I have seen a few comments here at BJ in the past few days that attempt to explain what it really means when we say that a vaccine provides 80% or 95% protection. And they are all different!
So, all you smart people and scientists and others who actually understand this – take your best shot at explaining this to the rest of us in the comments. (Everybody else, feel free to ask any questions you might have.)
Here are some of the questions/interpretations I have seen:
Does 95% protection mean that 5% of the people get no protection at all from the vaccine, and that the other 95% are good?
Does Moderna being 95% effective against the virus mean that 5 out of every 100 vaccinated people who are exposed to COVID will get it?
I’m pretty sure that both of those are untrue.
And since the variants seem to be more deadly and more contagious, how does that impact the 80% and 95% numbers which were the result of testing before the variants started showing up?
I have also read, regarding the 95% protection number, that it’s 95% for most people who get vaccinated, but that the number is actually 80% for people who are 65 and over. I have no idea whether that’s true, or not.
While I wait to see if anyone comments on this thread, I am going to attempt to make chicken pot pie for the first time. Though I am going to use my leftover turkey (which I froze after “the smallest turkey breast you have” turned out to be humongous). Wish me luck.
Update: This thread ended up with so much great information that I have included a link to it in the sidebar, near the other vaccination-related information at the top. Thanks so much to everyone who contributed.
MattF
My understanding:
Suppose you have two groups— 10,000 unvaccinated and 10,000 vaccinated. If the unvaccinated group gets 100 cases and the vaccinated group gets 10 cases, then the vaccine is 90% effective because it reduces the number of cases by 90%.
Kristine
I didn’t know how to explain it, so I looked it up. This from The Lancet:
Chetan Murthy
[erasing: Kristine’s cite, last para, is what I found also]
West of the Rockies
I believe commentator Martin gave an edifying answer to this yesterday or so. I hope he shows up; I don’t want to misquote him.
CaseyL
Wow, I’ve been interpreting the “95% efficacy” rate all wrong. I simply thought it meant per person by exposure: that if I were exposed to the virus, I had a 95% chance of not coming down with it.
bbleh
Just to clarify the Lancet math, it’s 100 x [ 1 – (attack rate w vaccine / attack rate w placebo) ]. Thus, Matt F’s example is correct. However, it’s all qualified by “within the parameters of the trial,” e.g., duration, population exclusions, etc.
Also, by “protected” is meant, “didn’t get the disease.” At least Pfizer, Moderna and J&J were 100% effective against hospitalization or death, meaning ZERO patients who received those vaccines were hospitalized or died due to COVID during the trials, even though some did contract COVID.
And of course, one can be infected by, and transmit, the virus without showing symptoms, so “protected” does NOT necessarily mean “entirely safe” (although there are data now that indicate that the vaccines also provide some level of protection against transmission). In other words, keep wearing the damn mask.
JoyceH
The math is beyond me, but I feel like the news media isn’t doing us any favors in their reporting on the vaccines. There was an article recently that headlined the fact that “105 fully vaccinated people diagnosed with COVID.” Then you read the article and learn that this is in Washington state, where 1.2 million people are vaccinated, giving an infected after vaccination rate of .01 percent – or one percent of one percent. The article went on to say that none of the infected got seriously ill. But I wonder how many people saw the headline or just skimmed the first couple paragraphs and came away thinking, “No point in getting the vaccine because they don’t work”?
MattF
OT. NYT: TFG is a crook.
NotMax
How much pot do you put in it?
:)
evap
I also read that in the trials for all (some?) of the vaccines, nobody in the group that received the vaccine died from COVID.
Villago Delenda Est
Water Girl, you should extend invitations to utter fuckheads like Alex Berenson and Robert Redfield to post here.
Hilarity ensues!
What Have The Romans Ever Done for Us?
@MattF: And water is wet, although what he did was pretty blatantly despicable. On the plus side after getting burned like that by Winred a lot of Republican donors will probably avoid using it for the foreseeable future, which won’t help Republican fundraising.
Villago Delenda Est
@MattF: I’m shocked, shocked.
WaterGirl
@Villago Delenda Est: You can do it! :-)
bluefoot
@bbleh:
I want to double down on this point about protected does not equal will not get infected. The clinical trials measured rate of severe disease or death. So with vaccine you are protected against severe disease (likely hospitalization) or death. It does NOT mean you can’t get infected, can’t get sick or won’t infect other people. Or not get long COVID. More and more data is coming out on these points, and will probably be submitted to the FDA as part of regular approval for each vaccine.
Considering the published immune response to the vaccines, it’s a good guess that the chances of getting infected are much lower once you’re vaccinated. But we don’t know that for sure yet. And we don’t know what “much lower” is yet. Some of the ongoing clinical trials are looking at rates of mild or symptomatic infection once vaccinated (by testing via PCR tests).
It’s also looking like being vaccinated offers some protection against infecting others. Which is great. It means we can drive prevalence way down once most people are vaccinated.
WaterGirl
@West of the Rockies: There were a few good ones recently, so I hope everybody shows up.
But even among the good ones they didn’t all seem to be saying the same thing, hence this post. Though it may well just be my lack of understanding.
Winston
Yeah, but if 90% of the population doesn’t come down with COVID anyway, then Big Pharma doesn’t get paid big bucks for preventing 90% of the population from coming down with COVID which they had nothing to do with. And that is proven by some god forsaken formula that no one can understand. And as more of the population comes down with COVID, the less effective they will tout the vax to be. Which is why Fauci said it takes 5 years to develop a vaccine. Plus now there are variants. And still if you got the vaccines, beware, cause you aren’t immune and still need a mask and social distance as I was roundly criticized a few months ago for pointing this out,
eta And I got the vax so now I’m in that 90% just like I was before.
Mike in NC
@MattF: The Orange Clown fleeced his dimwit supporters. Excellent work!
Redshift
@Kristine: Thanks a lot for that. It’s particularly good for the “OMG, it’s only 60% effective for older people/variant/ whatever so it doesn’t work” BS. It means 60% of the people who would have gotten it won’t, which is pretty damn good.
dmsilev
The basic meaning of 95% etc. has been covered well, but let me add two points:
Old Dan and Little Ann
@NotMax: All of it if you don’t have any plans for the next week or so.
WaterGirl
@dmsilev:
Please don’t assume that! My eyes started to glaze over while reading the info from Lancet.
