r/science Oct 06 '22

Low incidence of severe COVID-19 following vaccination and booster. The incidence - new cases over time - of hospitalization for COVID-19 pneumonia or death was 8.9 per 10,000 persons who had been vaccinated and boosted. Health

https://www.regenstrief.org/article/va-study-low-incidence-severe-covid-19-after-vaccination-booster/
3.2k Upvotes

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u/null640 Oct 07 '22

What's the incidence of unvaccinated?

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u/brokenbarrow Oct 07 '22

From what I gather, the article erroneously framed the study as a vaxed vs unvaxed comparison. The focus was actually a comparison of vaccinated people with conditions that made them “high-risk” vs vaccinated low-risk patients.

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u/N8CCRG Oct 07 '22

Not even the article's fault as much as inferring just from OP's title.

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u/wolphak Oct 07 '22

And people wonder why some conservatives don't trust science. I don't understand how biased and weighted studies like this are accepted academically.

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u/N8CCRG Oct 07 '22

The problem is OP's headline, but you want to blame the research and results?

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u/OnTheSlope Oct 07 '22 edited Oct 07 '22

The title of the article is, "Large JAMA study reports very low incidence of severe COVID-19 following vaccination and booster"

And prominently displays quotes like: "This is remarkable, good news about the power and effectiveness of receiving COVID-19 boosting for all groups"

And: "These results, from a period of Delta and Omicron predominance, should encourage people to get vaccinated and boosted"

It's not just op.

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u/lazyaznsing Oct 07 '22

I don't know if you will care, but - the article that was linked by OP is also not a direct link to the actual study but commentary on the study, so your qualms are valid but really only apply to the framing of the linked article. The actual study being referenced is much more - what you would expect from academia.

https://jamanetwork.com/journals/jama/fullarticle/2796892

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u/WatchingUShlick Oct 07 '22

Is it because they only pay attention to headlines, and not the actual science?

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u/Annahsbananas Oct 07 '22

If anti vaxxors could read, they'd be very upset

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u/berse2212 Oct 07 '22

The original title of the study is

Hospitalizations occurred almost exclusively among high-risk patients

I don't see how that is biased or weighted.

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u/chrisKarma Oct 07 '22

There does seem to be a lot of overlap between conservatives and people that skipped school the day their science teacher explained what primary sources are.

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u/KarnWild-Blood Oct 07 '22

And people wonder why some conservatives don't trust science

No, no we understand its because many conservatives lack critical thinking skills, or are too easily taken in by whatever propaganda their party spews in the name of "owning the libs."

In the modern world, with relatively easy access to information compared to any other point in human history, choosing to disbelieve in science wholesale is inexcusable willful ignorance of the highest order.

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u/CapableCollar Oct 07 '22

And people wonder why some conservatives don't trust science.

Just going to soft ball it in like that?

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u/2cap Oct 07 '22 edited Oct 07 '22

The benefits of a booster are even greater for those aged 70 and over.

For an unvaccinated male in this cohort, the estimated risk of death from Omicron is 362 per 10,000.

https://www1.racgp.org.au/newsgp/clinical/covid-19-chart-updated-with-omicron-risk-of-death

First, unboosted or unvaccinated populations were not included because a robust body of evidence has demonstrated the effectiveness of vaccine boosters, and there is a risk of measurement error and bias to the null given the possibility that unreported vaccination and boosters can occur. Second, potential confounders such as COVID-19 exposure behaviors could not be measured

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u/Teacherofmice Oct 07 '22

You would think that would be something important to include, hey? I mean, why even do a study about young people vs old or healthy vs immunocompromised. We have known elderly were at a much greater risk since like week 2. This is clearly a bait and switch.

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u/Few_Journalist_6961 Oct 06 '22

What I want to know is... Is the cell damage to say, the lungs, the same in vaccinated vs unvaccinated people who survived? Does the vaccine quell the virus in an efficient enough manner so that the type of cell damage we typically see/saw in the lungs doesn't occur in vaccinated individuals?

