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More good news on the vaccine front


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I'm keeping this cruise-related, don't worry. CDC has confirmed (via a study of ~4,000 US essential workers who were monitored as they continued to work) that after two doses, the Pfizer and Moderna vaccines both are 90% effective at preventing infection. And if you don't get infected, you can't spread the virus (not even asymptomatically).

https://www.washingtonpost.com/health/2021/03/29/vaccine-effective-essential-workers-study/

Quote

The Pfizer-BioNTech and Moderna vaccines being deployed to fight the coronavirus pandemic are robustly effective in preventing infections in real-life conditions, according to a federal study released Monday that provides reassurance of protection for front-line workers in the United States.

In a study of about 4,000 health-care personnel, police, firefighters and other essential workers, the Centers for Disease Control and Prevention found that the vaccines reduced the risk of infection by 80 percent after one shot. Protection increased to 90 percent following the second dose. The findings are consistent with clinical trial results and studies showing strong effectiveness in Israel and the United Kingdom, and in initial studies of health-care workers at the UT Southwestern Medical Center and in Southern California.

The CDC report is significant, experts said, because it analyzed how well the vaccines worked among a diverse group of front-line working-age adults whose jobs make them more likely to be exposed to the virus and to spread it.

The workers came from eight locations in six states — Arizona, Florida, Minnesota, Oregon, Texas and Utah. They received vaccinations between mid-December, when the doses first became available, to mid-March, a 13-week period that included the deadly winter surge that was killing more than 3,000 people a day by January. The study is also one of the first to estimate vaccine effectiveness among participants against infection — rather than just monitoring for symptomatic cases — including infections that did not result in symptoms, according to the CDC.

Among 2,479 fully vaccinated people, just three had confirmed infections. Among 477 people who received one dose, eight infections were reported.

By comparison, among 994 people who were not vaccinated, 161 developed infections.

No deaths were reported.

...

The study is ongoing and researchers will share more details on the infections in people who were partly or fully vaccinated, known as “breakthrough infections.” Researchers are also studying whether people who became infected despite vaccination may have less severe or briefer illnesses and whether they shed a lower amount of virus for less time.

The article goes on to talk about the study design and logistical challenges it faced (e.g., having to negotiate with UPS and FedEx to get thousands of sample kits shipped out and sent back in every week), as well as other potential challenges (e.g., the comparatively small number of participants, and compliance of participants with properly taking their own nasal swabs and sending them in on time each week).

But this is great news for the ship's crews and the upcoming vaccine-mandated cruses. Crew members are probably breathing a huge collective sigh of relief as they learn about this. And with such great prevention of infection, a ship that has nothing but vaccinated crew and mostly vaccinated passengers (i.e., most kids on board won't be vaccinated) is effectively a community with true herd immunity. I would sincerely hope it would also allow for elimination of mask requirements while on board, at least while outside on the pool deck and other very well-ventilated areas. Heck, given the studies that proved the cruise lines' ventilation improvements truly blocked airborne spread of the virus across the ship, it might even allow for elimination of masks throughout.

That light just keeps getting brighter, and it's not an oncoming freight train. It's the sun rising on a cobalt blue sea, with a ship sailing serenely across the waters.

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The part that stood out to me in that article is that after one shot, there's already about 80% efficacy.  Great news for Canadians who have to wait 4 months between shots.  The plot thickens in Canada.  Just a few minutes ago, Health Canada recommended that AZ not be given to anyone younger than 55.  Maybe we can strike a new deal, Pfizer or Moderna in exchange to open Canadian ports? lol

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This is as good a thread as any for me to ask this question.

 

With the vaccine being more plentiful and effective, it doesn't seem to me too far-fetched to think that 

the workers in the "tourist area" part of most ports can't be vaccinated, allowing passengers to at least

be able to walk around somewhere off ship.  We are hitting Falmouth in August and I love that separated

area - lots of things to do.  

 

Am I pipe-dreaming?   I know there are probably at least 1000 workers who are there, but would it be that

difficult to manage/maintain?   I don't mind staying onboard, but really want to get off for a little.  Not much

into ship-sponsored excursions.

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1 hour ago, Ray said:

Part that stood out for me was the 90% effective....so 10% ineffective...and people still wonder why safety measures such as masks have to be worn.....because its not 100% .....but no doubt those who know best will still ask why when they have had vaccine ?

We could get into a long argument and throw numbers around but I'm just going to go with what % is "good enough" ... nothing in life is 100%.

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46 minutes ago, Floski said:

This is as good a thread as any for me to ask this question.

