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Covid 19 vaccines contraindications


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On 8/4/2021 at 9:25 AM, ventana said:

 

Just had a IVDA and another whom smokes weed daily say they are not getting vaccinated "Cause who knows what is in that vaccine"    

Good Lord. I had a patient who was worried about the "tracking devices" in the vaccine. I told her if she is worried about someone tracking her she should get rid of her cellphone. 

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9 hours ago, rev ronin said:

Assuming the antecedent much?

I don't think so. I'll assume we are limiting our conversation to the US. There might have been an initial frenzy to get a shot, but at present, they are freely and widely available. There's no reason why anyone who wants a shot would not have one at this point.

I'll put another spike in the popular narrative balloon. Conventional wisdom would hold that the people not getting shots are Trumpian maniacs. I saw an article the other day (which I regrettably didn't hang on to) that was decrying the low vaccination rate in the Bronx and Brooklyn. NYC is not exactly a bastion of conservatism. 

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5 hours ago, CAAdmission said:

I don't think so. I'll assume we are limiting our conversation to the US. There might have been an initial frenzy to get a shot, but at present, they are freely and widely available. There's no reason why anyone who wants a shot would not have one at this point.

I'll put another spike in the popular narrative balloon. Conventional wisdom would hold that the people not getting shots are Trumpian maniacs. I saw an article the other day (which I regrettably didn't hang on to) that was decrying the low vaccination rate in the Bronx and Brooklyn. NYC is not exactly a bastion of conservatism. 

How can you sit there with a straight face and type that conservatism does not play a leading role in refusing the vaccine. Rather,  popular narrative and conventional wisdom? 

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The low vaccination rate in the Bronx is ultra orthodox conservative Jewish population.

Red states are by and far lowest vaccinated areas and highest COVID surges of recent. 

Anti Vax rhetoric and BS are most often found on the bumpers of cars spouting Trump stickers.............. just how it is.

A shovel is truly a shovel sometimes...............

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13 minutes ago, ANESMCR said:

How can you sit there with a straight face and type that conservatism does not play a leading role in refusing the vaccine. Rather,  popular narrative and conventional wisdom? 

By far, the least vaccinated county in my state of Pennsylvania is Philadelphia County. Only about 10% of that county are vaccinated.  (147,000/1.4 million) The next lowest county is 27.4%. 

By the way, Philadelphia county voted 84% for Biden. 

Be careful of generalizations...

 

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1 hour ago, briansk said:

By far, the least vaccinated county in my state of Pennsylvania is Philadelphia County. Only about 10% of that county are vaccinated.  (147,000/1.4 million) The next lowest county is 27.4%. 

By the way, Philadelphia county voted 84% for Biden. 

Be careful of generalizations...

 

That’s a great idea, let’s be careful about generalizations and look at the raw data from the entire country. Or you could quantify by congressional districts. Or just look at literally any other county…Do I really need to carry you to easily accessible data? 

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SCHOOL DAY ONE

What is herd immunity?

When most of a population is immune to an infectious disease, this provides indirect protection—or population immunity (also called herd immunity or herd protection)—to those who are not immune to the disease.

For example, if 80% of a population is immune to a virus, four out of every five people who encounter someone with the disease won’t get sick (and won’t spread the disease any further). In this way, the spread of infectious diseases is kept under control. Depending how contagious an infection is, usually 50% to 90% of a population needs immunity before infection rates start to decline. But this percentage isn’t a “magic threshold” that we need to cross—especially for a novel virus. Both viral evolution and changes in how people interact with each other can bring this number up or down. Below any “herd immunity threshold,” immunity in the population (for example, from vaccination) can still have a positive effect. And above the threshold, infections can still occur.

The higher the level of immunity, the larger the benefit. This is why it is important to get as many people as possible vaccinated.

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11 hours ago, CAAdmission said:

There's no reason why anyone who wants a shot would not have one at this point.

True, but you said 'needs' in the previous post. 

https://www.businessinsider.com/vaccine-skeptic-dad-dies-of-covid-19-wishes-got-shot-2021-7

Did Mr. Keenan need the vaccine? In retrospect, the answer is clearly 'yes' while the answer to whether he wanted it when he needed it is clearly 'no'.

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4 hours ago, mcclane said:

You should be more than capable of answering this on your own and god help your patients if you can't.

Nice hearing from you. I recall that a moderator directly ordered you to block me under pain of a permanent ban from this forum. Thanks!

 

2 hours ago, Reality Check 2 said:

When most of a population is immune to an infectious disease, this provides indirect protection—or population immunity (also called herd immunity or herd protection)—to those who are not immune to the disease.

Yeah, thanks, I understand the concept. The vast majority of people who are not immune are those that would choose not to get a vaccination. As said a bunch of times, that's their roll of the dice. 

 

1 hour ago, rev ronin said:

Did Mr. Keenan need the vaccine? In retrospect, the answer is clearly 'yes' while the answer to whether he wanted it when he needed it is clearly 'no'.

Ah, we've pulled out the old "retrospectoscope." Lots of people make bad decisions - the motorcyclist flying through the air without a helmet, the climber rappelling off the end of the rope, the guy entranced by the transvestite hooker. 

Keenan rolled the dice. He was dumb and the stats worked against him. Maybe it will change a few friends' minds. 

I talk stats with patients. Realistically, a bad outcome is fairly remote for an otherwise healthy person. In my area about 10% of the population tests positive for covid. Of the 1 in 10 people who catch it, only a very small percentage wind up in bad shape. On the other hand, millions of people have had the shot, and less than 5000 have died from an apparent adverse reaction. The numbers say the shot benefits everyone, and with comorbidities the numbers shift even farther in favor.