Brachiator
The BBC Radio 4 program “More or Less” dealt with this. You can listen to the program here. The segment that talks about this begins around the 9 minute mark.
So, one group was given the vaccine, and another group was given a placebo. You monitor the level of disease in each over a certain period of time, around 21 days.
Chetan Murthy
@bluefoot: I’ve been banging on this “protection from disease does not mean no asymptomatic infection” for a while. But there’s been a recent study of 4000 immunized healthcare workers, where they tested weekly, and found that immunization did indeed prevent (asymptomatic) infection. There may be caveats on that (Yves over at NC seems to think so, but …. she and her crew can be a little nuts sometimes with their contrarianism) but it seems good news: once you’re fully-immunized: go hug your grandkids. Or so it would seem.
Maybe the cautious should wait a bit for confirmation from other studies (which I’m sure are coming, viz. Israel), but this seems promising.
Lyrebird
@dmsilev:
Excellent points, just want to add, Pfizer has published some promising numbers on preventing transmission:
Here is a secondary report, not the original release
Overall, it’s those “thus far 100% not dying, not needing intubation” numbers that makes it totally worth doing, and yes you bet I am still wearing a mask everywhere I go!
dmsilev
@WaterGirl: Ok. Let’s take as an example a 90% effective vaccine. Two groups of 10,000 people, one group gets the placebo and the other gets the vaccine. Say that 5% of the placebo group, 500 people, test positive for the disease over the course of a trial. 90% effective means that in the vaccine group, you saw 10% of the cases that you’d expect based on the placebo group’s results, so 50 people tested positive.
SiubhanDuinne
I am determined to get vaccinated. Several weeks ago, I shared on a thread that I have a crippling fear of needles. It’s a genuine phobia; I’m not proud of it, but I’m also not quite sure how to overcome it.
Since then, I’ve been working to desensitise myself. A few days ago, I wrote a parody song and posted it in a BJ comment thread. It didn’t get any reaction, so I’m trying again — not for any plaudits or kudos, but because, for me, just being able to deal with such images is a huge breakthrough; I literally couldn’t have done it a month ago. If you have any kind of phobia of your own, you’ll know what I mean. If you’re lucky enough to have no phobias at all, I congratulate you and hope you can summon enough fellow-feeling to be empathic toward those of us who are.
WaterGirl
@Brachiator: Is shot #2 considered the “booster”, or is the booster a third shot at some future date?
MattF
@SiubhanDuinne: It might help to know that I felt -nothing- at my shot. It was surprising at the time, but if the needle is fine enough the shot is -entirely- painless.
ETA: FYI, I didn’t watch it happen.
WaterGirl
@Chetan Murthy:
Was that study on one particular vaccine, or a mix of them?
bbleh
@WaterGirl: How about this. If a vaccine is 95% effective, then in its clinical trials, some people got the vaccine and some got a placebo (unvaccinated), and some of each group got COVID, but the fraction of UNvaccinated people who got COVID was 20 times higher than the fraction of vaccinated people who got COVID.
hitchhiker
Look at an example from the USA.
South Dakota has had a little more than 13,000 cases per 100,000 citizens — meaning roughly 13 out of every 100 citizens in SD caught covid.
The death rate from covid in SD is a little over 200 per 100,000 — meaning about 1 in every 500 citizens of SD has already died from covid.
The vaccine results so far are that — if everybody in SD had been vaccinated — there would be no deaths at all, because the vaccine is so effective in reducing the severity of cases.
So what does the “95% effective” statistic mean? Remember the 13 out of every 100 people who caught covid? The 95% applies to them. 95% of those people would not have caught it at all.
Extrapolating (so that we don’t have to deal with decimal parts of people),13 out of each 100 is the same as 130 out of 1000. And 95% of 130 is about 124 … which means that if everybody is vaccinated, instead of 130 out of 1000 citizens of SD getting covid in the last year, only 6 or 7 out of 1000 would have gotten it. And all of them would still be alive.
The vaccines are utterly, fantastically, insanely effective.
SiubhanDuinne
@MattF:
Thank you.
WaterGirl
@SiubhanDuinne: I thought of you yesterday when two different people shared that either they or a family member had a needle phobia, and both of them had gotten shots.
I cannot recall whether that was in the most recent “I Got the Shot!” thread or the “Vaccine Venting” thread, but both threads were from yesterday and links are in the sidebar.
Anoniminous
There’s a preliminary report the Pfizer vaccine (BNT162b2) is effective against the emerging B.1.1.7, P1, and B.1.352 lineages (UK, Brazilian, and South African variants according to our moronic Infotainment Mediums.) This is a Big Deal because viruses evolve and being one step ahead of the little bastard is a triumph of Molecular Biology and Medical Science.
zhena gogolia
@SiubhanDuinne:
I enjoyed it the other day. It reminded me of Gary Cooper and Audrey Hepburn.
I have phobias (not this one), so I sympathize. Maybe keep your eyes closed as much as possible?
Anotherlurker
@SiubhanDuinne: Well done! You have an admirable skill in interpreting the standards!
zhena gogolia
@WaterGirl:
A booster is later.
WaterGirl
@dmsilev: @bbleh:
These two are super helpful, thank you!
J R in WV
@bluefoot:
Bluefoot, you make a number of assertions in your comment. Some of which appear to contradict other information I have seen reported.
Do you have / can you provide sources for any of your assertions? Are you in any of the medical trades? Edumacated professionally?
I’m not trying to be a prick, I’m just trying to learn where your information comes from… Thanks in advance.
WaterGirl
@hitchhiker: Also incredibly helpful!!!
SiubhanDuinne
@WaterGirl:
When it happens — and it WILL happen — it will be one of the biggest psychological wins of my life. I’ll probably demand double stickers!
WaterGirl
@SiubhanDuinne: I’m not sure if you are up for the morning COVID threads – because it seems like every other tweet has an image of a needle, or a needle going into someone’s arm.
I look at those and think the people who writing the tweets that Anne Laurie is posting should be thinking more about people who don’t like needles.
Anyway, last week there was a photo of a different kind – a big, strong, handsome, you black man pictured with his big, strong, handsome, black friend, who was holding his hand while he got the vaccine.
I loved that one! Someone here offered to go with you, I think, Hoping that might help, too.
