Author Topic: Which vaccine would you choose and why?  (Read 1688 times)

ericrugiero

  • Pencil Stache
  • ****
  • Posts: 731
Which vaccine would you choose and why?
« on: August 04, 2021, 02:24:16 PM »
If you could choose any of the vaccines that are available in the US, which would you choose and why?  The standard answer is "take the one that's available".  If they were all available, which would you pick? 

I delayed getting the vaccine initially because I'm low risk and I wanted to see more data on vaccine safety.  At this point, I'm still low risk but there is enough data on the vaccines that I'm thinking my vaccine complication risk is lower than my Covid risk.  About the time I was feeling more comfortable, the vaccines covid cases dropped.  But now, the The Delta variant is starting to spike in my area.  For reference, I'm Male & early 40's.  I'm a little less comfortable with the mRNA vaccines just because they are a newly used technology without long term track records.  But, the numbers seem to show them being slightly more effective. 

It looks like all 3 vaccines are available locally. 

DaMa

  • Pencil Stache
  • ****
  • Posts: 760
Re: Which vaccine would you choose and why?
« Reply #1 on: August 04, 2021, 03:07:14 PM »
Moderna.  The mRNA vaccines are more effective than the others against Delta.  I read something today that Israel's early studies are showing the effectiveness of the Pfizer vaccine is starting to wear off after a few months.  I'm sure it's too early to have any really good analysis on that point, but I would get Moderna if I was getting it now.

Edited to add:  I had the Pfizer.
« Last Edit: August 04, 2021, 04:01:14 PM by DaMa »

scantee

  • Pencil Stache
  • ****
  • Posts: 519
Re: Which vaccine would you choose and why?
« Reply #2 on: August 04, 2021, 03:12:45 PM »
Pfizer.

Simply because it is three weeks between the first and second shots rather than the four for Moderna.

It is true that the Pfizer studies are showing reduced effectiveness against Delta. Moderna almost certainly has similar reductions it is just that there are far fewer studies of it because it is less common outside of the US. My understanding is that the effectiveness of mRNA vaccines is thought to be essentially the same between the two that are available.

I got Moderna BTW.

dcheesi

  • Handlebar Stache
  • *****
  • Posts: 1127
Re: Which vaccine would you choose and why?
« Reply #3 on: August 04, 2021, 03:36:45 PM »
Until recently I would have said Pfizer, as theirs seems to have a slightly lower incidence of short-term side effects. But it does seem like Moderna might have slightly better long-term immunity against the newer strains. (Both of these are likely due to dosing; supposedly Moderna has more mRNA particles per shot).

Either of these is preferable to the J&J shot, which is just not as effective overall.

If I was getting it now, I'd favor Moderna. However, if you're prone to really suffering with colds or the flu shot, then maybe I'd still go Pfizer? They're so similar that it's really almost a toss-up. (FWIW I got Pfizer, while some friends/family got Moderna; not much difference in experiences between the two.)

As far as the technologies go, keep in mind that the mRNA approach is a lot more targeted than the older approaches like what's in the J&J shot. It uses a smaller section of the target virus' code, and no grafting it onto parts of an adenovirus to take it into the cells. So yeah, mRNA is newer, but it's also more precise, and with less extra baggage coming along for the ride.

Pfizer.

Simply because it is three weeks between the first and second shots rather than the four for Moderna.

It is true that the Pfizer studies are showing reduced effectiveness against Delta. Moderna almost certainly has similar reductions it is just that there are far fewer studies of it because it is less common outside of the US. My understanding is that the effectiveness of mRNA vaccines is thought to be essentially the same between the two that are available.

I got Moderna BTW.
Re: 3 vs 4 weeks: that's also another potential advantage for Moderna, given that some studies and reports have shown slightly better immunity metrics when the second shot comes a bit later. It's just a tradeoff between speed of immunization vs. potentially longer lasting immunity.

ncornilsen

  • Handlebar Stache
  • *****
  • Posts: 1009
Re: Which vaccine would you choose and why?
« Reply #4 on: August 04, 2021, 03:53:58 PM »
Moderna. I did feel like crap after shot #2, but I've been hearing the effectivness is a bit better.

meghan88

  • Pencil Stache
  • ****
  • Posts: 830
  • Location: Montreal
Re: Which vaccine would you choose and why?
« Reply #5 on: August 04, 2021, 04:03:48 PM »
Pfizer or Moderna.  As others have said, they seem to be similar, and there are fewer studies on Moderna which may be why its efficacy against the variants hasn't been documented as much as Pfizer.

Aside from injection site soreness and a bit of fatigue after dose #2, we were fine.  Same with just about everyone else we know.  I think one person had mild flu symptoms for a couple of days.

Good on you for seeing that COVID poses more of a threat than the jab.  Plus, you help protect the people around you, and your community.

trollwithamustache

  • Handlebar Stache
  • *****
  • Posts: 1021
Re: Which vaccine would you choose and why?
« Reply #6 on: August 04, 2021, 04:07:16 PM »
J&J, one and done and no risk on mRNA technology, which I think is small, but very difficult to find good, data driven, detailed info on mRNA vaccines. (not sayings its not out there, but hard to find for us no bio types)

that being said, since all the blood clots were in middle age women, I am happy my wife went another direction.

Paul der Krake

  • Walrus Stache
  • *******
  • Posts: 5630
  • Age: 13
  • Location: UTC-10:00
Re: Which vaccine would you choose and why?
« Reply #7 on: August 04, 2021, 04:12:07 PM »
I think it's pretty clear at this point that the mRNA vaccines are vastly superior, and essentially interchangeable. So one of those two.

