Covid-19 vaccines: excitement or fear?

[nuuskur]

Can't be mandatory, though, there are some reports around here that a chain of fuel stations threatens to lay off the workers who refuse to be vaccinated. Not a legal thing to do, not sure how that will pan out. The company likely gets sued for massive damages.

As for me, I look forward to getting vaccinated. A potential fever and maybe a sleepless night in exchange for being able to move freely. I'll take it.

 

[russ_watters]

Can't be mandatory, though, there are some reports around here that a chain of fuel stations threatens to lay off the workers who refuse to be vaccinated. Not a legal thing to do, not sure how that will pan out. The company likely gets sued for massive damages.

I'm not so sure. There are companies - usually medical practices - that require flu vaccines.

 

[StatGuy2000]

One of the frustrations I'm having is that here in the province of Ontario, Canada, we are currently still in Phase 1 of vaccinations (focusing on seniors in long term care facilities, front-line health care workers, and seniors 75 and above). Vaccines for the broader public are likely not available until July at the earliest -- see the official link from the province of Ontario COVID-19 vaccine plan below.

https://covid-19.ontario.ca/covid-19-vaccines-ontario

Vaccinations have been slow in part due to Pfizer temporarily shutting down their European manufacturing facilities to expand their production capacity (Canada at the moment does not have any domestic manufacturing sites for any of the COVID-19 vaccines). All of the news indicates that vaccinations are ramping up with increased supply (and my parents were able to be vaccinated this week, thankfully), but I'm getting rather impatient about when I can get it.

So as far as I'm concerned it is still far too premature to even talk about mandatory vaccinations if I can't even access them as of now.

 

[vela]

I'm not so sure. There are companies - usually medical practices - that require flu vaccines.

You're referring to companies in the US, right? I wonder if other countries have laws that would make mandatory vaccinations illegal.

From what I've read and heard, it seems in the US at least, if a business has a case that unvaccinated employees can put coworkers and customers at risk, it will probably be legal to require employees get vaccinated.

 

[Ygggdrasil]

Federal law prohibits employers and others from requiring vaccination with a Covid-19 vaccine distributed under an EUA:

The same section of the Federal Food, Drug, and Cosmetic Act that authorizes the FDA to grant emergency use authorization also requires the secretary of Health and Human Services to “ensure that individuals to whom the product is administered are informed … of the option to accept or refuse administration of the product.”

Likewise, the FDA’s guidance on emergency use authorization of medical products requires the FDA to “ensure that recipients are informed to the extent practicable given the applicable circumstances … That they have the option to accept or refuse the EUA product …”

In the same vein, when Dr. Amanda Cohn, the executive secretary of the CDC’s Advisory Committee on Immunization Practices, was asked if Covid-19 vaccination can be required, she responded that under an EUA, “vaccines are not allowed to be mandatory. So, early in this vaccination phase, individuals will have to be consented and they won’t be able to be mandatory.” Cohn later affirmed that this prohibition on requiring the vaccines applies to organizations, including hospitals.

https://www.statnews.com/2021/02/23...-a-covid-19-vaccine-distributed-under-an-eua/

Currently, all vaccines in use in the US are authorized for use under an emergency use authorization (EUA), and none have been given formal FDA approval, which would be a necessary pre-requisite for organizations to make the vaccine mandatory.

 

[bhobba]

You're referring to companies in the US, right? I wonder if other countries have laws that would make mandatory vaccinations illegal.

In Australia we have biosecurity laws that allow forced vaccination if necessary. But it is against our culture to do it except in an extreme emergency. A new computer model showed if 90% got vaccinated, and we use simple easily achievable measures like hand washing, just 40% of people socially distancing, efficient contact tracing, and recommended but not compulsory mask weaking, quarantine of arrivals except from counties where it is well controlled, things will be near normal. So I doubt anything but voluntary vaccination will be used because as soon as people see so many Australians get vaccinated without issues 90% is likely achievable. Just my observation about Australians and vaccinations, even though there are pockets like Byron Bay where anti-vaxxers tend to be more prevalent. But returnung to close to normality is a rather strong incentive.