 

With the vaccine being more plentiful and effective, it doesn't seem to me too far-fetched to think that 

the workers in the "tourist area" part of most ports can't be vaccinated, allowing passengers to at least

be able to walk around somewhere off ship.  We are hitting Falmouth in August and I love that separated

area - lots of things to do.  

 

Am I pipe-dreaming?   I know there are probably at least 1000 workers who are there, but would it be that

difficult to manage/maintain?   I don't mind staying onboard, but really want to get off for a little.  Not much

into ship-sponsored excursions.

Like with so much right now, the answer is most likely, “Yes. Eventually.”

Each island has to get supply. But the first-world countries all have first dibs due to pre-negotiated / pre-paid contracts. The US government has negotiated to send AZ vaccine to Canada and Mexico; I imagine that until it’s decided that there’s enough here / in the UK / in the EU to cover everyone in their own populations, island nations and other smaller governments will be similarly stuck waiting for handouts.

Places like St. Maarten or BVI may get supplies more quickly if they have arrangements with their “parent” government, but independent islands could be waiting for a fair while yet.

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1 hour ago, jticarruthers said:

We could get into a long argument and throw numbers around but I'm just going to go with what % is "good enough" ... nothing in life is 100%.

Wouldnt be a long argument...people ask and complain about the fact as to why RC are implementing the wearing of masks even when vaccine has been given...answer because its not 100% safe and they have to protect those that cruise....simple .....The End 

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This trial studied how many "essential workers" considered to be at high risk of exposure to persons infected with SARS2, by virtue of their line of work, actually became infected over varying times after vaccination. What's behind these 80% effective after the first dose and 90% after the second numbers?

3950 participants.

After the first dose of an mRNA vaccine, in a controlled for post vaccination times analysis before the second dose, eight participants tested + for COVID by PCR.

After the second dose, also in a controlled for times post vaccination analysis, 3 participants tested + for COVID by PCR

Let me reiterate that ....... 3 people out of 3950 got infected after their second vaccine dose > 14d. THREE. 

You have to read the study if this sort of thing interests you to understand how that data translates to the 80% and 90% numbers. https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm?s_cid=mm7013e3_e&ACSTrackingID=USCDC_921-DM53321&ACSTrackingLabel=MMWR Early Release - Vol. 70%2C March 29%2C 2021&deliveryName=USCDC_921-DM53321 

The study did not evaluate whether or not the 8 participants that became infected were capable of transmitting the disease. In other studies that have looked at this it has been found that subjects who did become infected with SARS after becoming vaccinated had significantly lower viral loads. What that translates to is a lower likelihood an infected person can pass SARS2 on to an uninfected person. 

This trail data suggests that on a cruise ship having around 4000 passengers and crew on board, you might get 3 infections regardless of symptoms displayed by an infected person who might have boarded during the cruise. Given how the cruise lines have layered mitigation measures that include pre-boarding PCR testing, onboard surveillance (random rapid tests), ID and isolation of COVID + persons and contact tracing, the risk of a bad COVID outcome on a cruise ship is so small as to be negligible - the cruise lines want it that way and have done a remarkable job of insuring that will be the norm on all operating cruise ships.

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2 hours ago, Ray said:

Wouldnt be a long argument...people ask and complain about the fact as to why RC are implementing the wearing of masks even when vaccine has been given...answer because its not 100% safe and they have to protect those that cruise....simple .....The End 

I think you are misunderstanding how the 90% numbers are derived and how herd immunity works.  It means that if you are 100% exposed to the virus, you have less than a 10% chance of contracting it.  It makes the virus very unlikely to spread among vaccinated people - especially if they have been tested before getting on the ship.  Even if you did get it, it would not be a serious virus.

 

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5 hours ago, Ray said:

Part that stood out for me was the 90% effective....so 10% ineffective...and people still wonder why safety measures such as masks have to be worn.....because its not 100% .....but no doubt those who know best will still ask why when they have had vaccine ?

Why not two masks?

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14 minutes ago, smokeybandit said:

There will be a small percentage of people who get covid with the vaccine. Just like there's a larger percentage of people who get the flu despite the vaccine. Really not a big deal scientifically, but surely will be made a big deal in the media.

Exactly.  The CDC will latch onto such events and use them to unscientifically support their actions.

 

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6 minutes ago, smokeybandit said:

The interesting thing is that if you look at the people who have gotten it, they're all people who are tested regularly due to their jobs or at-risk status. People who otherwise wouldn't have known they had it if they weren't getting tested every week. So that's a *good* thing for the vaccine.

That also supports that allowing cruise ships would aid in catching positive people who otherwise would not know they are positive.