If I absolutely had to choose between those two I'd pick Moderna over Pfizer to reward the industry newcomer over the established incumbent.

Adventine

  • Handlebar Stache
  • *****
  • Posts: 1904
  • Age: 32
  • Location: Memphis, USA
Re: Which vaccine would you choose and why?
« Reply #8 on: August 04, 2021, 04:25:54 PM »
We received Pfizer just because it was what was available, and if given the option today, we'd be happy to choose it again.

Dollar Slice

  • Walrus Stache
  • *******
  • Posts: 7575
  • Age: 44
  • Location: New York City
Re: Which vaccine would you choose and why?
« Reply #9 on: August 04, 2021, 05:10:03 PM »
I would pick Moderna due to the same reasons listed by dcheesi - it has a higher dose per shot compared to Pfizer and higher efficacy than J&J. Plus it has shown slightly better results in some recent, more specialized studies - things like eliciting antibodies in immunocompromised patients. Which makes me think it's a bit better overall at getting an antibody response.

If you are super concerned with side effects, Pfizer is probably the easiest to take, though.

MudPuppy

  • Handlebar Stache
  • *****
  • Posts: 1409
Re: Which vaccine would you choose and why?
« Reply #10 on: August 04, 2021, 05:19:59 PM »
I was able to pick my vaccine back in December. I work for two hospitals and each was offering a different one. I did pick Moderna. I stand by that choice in hindsight.

If I were picking now for my first time being vaccinated? Pfizer, simply because it has a shorter timeframe to fully vaxxed status and time means everything when you are racing a wave that has the potential to be a tsunami.

My third choice is J&J which does have a faster time to fully vaccinated status and is the clear choice for someone with follow up barriers (time off work, transportation, etc), but has a somewhat lower efficacy.


Like you said, the best vaccine is whatever you can get, but there’s my personal pro and con list.

Kris

  • Walrus Stache
  • *******
  • Posts: 6260
Re: Which vaccine would you choose and why?
« Reply #11 on: August 04, 2021, 06:00:25 PM »
At this point, I am just hoping to get the third “booster” shot as quickly as possible to protect against the Delta variant.

(We got Pfizer)

trollwithamustache

  • Handlebar Stache
  • *****
  • Posts: 1021
Re: Which vaccine would you choose and why?
« Reply #12 on: August 04, 2021, 06:10:05 PM »
At this point, I am just hoping to get the third “booster” shot as quickly as possible to protect against the Delta variant.

(We got Pfizer)

And this is why I chose Pfizer when making the stock purchase.

Kris

  • Walrus Stache
  • *******
  • Posts: 6260
Re: Which vaccine would you choose and why?
« Reply #13 on: August 04, 2021, 06:13:47 PM »
At this point, I am just hoping to get the third “booster” shot as quickly as possible to protect against the Delta variant.

(We got Pfizer)

And this is why I chose Pfizer when making the stock purchase.

I mean, any of the approved shots should be among the ones given for the booster shot…?

Also, it is still free for people.

DK

  • Stubble
  • **
  • Posts: 230
Re: Which vaccine would you choose and why?
« Reply #14 on: August 04, 2021, 07:24:56 PM »
If you could choose any of the vaccines that are available in the US, which would you choose and why?  The standard answer is "take the one that's available".  If they were all available, which would you pick? 

I delayed getting the vaccine initially because I'm low risk and I wanted to see more data on vaccine safety.  At this point, I'm still low risk but there is enough data on the vaccines that I'm thinking my vaccine complication risk is lower than my Covid risk.  About the time I was feeling more comfortable, the vaccines covid cases dropped.  But now, the The Delta variant is starting to spike in my area.  For reference, I'm Male & early 40's.  I'm a little less comfortable with the mRNA vaccines just because they are a newly used technology without long term track records.  But, the numbers seem to show them being slightly more effective. 

It looks like all 3 vaccines are available locally.
if you can wait for it, and it actually comes to the US soon (if u are in US) i'd go with the novavax. if not....per mrna's, are fairly interchangeable. per the JNJ would be one and done, and actually has a higher absolute risk reduction than the mrna's (1.7 compared to .7 and .9 if i remember right...always gotta know the relative plus absolute numbers...), plus it was tested with more variants out there. since you're not a middle aged woman would have less risks of the clotting issues with JNJ. being young-ish male for the mrna's might have some risk of the carditis issues but thats low probability (appears i was one of the 'lucky' ones....was in ER within 2wks of first shot. blech). per you saying low risk, being male does put you at higher risk, but highest risks would be having one or more comorbodities and low vit d status so keep that in mind, there's a lot of weird data stratification that seems to be going on. and per delta concern, seems it can be more contagious, but not necessarily any more deadly.

trollwithamustache

  • Handlebar Stache
  • *****
  • Posts: 1021
Re: Which vaccine would you choose and why?
« Reply #15 on: August 10, 2021, 12:31:20 PM »

the JNJ would be one and done, and actually has a higher absolute risk reduction than the mrna's (1.7 compared to .7 and .9 if i remember right...always gotta know the relative plus absolute numbers...)

can you explain this some more? The entire inter-web tells me that J&J is the least effective of the 3 vaccines available in the US.

brandon1827

  • Bristles
  • ***
  • Posts: 347
  • Location: Tennessee
Re: Which vaccine would you choose and why?
« Reply #16 on: August 10, 2021, 01:03:51 PM »
I'm early 40s as well, I took the Pfizer as at the time, I'd heard of potential issues with the J&J, and the effective percentage of Pfizer was higher.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 18984
  • Age: 40
  • Location: Toronto, Ontario, Canada
Re: Which vaccine would you choose and why?
« Reply #17 on: August 10, 2021, 01:18:52 PM »
Pfizer or Moderna.  They both seem to be very similar in side effects and outcome.