Thanks
Bill

 

[Ygggdrasil]

Federal law prohibits employers and others from requiring vaccination with a Covid-19 vaccine distributed under an EUA
https://www.statnews.com/2021/02/23...-a-covid-19-vaccine-distributed-under-an-eua/

As a counterpoint to the article cited above stating that vaccines released under EUA cannot be mandated, STAT News published an opinion piece making the opposite argument. Here's an excerpt:

Among those who believe that EUA vaccines cannot be mandated, the best two arguments are a legal argument and a policy one. The legal argument is that the law setting out the requirements for emergency use authorization contains language requiring the Secretary of Health and Human Services to ensure that people know they can refuse or accept the vaccine. The same language requires the informational materials accompanying EUA vaccines to tell people that “It is your choice to receive” the relevant vaccine.

The policy argument against mandates is that the standards for emergency use authorization are lower than the standards for full approval, that the vaccines are “experimental” and not enough is known about them, and it is therefore unfair to mandate them. Two lawsuits have already been filed making both the legal and policy arguments, one by a corrections officer in New Mexico, and one by employees of the https://www.ktvn.com/story/43520501/employees-sue-lausd-for-mandating-experimental-covid-19-vaccine.

There are good reasons to reject both of these arguments, though. On the legal side, the EUA statute says nothing directed at employers or universities. Instead, it addresses the actions of federal officials, such as the HHS secretary and the president — not private actors. Private employees are generally “at will,” meaning they can be terminated for any reason that is not explicitly illegal. Those arguing that the EUA statute prohibits mandates by at-will employers are claiming that this federal law is changing existing state employment law on the topic by mere implication. They are reading in a broad prohibition covering all employers and universities in the U.S. that is not, in fact, in the statute. Such broad preemption would require, at a minimum, clearer language.

During the pandemic, employers and universities have already required Covid-19 tests, many of which are being provided under emergency use authorization, for their in-person employees and returning students. If mandating products like tests under an EUA is unlawful, then every employer or university requiring the use of those tests has been flagrantly violating the law.

The full piece (linked below) is worth a read if you are interested in the topic:

‘Authorization’ status is a red herring when it comes to mandating Covid-19 vaccination
https://www.statnews.com/2021/04/05...19-vaccine-red-herring-mandating-vaccination/

 

[Vanadium 50]

Odds not good enough? Nothing says one needs to claw one's way to the head of the line. If a million people go first, and they do not show any bad reactions, your sensitivity is about 3 x 10^-6 level, or about 1000 bad reactions. This is less likely than going to the ER because of a pogo-stick injury.

So we have actually more or less experienced this. There is a problem at the 2 x 10^-6 level with the J&J vaccine and blood clots.Fatalities are at the 4 x 10^-7 level. It took eight million doses to find this out.

As an aside, 3000 people a week are dying in the US from Covid. If everyone in the US were vaccinated with J&J, there would be about 130 fatalities, or about 7 hours worth.

As a second aside, only women have had adverse reactions. There is no reason not to have allowed men to keep receiving this vaccine. Of course, we might discover a problem at 80 million doses that we couldn't see at 8 million. But that's equally true for Pfizer and Moderna.

 

[bhobba]

As an aside, 3000 people a week are dying in the US from Covid. If everyone in the US were vaccinated with J&J, there would be about 130 fatalities, or about 7 hours worth.

People not understanding risk is the norm and has been so ever since I can remember. The oxford vaccine has a bit higher risk, but not by a lot. Yet here is what is happening in Aus:
https://www.skynews.com.au/details/_6249158643001

Go figure,

Thanks
Bill

 

[Ygggdrasil]

People not understanding risk is the norm and has been so ever since I can remember. The oxford vaccine has a bit higher risk, but not by a lot. Yet here is what is happening in Aus:
https://www.skynews.com.au/details/_6249158643001

Are you sure that you are correctly evaluating risk? Perform Vanadium's calculation except for Australia, which, for the past 6 months, looks like it has experienced zero deaths from COVID-19 (and in fact, overall has experienced decreased overall mortality during the pandemic).

Now, this is not an argument against vaccination in Australia (given that the risk-benefit calculation is not solely based on preventing deaths but also on enabling society to return to normal), but just a note that relative risks can vary quite a bit depending on circumstances. A choice that absolutely makes sense in the US may not necessarily make sense elsewhere.