Just as testing caught these dozen or so cases (out of hundreds and hundreds), testing would-be cruise ship guests can also catch individuals who are anomalies.  

Without the tests they go around potentially spreading to family members and others they come into contact with.   

Testing before heading to the cruise terminal is also a good thing for the community.

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What I found odd about that article was the fact that the woman first mentioned in the story noted that several of her family members also contracted Covid after being vaccinated. Assuming they all got vaccinated at the same site, it makes me wonder if they (and probably others who went there) got a bad batch of vaccine (e.g., left out of the freezer too long) or something similar.

Statistically, you'd expect to see the numbers of positive cases scattered around like most of the report mentions (multiple states, nothing finer-grained than county level). For a half-dozen members of the same family, who the article suggests all live close to one another, to all contract the virus smacks more of a sub-par set of vials, or maybe sub-optimal administration of the vaccine, in their vaccine center than any major shortcoming with the vaccine overall.

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37 minutes ago, smokeybandit said:

There will be a small percentage of people who get covid with the vaccine. Just like there's a larger percentage of people who get the flu despite the vaccine. Really not a big deal scientifically, but surely will be made a big deal in the media.

You got it.  And the media makes it a big deal, which fans the flames of people look for any excuse not to get it, and we end up with a bigger problem than the actual cases in this article.

For the CDC, while these cases happen, the difference is these people won't face life threatening conditions as a result of getting covid.  With that in mind, that definitely falls under "acceptable risk".

People got sick from colds, the flu, noro, etc on a ships in the past. A no sail order wasn't necessary for that because it really was not life threatening.  

This should be the logical conclusion based on vaccine rollout for allowing ships to sail.

Wait, let me write @twangster response to my post for him....

"Logical is the key word there. Also, @Lovetocruise2002 started her live blogs like eight months early"

Yup, you're right.

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2 hours ago, twangster said:

A 3rd wave, the impending doom of a potential 4th wave and now this:

https://www.clickorlando.com/news/local/2021/03/29/dozens-in-central-florida-contract-covid-19-after-being-fully-vaccinated/

I really don't see the CDC letting go any time soon.

I feel like this news story is being overly dramatic   

Everything I’ve read and watched about the vaccines has said it’s possible to get COVID after being vaccinated.  What the vaccines do is keep people out of the hospital as well as keep them alive. 
 

I got the first round of Moderna Saturday at a shot fair in a local hospital.  All the info they passed out to those of us getting our shots said this.   They were very clear that even after being fully vaccinated, we could be carriers. 

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On Walenski’s statement yesterday and her doomsday prediction …….

Look, new case numbers are rising, right? She's a smart woman and there are a lot of smart folks around her ...... drops head and sulks, "she's probably right." The pandemic is going to go on and continue to interrupt normal life for years.

Wait, I have some questions:

In what age group are cases rising? Should we be overly concerned about transmission in the 18-35 crowd where it has been clear for months that this cohort has mild symptoms from an infection? Are at risk groups dying at a higher rate because younger people are getting infected and spreading it to higher risk groups? If so, wouldn't that mean increasing deaths, CFR and hospitalizations? Where are these rising case numbers occurring? Which regions of the country and world are approaching or even reaching herd immunity and doing well? What is the impact of vaccines on serious illness, deaths and transmission rates across all age groups? Do you think it's just possible that focusing more on a vaccine drive, getting everyone in the US vaccinated might be better than doomsday predictions?

CONTEXT is completely missing and has been since the beginning of the number crunching designed to track the course of SARS2 pandemic.

The messaging coming from the world renowned CDC is counterproductive. Going forward there are discernible end points. They aren't tomorrow or next week or even next month but the US and other countries that have their vaccination programs up and running are moving toward them.

 I’m pretty sure that the CDC sees Americans as not smart enough to understand the nuances, the subtleties of significant improvement in the word's chances to end the pandemic. With that end comes a return to something less than but very much like pre-pandemic life. Instead, they keep beating the “hold on for a while” drum.

The way to talk about this is by outlining the progress and the risks going forward and how to lessen their impact that might delay a return to normal life in a post SARS2 pandemic world. I found this article yesterday. It's long, detailed and very encouraging. There author defines to important pandemic related endpoints. (1) Resumption of mostly unrestricted life and commerce, (2) Herd immunity that follows and results in other than sporadic virus outbreaks that are easily controlled.

