Pro-vaccine messaging to patients

[rev ronin]

OK, now that we've gotten our Pfizer or Moderna vaccines, what are your clinics doing to try to maximize patient uptake when it comes time?  Obviously, unless you're in IM or geriatrics, you're probably not going to have a lot of patients who are eligible right away.

Do you talk up the vaccine? Share your own experience?  If so, how are patients reacting?

[ventana]

yes

state 100% recommended

then go on to talk about how I had my reservations on getting it, but comparing the risk of covid to the risk of the vaccine the benefit is clear.  I do not state it is 100% safe (in fact nothing is 100% safe i.e. to much oxygen and too much water will both kill you)  but that it is reasonable to get the vaccine.

I make sure to talk about my own hesitant about it - I think it helps people to accept that it is a little scary, but the right thing to do.  

I have only had a single person state they were not going to get it in the past month, almost everyone is saying "as soon as I can"

[rev ronin]

Ok, I got my second shot Saturday, and I was feeling lousy (running 101F temp with all the associated constellation of subjective complaints) from 6 to 36 hours later, at which time I broke down and took some Naproxen--which did help me to sleep well last night and be appropriately ready for a full clinic day.

That was the least fun vaccination I have *ever* had, except maybe anything before 5 years of age. :-S

[camoman1234]

18 hours ago, rev ronin said:

Ok, I got my second shot Saturday, and I was feeling lousy (running 101F temp with all the associated constellation of subjective complaints) from 6 to 36 hours later, at which time I broke down and took some Naproxen--which did help me to sleep well last night and be appropriately ready for a full clinic day.

That was the least fun vaccination I have *ever* had, except maybe anything before 5 years of age. :-S

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

[rev ronin]

52 minutes ago, camoman1234 said:

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

Well, I was actually really sick back from 12/23 through about mid-January; was watching my O2 sats in the low 90's for New Year's Eve. I tested negative via nasal swab 12/28, and my wife and daughter were never tested, but both got sick before and recovered sooner than I did.  My wife has idiopathic anosmia, but my daughter and I never lost my sense of smell.  So, TODAY I see a study that says the vaccine reactions are WORSE in people who have actually had Covid-19, which reinforces my suspicion that we all had it back in December.  And yes, I was feeling fine when I wrote the previous post.  Just Saturday afternoon and Sunday were not fun.

[Photograph51]

I read about that same study.  I figured that was why I had a terrible time after getting the vaccine.  I get the second vaccine on Saturday and I'm not looking forward to it.  The day after getting the first vaccine was worse than any day of when i had COVID.

[Dwebb97]

I'm interested to see the data surrounding reactions after the general public starts getting the vaccines and we have more participants to see if blatant trends exist between Moderna/Pfizer and if the first/second dose is substantially different. Anecdotally I was seeing the same as Ronin, people with COVID within the 3 months prior to getting their doses were more likely to have side effects than those who haven't had COVID yet. I will say that almost my entire office had side effects (mostly body aches and headaches) after getting the second dose and got lousy sleep

[ventana]

20 hours ago, camoman1234 said:

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

Yikes.  
time to go back to school and study immunology and read up on vaccines and mRNA.  
 

asking thus question show a startling lack of understanding.  

[camoman1234]

2 hours ago, ventana said:

Yikes.  
time to go back to school and study immunology and read up on vaccines and mRNA.  
 

asking thus question show a startling lack of understanding.  

Our 2 hour lecture on vaccines was a pediatrician telling us the vaccine schedule....never studies mRNA vaccines in PA school. We studied mRNA and genetics. Not sure where you went to school that  studied these newer types of vaccines...???

[rev ronin]

I dunno, I thought there was plenty of explanation about how an mRNA vaccine works online.  I'm actually pretty sick of hearing how mRNA needs a lipid capsule to get into the cytoplasm, and never touches the nucleus.  But I mean really... as soon as I heard "mRNA to make the spike protein" I knew exactly how the vaccine worked.

I don't "go back to school" by going, well, to school.  I use reputable online resources, with free CME if I can get it, since I learned to teach myself about medicine as part of PA school.

[LT_Oneal_PAC]

I don’t think I’ve had COVID yet. I’m the only provider in the ED that hasn’t used sick time this year and the only one who was totally fine after the vaccine. I even got it at the start of my 72 hour shift and finished it out with no issues. So, anecdotally, I think the increase in symptoms with the vaccine tracks with prior COVID infection 

[Cideous]

I have a picture of a Monkey, a Neanderthal and a saber tooth tiger.