 

[bhobba]

Are you sure that you are correctly evaluating risk?

Good point. Due to our control of Covid, let me rephrase it. At the moment, Covid has, for all practical purposes, been eliminated here in Aus. If that remains the same, the risk vs reward is not to bother vaccinating. The trouble is, at some time, we are going to have to relax our measures at least to some extent. That will be easier if as many people as possible are vaccinated. That needs to be factored in. Before the discovery of rare Oxford vaccine side effects, everyone wanted vaccination. Now they are reconsidering. I know some are waiting for safer vaccines, such as Pfizer or perhaps Novavax when released. There are always people like me that do not worry about the risks of death in the 1 in a million range and people that do worry about it. Australia is indeed in a lucky position. Consider though it has been at a terrible economic cost, with many businesses going to the wall and is still going on. Recently there was a 3-day lockdown in Perth, and that was the straw that broke the camels back for some businesses. Just heard we only had about 32,000 people vaccinated today in the whole of Australia. If that continues it is going to take years for people to be vaccinated.

Thanks
Bill

 

[Mayhem]

Why should we? Every member of PF was mandatorily vaccinated against many common diseases and we are all happy, healthy and kicking.

Actually if not for those mandatory vaccines number of happy PF users would be substantially lower.

Can confirm. Never got my vaccine and I'm chronically depressed.

 

[Vanadium 50]

Consider though it has been at a terrible economic cost, with many businesses going to the wall and is still going on. Recently there was a 3-day lockdown in Perth, and that was the straw that broke the camels back for some businesses.

Yes, but these are non-essential people. Unimportant people. Probably even voted for The Nats.

I see no reason for a 3-day lockdown. If the concern is that the infected and quarantined individual infected others, who infected others, and so on, 3 days isn't enough. It needs to be at least 10 and maybe 15. It's hard to see this as a reasoned response and not just politicians reacting to "something must be done!"

Just heard we only had about 32,000 people vaccinated today in the whole of Australia.

This article says there have been almost 90,000 in Western Australia alone. Granted, that's only 3.4% of the WA population, but it's a lot more than 32,000 nationwide. Perhaps "vaccinated today" meant "received their vaccination today" and not "have been vaccinated by today". That sounds more reasonable - although at this rate it will be about 2 years to get everybody.

 

[bhobba]

Excellent comments.

That 90,000 is not in one day - it is since vaccination started early this year. Perfectly understandable anyone would think it was just one day. Pathetic, isn't it.

Here is the real-time time tracker so you can see the exact numbers in Aus:
https://www.abc.net.au/news/2021-03-02/charting-australias-covid-vaccine-rollout/13197518?nw=0

The number in Aus yesterday was 31.9k. But today, and it is not over yet, is going gangbusters. Let's hope the trend continues.

NZ has given up and has decided to take it slowly and vaccinate only with Pfizer even though it will take a year:
https://www.abc.net.au/news/2021-04-27/new-zealand-covid-vaccination-program-on-track/100071086

There was no reason at all for a 3-day lockdown. The Premier did it purely because the vast majority of citizens like it - calling it a 'circuit breaker' to prevent possibly a longer lockdown later. What should have occurred is increased contact tracing, isolation of close contacts, and tests. In WA, the opposition was virtually wiped out at the last election by the Premier simply not following the science and doing what the polls said people wanted. They wanted policies that made them feel good, so that is what they got. Roundly condemned by quite a few commentators and premiers of other states, especially NSW. NSW has been a shining light in the pandemic. NSW results are as good or better than any other state. You would think that would be the model all would use - but it isn't. Balancing it with the economy - NSW does it - other states give it the 'finger' - as you say, they likely vote for the opposition anyway. Welcome to pandemic 'politics' here in Aus. I am a patriotic Australian, and like nearly all Australians, proud of being a free country:
https://www.statista.com/statistics/256965/worldwide-index-of-economic-freedom/

While effective, our pandemic response has been cringe-worthy and nothing to be proud of.