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u/modilion Oct 06 '22

This article might help.

Overall, vaccination was associated with reduced risks or odds of long-COVID, with preliminary evidence suggesting that two doses are more effective than one dose. Eleven studies (n=36,736 COVID-19 survivors) investigated changes in long-COVID symptoms after vaccination (infection-long-COVID-vaccine design).

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u/DrunksInSpace Oct 06 '22

There’s no way to know if you’re comparing “apples to apples” when comparing x-rays from both cohorts though, unless you had measurable, meaningful imaging markers to quantify and compare over larger sample sizes, you’re just comparing two x-rays with too many variables from which to draw any conclusions.

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u/jiggamahninja Oct 07 '22 edited Oct 07 '22

You’re asking for x-rays to see CELLULAR damage? Even if you knew what to look for, you’d have trouble finding it via X-ray. What you can see is the extent of lung involvement, tho.

But to answer your question, so long as the vaccine shortens the incubation period before the body detects the virus (it does) and/or reduces viral load - then you’ll likely find less lung damage in the vaccinated compared to the unvaccinated.

This isn’t groundbreaking either: lung infections are relatively rare because the body has several ways of ridding a pathogen before it gets to your lungs. Only in cases where a person is susceptible to lung infections and/or if a virus is particularly good at evading the immune system are lung infections more common. Since the vaccine ameliorates the latter, then you’re gonna have less cell damage in the lungs, a.t.e.

Edit: don’t take my word for it. Here are some studies

https://healthimaging.com/topics/clinical/covid-19/covid-pneumonia-vaccinated-vs-unvaccinated

And another “The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant.”

https://mdpi-res.com/d_attachment/jpm/jpm-12-00955/article_deploy/jpm-12-00955-v2.pdf?version=1655109854

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u/You_Dont_Party Oct 07 '22

What I'd specifically like to see is x-ray images of multiple individuals lungs within a certain time range after infection. And see the difference between those who are vaccinated vs those who are unvaccinated

X-rays really aren’t the best imaging for COVID, but I wonder why you don’t think the other approach is valid?

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u/Supp_Carries_U Oct 06 '22

People with long covid and lingering effects can have completely normal X rays

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u/modilion Oct 06 '22

What I'd specifically like to see is x-ray images of multiple individuals lungs within a certain time range after infection.

Are you an expert at x-ray diagnosis?

Because... if not... what you are asking for is worthless to you. What I sent you is a large scale study review that you can actually read and understand.

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u/slanger686 Oct 07 '22

Surely he is a qualified radiologist and can interpret lung xray photos

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u/werofpm Oct 07 '22

He’s “doing his own research bro”

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u/1-760-706-7425 Oct 07 '22

jUST AsKiNg qUeStIoNS.

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u/letthemswim Oct 07 '22

Lung function testing or a cardiopulmonary stress test would serve would serve as a more proper physiologic assessment. Plain X-ray is next to useless for subtle lung findings, and while ct is great, it is not representative of function.

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u/Timothy303 Oct 06 '22

You have to admit that this study most definitely hints at exactly the impact you are looking for, no?

Getting a study done like you wish, that is properly controlled, is pretty non-trivial.And expensive. Right?

Given that the unvaccinated are more likely to die than the vaccinated, it sure does seem the vaccine is reducing all forms of damage the virus causes in bad cases.

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u/MBG612 Oct 06 '22

*Anecdotal, but i look at a lot of chest x rays. I practically don’t see any x ray findings in a vaccinated person compared to non vaccinated.

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u/diagnosedwolf Oct 06 '22

What kind of lung damage are you interested in, specifically?

There are a few different things that can go on in a bad case of covid, and whether they’ll happen equally in vaccinated vs unvaccinated depends on what happens. The main strength of the vaccine is that it prevents you from ever getting to the “cells are permanently damaged” stage.