I say...which one of these species used their brain and survived?   

Edited February 4, 2021 by Cideous

[TheFatMan]

On 2/2/2021 at 10:03 PM, camoman1234 said:

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

-26 million covid infections in the US and 430k+ dead.

-29 million covid vaccines administered in the US, many sore arms and some body aches, relatively few anaphylactic reactions, 0 deaths.

I think I'll stick with the vaccine...

Cases and hospitalizations decreasing. We are hopefully seeing the light at the end of the tunnel.

mRNA technology has been being researched for decades and has gone through the same meticulous process of any other approved vaccine. These are very large, well done trials, with ongoing research and review. 

[ventana]

10 hours ago, camoman1234 said:

Our 2 hour lecture on vaccines was a pediatrician telling us the vaccine schedule....never studies mRNA vaccines in PA school. We studied mRNA and genetics. Not sure where you went to school that  studied these newer types of vaccines...???

way to own your own education

still dismayed at lack of insight......

go open a book, read CME (NEJM has been providing FREE resources on covid for a year) heck even watch some news casts and try to figure out the facts, but above all education is key.  

 

This is a quote from you that I had to go re-read as it is floored me on so many levels.....

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

 

Covid does not equal feeling sick from a shot, covid can be fatal and morbidity is unknown.   Then to follow up with saying you were not taught it is school?  PA school is only the entrance fee to become a PA - after a year in a world wide epidemic of COVID I would hope that ALL PA's have learned about COVID and the Vaccines - to not do this could be interpreted as a PA not caring at all about their population, patients, career or society due to blatantly disregarding what is a clear and present danger to the health and well being of you patients.  I literally can not think of a single job where you could work as a PA and not have COVID being part of your knowledge base.  Even if it is just as a knowledge resource to your co-workers.

 

I do not mean to come across as harsh, and apologize if so.  Just wonder how on earth you can be a medical professional and not own your own education and not look to the science of a world wide epidemic.  

 

 

[True Anomaly]

The facility I work at provided large orange buttons that say “Vaccinated against COVID-19” which I just attached to my badge, and other PAs/docs/nurses/staff have also worn them as a “We walk the walk” approach to showing patients that we embrace these vaccines and would hope they do as well

[Cideous]

3 hours ago, True Anomaly said:

The facility I work at provided large orange buttons that say “Vaccinated against COVID-19” which I just attached to my badge, and other PAs/docs/nurses/staff have also worn them as a “We walk the walk” approach to showing patients that we embrace these vaccines and would hope they do as well

I thought your large orange button said, "Hook'm Horns!"

[rev ronin]

3 hours ago, True Anomaly said:

The facility I work at provided large orange buttons that say “Vaccinated against COVID-19”

I want one.  I wish these were standardized countrywide, if not worldwide.  Seriously, anyone know if these are available for purchase anywhere?

[TheFatMan]

8 minutes ago, rev ronin said:

I want one.  I wish these were standardized countrywide, if not worldwide.  Seriously, anyone know if these are available for purchase anywhere?

Looks like there are a lot of cool options on Etsy. This is an excellent idea! https://www.etsy.com/search?q=covid vaccine pin

[camoman1234]

On 2/4/2021 at 7:33 AM, ventana said:

way to own your own education

still dismayed at lack of insight......

go open a book, read CME (NEJM has been providing FREE resources on covid for a year) heck even watch some news casts and try to figure out the facts, but above all education is key.  

 

This is a quote from you that I had to go re-read as it is floored me on so many levels.....

Sounds like getting Covid would have been easier and less painful for you? How do you know you are not contagious with the virus? This is something that scares me about these mRNA vaccines. Not enough research, but I guess we all have to start somewhere! I hope you are feeling better!

 

Covid does not equal feeling sick from a shot, covid can be fatal and morbidity is unknown.   Then to follow up with saying you were not taught it is school?  PA school is only the entrance fee to become a PA - after a year in a world wide epidemic of COVID I would hope that ALL PA's have learned about COVID and the Vaccines - to not do this could be interpreted as a PA not caring at all about their population, patients, career or society due to blatantly disregarding what is a clear and present danger to the health and well being of you patients.  I literally can not think of a single job where you could work as a PA and not have COVID being part of your knowledge base.  Even if it is just as a knowledge resource to your co-workers.