IMHO, while I am happy to get the Oxford vaccine, perhaps we should do what NZ is doing and use Pfizer and fast track our own mRNA manufacturing:
https://www.abc.net.au/news/2021-04-21/victoria-to-develop-mrna-covid19-vaccine-facilities/100083372

The next major 'leap' in Aus will be when the Novavax vaccine is approved and hopefully manufactured here by CSL. But CSL quickly changing course has issues:
https://www.smh.com.au/business/com...-switch-on-vaccine-plans-20210409-p57hsx.html

Thanks
Bill

 

[Vanadium 50]

A lot of effort has gone into the question of what is the best vaccine. My reasoning is pretty simple: I went with Moderna because I could get it. I'm sure if I wait long enough some other kind will be made available, but it seemed to me getting something that was good enough today made more sense than waiting for one that is incrementally better tomorrow.

 

[Rive]

because I could get it.

At this point that's the best. The one which you can get.
I'll get my second sputnik in a few days.
Not really a thing to brag about, but it's 'in'.

 

[JT Smith]

At this point that's the best. The one which you can get.

I have a different point of view. In my country it's likely that a significant percent of the population will remain unvaccinated so I am motivated to obtain the best protection for myself personally. Even though the differences in effectiveness are not known with precision the current understanding does rank the vaccines.

If there were no choice then I would happily take would what I could get. But if obtaining a vaccine of perceived higher effectiveness meant that I'd have to wait a couple of more months I would refuse a "lesser" vaccine. I've been masked and avoiding close interactions with people for 15 months now. A couple more months is nothing. Even with a vaccine I will still have to take certain precautions for quite some time into the future.

So for me: I would insist on Pfizer or Moderna or otherwise wait.

 

[Astronuc]

My reasoning is pretty simple: I went with Moderna because I could get it. I'm sure if I wait long enough some other kind will be made available, but it seemed to me getting something that was good enough today made more sense than waiting for one that is incrementally better tomorrow.

I applied the same reasoning, and took what was available, which happened to Pfizer. I would have taken Moderna or JNJ if either were offered.

 

[russ_watters]

As I mentioned in the other thread I was originally signed up for the J&J but switched to Pfizer when J&J was paused. I'm not sure if it's the better choice or not, but I feel better about it at least.

[edit]
Incidentally, use of the J&J vaccine has been slow to pick back up after its reauthorization 5 days ago; in my area at least, they are just starting to use it today. I'm not sure if they stopped shipping them ("delevered"ing), but the pace reported so far this week is down even from last week in both "delivered" and "administered". I think "delivered" is reported the next day whereas "administered" is supposed to be within 72 hrs but, sometimes lags more. And unless I'm missing it, "delivered" isn't broken down by type.

 

[Vanadium 50]

But if obtaining a vaccine of perceived higher effectiveness meant that I'd have to wait a couple of more months I would refuse a "lesser" vaccine.

I am not sure that makes sense from an individual perspective. It certainly depends on the numbers. If p₁ is the probability of exposure between now and when a "better" vaccine is available, and p₂ is the probability of exposure after that, and p_A is the probability vaccine A does not provide protection and p_B is the probability vaccine B does not provide protection, here's how the numbers work out.

Your probability of contracting Covid if you get vaccine A is $p_A(p_1 + p_2)$ and your probability of contracting Covid if you get vaccine B is $p_1 + p_B p_2$. Which is greater? Depends. Using J&J and Pfizer numbers, and assuming the risk goes down linearly with time puts the breakeven around 7-8 months from now. If the risk falls more slowly than that, you are better waiting. If it falls more quickly, you are better off getting what you can now. In the US with present vaccination rates (almost 1%/day), it is advantageous to go with whatever you can get.

Different vaccines, different countries, different breakeven points.

A different question is whether it is better for society if you go now with what's available or wait. That's a classic Prisoner's Dilemma problem.

 

[Astronuc]

Incidentally, use of the J&J vaccine has been slow to pick back up after its reauthorization 5 days ago; in my area at least, they are just starting to use it today. I'm not sure if they stopped shipping them ("delevered"ing), but the pace reported so far this week is down even from last week in both "delivered" and "administered". I think "delivered" is reported the next day whereas "administered" is supposed to be within 72 hrs but, sometimes lags more. And unless I'm missing it, "delivered" isn't broken down by type.

JNJ is being offered at my place of employment. However, I know colleagues who went through the state/county program already, and they received Pfizer or Moderna depending on which site they visited.