A ventilator causes lung damage. That is universal across every person who is put on a ventilator, so vaccination won’t help you if you get to the point of needing a ventilator. Fewer vaccinated people need a ventilator, so fewer suffer this kind of damage.

An immune storm is the direct way covid kills you. It causes systemic cell damage. That is far more likely to happen if you are unvaccinated, but again once you get to the point of actually having the storm a vaccine won’t help you.

A vaccine will help prevent you from getting sick enough to get a secondary infection, the other way covid kills. But if you do get pneumonia, in general you would expect lung damage to be more in vaccinated people than in unvaccinated people, because the unvaccinated people’s bodies are more taxed by the two diseases.

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u/Professional_Pain411 Oct 06 '22

https://pubs.rsna.org/doi/full/10.1148/radiol.213072

https://pubs.rsna.org/doi/10.1148/radiol.220129

Here ya go. Here's radiologists commenting on pneumonia and other abnormal findings on chest CTs in vaccinated and unvaccinated patients.

While I'm not a medical dr I am getting a phd in immunology so am very aware of vaccines and disease pathology. In short yes. The virus is the damaging agent. The control of the virus by the immune system is what determines the severity of the damage. Some people are vaccinated but will have inadequate immune control, like those who are on immunosuppressive therapies. Likewise some patients will have underlying damage to their organs so that the symptoms are more severe or the inflammation is more disruptive. Think of it like an enemy tank rolling on a highway, tank is virus, highway is lungs. In a healthy person with high functioning infrastructure it's easy for the body to deploy defenses and stop the tank. When the highway is damaged, say like in COPD, lung transplant, cystic fibrosis etc the 'highways' are difficult to manoeuvre. Because of this the body struggles to roll out defences, or the defences they do roll out (mucus, inflammation) have the side effect of clogging the highway and making everything more complicated and messy. In collapsed infrastructure it can be easier for the tanks to take shelter and more difficult for the immune system to target the virus. Clogged highways (aka difficulties breathing) also has major knock on consequences for a host of other normal body functions.

Basically yes. If you take lung cells on a Petri dish with no immune cells, the virus will infect them in the same mechanism even if those lung cells came from a vaccinated individual. The virus doesn't change its how our systems can handle the virus which changes.

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u/eutropy Oct 06 '22

yeah, that’s the problem of not using an unvaccinated control group, isn’t it? even in a retrospective study like this, they excluded the unvaccinated altogether. the results are meaningless, because the numerator of their results has no denominator for comparison. garbage in garbage out.

“The cohort was restricted to participants who had a primary care visit during the prior 2 years to ensure adequate baseline data on health status. Participants who did not have a record of vaccination, did not receive the second mRNA dose within 6 weeks of the first dose, had no record of a booster dose or type, received their last mRNA vaccine dose within 5 months or last Ad26.COV2.S vaccine dose within 2 months of a prior dose,9 received hospice care within 2 years, resided in a nursing home or domiciliary within 2 years, or had a history of COVID-19 from 90 days before until 13 days after the booster were excluded (eFigure 1 in the Supplement).”

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u/awfullotofocelots Oct 06 '22

Numerous of other peer reviewed and published studies have established the incidence of COVID hospitalizations in vaccinated versus unvaccinated groups, using separate data sets. Just because we can't learn everything from a single set of data doesn't mean that dataset is entirely useless. Sound medical research is multimodal research that looks at as many reliable data sets, from as many scientifically valid angles, as possible.

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u/wealhtheow Oct 06 '22

They excluded people without a vaccination record in the VA data warehouse to avoid misclassification bias. With only the VA and COVID shared data resource to work with, researchers could tell who did have a vaccination& booster, but not who didn't. That's perfectly reasonable.

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u/[deleted] Oct 06 '22 edited Oct 06 '22

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u/Talldarkn67 Oct 07 '22 edited Oct 07 '22

This. It’s fairly pointless to do a study on the effects of a vaccine or any other drug without a placebo group.