I got Astra Zeneca initially and Pfizer for my second shot.  The Pfizer side effects were much less than the AZ ones.  I thought that AZ was similar to J + J . . . if so the chance of blood clots is significantly higher in younger than older people.

PDXTabs

  • Magnum Stache
  • ******
  • Posts: 3328
  • Age: 38
  • Location: Portland, OR, USA
Re: Which vaccine would you choose and why?
« Reply #18 on: August 10, 2021, 01:24:23 PM »
I got Pfizer just because it was the first one available to me and I would do it again. Everyone I know that got Pfizer had less side effects than everyone I know that got Moderna. That's some anecdata, but you asked me what I would do.

Alternatively, Sputnik V if I could get it around here, just to be contrarian and use its novel delivery mechanism.

gaja

  • Handlebar Stache
  • *****
  • Posts: 1576
Re: Which vaccine would you choose and why?
« Reply #19 on: August 10, 2021, 02:05:37 PM »
I would like one of each of Pfizer and Moderna, and maybe a shot of J&J just to be sure.

ChpBstrd

  • Magnum Stache
  • ******
  • Posts: 3564
Re: Which vaccine would you choose and why?
« Reply #20 on: August 10, 2021, 02:43:35 PM »
This is a hard choice that should be an easy choice - hence the advice to get the first shot available to you. A week or two spent deliberating puts you at far greater risk than the one-in-a-million side effects or effectiveness differences that get so much press coverage. If you haven't yet been struck by lightening in your life, you'll no doubt be fine with any vaccine. Hundreds of wait-and-see folks are dying each day.

I got Pfizer in March, experienced no symptoms, and have not contracted COVID either. I also skipped by usual early summer head cold in 2021, but that might have been due to working from home instead of the office. I always knew it was my coworkers' fault!

Also, get your annual flu shot. People forget that flu routinely kills tens of thousands of people in the US in a typical season. Plus there is early evidence that a flu shot helps your immune system when it has to fight off COVID.
https://www.theguardian.com/science/2021/jul/12/flu-jab-may-reduce-severe-effects-of-covid-suggests-study

SunnyDays

  • Handlebar Stache
  • *****
  • Posts: 2296
Re: Which vaccine would you choose and why?
« Reply #21 on: August 10, 2021, 03:58:28 PM »
I got Pfizer, but I think Moderna is fine too.  I don't know if it's wise to get J and J if you plan to travel out of the US.  Some countries aren't accepting it, apparently.  Whatever, you choose, get it ASAP - don't risk Delta or be a vector for further mutations.

geekette

  • Handlebar Stache
  • *****
  • Posts: 2212
Re: Which vaccine would you choose and why?
« Reply #22 on: August 10, 2021, 04:22:37 PM »
I got the J&J back in March.  The latest studies (still pre-print) show it effective against the Delta variant, but they're all effective.  I will bare my arm for a booster as soon as it's allowed.  I do think we need to spread the wealth, so to speak.  It infuriates me that Alabama threw away 65,000 expired doses.  A little planning, people?

I can't find any info on travelers being turned away for the J&J, @SunnyDays  - do you have any cites?

SunnyDays

  • Handlebar Stache
  • *****
  • Posts: 2296
Re: Which vaccine would you choose and why?
« Reply #23 on: August 10, 2021, 04:57:49 PM »
I got the J&J back in March.  The latest studies (still pre-print) show it effective against the Delta variant, but they're all effective.  I will bare my arm for a booster as soon as it's allowed.  I do think we need to spread the wealth, so to speak.  It infuriates me that Alabama threw away 65,000 expired doses.  A little planning, people?

I can't find any info on travelers being turned away for the J&J, @SunnyDays  - do you have any cites?

Oops, my error!  I was confusing it with the AstraZeneca that is not accepted FROM some countries.  Apologies, didn't mean to freak anyone out.

YYK

  • Stubble
  • **
  • Posts: 132
  • Location: Scattered disc
Re: Which vaccine would you choose and why?
« Reply #24 on: August 12, 2021, 08:11:19 AM »
This is a hard choice that should be an easy choice - hence the advice to get the first shot available to you. A week or two spent deliberating puts you at far greater risk than the one-in-a-million side effects or effectiveness differences that get so much press coverage. If you haven't yet been struck by lightening in your life, you'll no doubt be fine with any vaccine. Hundreds of wait-and-see folks are dying each day.

I think it's funny how spoiled for choice we are, and it speaks to how incredible the new technology is, that we look at what would have been great vaccines pre-mRNA days, J&J and AZ, and relegate them to second-class status. I'm very excited to see what will be possible with mRNA vaccines going forward.

As to the OP, I'd go with pfizer since I got that originally. No side effects for me. My arm was even less sore than with the flu shot.
« Last Edit: August 12, 2021, 08:13:18 AM by YYK »

J Boogie

  • Handlebar Stache
  • *****
  • Posts: 1531
Re: Which vaccine would you choose and why?
« Reply #25 on: August 13, 2021, 12:02:51 PM »
Well, if we get to choose, I'd choose Novavax. Not available in the US at this time though.

MudPuppy

  • Handlebar Stache
  • *****
  • Posts: 1409
Re: Which vaccine would you choose and why?
« Reply #26 on: August 13, 2021, 12:28:08 PM »
@ericrugiero have you gotten a vax yet?