SiubhanDuinne
@zhena gogolia:
Love in the Afternoon — exactly what I had in mind as I wrote it! (Such an age mismatch, but still one of my favourite movies!)
NotMax
@SiubhanDuinne
And end up hanging out at acupuncture parlors?
:)
Anoniminous
@WaterGirl:
Shot #2 is the booster.
Gretchen
@SiubhanDuinne: nice song! I agree with MattF that it didn’t hurt and I didn’t look. But I understand phobias. Mine is about anything near my eyes. When I needed cataract surgery, the doc told me it’s no big deal. I told her there was no way she’d get near me long enough to do the procedure. She said she’d only had to put one person under of all the cataract procedures she had done. I was #2.
WaterGirl
@SiubhanDuinne: I will give you all the stickers. Every day for a month. :-)
WaterGirl
@Anoniminous: @zhena gogolia:
These seem to contradict one another. ??
sab
@WaterGirl: I think (NOT in any way a statistician or an epidemiologist) that the underlying point is that not everyone in the general population wandering at risk around gets Covid. That is your placebo group.
This is my layman’s guess what this means: So out of a 100,000 maybe 1,000 get Covid in that group. Why is that? Maybe some of the others are are somehow naturally resistant, but most are just damn lucky that they didn’t caught up in a situation where their exposure was higher. So out of 100,000 about 99,000 lucked out and didn’t happen to get exposed enough to catch it living their normal lives. 1,000 were not so lucky.
If these people had been vaccinated, only 50 would have caught Covid.
My ignorant guess is that 1,000 number is not a hard number. As Covid gets more prevalent in the general population so everyome’s risk of exposure increases, more than 1,000 out of 100,000 will catch it when unvaccinated. Also too, as more infectious Covid variants emerge.
That’s my guess what it means. Does that bear any relation to reality.
SiubhanDuinne
@WaterGirl:
Oh, I see them — just almost never comment at that time of day. It was JPL (whom I know personally) who offered to hold my hand. I may yet take her up on that, but I’m still working on pulling up my big girl pants all by myself. But JPL, if you’re listening, stand by for an SOS!
NotMax
@SiubhanDuinne
Yup. Coop had entered his craggy phase by then. And Hepburn so waiflike they may have needed to stuff her cello with helium filled balloons so she could lift it.
John Revolta
@SiubhanDuinne: I started trying to work up a “Vaccination” parody a few days ago but then I got distracted remembering Alan Sherman’s “Automation” thing from way back when and I lost interest. Wouldn’t have been as good as your’n anyhow.
If it helps, I’ve had both shots now and I barely felt either one. The n****e they used was very small and thin, unlike the ones in the photos they keep showing us for some reason.
J R in WV
@SiubhanDuinne:
Others have suggested you close your eyes. I suggest you show up, tell staff of your phobia, then put on a blindfold, asking them to pretend you are blind, to lead you to the shot station, to not tell you when anything is happening.
Then do your best to ignore the alcohol swab before the shot…
You can also softly chant something, Ommm, a poem, whatever, so as to not hear anything. Hope this helps.
Juju
@MattF: I am shocked to read that about Trump. I never saw it coming. ?
WhatsMyNym
This makes the math easy
ETA: from Bloomberg
Frankensteinbeck
Let me add: If* the vaccination gives a strong protection against transmitting the disease, the disease’s R rating drops like a friggin’ rock. You’re not just protecting yourself, or the people around you, or some stranger who caught it through a chain. You’re contributing to burning the virus out because it can’t find chances to spread.
*as is likely in theory and evidence is starting to come in suggesting it’s true
WaterGirl
@SiubhanDuinne: Phobias have nothing to do with maturity or will power or big girl pants!
I wonder if when you get to the site if you could tell the check-in person that you aren’t crazy about needles (understatement, I know!) and ask for the most experienced person they have got.
My first shot hurt not at all, and the 2nd one burned like hell. Totally related to the skill of the shot giver.
randy khan
My simple way of describing what 95% effective means is that if you had a 10% chance to get it before you were vaccinated, you have a 0.5% chance of getting after you’re vaccinated.
On one of the other broad topics of this thread – the trials all were looking at specific things, basically who got symptomatic COVID-19 and outcomes among the people who did, so (correctly) the early reports indicated that there were a lot of things we didn’t know about whether the vaccines prevented actual infections or kept people from spreading the disease. Now we’re starting to know more about those other questions, and so far it’s all good news.
dexwood
@WaterGirl: When I got a text from our Dept. of Health reminding me of my second shot appointment, it was called a booster in the message.
Anoniminous
@WaterGirl:
Same thing, we just used different nouns.
Brachiator
@SiubhanDuinne:
I used to have a big fear of needles. I also used to have a problem swallowing pills. I would have to try to drink a lot of liquid or trick myself into swallowing the pill while eating a dessert like ice cream or pie.
I am better now. The needles they use for the vaccine are small and practically painless. But I remember that I had to remind myself to relax before getting the vaccine. It makes it easier and quicker.
Someone suggested that if you distract yourself my imagining different colors it can make it easier.
I sympathize big time. Ultimately, I kinda learned to cope because I had to. I had to get some medical treatments requiring blood tests and intravenous drugs. My desire to get healthy was stronger than my fear of needles.
But it took a while. I don’t know. After a while, I just got tired of being afraid.
But again, I know how hard it can be. In college I almost lost a girlfriend because “we” had agreed to give blood during a Red Cross campaign, and I did not show up. Totally chickened out.
J R in WV
@Anoniminous:
This is interesting. I want to point out that these variants being named for where they are first found doesn’t mean that those new varieties of Covid are being transmitted from person to person to arrive in a rural MA town.
I suspect the rural person got a mutation that happened more than once, first where it was identified for the first time, and again later in or near rural MA, where the rural person caught it …
I do not know this as a fact, I’m not a medically trained person, but it seems logical, and far more likely than someone with the South African variant flying to MA and infecting the rural person, especially given the lack of international travel right now.
SiubhanDuinne
@John Revolta:
Alan Sherman
JaneE
To me it means that I am X% less likely to have result Y than someone who was not vaccinated. The result could be “catching” Covid-19, where catching can mean one or more positive PCR tests or a given number of symptoms or both. It could mean the likelihood of being admitted to a hospital, or an ICU unit or dying. Of all the possible results, the only one that is firmly fixed forever is dying. Getting symptoms or having a positive test result may or may not indicated a real case of Covid-19. Who gets admitted depends on more than just the severity of symptoms.