Considering the fact that vaccinated and boosted individuals are catching the virus multiple times, it doesn’t make sense to not have a control group be part of a study like this.

Virtually useless without a simultaneous study being done on the unvaccinated/placebo group. No one tests any medication without one.

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u/Drdory Oct 07 '22

Effects. And the unvaccinated are the control

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u/Talldarkn67 Oct 07 '22

Thanks and the unvaccinated that weren’t included in the study? Those unvaccinated?

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u/timberwolf0122 Oct 07 '22

A vaccinated person will have a shorter period of infection with lower viral load, this will almost certainly translate to reduced damage to cells.

Naturally we will need to collect evidence to back this up, a lung capacity + VO2Max stress test would provide the data we need

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u/Wagamaga Oct 06 '22

A large study of COVID-19 disease following vaccination and booster, published in the Journal of the American Medical Association (JAMA), reports surprisingly low incidence, especially in individuals younger than 65 years of age with no high-risk conditions. Hospitalizations for COVID-19 disease among individuals who had received vaccines and boosters occurred almost exclusively among high-risk patients including older adults and adults of all ages with certain comorbidities or immunocompromising conditions. This retrospective study of 1.6 million patients at Veterans Health Administration facilities, the largest integrated healthcare system in the U.S., found the incidence – new cases over time — of hospitalization for COVID-19 pneumonia or death was 8.9 per 10,000 persons who had been vaccinated and boosted. While the incidence for vaccinated and boosted older adults with comorbid or immunocompromising conditions was tenfold higher, it was still a relatively low rate of occurrence of bad outcomes.

https://jamanetwork.com/journals/jama/fullarticle/2796892

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u/ddrcrono Oct 07 '22

...hospitalization for COVID-19 pneumonia or death...

It's very odd that they didn't just tell us what the death rate was as well. I'm honestly more interested in that than hospitalization + death rate.

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u/Smodey Oct 07 '22

Probably because the definitions are a bit of a grey area. i.e. 'died with COVID' vs. 'died because of COVID' vs. 'died due to complications involving COVID' vs. 'died within X time of COVID infection'.

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u/ddrcrono Oct 07 '22

What I mean here is that there is no death rate included, which normally is, even if the difficulties you're describing apply.

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u/A7omicDog Oct 06 '22

"Low incidence" compared...to...what?!

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u/[deleted] Oct 06 '22

Compared to before vaccines became available, for one thing.

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u/TheUnweeber Oct 07 '22

Well, sure. people getting covid at this point are either vaccinated or survivors, or both. It cleaned out who it was likely to.

A better metric than 'before vaccines became available' would be 'vs unvaccinated'.

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u/ArmchairQuack Oct 07 '22

That was a wholly different strain, chief.

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u/A7omicDog Oct 07 '22

Where does it show those statistics?

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u/[deleted] Oct 07 '22

Rate of severe infection has been replaced in many other papers.

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u/[deleted] Oct 06 '22

Different strain of the same virus.

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u/sloopslarp Oct 06 '22

That was still coronavirus

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u/inteliboy Oct 07 '22

not having the vaccine or booster.

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u/TheUnweeber Oct 07 '22

Sure, that would be a good metric, but is that what the study found?

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u/JesusSaidItFirst Oct 07 '22

I hope I never get hospitalized for death. Sounds rough.

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u/MatthewAllan1969 Oct 07 '22

Gosh Ill need to check thos numbers. They seem high. I thought it was 9 per 100000 for unvaccinated and 3 vaccinated

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u/Parafault Oct 07 '22 edited Oct 07 '22

I feel like the way this statistic is reported is extremely misleading. They’re reporting number of severe cases per total number vaccinated/boosted, but most of those who were vaccinated/boosted probably never developed a symptomatic infection, and may have not even been exposed to the virus. Others may have gotten vaccinated shortly after having covid, and therefore still have immunity from a prior infection. I think it is much more beneficial to assess both the change in infection risk, and the change in severe disease risk once you develop a symptomatic infection. Ideally it would be nice to know this as a function of time since your last booster.