ChpBstrd

  • Magnum Stache
  • ******
  • Posts: 3564
Re: Which vaccine would you choose and why?
« Reply #27 on: August 13, 2021, 08:08:38 PM »
I'll change my answer to Moderna based on new, very limited, and very preliminary information that could change in the future:

https://www.yahoo.com/news/pfizers-vaccine-efficacy-dropped-42-105945416.html

DK

  • Stubble
  • **
  • Posts: 230
Re: Which vaccine would you choose and why?
« Reply #28 on: August 15, 2021, 07:01:29 AM »

the JNJ would be one and done, and actually has a higher absolute risk reduction than the mrna's (1.7 compared to .7 and .9 if i remember right...always gotta know the relative plus absolute numbers...)

can you explain this some more? The entire inter-web tells me that J&J is the least effective of the 3 vaccines available in the US.

I've read and heard it a few times, i think here's the first time i heard it - should be about 38:15 in here where they start talking about it if the timestamps in notes are correct. (Peter's a very smart critical thinking doc, and paul offit has been involved in vaccine mfg, and actually on the fda advisory board.)
https://peterattiamd.com/pauloffit2/

it's tough with how its being reported, and ppl's lack of knowledge on statistics, probabilities, predictive values, etc. Not to mention different times the trials were done, and different endpoints.

i think most people hear 95% effective and it means if 100 ppl got the vaccine, 5 would still get covid if exposed. that's not how it works....that number comes more from the difference of people who got covid, between the vaccine group and placebo group. it was only if they would have gotten exposed in their day to day lives (when most things were shutdown and lot's of mask wearing going on. With some rounding, it was basically 99% who got the vaccine in the trial didn't 'get' covid, and 98% who did NOT get the vaccine, didn't 'get' covid. So the absolute risk reduction was roughly 1%.

maybe something to help explain absolute vs relative, is let's say you see an article saying eating hot dogs increases your risk of getting prostate cancer 50%. you get scared, everybody gets scared, and hot dogs are banned. but if you look at the study behind it, you would see something like the normal risk of getting prostate cancer is 1%, and in the study they saw an increase of 50%, which means, your new risk of getting is 1.5%. so absolute risk is the 1% -> 1.5%.....the relative risk is the 50% increase. that's why its important to know both numbers to see whats actually changing. 1 -> 1.5 might not bother you or anyone at all. but - now let's say the base risk is 10%, and increase of 50% there turns the absolute risk to 15%....which actually might make you think about reducing hot dog intake.

maybe that helps a bit?

Malcat

  • Walrus Stache
  • *******
  • Posts: 8982
Re: Which vaccine would you choose and why?
« Reply #29 on: August 15, 2021, 07:23:15 AM »
I didn't care.

I've taken multiple drugs today with higher risks than covid vaccines.

FWIW, I had one shot of Pfizer and one shot of moderna.

I assume that if one vaccine pulls ahead dramatically in terms of efficacy, then we'll all get boosters with that one in the end.

I have bigger health fish to fry than either covid or the vaccines. I just don't worry about them.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 18984
  • Age: 40
  • Location: Toronto, Ontario, Canada
Re: Which vaccine would you choose and why?
« Reply #30 on: August 15, 2021, 10:13:23 AM »
I didn't care.

I've taken multiple drugs today with higher risks than covid vaccines.

Really?  Which other drugs have you taken that were only emergency authorized by the FDA?  My understanding was that this is a pretty unusual situation.

Malcat

  • Walrus Stache
  • *******
  • Posts: 8982
Re: Which vaccine would you choose and why?
« Reply #31 on: August 15, 2021, 10:16:37 AM »
I didn't care.

I've taken multiple drugs today with higher risks than covid vaccines.

Really?  Which other drugs have you taken that were only emergency authorized by the FDA?  My understanding was that this is a pretty unusual situation.

Just because a drug is approved doesn't mean it's low risk, it means the known risks are considered acceptable compared to the illness it is treating.

I take an approved medication that has caused major internal bleeding *twice*.

So no, the vaccine risks just don't concern me very much.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 18984
  • Age: 40
  • Location: Toronto, Ontario, Canada
Re: Which vaccine would you choose and why?
« Reply #32 on: August 15, 2021, 12:33:49 PM »
I didn't care.

I've taken multiple drugs today with higher risks than covid vaccines.

Really?  Which other drugs have you taken that were only emergency authorized by the FDA?  My understanding was that this is a pretty unusual situation.

Just because a drug is approved doesn't mean it's low risk, it means the known risks are considered acceptable compared to the illness it is treating.

I take an approved medication that has caused major internal bleeding *twice*.

So no, the vaccine risks just don't concern me very much.

It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

PDXTabs

  • Magnum Stache
  • ******
  • Posts: 3328
  • Age: 38
  • Location: Portland, OR, USA
Re: Which vaccine would you choose and why?
« Reply #33 on: August 15, 2021, 12:40:37 PM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

I almost half-way agree with you, in the general sense. Except that the OP was asking advice about what others on this board would do, and Malcat has actual data on her body. She has empirical evidence about her body and responded that she wasn't concerned relative to her other medications. That is absolutely logically valid.

habanero

  • Handlebar Stache
  • *****
  • Posts: 1010
Re: Which vaccine would you choose and why?
« Reply #34 on: August 15, 2021, 12:49:41 PM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Some approved drugs have a list of known, harmful and pretty serious side effects longer than the old fashioned phone book. The main difference is that drugs are given to someone with a condition, and presumably that condition is (much) worse than whatever side effects a drug can have. Vaccines on the other hand are given to "every" healthy individual so you can't accept much risk from 'em. Here (Norway) there was some debate as to we could even administer AZ after what was discovered as it was, at best, doubtful you could administer a vaccine with a meaningful probability of death for young, healthy individuals - we had six deaths in 140k shots of AZ administered. The only exception in use is, apparantly, the vaccine against dengue fever. But since we have no dengue fever in the country there aren't that many who get it each year.