All things being equal (which they never will really be) I would expect for every 100 cases among unvaccinated persons, there would be only 3 cases for a 97% effective vaccine, or 20 cases for an 80% effective vaccine. The same vaccine could be 97% effective at keeping people from dying, and still be only 80% effective at keeping people from coming down with the disease.
For that matter, if coming down with Covid-19 means a slight cough or no symptoms at all, so far as I am concerned my vaccine was totally effective.
sab
We all have phobias. I am terrified of tightly enclosed spaces, and I hate being in a jostling crowd. How do people enjoy spelunking, or rock concerts, or holiday shopping?
As my eyesight gets worse while aging, I have suddenly acquired a fear of heights I never had before. I cannot get anywhere near the safe fence at scenic lookouts. My husband finds it hilarious, because he remembers when I would clamber up anything and laugh at him for lagging.
Good luck. Look away and think of babbling brooks, or howling jackals or something. Modern disposable needles are a miracle of modern technology. Tiny and very sharp. You will hardly feel it.
SiubhanDuinne
@Brachiator:
Oh, I get it. I’ve felt guilty for decades because I’ve never had the nerve to be a blood donor.
I often joke that I’m probably the only woman in North America whose ears aren’t pierced.
Can you say more about the picturing different colours thing? That sounds like something that might be helpful for me.
Anoniminous
@J R in WV:
Even as we type Asian-Americans are being viciously attacked and murdered because some {profanity laden rant deleted} scuzball used racist terms wrt the origin of Covid-19.
It would be nice to avoid that kind of thing going forward.
sab
@randy khan: You math
inclinedtalented people certainly can cut through stuff quickly. I wade through this swamp of calculation, and you just go bing times bing then presto. Urk.Gretchen
The nurse giving my shot told me to relax the muscle.
John Revolta
@SiubhanDuinne:
Another good one! I remember being a tyke and having to have that one explained to me.
Brachiator
@SiubhanDuinne:
As I understood it, it would be like closing your eyes and imagining a series of colors, like “Red, purple, blue, orange, yellow” and really bringing them to mind.
NotMax
@Brachiator
Too soon.
;)
Don’t they use that spray that temporarily freezes the area to be poked to numb it anymore?
sab
@Anoniminous: I am white, northeast European ancestry with people mostly here from before the American Revolution. I also have Black grandchildren (ancestors also here before Revolution) and recent immigrant Chinese in-laws that are so exceptional that it makes me proud as an American that they wanted to immigrate to here instead of elsewhere in the whole wide world.
John Husted, Ohio’s Lieutenant Governor, called Covid the “Wuhan virus” just last week. He used to be very right wing but decent and rational. WTF. Now he is dead to me. The Republican machine just poisons everything and everyone it touches. Maybe he thinks its just some buzzword. But I think he is willingly endangering those I love, for political expediency.
What is wrong with these people?
Brachiator
@WaterGirl:
Here, I think they were just talking about the second shot.
sab
@SiubhanDuinne: You would have hated my dad. He was a doctor (pathologist) and gave us our shots at home. When, as tiny children, we objected, he came up with the brilliant idea of giving us shots in our sleep. Made us afraid to sleep.
ColoradoGuy
Regarding phobias: I have a needle phobia that strikes unpredictably. Sometimes nothing, sometimes I crash down on the floor (from a height of 6 foot 1 inch). For blood draws, I ask for a lie-down, as I jokingly tell the nurse at least I won’t have far to fall. The nurse does a good job of distracting me by chatting about this and that the whole time, and they give a kid’s juice box of apple juice right afterward. It seems to work. As for the Moderna, it went so fast the next thing I knew it was the bandage going on. Both times.
The other bit of advice is to look away from the TV whenever they have Covid coverage. All they show are closeups of the shot or horror pics of somebody unconscious in the ICU. Both are traumatizing to watch, and that’s exactly why they show it. It gets a reaction out of people. But facts and figures are dull, so they show medical procedures that are uncomfortable to watch. I finally figured out I was being manipulated, so I always look away.
I am particularly annoyed at vaccine coverage on TV where they always show a closeup of something that looks really uncomfortable, while in reality it is not even perceptible if there is a slight distraction, like chatting with the nurse.
JaneE
@SiubhanDuinne: I used to have a phobia about needles too. I once belted a nurse when I was hospitalized because she insisted I act like a grown-up (I was 20) and waved a syringe in my face. The only time in my life I have hit someone with a closed fist.
The older I got the more often I needed injections for one reason or another, and blood draws for one reason for another, and it still takes a conscious act of will to close my eyes and stand still until it is over, but I can remember that I need a vaccination or lab work and go have it done. When I was younger (a young adult, not a child) I could block out any thought of any need for an injection within seconds of being told, and then argue with the person who told me that they never said that. Even now there are times when I can tense my muscles so much that the needles won’t go in, and sometimes they keep me for a few minutes to make sure I don’t go into shock or something, but those providers are just extra cautious and haven’t seen me before.
I have yet to convince anyone that I need to be sedated before they give me a shot. They only think I am kidding. But it can be done.
sab
Typo. Northeast should be northwest. Brit, Swiss, Irish.
@sab:
SiubhanDuinne
@sab:
Isn’t there a convention (don’t know if it is an actual rule) that proscribes physicians/surgeons from treating their own families? (Obviously not talking about slapping a bandaid on a scratch or similar.) Yes, I would have been terrified to go to sleep in your house!
frosty
@SiubhanDuinne:
Good for you for the poem! Best of luck at confronting the phobia. I don’t have it, but as a mild attempt at sympathy, I NEVER watch the blood come out when I get a blood test. Yuck!
Ruckus
@SiubhanDuinne:
I’m not sure I do or don’t have a phobia but I don’t like needles. I wish I could help you, because we all need the vaccine.
If talking/reading about it makes it worse, read no more.
I don’t know too many who actually do like them.