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u/[deleted] Oct 07 '22

Maybe you should submit a research grant proposal so you can do it correctly.

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u/Thewalrus515 Oct 07 '22

Grant writing suuuuccccckkkksss. I’d rather do secondary research and pocket the extra money from the grants like a true grad student.

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u/[deleted] Oct 06 '22 edited Oct 08 '22

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u/derphurr Oct 06 '22

US COVID mortality was 320 per 100k, Canada was 118 per 100k pop. (According to John's Hopkins)

So yeah 89 per 100k isn't really great. It's smaller by 1/4, so good. But an effective vaccine should be at least 10x reduction in deaths.

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u/jeffwulf Oct 06 '22

The 89/100k for is Hospitalizations or Deaths, not just deaths. From their data, limiting it to Severe Hospitalizations or Death get it down to 34/100k. They don't report the number for just deaths though for some reason.

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u/Runawaybucket Oct 06 '22

89/100k is hospitalization not deaths, right? Deaths i assume are lower?

And hospitalization of total US population is higher than 320/100k since that’s deaths?

I think you’re comparing the wrong numbers possibly?

Edit: wait it says hospitalization OR death? For 89/100k?

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u/ddrcrono Oct 07 '22

To be fair it's really weird that the article referenced hospitalization + death since the standard in most of these analyses have been to go straight to death rate only or mention both. Threw me off for a second too.

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u/Scarlet109 Oct 07 '22

89 is just over a quarter of 320.

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u/derphurr Oct 07 '22

I said exactly that

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u/fauxberries Oct 07 '22

"smaller by 1/4" to me means "subtract 25%". I thought you were comparing 118 and 89.

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u/ds61533 Oct 07 '22

Does much negative news about Covid and boosters pop up on this sub or is it all mostly positive? Always good to hear both sides ya know?

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u/Baud_Olofsson Oct 07 '22

It follows what the published peer-reviewed research says. Reality tends to be one-sided.

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u/ChickenCannon Oct 07 '22

Negatives posts (and even comments) are cause for an immediate deletion/ban around this sub. You’d best check others for that sort of info.

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u/OnTheSlope Oct 07 '22

Sir, science is to be trusted, not investigated or debated.

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u/[deleted] Oct 07 '22

"Trust the science"... as they make it all about politics.

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u/beyondclarity3 Oct 07 '22

I live in a very red rural area, been jabbed 3 times, got covid the same week as two other people I know well, they both reported very serious issues, like a 104 temperature and days of inability to do anything. I had symptoms akin to a moderate cold for 2 days.

This anecdotal evidence isn’t science, just more confirmation that my neighbors are real dumb.

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u/fleadavid Oct 07 '22

Unvaccinated and caught it once, had a fever for 1 night then next morning was perfectly fine. Same with wife. Friends and family all vaccinated, sick for two weeks constantly showing symptoms

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u/Suprben Oct 07 '22

I’ve had Covid twice, never been vaccinated. First time I was sick for 4 days, and the second time I was sick for 3 days. The second time I had to work 12-15hr shifts in 15-20F degree weather and I was fine. I wouldn’t say I’m some super healthy person either, because I worked 12-15hr shifts for roughly 2/3-3/4 of the year while drinking 2-3 Red Bulls or energy drinks and eating junk food just about everyday, and only sleeping 4-5hrs a day.

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u/santiagodelavega Oct 07 '22

I’ve had Covid twice, never been vaccinated

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u/iqisoverrated Oct 07 '22

Well whaddaya know. Science and medicine work. Whoda thunk it.

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u/ArmchairQuack Oct 07 '22

Quoting misleading figures works on you apparently.

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u/the_scarlett_ning Oct 07 '22

Once you’ve had Covid, how long are you supposed to wait until getting a booster? I’ve had both vaccines, but since then, have had covid or long Covid for the past 10 months now.