An example (Remsima)

https://www.medicines.org.uk/emc/files/pil.3709.pdf

Very common: may affect more than 1 in 10 people
• Stomach pain, feeling sick
• Viral infections such as herpes or flu
• Upper respiratory infections such as sinusitis
• Headache
• Side effect due to an infusion
• Pain.
Common: may affect up to 1 in 10 people
• Changes in how your liver works, increase in liver enzymes (shown in blood tests)
• Lung or chest infections such as bronchitis or pneumonia
• Difficult or painful breathing, chest pain
• Bleeding in the stomach or intestines, diarrhoea, indigestion, heartburn, constipation
• Nettle-type rash (hives), itchy rash or dry skin
• Balance problems or feeling dizzy
• Fever, increased sweating
• Circulation problems such as low or high blood pressure
• Bruising, hot flush or nosebleed, warm, red skin (flushing)
• Feeling tired or weak
• Bacterial infections such as blood poisoning, abscess or infection of the skin (cellulitis)
• Infection of the skin due to a fungus
• Blood problems such as anaemia or low white blood cell count
• Swollen lymph nodes
• Depression, problems sleeping
• Eye problems, including red eyes and infections
• Fast heart beat (tachycardia) or palpitations
• Pain in the joints, muscles or back
• Urinary tract infection
• Psoriasis, skin problems such as eczema and hair loss
• Reactions at the injection site such as pain, swelling, redness or itching
• Chills, a build-up of fluid under the skin causing swelling
• Feeling numb or having a tingling feeling.
Uncommon: may affect up to 1 in 100 people
• Shortage of blood supply, swelling of a vein
• Collection of blood outside the blood vessels (haematoma) or bruising
• Skin problems such as blistering, warts, abnormal skin colouration or pigmentation, or swollen
lips, or thickening of the skin, or red, scaly, and flaky skin
• Severe allergic reactions (e.g. anaphylaxis), an immune system disorder called lupus, allergic
reactions to foreign proteins
• Wounds taking longer to heal
• Swelling of the liver (hepatitis) or gall bladder, liver damage
Uncommon: may affect up to 1 in 100 people
• Feeling forgetful, irritable, confused, nervous
• Eye problems including blurred or reduced vision, puffy eyes or sties
• New or worsening heart failure, slow heart rate
• Fainting
• Convulsions, nerve problems
• A hole in the bowel or blockage of the intestine, stomach pain or cramps
• Swelling of your pancreas (pancreatitis)
• Fungal infections such as yeast infection, or fungal infection of the nails
• Lung problems (such as oedema)
• Fluid around the lungs (pleural effusion)
• Narrowed airway in the lungs, causing difficulty breathing
• Inflamed lining of the lung, causing sharp chest pains that feel worse with breathing (pleurisy)
• Tuberculosis
• Kidney infections
• Low platelet count, too many white blood cells
• Infections of the vagina
• Blood test result showing ‘antibodies’ against your own body.
Rare: may affect up to 1 in 1,000 people
• A type of blood cancer (lymphoma)
• Your blood not supplying enough oxygen to your body, circulation problems such as narrowing
of a blood vessel
• Inflammation of the lining of the brain (meningitis)
• Infections due to a weakened immune system
• Hepatitis B infection when you have had hepatitis B in the past
• Inflamed liver caused by a problem with the immune system (autoimmune hepatitis)
• Liver problem that causes yellowing of the skin or eyes (jaundice)
• Abnormal tissue swelling or growth
• Severe allergic reaction that may cause loss of consciousness and could be life-threatening
(anaphylactic shock)
• Swelling of small blood vessels (vasculitis)
• Immune disorders that could affect the lungs, skin and lymph nodes (such as sarcoidosis)
• Collections of immune cells resulting from an inflammatory response (granulomatouslesions)
• Lack of interest or emotion
• Serious skin problems such as toxic epidermal necrolysis, Stevens-Johnson syndrome and acute
generalised exanthematous pustulosis
• Other skin problems such as erythema multiforme, blisters and peeling skin, or boils
(furunculosis)
• Serious nervous system disorders such as transverse myelitis, multiple sclerosis-like disease,
optic neuritis and Guillain-Barrι syndrome
• Inflammation in the eye that may cause changes in the vision, including blindness
• Fluid in the lining of the heart (pericardial effusion)
• Serious lung problems (such as interstitial lung disease)
• Melanoma (a type of skin cancer)
• Cervical cancer
• Low blood counts, including a severely decreased number of white blood cells
• Small red or purple spots caused by bleeding under the skin
• Abnormal values of a blood protein called ‘complement factor’ which is part of the immune
system
• Lichenoid reactions (itchy reddish-purple skin rash and/or threadlike white-grey lines on
mucous membranes).
« Last Edit: August 15, 2021, 12:55:41 PM by habanero »

lost_in_the_endless_aisle

  • Handlebar Stache
  • *****
  • Posts: 1416
Re: Which vaccine would you choose and why?
« Reply #35 on: August 15, 2021, 12:51:41 PM »

the JNJ would be one and done, and actually has a higher absolute risk reduction than the mrna's (1.7 compared to .7 and .9 if i remember right...always gotta know the relative plus absolute numbers...)

can you explain this some more? The entire inter-web tells me that J&J is the least effective of the 3 vaccines available in the US.