 

[wukunlin]

Everyone at my workplace got jabbed with the Sinopharm vaccine the other day. People can refuse to get the vaccine but they have to put their name down for it.

 

[JT Smith]

I am not sure that makes sense from an individual perspective. It certainly depends on the numbers. If p₁ is the probability of exposure between now and when a "better" vaccine is available...

...A different question is whether it is better for society if you go now with what's available or wait. That's a classic Prisoner's Dilemma problem.

The probability of exposure for me given my situation is very, very low. Like I said, another couple of months of keeping my head low is not a big deal for me. I know that's not so easy for many other people.

The question of what's best for society is to a great extent outside of my control. I know that there is a large fraction of our population who will refuse to be vaccinated. So community transmission at some level will probably be a reality for some time to come. I can't do anything about that.

If almost everybody were on board with getting a vaccine I would happily take any of the available vaccines since herd immunity would then be the primary goal. But since that's not likely to be a reality the best approach for me is to protect myself personally to the best extent possible. Or at least that's what I believe. I could be wrong. Risk assessment is something humans are quite poor at. I'm human.

 

[berkeman]

The probability of exposure for me given my situation is very, very low. Like I said, another couple of months of keeping my head low is not a big deal for me. I know that's not so easy for many other people.

If almost everybody were on board with getting a vaccine I would happily take any of the available vaccines since herd immunity would then be the primary goal. But since that's not likely to be a reality the best approach for me is to protect myself personally to the best extent possible.

Your position seems reasonable to me, since you are able to keep clear of others until you get the vaccine. I work part time in EMS, so I got my shots as soon as I could. Be well.

 

[bhobba]

Different vaccines, different countries, different breakeven points.

Exactly. Different vaccines, different characteristics, e.g. the Oxford is cheap (about $3 per dose) and relatively easy to manufacture. It has a low probability blood clotting issue, requires the second dose 12 weeks later for maximum effectiveness, and is about 83% effective at preventing getting Covid. The Pfizer is more expensive (about $20.00 per dose), only requires a second dose 3 weeks later and is about 95% effective at preventing Covid. The J&J requires just one shot, has the same blood clot issue as Oxford (it is at a lower level - 86 out of 25 million doses for the Oxford in Europe vs 8 out 7 million for the J&J in the US), is still cheap at about $10.00 per dose (remember you need one-shot) and is about 75% effective at preventing Covid. Here is the kicker. All seem 100% effective at preventing hospitalisation. I saw an interview with a doctor in India where a very virulent strain is running wild. He has had both the normal and the new strain. Since he had the normal strain before and still had some immunity from that, he fought the new strain off without problems. While only about 2% of the Indian population has been vaccinated, he has noticed that those who were vaccinated, even with the new variant, only got Covid mildly. So it may be all vaccines provide excellent protection, even for the new varients, against getting seriously ill. To me, that is the main issue - not how effective it is in getting Govid - Pfizer wins on that - but in preventing serious life-threatening cases.

Where I am in Aus, the risk vs reward, on a selfish basis (not thinking also about the economy) or not considering the quarantine measures may break down at any time, is not to bother vaccinating - it is eliminated here for all practical purposes. The economy must fully open sometime, so everyone needs to be vaccinated - eventually. We can wait and let people decide for themselves which vaccine they want. I personally would go for the J&J vaccine simply because you need one shot. A rather crass reason - but having to schedule another appointment with my GP for a second shot is a pain. It's a non-issue in Aus because J&J is not one of the vaccines available.

It is interesting how the general public looks at getting vaccinated in Aus - I will do a separate post about that.

Thanks
Bill

 

[bhobba]

Here is what Australians currently think of getting vaccinated:
https://www.theguardian.com/austral...willing-to-get-pfizer-or-astrazeneca-vaccines

You can make up your own mind if it is reasonable. Personally, I think it underestimates the chance of Covid escaping quarantine and wrenching havoc as happened in Victoria. Just my view.

Thanks
Bill

 

[bhobba]

As an aside, 3000 people a week are dying in the US from Covid. If everyone in the US were vaccinated with J&J, there would be about 130 fatalities, or about 7 hours worth.