My dislike is medical, mainly I think because of the multitudes of them I’ve had over the decades, especially the last decade. I’ve had more medical procedures over the last decade than any other one of my life other than possibly the first one. I’ve learned that sharpness and size is vastly important to reduce the concept of harm they bring on. The way needles are made today increases the sharpness a lot. The randomness of the sharpness of needles has been reduced dramatically as well. IOW needles are far more consistently far sharper. Also the size of the needles has been able to be reduced, and as many of you who have gotten shots for Covid, the needles are rather small and therefore relatively painless. I get blood draws on a regular basis and those needles are a lot larger than the Covid shot needles and I can very rarely watch. I do find that often watching either makes it a lot better – or worse, and I never know which it will be for any particular time. But I’ve found that even my limited watching, over time, makes it easier, and I think it’s because I know what to expect and when.
As I said I’m not sure I have a real phobia or just dislike being poked with sharp things.
I also work machining metal and have for the vast majority of my life, so I’m around sharp objects all the time and the tiny bits of metal that metalworking creates seem to have a real attraction to my body, so I get things stuck in me on a real regular basis. Neosporin is my friend. It took me a while to learn how to get most of them out with minimal pain and bleeding.
SiubhanDuinne
@JaneE:
I had a surgery about 20 years ago. Was so screamingly terrified of the IV that I persuaded the anæsthesiologist to give me nitrous oxide first so I could relax enough to let them insert it. I knew from experience with many dental procedures that that’s the only thing that works with me.
And Valium. Valium and Laughing Gas.
MattF
@SiubhanDuinne: I suspect that the ‘rule’ amounts to physician’s kids simply not getting regular medical care. I’m speaking here as a personal case in point— I didn’t have a regular ‘doctor’ to call on until I was well into my 20s.
Martin
I feel like I’m getting called out by this thread…
The thing to understand about vaccines is that epidemiologists don’t care about you. They care about us. You are just a statistical datapoint, and their focus isn’t on eradication of the disease, just on control of it.
The thing they are laser focused on is R0 – the rate at which the disease spreads. If on average a sick person gives it to more than one other person, we have a big problem – a pandemic. If on average a sick person gives it to fewer than one other person, then the disease starts to go away, but you may or may not be able to dismantle the things that allow it to go away. If you can get that to MUCH fewer than one other, then it goes away very quickly and you can start to dismantle things like mask wearing.
The 95% number means that on average you are 95% less likely to develop Covid (the disease) from the SARS virus. What we didn’t know was whether that also meant you were less likely to pass the virus onto others. Maybe it just turns everyone into carriers of the virus? So worst case we’d help keep hospitals from overflowing, but maybe not slow the rate of spread. But it turns out it also makes you less likely to spread it. Is that also 95%? They don’t know, but evidence suggests it’s pretty high. This was the real hope of the vaccine, and usually blocking the disease also blocks the transmission, so they were pretty hopeful that would work out.
Now, what happens for the remaining 5%? Well, maybe nothing, but the various vaccines seem to mitigate the severity of the disease for that 5% by varying degrees – more with J&J and less with Pfizer.
Does it matter that some are more effective than others? No, because this exercise isn’t really about us individually. It’s about us collectively, and the more we try to optimize our personal safety in the near term, we risk making it worse in the long term.
Lets take the case of a large university classroom. I’ll make it 1000 people just to ease the math. They are packed together. In this space, transmission is going to be off the charts. You probably have 10 people within 6′ of you. You need to climb over people to get to your seat. Everyone is touching armrests and such for balance moving about. You are mixed in with a different 10 people within 6′ when you both enter and leave the room. If R0 in society overall was about 2 (2 people get the virus from every 1 person that has it) then in our lecture hall it’s probably going to be an R0 of 10. So if 1% of the people in the room (10 individuals) are infected, then they’re each going to spread it to 10 others, so now 110 people have it. If 3 days later they return to the same classroom and are now all infectious but not showing symptoms, then the original 10 people might be absent because they’re sick but we have 100 infected people spreading it to pretty much everyone in the room. This is the scenario I was facing at work a year ago.
But let’s put masks on everyone. We’ve found that masks are about 75% effective (so you transmit at 25% the previous rate). Now instead of spreading it to 10 people, you’re spreading it to 2-3. That’s still bad. After day one, 10 people are infected, 25 are exposed. At the class 3 days later, the original 10 are absent because they’re sick but now the 25 infected each spread it to an average of 2.5 other people, so we have 63 people leaving having been exposed. That’s bad, but without the masks it was 1000 – a HUGE difference. The point being that every bit of protection you add compounds for each generation of transmission.
Now, if we add social distancing and ensure nobody ever gets within 6′ of someone else (good luck pulling that off when loading a lecture hall – which now only has a capacity of about 100 people instead of 1000) then we might break even – each infected person passes it only one other person. Still bad, but not spiraling out of control.
Now, if we start vaccinating people, that compounding really starts to add up. If everyone in the room is vaccinated (5% chance of transmission) and masked (25% of transmission) and we keep capacity at 1000, then our R0 falls from 10 (each sick person gives it to 10 others) to 10 * 0.25 (masks) * 0.05 (vaccine) = 0.125. So our original 10 infected people are now spreading it to an average of 1.25. 3 days later, our 10 infected people are home sick, there’s only 1-2 in the room who are infected. Then there’s only about a 12-25% chance that anyone in the room gets infected from them, and the next meeting 3 days after that, odds are nobody is sick. Worst case we go through a couple of iterations of that before the virus stops spreading. At this point everyone is safe, even if they aren’t masked or vaccinated.
Now, you could drop the masks and still get there, but it’ll take a lot longer. Without masks, your original 10 infects 5, then 3 days the 5 infect 2-3, then 3 more days the 2-3 infect 1-2, etc.
As Albert Einstein said:
So, the difference between an 80% and a 95% effective vaccine turns out to not matter that much. They’re both so high that just a little bit of compounding will simply crush this virus. It doesn’t so much matter which vaccine you get, as much as it matters how quickly we get people vaccinated. If you are trying to minmax the best vaccine and end up getting in the way of the pace of the rollout, you’re making things worse, and likely increasing your long-term risk. Whichever vaccine you get, for now, you should still stay home as much as possible, stay masked, don’t fly, etc.
What’s the metric for when we can back off? Not when we’re vaccinated. It’s when the number of cases in the wild is low enough that you’re unlikely to run into someone who is infected. The vaccine isn’t the metric – it’s the mechanism to get to that point. Once we get there it won’t matter if you are vaccinated or with which vaccine. That’s what herd immunity is – the disease simply can’t spread.