I've read and heard it a few times, i think here's the first time i heard it - should be about 38:15 in here where they start talking about it if the timestamps in notes are correct. (Peter's a very smart critical thinking doc, and paul offit has been involved in vaccine mfg, and actually on the fda advisory board.)
https://peterattiamd.com/pauloffit2/

it's tough with how its being reported, and ppl's lack of knowledge on statistics, probabilities, predictive values, etc. Not to mention different times the trials were done, and different endpoints.

i think most people hear 95% effective and it means if 100 ppl got the vaccine, 5 would still get covid if exposed. that's not how it works....that number comes more from the difference of people who got covid, between the vaccine group and placebo group. it was only if they would have gotten exposed in their day to day lives (when most things were shutdown and lot's of mask wearing going on. With some rounding, it was basically 99% who got the vaccine in the trial didn't 'get' covid, and 98% who did NOT get the vaccine, didn't 'get' covid. So the absolute risk reduction was roughly 1%.

maybe something to help explain absolute vs relative, is let's say you see an article saying eating hot dogs increases your risk of getting prostate cancer 50%. you get scared, everybody gets scared, and hot dogs are banned. but if you look at the study behind it, you would see something like the normal risk of getting prostate cancer is 1%, and in the study they saw an increase of 50%, which means, your new risk of getting is 1.5%. so absolute risk is the 1% -> 1.5%.....the relative risk is the 50% increase. that's why its important to know both numbers to see whats actually changing. 1 -> 1.5 might not bother you or anyone at all. but - now let's say the base risk is 10%, and increase of 50% there turns the absolute risk to 15%....which actually might make you think about reducing hot dog intake.

maybe that helps a bit?
Why would the particular absolute risk reduction in a study be the important metric? If one vaccine was tested during lower population disease prevalence than another, wouldn't the absolute risk reduction of the vaccine tested in an epidemic's lull be lower than that tested in a peak, all else being equal? What matters in making a personal risk/reward assessment is the relative risk reduction relative to the odds of being exposed to covid over some time into the future. If a 3 month study had 3% of participants exposed to potential infection, that doesn't address the absolute risk reduction of Delta covid where perhaps 30% may be exposed July-September of this year. Or am I missing something here?

PDXTabs

  • Magnum Stache
  • ******
  • Posts: 3328
  • Age: 38
  • Location: Portland, OR, USA
Re: Which vaccine would you choose and why?
« Reply #36 on: August 15, 2021, 12:56:07 PM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Some approved drugs have a list of known, harmful and pretty serious side effects longer than the old fashioned phone book.

Along those lines, Pfizer is fully approved in Bahrain, Brazil, New Zealand, Saudi Arabia, Switzerland. One way around GuitarStv's logical argument is to figure out how to get to one of those places and get your doses there.

habanero

  • Handlebar Stache
  • *****
  • Posts: 1010
Re: Which vaccine would you choose and why?
« Reply #37 on: August 15, 2021, 01:00:19 PM »
Why would the particular absolute risk reduction in a study be the important metric? If one vaccine was tested during lower population disease prevalence than another, wouldn't the absolute risk reduction of the vaccine tested in an epidemic's lull be lower than that tested in a peak, all else being equal? What matters in making a personal risk/reward assessment is the relative risk reduction relative to the odds of being exposed to covid over some time into the future. If a 3 month study had 3% of participants exposed to potential infection, that doesn't address the absolute risk reduction of Delta covid where perhaps 30% may be exposed July-September of this year. Or am I missing something here?

No you're not. This is quoted extensively as a reason why it's not much use to take the vaccine, but quoters fail to understand that it is just valid for this short time window.

I can, with the same validity say that where I live, during say the last 2 months, the probability of me getting covid was pretty much zero. That wouldn't hold in a society everyone returned to normal and noone was vaccinated.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 18984
  • Age: 40
  • Location: Toronto, Ontario, Canada
Re: Which vaccine would you choose and why?
« Reply #38 on: August 15, 2021, 01:17:05 PM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

I almost half-way agree with you, in the general sense. Except that the OP was asking advice about what others on this board would do, and Malcat has actual data on her body. She has empirical evidence about her body and responded that she wasn't concerned relative to her other medications. That is absolutely logically valid.

Feelings and anecdotes don't play into the logic.

A - Super high risk drug that might cause your bones to liquify and drip out your nose.
B - Drug where risks are not yet fully understood.

Is 'A' high risk?  For sure.  Is 'A' higher risk than 'B'?  Dunno - the claim cannot be supported by available information.



It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Some approved drugs have a list of known, harmful and pretty serious side effects longer than the old fashioned phone book.

Along those lines, Pfizer is fully approved in Bahrain, Brazil, New Zealand, Saudi Arabia, Switzerland. One way around GuitarStv's logical argument is to figure out how to get to one of those places and get your doses there.

The FDA ensures that risk is known and quantified, not that it is absent.  The point is not meaningless approval.

lost_in_the_endless_aisle

  • Handlebar Stache
  • *****
  • Posts: 1416
Re: Which vaccine would you choose and why?
« Reply #39 on: August 15, 2021, 02:00:32 PM »
^I think it's a matter of how to evaluate the unknown tail risk of a relatively new drug or vaccine. It can both be true that the expected risk of a vaccine is much lower than that of a well-studied drug, but that the potential unknown risks of that same vaccine could be much less constrained, and therefore, potentially higher than the well-studied drug. Allow me to prove through MS Paint below. We don't absolutely know which one is more dangerous, so we can compare the expected value of the risks, or we can compare risks on the severe ends of the probability distribution.

PDXTabs

  • Magnum Stache
  • ******
  • Posts: 3328
  • Age: 38
  • Location: Portland, OR, USA
Re: Which vaccine would you choose and why?
« Reply #40 on: August 15, 2021, 02:07:24 PM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Some approved drugs have a list of known, harmful and pretty serious side effects longer than the old fashioned phone book.