Here is another interesting statistic - the risk of Deep Vein Thrombosis (DVT) from flying:
https://www.healthline.com/health/dvt-and-flying#dvt-and-flying

Here is the risk of dying from DVT:
https://www.cdc.gov/ncbddd/dvt/data.html

With Covid, we have less flying:
https://www.oecd.org/coronavirus/po...ndustry-impact-and-policy-responses-26d521c1/

This, of course, will be reflected in a reduction of the risk of getting DVT and dying. While I have not done the detailed calculation, I think it likely the risk of dying from vaccine blood clots is lower than the extra risk when the airline industry recovers. Food for thought.

Thanks
Bill

 

[Vanadium 50]

There was a meeting between the bosses and lawyers on a separate topic (Can we require a 15-day quarantine for people returning from India? The answer was "No, but") The issue of whether we can require mandatory vaccination came up. I was not at the meeting, but I did get a summary. The answer was: "Legally probably, but it is a bad, bad, bad idea."

The big issue is liability. If the employer requires the employee to participate in an experimental medical procedure - and that's what the EUA is - and then gets sick or dies, the liability could be enormous. Juries won't like the idea of employers requiring elective medical procedures, especially experimental ones, so the best thing to do is to keep this far away from a jury.

The lawyers recommended "encouragement" over "requirement". Things like time off for vaccination and changes of duty. For example, instead of firing Prof. Jenny McCarthy (who may be tenured which opens up a can of worms in and of itself), a university can say "OK, but we have to protect our students, so you're not allowed in the classroom, However, we are still paying you, so we want you to spend your day calling alums seeking donations."

 

[berkeman]

The big issue is liability. If the employer requires the employee to participate in an experimental medical procedure - and that's what the EUA is - and then gets sick or dies, the liability could be enormous. Juries won't kike the idea of employers requiring elective medical procedures, especially experimental ones, so the best thing to do is to keep this far away from a jury.

This ties into my post that you replied to. It seems that an accelerated full approval has multiple benefits. I wonder if the EUA can be deemed an extended stage-3 trial...

https://www.physicsforums.com/threads/coronovirus-vaccine-progress.992484/post-6487132

 

[Mayhem]

I'm probably not getting the vaccine. It appears to be the narrative that I can still infect others if I get vaccinated. But I can also do that if I'm not vaccinated, and since I'm in an age group and demographic that has 0% chance of getting seriously ill from this disease, I'll take my chances.

 

[pinball1970]

I'm probably not getting the vaccine. It appears to be the narrative that I can still infect others if I get vaccinated. But I can also do that if I'm not vaccinated, and since I'm in an age group and demographic that has 0% chance of getting seriously ill from this disease, I'll take my chances.

If you get vaccinated you have a reduced risk of passing it on.
If don't get vaccinated you have an extremely good chance of passing it on and keeping this thing going.
https://www.bmj.com/content/373/bmj.n1112

 

[Mayhem]

If you get vaccinated you have a reduced risk of passing it on.
If don't get vaccinated you have an extremely good chance of passing it on and keeping this thing going.
https://www.bmj.com/content/373/bmj.n1112

Give it a year.

 

[pinball1970]

Give it a year.

We have had since Dec 2019 and 3.1 million deaths. Now we have vaccines. What is it you are waiting for? More deaths?
On the 0% risk thing, I would look at stats for deaths regarding children, it's not zero, also variants in the future may have higher virulence in your age group?
No one knows.

 

[Mayhem]

We have had since Dec 2019 and 3.1 million deaths. Now we have vaccines. What is it you are waiting for? More deaths?
On the 0% risk thing, I would look at stats for deaths regarding children, it's not zero, also variants in the future may have higher virulence in your age group?
No one knows.

The entire situation is very speculative and continues to be so. So I'm not doing something irreversible to myself until we know better.

 

[Vanadium 50]

The entire situation is very speculative and continues to be so

I'm sorry, but that's just a cop-out. It's equivalent to the statement "because we don't know everything we don't know anything."

If you want to be taken seriously on a science forum, you will have to be much more specific. For example, the following statements can be discussed in a less woolly way than your statement:

• I don't believe Covid-19 exists.
• I don't believe that the vaccines provide any protection.
• I believe that the risk of side effects is larger than being reported, and here is my evidence.
• I believe I am in such a low-risk category it's not worth my time or trouble.