 

I do not mean to come across as harsh, and apologize if so.  Just wonder how on earth you can be a medical professional and not own your own education and not look to the science of a world wide epidemic.  

 

 

I know a lot about Covid and the statistics do no lie. The majority of deaths are in very unhealthy and >65 yr olds. There have been numerous doctors saying 10 different things, look at the front line doctors, they get black listed and people call them crazy etc. Just as I am doing here, if I do not go with the main stream medical world you all are loosing your minds. How about being healthy? NOT being diabetic (type 2) or overweight or smoke/drink, etc. How about running, eating clean organic food, meditate, de-stress, take vitamins, etc. There's much more to this than what you are all saying. So you are saying that people under <50 are better off getting the vaccine than getting covid, when the death rate is 99.97%? I think natural immunity is much better than vaccine immunity. Last forever (not compared to the Covid vaccine that they still tell you to social distance, STILL wear a mask, and they have no idea how long immunity is for). How is this much better? We also have great treatments for Covid (the death rate has dropped ~85% compared to last year so people are not dying of covid as they were 6-9 months ago. How about HCQ or Ivermectin?  Now double masking will save the world?

[rev ronin]

19 hours ago, camoman1234 said:

[...], when the death rate is 99.97%? [...]

Substantiate your number, please; I assume you meant survival rate, right?  We're scientific professionals--let's deal in numbers, not talking points, shall we?

- 484k out of 330m Americans are dead.  Even if you postulate that that number is inflated, the excess death rate puts a lower limit on the net deaths caused by Covid-19 plus countermeasures.  We're approaching a 0.15% fatality rate of ALL Americans--and what's the projected penetrance by now--20% or more? 27.5m documented cases is under 10%, but I am relatively certain I had Covid-19 as did my wife and daughter, and none of us are officially counted. Anecdote, but our stories are far from unique.

- Yes, it absolutely disproportionately kills the elderly and those in poor health, which is probably why black people in the U.S. did a lot worse than actual Africans, who tend to be younger and NOT have American lifestyle diseases. That, and Africans don't have much use for anti-vaxxers.

- There's no evidence natural immunity lasts longer than vaccine immunity, nor the opposite, is there?  There's a bunch of conjecture, to be sure.

- Remdesevir barely works, despite massive pharma push into it.  Convalescent plasma doesn't really work, despite the fact that it solved all the problems nearly instantaneously in Outbreak. And we're supposed to believe that despite the actual trials, HCQ and ivermectin are somehow leagues better but suppressed by The Powers That Be?  Nothing has worked well, per any well-put-together trial, with the exception of steroids--oh, gosh, another cheap intervention that big pharma failed to suppress.

- Don't confuse the fact that people want to exploit this pandemic for their own political purposes with science. Double masking is a stupid idea, in that it increases the cost of masking and uses up PPE for imperceptible decreases in R0. We're still calling neck gaiters "masking", which is nonsense. Masking after fully vaccinated or recovered is also stupid, because there's simply no evidence that it does anything to prevent spread--just more conjecture that people may be contagious even as their own immune system is succeeding against a new infection.  Masking was at best a bridge to an effective vaccine, and pretty soon we're going to have to start counting effective vaccines using two hands.

Edited February 14, 2021 by rev ronin
typos, incomplete sentence

[UGoLong]

I haven't read much about a scientific study on COVID vaccine responses.  Some anecdotal vaccination results in my circle: it seems that younger people and those previously exposed to COVID have worse symptoms after vaccination.

My wife and I are both in our 70s and had only sore arms and some fatigue for the first 24 hours (me Moderna and her, Pfizer). My Dad, who is 100, had the Pfizer series in his ALF and had nothing other than a sore arm for a day each time. Same with my mother-in-law, who is 98 and previously tested positive for COVID with no symptoms. On the other hand, two guys I teach with are younger (early 50s and early 40s), one works in an ER and the other in UC. Both had 102-103 fevers and felt miserable for about 3 days.

I talked with a virologist on our staff who has seen the same thing. She postulates that us older people mount a less vigorous immune response and perhaps that explains some of this.

