over the period.

It is not relevant to Delta, and is no longer relevant if the CDC's understanding based on observations since are confirmed. That's history.

There is a big difference between mean, median & max. The graphs also show the range of outcomes for each - some unvaccinated infected carried a massively lower viral load than fully vaccinated & vice-versa.

What I originally stated, may have been better if I added the word 'could'. The question remains how do you know if a fully vaccinated person is actually infected with Delta, asymptomatic and carries a massive viral load of the Delta strain?

In NSW's case that is now through mandatory 3 day surveillance testing for 8 LGAs 'essential workers', & regular testing in other roles (HQ etc).

I do not think you dispute that there is a growing body of evidence that the viral load carried by a fully vaccinated person infected with Delta can be (not always) just as high as the viral load carried by a Delta infected unvaccinated person with a high viral load.

Throughout this pandemic there have been case after case of 'shooting the messenger' (it seems in China both literally & figuratively).

It took over a year (IIRC) for the Australian Federal Govt/Health to acknowledge/accept on any of its web pages that CV can be spread through the air by small aerosol particles in addition to those generated by a cough or a sneeze. At one testing site in Sydney this week their procedures manual (stapled pages) still does not reference aerosol transmission just the risk from droplets generated by a cough +/or sneeze - I asked the question & as they had no queue they went & got it for me, but held it so I could read it though
.

There's no 'weird agenda' as some have conjectured - but personally I would like to be told (if I had not come across this change in understanding) that even when fully vaccinated I can still pose a risk to any immuno-compromised, or elderly or anyone by being infected with the Delta variant, asymptomatic yet carrying a viral load hundreds of times greater than that generated by the original Wuhan virus.

I think about the twin removalists who were asymptomatic and perhaps infected their mother. I would not want to be in that situation.

Forewarned is forearmed.
No filtering information to get the worst possible scenario is a raison d'etre of the media.The article you quoted initially was based on 1 study of one outbreak in Provincetown with analysis of just over 200 cases that suggest that viral loads are as great in vaccinated people who have a breakthrough infection as in unvaccinated cases.
One study is not proof.If greater numbers were studied it could well be that the trend to lower viral loads in breakthrough cases would become statistically significant then your predictions would collapse.

The Provincetown outbreak is widely different to a major outbreak in LA county where there were many thousands of cases.In Provincetown 74% of the outbreak were breakthrough cases.In LA county it was ~ 1.5% of the total number of cases.Also in the Provincetown outbreak none of the breakthrough cases were hospitalised or died.

Then you assume that a high viral load will lead to more transmission.That is not neccessarily so.here is an article where the results of studies are mixed as to viral loads.
Patients with severe symptoms of COVID-19 in one study presented 60 times higher viral load and prolonged viral shedding than patients with mild symptoms [76]. In another study higher viral load was not correlated with outcomes including ICU admission, mortality and oxygen requirement in hospitalised patients [77]. In a study on 4172 patients, higher viral loads were observed in the first phase of the outbreak and the first phase of disease. The same study reported lower viral loads in ICU patients than patients in other wards [78].


So despite your alarmism vaccinated patients have a very much lower chance of getting covid,less chance of it being severe and less likely to die especially if young and if no co morbidities.
Bottom line--vaccinate ASAP.
 
This morning, when questioned, Brad Hazzard revealed that the death toll tied to the breakthrough infection at Liverpool hospital is now 5, from the fully vaccinated nurse. Total breakthrough infections within RPA now reached 4.

Currently 4 other staff (3 fully vaccinated & 1 with 1st dose) and 29 in-patients (not in Liverpool hospital for CV reasons) are/were infected.

Vaccines can save your life but with Delta you may still infect others - even other vaccinated people. The Delta variant has changed the ground rules.

A major problem is that neither NSW nor any State/Territory in Australia has enough negative pressure isolation hospital rooms if numbers rise much more..


Updated as of July21st, 2021 - and still based on protocols now discredited from Quarantine Hotel outbreaks due to airflow such as:

"Have a marked exclusion zone of 1.5m outside the operating theatre entry and exit doors. The exit zone can also double as the doffing zone for masks and eye wear when the door is closed."

Nothing to stop the airflow from the operating theatre going into the corridor, just a precautionary 1.5m exclusion zone so people do not stand there.

One of NSW's largest public hospitals has just 6 such negative pressure rooms. They have the 'capacity' for dozens of ICU cases - just not in negative pressure rooms/areas. One of their 'surge capacity' ICU areas is the pre-op area for the theatres. From NSW Health:

"Negative pressure room: A single-occupancy patient-care room used to isolate persons with a suspected or confirmed transmissible airborne communicable disease. Environmental factors are controlled in negative pressure rooms to minimise the transmission of infectious agents that are usually transmitted from person to person by droplet nuclei associated with coughing or aerosolisation of contaminated fluids [2].

The air handling system provides negative pressure by air flow into the room and direct exhaust of air from the room to the outside of the building or recirculation of air through a HEPA filter before returning to circulation. [2]
"

Another Sydney hospital did plan ahead last year.

Meanwhile is NSW Health (admin) letting too much slip through the gaps?

Here is one example, the NSW "venues of concern" list has not been updated for more than a week, and at that date it concerned locations from a week earlier (July 24th). Perhaps someone has gone on leave or is in isolation?


Luckily, scrolling further down the page, the "NSW COVID-19 case locations table" is up to date.

Edited: Corrected naming of wrong hospital, not RPA but at Liverpool hospital.
 
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So despite your alarmism vaccinated patients have a very much lower chance of getting covid,less chance of it being severe and less likely to die especially if young and if no co morbidities.
Bottom line--vaccinate ASAP.
I posted, an excerpt from The Age article, that a breakthrough infected person (someone fully vaccinated) can infect many others including other fully vaccinated people. Trouble is, as a fully vaccinated person has a much greater probability of being asymptomatic if infected & thus they can be unwittingly infecting many others.

Sadly this is what happened at Liverpool hospital here in Sydney with a fully vaccinated nurse around the time of my post.

Warning people of a risk that is against the conventioned wisdom is not alarmism - it is being responsible.

The study posted to discredit my point was solely based on the time period pre-Delta = so not at all relevant. Yet not acknowledged - harmful mis-information? Perhaps requiring a warning on it?

Vaccination massively reduces the risk of serious illness/death for the vaccinated person but now with the Delta variant it makes the minority of fully vaccinated who suffer a breakthrough infection, more likely to be asymptomatic and unknowingly be infecting others.

Bottom line: Even if fully vaccinated, act as if you are not.

Wear a mask & eye protection when out & about because even though you are unlikely to suffer serious adverse affects - you may just infect others.
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Is not the "outbreak" in Liverpool hospital, not RPA?
And now John Hunter hospital in Newcastle is a close contact site 🚑
Correct - my mistake. I mixed up the infection of the Adelaide man at RPA with it.

Thanks for correcting my mistake!
 
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