Odds are this will remain regional for a long time – maybe years. As of yesterday CA has the lowest test positivity rate in the US at 1.5%. Encouraging since things were pretty bad here not that long ago. Idaho is 28%, Iowa 19%, Michigan 14%. If CA can hold things here and resist the urge to back off, the vaccination effort will pay off super-fast. Even if Idaho is vaccinating quickly, it’ll take them longer to get on top of this. West Virginia who got praise for their rapid vaccination roll out – 4.5%. Not terrible but 3x worse than CA who had a bit of a slow start to vaccines. That’s because CA is masking and distancing better and as a result the benefits are compounding better.
tl;dr: Don’t worry about it. Get your shot ASAP and continue to act like you didn’t get a shot. If we all do that, it’ll be over with pretty quickly.
Argiope
@WaterGirl: I just got back from giving 80-some shots today, and I’m going to beg to differ. I think it has to do with how close to teeny tiny nerves we get, and sadly arms aren’t see-through and every human is “wired” a little differently anatomically. Out of about 80 shots, I’d say about 3 hurt, and about 5 people don’t feel at all (as in, “you’re kidding me, I didn’t even feel that.) Same vaccinator, same day, what’s different is the arms. If only they were translucent.
frosty
@SiubhanDuinne: And Valium. Valium and Laughing Gas.
Oohh, nice combination!
Martin
@JaneE: Yeah, my son has a needle phobia. We discovered it when he needed a minor outpatient procedure as a teenager and he was resisting the anesthesia and when I came in to help him through it realized he was on the verge of murdering me.
I’m currently tracking this: https://ir.altimmune.com/news-releases/news-release-details/altimmune-commences-enrollment-phase-1-clinical-trial-adcovidtm
I’ve also worked out how to get him a J&J, and we’ll see if we can Xanax his way through that, or if we need to wait and see if the spray makes it to market.
Argiope
@SiubhanDuinne: So, can you get your provider to write you a valium for shot day, and have a friend drive you? I also heartily endorse telling your vaccinator. Even though our clinics are super busy I take the 30 seconds to find out what will make it easiest for the vaccine-phobic when they disclose: eyes closed with me talking them through it, eyes open but looking away, eyes open for everything but no line of sight to the needle–whatever works, I do. If it helps, you are far from alone in your needle phobia. I vaccinated a 68-year old who hadn’t had a shot since he was 9 because he was so afraid of needles. He did great. You will too, and yes to double stickers! It inspires me when people who are so scared go ahead and do it anyway. They are the bravest among us.
Martin
@Argiope: It’s funny, I’m not a fan of shots – I get pretty nervous about them, but it’s bifurcated to where an injection doesn’t bother me that much any more, but a blood draw makes me really anxious.
I don’t care about the pain – I’m pretty resilient to that. It’s more the act of adding or removing something from my body, I think.
I didn’t even feel my covid shot, and I was excited enough to get it that I wasn’t at all nervous. it helped that the nurses were all in really good moods. This was clearly the best part of their job.
Carlo
Here’s an explanation that I wrote up for a friend,
Epidemics are a numbers game. Whether a person suffers contagion during a contact with an infected individual cannot in general be understood in terms of a deterministic mechanical model. Rather, a probabilistic model is required. There is a certain probability, call it p, that an infection will occur during an encounter. The probability p varies by type of encounter (indoors, outdoors, masked, distanced, etc.) but let’s just consider one type of encounter that has a transmission probability p=0.01 — a 1% probability of infection.
Vaccine efficacy measures the reduction in the probability p. If a vaccine has an efficacy of, say, 80%, then an individual who has been inoculated using that vaccine has (on average over the population) a probability of infection that is reduced by 80% with respect to what it would be where he or she not vaccinated. So, in our example, the 1% probability of infection during an encounter is reduced to a 0.2% probability (because a reduction by 80% means that the new probability is 20% of the old one, and 20% of 1% is 0.2%).
While it would be great if the efficacy were higher or even perfect, note that the principal job of the vaccine is done simply by making it harder for the virus to find its next receptive host. Again, controlling an epidemic is a numbers game. An epidemic can be extinguished by using a vaccination program to create a hostile landscape for the virus to propagate in, even if the protection afforded by vaccines for individuals is not perfect.
Chetan Murthy
@WaterGirl: https://www.cdc.gov/media/releases/2021/p0329-COVID-19-Vaccines.html#:~:text=A%20new%20CDC%20study%20provides,responders%2C%20and%20other%20essential%20workers.
Both mRNA vaxxes. Glad you asked, I’d forgotten.
Ruckus
@SiubhanDuinne:
I like to be as independent as anyone else but as I’ve gotten older I’ve learned that there are things that I just can no longer do with any ease/grace/safety, and I’ve finally learned to ask for help without being told. Like pick up a heavy weight. We have younger guys at work with backs that haven’t been hurt by being too damn independent and I wish I’d learned this lesson long ago. Oldfartitious can be entertaining but is rarely healthy.
bbleh
@randy khan: @JaneE: This may be getting into the weeds, but be careful interpreting statistical results, which apply to a group (population), as applying to an individual. For example, “95% effective” means that the rate (fraction) of people getting COVID in a vaccinated group is reduced to only 5% of the rate of people getting it in a comparable UNvaccinated group, but that doesn’t mean the reduction applies uniformly to every individual in the vaccinated group; the number is meaningful only when applied to the aggregate.
Now you might say loosely that it applies to individual people in the group “on average,” so that on average a person is “5% as likely” to get COVID if s/he is vaccinated than if s/he is not, but there’s no such thing as an “average” individual; each individual ultimately either gets COVID or not. Generally there are some people in any representative group who are intrinsically more at risk (in this case perhaps older people, or people with other conditions that make them susceptible) and some who are less at risk, and the vaccine reduces their individual risks by varying amounts. For some, due to some medical/biological process or condition, it may reduce the risk spectacularly, and for others it may not — perhaps because they’re not much at risk at all, or perhaps (hope not) because there’s nothing that can be done for them. The 95% figure is an average over all people in the group — those for whom it works really well, those for whom it works well, and those for whom it doesn’t work so well. Absent other information, you don’t know which kind of person you are, and you should not assume that the 95% figure applies to you.
Bottom line: given it’s so effective in aggregate, it probably does reduce almost everybody’s risk to at least some degree, but keep wearing the damn mask anyway. :)
Ruckus
@sab:
Every. Damn. Thing.