Takeaways include from the article linked below:

  • The US will probably reach herd immunity in the third quarter.
  • In anticipation of that, PH officials will start, or should start, easing mobility restrictions along with prohibitions on certain type of activities.
  • There are risks to achieving those two end points: SARS2 variants rendering vaccines less effective in preventing disease and transmission, immunity from previous infection or vaccination being of shorter duration than most anticipate, vaccine supply and/or distribution delays and interruptions among a few other.

 In this report, and contrary to the Walenski dire warnings, scant mention is made of doomsday scenarios or a need for humans to "not let their guard down" .... whatever that actually means. Hide in the basement, don't go out at all? I have no idea because the central thrust of our public health messaging is that impending doom is close. It's not on how to safely and responsibly go about one's life in the current circumstance. Specifically, with increasing vaccine availability, vaccination rates and proven reduced transmission rates the pandemic is going to end.

Read this and my advice is to take whatever Walenski and the CDC  has to say going forward with a grain of salt:
https://www.mckinsey.com/industries/...9-pandemic-end

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7 minutes ago, JeffB said:

CONTEXT is completely missing and has been since the beginning of the number crunching designed to track the course of SARS2 pandemic.

Also generally ignored throughout is the Hope-SImpson scale, a measure of seasonal viral activity based on latitude. Which predicted a slight increase in northern states through the beginning of April, then a sharp decline after that.

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I hate to keep dumping on the CDC but I feel that this is  important to understand among our group of cruise fanatics. The reason is that when confronted with arguments against a resumption of cruising, you'll be armed with the facts.

The news this morning was about travel. Lots of it. United made more money in the last month than they did since march of 2020! Surprise, people are traveling. With out a doubt this sort of thing has the potential to increase human contact and spread disease. And what is new about that! Restricting travel and mobility are prime ways to reduce the spread of a global pandemic. Fine, I get that.

Hello, humans will be human. They are generally ignoring government pleas to stay in your homes to stop COVID. This is happening everywhere on the planet not just i n the US. After a year of locking people inside their homes, shutting airports and sea ports, directing businesses to have employees not come to the office and instead work from home, closing businesses in the travel and leisure sector, citizens in various countries are saying to hell with that. I'm going to my local bar or restaurant, I'm jumping on an airplane and flying to some Caribbean island that wants us to be there or Mexican resort in Cancun or Madrid or any number of places that are saying, "come on down!" Some of that activity is being carried out carelessly and without regard for the continuing risk of SARS2 transmission and if we were gettting better messaging from public health officials the impact of that on disease spread could be reduced.

When Angela Merkle said, I'm locking all you German citizens down for the 2 weeks that include Easter, there was such outrage that she backed off a shut down entirely. The French have never been enthusiastic about Macron telling them to not go out and drink wine. Italians? Same. Then, of course we have the Swedes that took a different path of figuring out how to cope with the virus from the start, instead of trying to eliminate any risk that you might catch COVID. They seem to be doing about the same as other EU countries. Well, no kiddding. Governments ..... it's time to wake up.

What's not getting enough attention is the on-the-ground reality of the impact of vaccines. If I put together a graph of two variables, vaccination rates and serious illness on the Y axis and time in months on the X axis, color coded vaccination rates in blue and serious illness and death in red, you'd have a positive slope on the blue line and a negative one on the red with the lines intersecting sometime in May. Forget about putting case numbers on the graph but if you did you'd continue to see the predictable peaks and troughs over time with peaks getting lower and troughs deeper. It's what viruses due. It's what SARS2 has done for over a year.

Now, yes, we can think about things like variants that might render these miracle vaccines less effective delaying the decline in serious illness over time. But, I'm telling you, vaccination science involving genomic technology (that's the novel mRNA vaccines) have revolutionized vaccine development and production making it much easier to adapt vaccines to genomic variations in a given virus and provide boosters.

Trust me and many other experts who are saying SARS2 is going to become a seasonal thing just like H1N1 Influenza and all it's variants. But the disease burden that was very high from this virus a year ago has steadily declined over that same period and will continue to do so in the long term.

Why is this so hard to understand among government officials who are making public health policy? The smart thing to do is to tell businesses how to minimize viral spread in their places of business (already being done, e.g., airlines and the cruise industry) and, more importantly, tell citizens how to safely return to normal activities - because that's what the citizens are going to do anyway whether you tell them how to make it safe or not. The right approach is to recognize that over time in a pandemic (global) circumstance, there will be a predictable transitioning to an epidemic (regional) and then to small (local) outbreaks. At that point outbreaks are easily ID'ed and controlled (see the Ebola virus experience and many others). And, shockingly, this is exactly the circumstance expanding availability of SARS2 vaccines and the miracle technology that can adapt vaccines going forward are making obvious.

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