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u/[deleted] Oct 07 '22

p.s. if you are suffering from long covid, you should probably talk to a doctor about whether (or when) to get vaccinated.

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u/catboogers Oct 07 '22

The protection given by fighting off an infection is different from different strains. While earlier strains were giving protection for about 3 months, the newer BA5 might be only about a month. Unfortunately, without sequencing you can't know for sure which you have, just guessing based on your community at the time.

The real answer, especially if you are still suffering from long covid, is to discuss with your doctor.

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u/[deleted] Oct 07 '22

CDC says you may want to wait 3 months, but it doesn't sound like a firm rule. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

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u/huskywhisperer870 Oct 07 '22

Sure… Keep trying to sell us. COVID’s over, come up with something else to create mass hysteria

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u/GoukiBalboa Oct 07 '22

Didn't get any covid vax and never got covid or flue for the past years. Meanwhile, my wife got her three jabs and gets sick every two months...

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u/OpinionOrdinary8096 Oct 07 '22

What about the millions dying and suffering serious illnesses from the jab?

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u/Baud_Olofsson Oct 07 '22

They don't exist.

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u/OpinionOrdinary8096 Oct 07 '22

At least not on Liberal Reddit. But the evidence is there.

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u/Baud_Olofsson Oct 07 '22

Where? Please post some peer-reviewed evidence.

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u/OpinionOrdinary8096 Oct 08 '22

VAERS data on the CDC website

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u/AnonymousWritings Oct 07 '22

What I want to know is how much I just screwed myself by getting a regular Pfizer booster just before eligibility opened up for the new bivalent one, meaning I can't get the bivalent booster until February.

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u/Orcrin12 Oct 07 '22 edited Oct 07 '22

The (very limited) evidence that we currently have for bivalent boosters indicate that they are at most only marginally more immunogenic than their monovalent counterparts, meaning they generate slightly higher numbers of neutralizing antibodies. There is no evidence that these differences in antibody counts will lead to clinically significant differences in outcomes.

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u/AnonymousWritings Oct 07 '22

That's good to know.

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u/prismmonkey Oct 07 '22

I got the bivalent booster on Monday, and the pharmacist told me you only had to wait two months after getting a regular booster before you can get the bivalent one. A friend had gotten the older one over the summer and asked me to inquire about it for him. I glanced at the CDC site, and they also say two months between older booster and new bivalent.

I wonder why someone told you February.

Edit: I've had all Pfizer shots/booster/bivalent.

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u/Trpepper Oct 06 '22

For every one vaccine recipient that received a vaccine and had a blood clot, there are 8 covid patients who did not receive a vaccine and had a blood clot.

https://www.novanthealth.org/healthy-headlines/vaccines-and-blood-clots

that https://www.novanthealth.org/healthy-headlines/vaccines-and-blood-clots

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u/[deleted] Oct 06 '22

Actually, covid infection is more likely to cause blood clots than covid vaccines.

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u/JULTAR Oct 07 '22

I know it happened with the J&J shot

But is that only those shots or is it the same for the others as well?

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u/MadeJust Oct 07 '22

And 93% of people who eat cheerios haven't had a heart attack. Science.

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u/SkippyBojangle Oct 07 '22

Ya except that's not even close to what they did. That analogy would work if you took a sample population of people who had all had heart attacks and compared those who had eaten Cheerios vs those who haven't, and then noted a 10 fold difference in survival of those who are Cheerios.

The study shows vaccinated and boosted patients at the VA were effectively 10x less likely to go have severely morbid or fatal outcomes vs those who were not.

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u/Lirdon Oct 07 '22

My mom is immuno deficient because of her history with cancer. It was a great relief for me that she didn’t get sick at all when I did although we shared the same spaces. And I myself only got extremely mild symptoms with no long term effects.

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u/Ok-Fortune2169 Oct 07 '22

Notice immunized is not the nomenclature for this vaccine(s). The fuckery is astonishing and surprisingly accepted.

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