Along those lines, Pfizer is fully approved in Bahrain, Brazil, New Zealand, Saudi Arabia, Switzerland. One way around GuitarStv's logical argument is to figure out how to get to one of those places and get your doses there.

The FDA ensures that risk is known and quantified, not that it is absent.  The point is not meaningless approval.

Are you a US citizen now? I thought that you were Canadian? I might understand your comment if you were a yank, but come on. Switzerland and New Zealand aren't banana republics handing out rubber stamps for the safety and efficacy of vaccines. As a fellow commonwealth citizen I am personally offended that you would question the integrity of the institutions in New Zealand.

habanero

  • Handlebar Stache
  • *****
  • Posts: 1010
Re: Which vaccine would you choose and why?
« Reply #41 on: August 15, 2021, 02:33:55 PM »
I might understand your comment if you were a yank, but come on. Switzerland and New Zealand aren't banana republics handing out rubber stamps for the safety and efficacy of vaccines. As a fellow commonwealth citizen I am personally offended that you would question the integrity of the institutions in New Zealand.

Banana Republics they ain't, but none of them has done their own clinical trials - at least not to my knowledge. US is a bit special as afaik the US does not accept phase-3-data from outside the US. The EU emergency approval was done off of US data.

AZ is not approved in Switzerland, btw and think it never was. I have read they have the strictest procedure in Europe but as this is way outside my domain I really have no real clue if it actually is so. Approval in Europe is done by an EU body and if approval is granted, it's up to individual countries if they want to have it ok'ed or not (as mentioned, we, Norway, has ditched AZ completely) but think the other way around is much more difficult, i.e. national approval without EU approval.

PDXTabs

  • Magnum Stache
  • ******
  • Posts: 3328
  • Age: 38
  • Location: Portland, OR, USA
Re: Which vaccine would you choose and why?
« Reply #42 on: August 15, 2021, 02:48:44 PM »
I might understand your comment if you were a yank, but come on. Switzerland and New Zealand aren't banana republics handing out rubber stamps for the safety and efficacy of vaccines. As a fellow commonwealth citizen I am personally offended that you would question the integrity of the institutions in New Zealand.

Banana Republics they ain't, but none of them has done their own clinical trials - at least not to my knowledge. US is a bit special as afaik the US does not accept phase-3-data from outside the US. The EU emergency approval was done off of US data.

Yes, but as a US taxpayer, should I care? Along those lines, to the best of my knowledge, the US is making the vaccine manufacturers tabulate and submit their final safety data from their own trials to the FDA. But in parallel the CDC (or is it the FDA?) is collecting a bunch of safety data of their own. To me, as a US taxpayer, that's just dumb. As soon as they have enough data to say with a straight face that the vaccine is both safe and effective they should approve it, IMHO. They shouldn't wait for a book report from Pfizer.

Along those lines, if the OP wanted the vaccine with the most full approvals from total countries or developed western democracies the answer is Pfizer (today).

EDITed to add - I guess that the other thing full FDA approval vets is manufacturing: https://www.nytimes.com/2021/08/03/us/politics/pfizer-vaccine-approval.html
« Last Edit: August 15, 2021, 05:19:30 PM by PDXTabs »

habanero

  • Handlebar Stache
  • *****
  • Posts: 1010
Re: Which vaccine would you choose and why?
« Reply #43 on: August 15, 2021, 03:16:43 PM »

Yes, but as a US taxpayer, should I care? Along those lines, to the best of my knowledge, the US is making the vaccine manufacturers tabulate and submit their final safety data from their own trials to the FDA. But in parallel the CDC (or is it the FDA?) is collecting a bunch of safety data of their own. To me, as a US taxpayer, that's just dumb. As soon as they have enough data to say with a straight face that the vaccine is both safe and effective they should approve it, IMHO. They shouldn't wait for a book report from Pfizer.

Along those lines, if the OP wanted the vaccine with the most full approvals from total countries or developed western democracies the answer is Pfizer (today).

As we are a tiny country it makes no sense to do any trials for approval here so we get it from grown-ups elsewhere. However, after the AZ incident, our "FDA" expressed rather low confidence in the US safety monitoring related to J&J (which we in the end pretty much ditched as well). The reasons stated iirc was the fragmented nature of the US healthcare system and also that J&J apparently early on was given in rather large quantities to Americans where proper surveillance would be much harder - it was used quite a lot in hard-to-reach parts of the population where the single-dose-regime was very practical. So they were basically worried that similar problems as with AZ - when some cases were reported out of the US - had a meaningful risk of being under-reported as it is harder to monitor in the US with 50 states than in a smaller country with a much more unified health system. So our "FDA" wanted to wait a and in the end J&J turned out not to be crucial due to increase supply of mRNA and generally low infection rates in the country so we could afford to wait for Pfizer and Moderna. You could in theory get J&J here but it was in practice borderline impossible - you needed a valid reason, had to see a doctor for a talk and most doctors refused to administer it and in large parts of the country there were noone who would do it so you would need to travel quite far.

Only 0.1% of doses distributed here are J&J and I guess way fewer have been administered as they come in certain package sizes so there is a minimum order if some doctor wants to order a batch.

If this worry was justified or not I have no clue, I guess probably not now that a lot of doses have been administered in lots of countries.

Malcat

  • Walrus Stache
  • *******
  • Posts: 8982
Re: Which vaccine would you choose and why?
« Reply #44 on: August 15, 2021, 04:16:51 PM »
I didn't care.

I've taken multiple drugs today with higher risks than covid vaccines.