Edited February 14, 2021 by UGoLong

[ventana]

12 hours ago, camoman1234 said:

I know a lot about Covid and the statistics do no lie. The majority of deaths are in very unhealthy and >65 yr olds. There have been numerous doctors saying 10 different things, look at the front line doctors, they get black listed and people call them crazy etc. Just as I am doing here, if I do not go with the main stream medical world you all are loosing your minds. How about being healthy? NOT being diabetic (type 2) or overweight or smoke/drink, etc. How about running, eating clean organic food, meditate, de-stress, take vitamins, etc. There's much more to this than what you are all saying. So you are saying that people under <50 are better off getting the vaccine than getting covid, when the death rate is 99.97%? I think natural immunity is much better than vaccine immunity. Last forever (not compared to the Covid vaccine that they still tell you to social distance, STILL wear a mask, and they have no idea how long immunity is for). How is this much better? We also have great treatments for Covid (the death rate has dropped ~85% compared to last year so people are not dying of covid as they were 6-9 months ago. How about HCQ or Ivermectin?  Now double masking will save the world?

Your response has nothing to do with the reason I posted the initial reply

 

in short I read your post as you asked rather someone could be contagious from from getting an mRNA vaccine, then you did not own the fact you were asking such a question and had snarky reply. 

 

I have been following COVID closely (am associate medical director for a LTC facility and have a very active DPH and have managed two separate outbreaks and been one of the first in the state to prove false positive test results)

 

I actually agree with a lot of this post, and the old age seems to confer additional risks of mortality.  But the public health side of this is real.  How is it getting to the old and infirm??  they young and healthy workers - we need to approach this from a population wide approach.

[TheFatMan]

@camoman1234

"How about being healthy? NOT being diabetic (type 2) or overweight or smoke/drink, etc. How about running, eating clean organic food, meditate, de-stress, take vitamins, etc."

- these aren't modifiable for all people (death rates much higher in lower socioeconomic classes - not all have the privilege of eating nutritious food, meditating, living stress free, or even affording vitamins)

- you are oversimplifying complex issues

- please elaborate on how paying more money for organic food with no nutritional benefit over conventionally grown crops will stop someone from dying from covid

"There's much more to this than what you are all saying. So you are saying that people under <50 are better off getting the vaccine than getting covid, when the death rate is 99.97%? I think natural immunity is much better than vaccine immunity."

- as I said earlier, 'natural immunity' has killed nearly 500k Americans now, the vaccine has killed none.

- 'natural immunity' also has many lasting health effects (CKD, amputations, long covid, massive hospital bills, the list goes on); there is no reason to think the vaccine will have any lasting health effects other than keeping you out of the hospital.

"Last forever (not compared to the Covid vaccine that they still tell you to social distance, STILL wear a mask, and they have no idea how long immunity is for). How is this much better?"

- see above. Why do wear a seatbelt when there are traffic laws? Why do you need airbags when your seatbelt works and vice versa?

"We also have great treatments for Covid (the death rate has dropped ~85% compared to last year so people are not dying of covid as they were 6-9 months ago. How about HCQ or Ivermectin?"

-  HCQ and Ivermectin don't work. Anecdotes don't count as evidence. I'll agree more research should be done on Ivermectin, but, the research has already been done on the vaccines that are available and they've been shown to work.

"Now double masking will save the world?"

- Hyperbole. No one said that.

- There's evidence it helps, and just like wearing one mask, it is hardly an inconvenience (so now they are saying a seatbelt isn't good enough, we have to have a car with airbags *gasp*). If it saves even one life or prevents a single person from being hospitalized I will gladly wear two masks.

[LT_Oneal_PAC]

16 hours ago, camoman1234 said:

... I think ...

I don’t believe you’ve ever done such a thing.

[MediMike]

14 hours ago, rev ronin said:

Masking after fully vaccinated or recovered is also stupid, because there's simply no evidence that it does anything to prevent spread--just more conjecture that people may be contagious even as their own immune system is succeeding against a new infection.  Masking was at best a bridge to an effective vaccine, and pretty soon we're going to have to start counting effective vaccines using two hands.

As this is the first mRNA vaccine directed against a spike protein...do you know for sure that you can't be an asymptomatic carrier post vaccination? None of the studies have tested for infection, simply clinical symptoms/hospitalization/death.

Until we know this I believe it to be reasonable to continue masking regardless of vaccination status until we reach a much greater majority of the population who got the shot(s).

Unless you have other information? To be honest I've had a bit of COVID fatigue and haven't been following the newest and greatest.