Weekend Editor
Basically, vaccine efficacy measures the risk reduction of the vaccinated group with respect to an unvaccinated control group.
If pvac is the probability per unit time of infection in the vaccinated group, and pctl is the probability per unit time of infection in the treatment group, then the vaccine efficacy is:
VE = 100% * (1 – pvac / ptrt)
So a 95% efficacy (Pfizer, Moderna) means the vaccinated population has about 5% of the rate of infection compared to the unvaccinated population. (Note the word “population”: it doesn’t have much to say about individuals. It could mean everybody gets a 95% risk reduction, or it could mean 95% of the people get 100% risk reduction and 5% of the people get nothing. Both would lead to the same overall result.)
Here’s a post I wrote when somebody asked about computing the Pfizer efficacy and its confidence intervals. And here’s one I wrote when watching the J&J approval hearing, trying to figure out the efficacy calculations from their trial numbers.
Carlo
I meant to add that there’s an important caveat to the notion of vaccine efficacy: it is averaged over the population of vaccinated individuals. But individual immune response to vaccination is highly individualized (not the variation in side effects from shots).
We don’t actually have any kind of handle on the population spread in vaccine efficacy — the degree to which it varies across the population — because phase 3 trials are not designed to quantify that spread. Nor, for example, do we know the spread in the time from, say Pfizer shot 2 to 95% max immunity. It’s a slightly worrying knowledge gap, because it also means we don’t know who responds worse or better to which type of vaccine, or for what reason.
Buckeye
@sab:
I’ll admit to never thinking that he was decent, though perhaps rational. Though Mandel makes him like a sane GOPer.
J R in WV
I — We — Plan to be wearing masks in public for a very long time. Once we arrive at a willingness to eat in public at a restaurant (which will be a long time from now!) we will wear a mask until food and drinks are being consumed.
Even if the pandemic is over, it is obvious that masks prevent way most of the seasonal flu and colds. I don’t want flu, or colds.
If a mask keeps that from infecting the population, why would anyone not join in that plan? Crazy not to keep flu and colds from running rampant through the population~!!!~
We have eaten out twice in the past year, once take out eaten in the car, once, same take out (Thai chow great!) but outdoors last fall on tables in the farmer’s market. And twice sandwiches from a drive thru in the car after Wife’s cataract procedures. On the way from the surgery center to the doctor’s office for a same day follow up.
But I’ve seen people working in health care react as if I was crazy when I said we would be wearing masks in the future! Why? One lady said, and I said I don’t want the flu, and she said “Get a Flu shot!” which is not nearly as effective as the Covid shots..
Some people~!!~
Kristine
@WaterGirl:
Argh–sorry. That’s why I bolded the last bit since it directly answered the question.
sab
@Buckeye: Doesn’t matter. He is dead to me.
Kristine
@Redshift: Glad it helped. I guess I could’ve left off the chewy first bit but since it explained a misinterpretation I thought I had better leave it in.
trnc
@Winston: I feel a little dirty coming to the defense of pharmaceuticals, but I’m not sure what to make of your complaints, especially since you made the decision to get the vaccine.
I’m not aware of pharmas getting a ton of credit for illnesses they haven’t stopped.
Have the manufacturers claimed that there will be no adjustment to the effectiveness rate? We got the rates for the trials, and so far those numbers appear to be holding up after millions of doses administered.
Sure, but there have been some explanations about how they managed to develop these more quickly, and Fauci is totally on board with them.
There are flu variants, too, which is why we are always cautioned that the flu vaccine won’t protect against all of them.
Yes, we still have to wear masks in public or around people who haven’t been vaccinated, but we can hang out with other fully vaccinated people without masking or social distancing, and we don’t have to isolate if we are exposed to covid unless we develop symptoms.
90% odds you don’t get it, just like before, but also close to 100% chance you don’t die or have to be hospitalized if you do get it. I think that’s a pretty fucking big difference.
sab
@Martin: Could you comment on my sad little comment. On post, or dangerously off.
An opinion one way or the other would would be helpful.
Alternatove is Martin is full of s
PAM Dirac
@Kristine:
Others have explained the latter half of this statement pretty well, but I want to point out the first part of the statement. All the statistical conclusions that are drawn are only strictly valid for conditions that are like the trial conditions. If the trial population had a certain level of masking and social distancing, you can’t be at all confident that the same statistics apply to very different masking and social distancing conditions. Just because you are vaccinated you can’t be confident that you are 95% protected if you throw away your mask and head out to crowded bars.
RSA
Here’s how I’ve explained this to a friend elsewhere, based on Pfizer’s Phase 3 study. I think it’s roughly right, though feel free to correct any mistakes I’ve made:
Pfizer ran a study with over 43,000 people. Generally in studies like these, half get the vaccine being tested, half a placebo. Of that pool, 170 cases of COVID-19 were confirmed and evaluated. How well did the vaccine work? Only 8 of the 170 cases were people who had the vaccine, the other 162 having had the placebo. None of the 8 people had a serious case.
The 95% efficacy works like this: 8 divided by 162 gives 0.0494. Subtract that from 1 and you get 0.9506. Convert that to a percentage and you get about 95%. Another way to think of this number is that it’s about 19 to 1.
For an analogy, think of some risky activity you might like to do, and you have the option of wearing protective equipment or not. If you go for the protection, your risk is 19 times less than going without.
Another Scott
To reiterate: Even if vaccination is not 100% protective, going without is worse.
ScienceMag:
NIH republication of Lancet article:
Vaccination is the only way out. The vaccines are excellent, but not perfect. We must still be vigilant.
Cheers,
Scott.
KayInMD (formerly Kay (not the front-pager))
@SiubhanDuinne: I know you can’t choose your vaccine, but I suspect pharmacies and doctors’ offices are more likely to use the Johnson & Johnson vaccine, a 1 dose option. That’s the one for you. Other than that, may I suggest the technique I use for CT scans. Tell the person going in that you have a problem, and you are going to deal with it by ignoring the situation, please don’t think you rude (they won’t they’ve seen it before). I close my eyes as soon as I’m lying on the table, picture a bright, sunny meadow, and put myself there. I don’t open my eyes again – for anything – until I’ve been rolled into the machine, listened to the distant thunder (the loud CT process), and been rolled out again. In other words, I refuse to be present.