Really?  Which other drugs have you taken that were only emergency authorized by the FDA?  My understanding was that this is a pretty unusual situation.

Just because a drug is approved doesn't mean it's low risk, it means the known risks are considered acceptable compared to the illness it is treating.

I take an approved medication that has caused major internal bleeding *twice*.

So no, the vaccine risks just don't concern me very much.

It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Steve, I don't feel like arguing with you on this or explaining how several of the drugs I'm on are still finding out what the side effects are.

I'm a medical professional with extensive first hand experience with drugs and finding out how many side effects can come up *after* FDA approval.

Some drugs are approved even after testing shows very early on that they are incredibly dangerous. So yes, even with shorter testing, some drugs are clearly more dangerous than others.

Also, as much as covid vaccines have has had a shorter phase of testing, they have benefitted from scale. Many drug side effects aren't revealed until well after they've been approved just because of how few people use them.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 18984
  • Age: 40
  • Location: Toronto, Ontario, Canada
Re: Which vaccine would you choose and why?
« Reply #45 on: August 16, 2021, 07:48:37 AM »
It's not logically valid to say that the risks from a known drug are higher than the risks from a drug that still has unknowns.

Some approved drugs have a list of known, harmful and pretty serious side effects longer than the old fashioned phone book.

Along those lines, Pfizer is fully approved in Bahrain, Brazil, New Zealand, Saudi Arabia, Switzerland. One way around GuitarStv's logical argument is to figure out how to get to one of those places and get your doses there.

The FDA ensures that risk is known and quantified, not that it is absent.  The point is not meaningless approval.

Are you a US citizen now? I thought that you were Canadian? I might understand your comment if you were a yank, but come on. Switzerland and New Zealand aren't banana republics handing out rubber stamps for the safety and efficacy of vaccines. As a fellow commonwealth citizen I am personally offended that you would question the integrity of the institutions in New Zealand.

I don't question the integrity of institutions in New Zealand, and it's certainly not a matter of being a 'banana republic'.  Different regulatory bodies have to follow different rules.  Canadian regulators (as an example) follow less stringent requirements to approve than the FDA does - leading to different approval rates.

DK

  • Stubble
  • **
  • Posts: 230
Re: Which vaccine would you choose and why?
« Reply #46 on: August 20, 2021, 04:56:39 PM »

the JNJ would be one and done, and actually has a higher absolute risk reduction than the mrna's (1.7 compared to .7 and .9 if i remember right...always gotta know the relative plus absolute numbers...)

can you explain this some more? The entire inter-web tells me that J&J is the least effective of the 3 vaccines available in the US.

I've read and heard it a few times, i think here's the first time i heard it - should be about 38:15 in here where they start talking about it if the timestamps in notes are correct. (Peter's a very smart critical thinking doc, and paul offit has been involved in vaccine mfg, and actually on the fda advisory board.)
https://peterattiamd.com/pauloffit2/

it's tough with how its being reported, and ppl's lack of knowledge on statistics, probabilities, predictive values, etc. Not to mention different times the trials were done, and different endpoints.

i think most people hear 95% effective and it means if 100 ppl got the vaccine, 5 would still get covid if exposed. that's not how it works....that number comes more from the difference of people who got covid, between the vaccine group and placebo group. it was only if they would have gotten exposed in their day to day lives (when most things were shutdown and lot's of mask wearing going on. With some rounding, it was basically 99% who got the vaccine in the trial didn't 'get' covid, and 98% who did NOT get the vaccine, didn't 'get' covid. So the absolute risk reduction was roughly 1%.

maybe something to help explain absolute vs relative, is let's say you see an article saying eating hot dogs increases your risk of getting prostate cancer 50%. you get scared, everybody gets scared, and hot dogs are banned. but if you look at the study behind it, you would see something like the normal risk of getting prostate cancer is 1%, and in the study they saw an increase of 50%, which means, your new risk of getting is 1.5%. so absolute risk is the 1% -> 1.5%.....the relative risk is the 50% increase. that's why its important to know both numbers to see whats actually changing. 1 -> 1.5 might not bother you or anyone at all. but - now let's say the base risk is 10%, and increase of 50% there turns the absolute risk to 15%....which actually might make you think about reducing hot dog intake.

maybe that helps a bit?
Why would the particular absolute risk reduction in a study be the important metric? If one vaccine was tested during lower population disease prevalence than another, wouldn't the absolute risk reduction of the vaccine tested in an epidemic's lull be lower than that tested in a peak, all else being equal? What matters in making a personal risk/reward assessment is the relative risk reduction relative to the odds of being exposed to covid over some time into the future. If a 3 month study had 3% of participants exposed to potential infection, that doesn't address the absolute risk reduction of Delta covid where perhaps 30% may be exposed July-September of this year. Or am I missing something here?

that's definitely the nuance to discussions like these, it is hard to do direct comparisons to different studies. Even the moderna vs pfizer can't control to be exactly same population sample and location...but would be closer to compare, compared to those mrna ones vs the JNJ that was studied later. adding in population prevalence brings in more to more of the positive/negative predictive values which can get even more confusing.

i agree with that one point, and i think that makes the case for the jnj even better because there was more prevelance, lockdowns were going away, etc. the mrna trials seemed to be going on at the height of lockdowns and isolating people reducing how many people were exposed. but there is a lot of location based stuff going on there - for instance - my friend is a pharmacist in a hospital....at the height of lockdowns he mentioned about a local restaurant providing meals as a thank you to first responders/nurses/etc and braving covid.....while at the time they were dealing with hardly any covid patients, or any patients in general, and they were laying off people due to the 'stay home' messaging getting out there. that's a whole different story compared to say, new york at the start.