I wholeheartedly agree that we should get a shot in anyone willing to have one. I think we should work to convince the reluctant (without insulting or patronizing them). And I'm 100% opposed to forcing someone who does not want one to get one. 

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9 hours ago, CAAdmission said:

Be that as it may, if you have a shot, and everyone in your family has a shot, why do you care if someone else chooses to opt out? From a statistical point of view it's a stupid decision, but if they are willing to live with the potential consequences that's on them. 

I do agree that you should educate why they should get the shot but ultimately it is every patient's decision. I'm just pissed that mask mandates are coming back because of the rise in infections/hospitalizations due to the unvaccinated.

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15 hours ago, CAAdmission said:

Be that as it may, if you have a shot, and everyone in your family has a shot, why do you care if someone else chooses to opt out? From a statistical point of view it's a stupid decision, but if they are willing to live with the potential consequences that's on them. 

ahhhh

mutations that the shot will not cover - think Delta - yup you got your shot, and your family got the shots - but no one else did and therefor a mutation occurred and your son/daughter/father/mother/wife/husband just caught it and died....  seems like a good reason to me...

And I will not even go down the rabbit hole of economic impact

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2 hours ago, ventana said:

mutations that the shot will not cover - think Delta - yup you got your shot, and your family got the shots - but no one else did and therefor a mutation occurred and your son/daughter/father/mother/wife/husband just caught it and died....  seems like a good reason to me...

If that's your fear, we are in a hard place, because there are a ton of third-world spots where mutations are going to continue to brew. Our government also has a policy of letting known infected people from these third-world countries across the border and is then bussing them elsewhere. Does that seem like a rational policy if they are taking this seriously?

This virus is the new flu. It isn't going anywhere.

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I think the point of the posts above is that IF we had vaccinated properly, early, and more completely, the mutation would be less of a problem.

Fewer overall cases, less opportunity for mutation, spread is slowed - problem moving forward is less deadly.

Nip the issue early and the future is a tad bit easier.

When 99% of the current deaths are Unvaccinated - that says a lot.

I am vaccinated and awaiting a booster - Delta isn't as scary now for me personally and I am not as likely to get critically ill or die or spread it. 

If I don't spread it - and those that are vaccinated are not as likely to spread - the math is real.

The Unvaccinated ARE THE PROBLEM.

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14 hours ago, CAAdmission said:

Ah, we've pulled out the old "retrospectoscope." Lots of people make bad decisions - the motorcyclist flying through the air without a helmet, the climber rappelling off the end of the rope, the guy entranced by the transvestite hooker. 

Keenan rolled the dice. He was dumb and the stats worked against him. Maybe it will change a few friends' minds.

Absent a retrospective perspective, how else do you ascertain 'need'?  I mean, by the same token, I've not 'needed' my life insurance to date because, well, I haven't died and therefore my family have not benefited, but I wouldn't've ever said I needed it in the first place, just made an informed risk decision that the benefit was worth the cost.

Keenan needed vaccination, in retrospect, because he died, just like your first two examples (not sure how to parse the third in the context of retrospective need?) will have needed the protection they forewent should an adverse event that would have been mitigated by that protection have come to pass.  And I think that last sentence needed more conditionals and perfect tenses, don't you?

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On 8/7/2021 at 9:08 AM, CAAdmission said:

If that's your fear, we are in a hard place, because there are a ton of third-world spots where mutations are going to continue to brew. Our government also has a policy of letting known infected people from these third-world countries across the border and is then bussing them elsewhere. Does that seem like a rational policy if they are taking this seriously?

This virus is the new flu. It isn't going anywhere.

Omg. You really don’t get it.  You asked for reasons: you use herd immunity to argue the counter point of your prior point.  Come on make a logical argument please. Circular logic is logic error. 

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On 8/7/2021 at 12:40 PM, rev ronin said:

And I think that last sentence needed more conditionals and perfect tenses, don't you?

I'm ashamed to confess that I an sufficiently grammatically deficient that I'm not even sure what that means. 

 

On 8/7/2021 at 12:46 PM, ventana said:

You asked for reasons no you use herd immunity to argue 5he counter point of your prior point.

Ditto. 

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On 8/4/2021 at 11:25 AM, ventana said:

 

Can you get the COVID-19 vaccine if you are breastfeeding?

 

 

Sorry no studies means I can't recommend it, or recommend against it...

I’m not sure if this a personal preference or your thoughts on how others should practice. If the latter, I would disagree. Zofran is cat B, but we absolutely recommend it in hyperemesis gravidum because the benefits far outweigh the risk. I think the same applies here. In this case we are calculating that risk based off of physiology, anecdote, and expert opinion, but we can, and do, make recommendations without significant evidence

 

i tell people unless you almost died, quite literally, then you should get the vaccine. If it was an allergy, I recommend you, i recommend you get it and let me stand by you with an epi pen.

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19 minutes ago, LT_Oneal_PAC said:

I’m not sure if this a personal preference or your thoughts on how others should practice. If the latter, I would disagree. Zofran is cat B, but we absolutely recommend it in hyperemesis gravidum because the benefits far outweigh the risk. I think the same applies here. In this case we are calculating that risk based off of physiology, anecdote, and expert opinion, but we can, and do, make recommendations without significant evidence

 

i tell people unless you almost died, quite literally, then you should get the vaccine. If it was an allergy, I recommend you, i recommend you get it and let me stand by you with an epi pen.

Yeah and I'm happy to talk to anyone's patients about what a crash C-section looks like in the ICU as your sats are 70 and so is your baby's HR.

There was a prospective obs study looking at pregnant women who received it and while the #s weren't huge there was no difference in any of their outcomes.

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