I don’t know if it will help to tell you this, but it doesn’t hurt. The needles they use now are very fine. Honestly, my arm was still cold from the alcohol wipe so I didn’t even feel it (I’m not afraid of needles, but I’m not a masochists; I didn’t look).
Good luck. I know you can do this!
Ivan X
This is the tough sell. I’ve heard it a hundred times, and every time I do, I feel the utter disconnect between the rational side of my brain and the animal side of my brain. I can’t synthesize it. I know that the good of the whole is the way out of this, but I want out of the cage we’ve all been in so much that the idea of having to defer conferred invincibility is a bitter and unintuitive conceptual pill to swallow. Fuck man, all I want to do is get back on a plane and see New York City again; I left for a week, and now it’s been 13 months. And if I feel that way as a jackal, I don’t see how we’re going to persuade the bulk of people out there to act as if they weren’t vaccinated for an indefinite period of time.
Laura Too
@bluefoot: #15 Please tell me where this comes from!! I have a friend who swears you can still get long Covid after vaccination. I read the amazing Anne Laurie’s column every single day and have never seen mention of this. I have, however, seen mention of Russian propaganda against vaccines which would seem like a source. My friend is Turkish, so I know she reads newspapers published outside the US. Thanks for any light you (or anyone else) can shed on this.
Chris T.
Disclaimer, dat-claimer, de-other-claimer: not an immunologist, etc. My take:
The me-centric take is this: I can either get the shot, or not get it (yet). Those are my only actual choices.
The only logical conclusion possible is that I should get the shot as soon as I can.
(Here in Washington state, I thought that would be April 1, but when I went to fill out a form, it said “severe” obesity. I’m only mildly fat, not severely fat. So apparently that’s April 15 now.)
Chris T.
@Brachiator: In my case, I had several phobias that were all alleviated by just the tiniest dose of antidepressants. My doctor tells me that most people go to 10 or 20 mg of the one I’m on, that 5 mg is the “baby dose”. I said “yeah but it’s working!”
(The most important two of these are: now I can climb a ladder to swap out the battery in the smoke alarm, and now I can use the spider-catcher to catch spiders and toss them outside.)
Ruckus
@KayInMD (formerly Kay (not the front-pager)):
I’ve had a number of CTs and an even larger number of MRIs. In different machines, in a couple of states. (I know of 4 different MRI machines in the VA hospital in LA, I’ve been in every one of them, a couple more than once, and there may be more.) The CT machines didn’t make a lot of noise. OTOH an MRI is a very noisy process and the early machines (25 yrs ago) had a much smaller opening, not that current machines have a huge opening but it is bigger.
My point is, did you mean MRI in place of CT? Both can give the experience of some degree of claustrophobia, my experience is that an MRI is far worse.
cope
Chicken/turkey pot pie recipe. I will post this incredibly easy and surprisingly delicious recipe our neighbor gave us only because this late in the thread, I hope to be spared what would surely be major shade thrown my way by some of the many talented cooking people who post here.
Using a store bought package of two pie crusts, line the bottom of a suitable casserole dish with one. In a bowl, mix together one large family style can of Campbell’s Cream of Chicken Soup and one large can of Veg-All homestyle large cut vegetables, drained. Add shredded or chopped chicken or turkey, pour into the waiting casserole dish and cover with the other crust. Make a pretty border by crimping the crusts together (or not), cut a couple of vent holes in top and place in a 450 degree oven until the top is nicely brown. We have glass casserole dishes so I can also check that the sides and bottom are also browned.
We have made this many, many times usually with chicken (which I poach in onions, carrots, celery and garlic) or using leftovers from bird centric meals. I save the poaching broth for soups and we enjoy a most homey, satisfying, comforting pot pie.
That’s it.
KayInMD (formerly Kay (not the front-pager))
@Ruckus: CT or MRI? When I was writing that I wasn’t sure, and just went with CT. So you’re probably right, MRI. I’ve had both, but one is definitely longer and louder. But I don’t like either of them. (I don’t know the size of the opening, because I close my eyes as soon as I get on the table and don’t look at it.)
Steeplejack
@SiubhanDuinne:
I will echo what MattF said: I felt nothing when I got my (first) Pfizer shot. It’s a very thin needle. Not that you want to hear about needles!
My advice: tell your shot-giver that you are afraid of needles, tell them which arm you prefer to get it in (if you care) and then focus on something somewhere else in the room. They usually have some little tricks and misdirections to give nervous people the shot before you know it.
Which arm? I didn’t have any discomfort afterwards, but I chose my right arm, because I have a tendency to sleep on my left side and didn’t want to potentially be sleeping on a sore arm.
WaterGirl
@Martin: THANK YOU, Martin!
WaterGirl
@Argiope: Interesting!
Would proximity to the nerves also explain why it looked like my upper arm was on fire for well over a week? (Picture the reddest red you can think of, and that was my upper arm.)
P.S. Thanks for vaccinating people!
WaterGirl
@Chetan Murthy: Thank you!
WaterGirl
@Kristine: No apologies! Every bit of information in this thread has been useful.
Catherine D.
@Argiope: Ha! I can testify to that. I don’t have a problem with needles, but one flu shot (out of many) hit a nerve, and my arm lit up like a pinball machine. A little disconcerting, but minor. ETA – only lasted about 10 minutes
Anxiously awaiting my second Moderna shot in just over a week.
Ruckus
@KayInMD (formerly Kay (not the front-pager)):
Yeah, I learned the hard way about closing the eyes. My first few MRI experiences were lower body, so head never went inside. After that they have all been head first. The first time I went head first, I didn’t close my eyes. This was an old machine, with an opening that my shoulders rubbed on the sides and my nose was very close to scraping. And I’m a rather average sized, like a large fits fine. I never knew I was claustrophobic till that day. Now I always close the eyes. Always. The oldest CT machine I’ve been in was about the same opening size but it’s just a frame that never really goes dark but yes, close the eyes, it’s easier. The length of time you spend depends on the scan, the last MRI ride I had was two separate scans, about 50 min total one without and one with contrast, of the brain.
Hey I got points, they found one!
debbie
@SiubhanDuinne:
I passed out the first time I had to get a blood test, so I know where you’re coming from. I’ve had dozens of blood tests since then, and I still get just as nervous.
The Pfizer injections really weren’t that bad. The second hurt a bit more, but that could have been due to the shot-giver’s expertise. I find if I look the other way, the fear level is much less.
WaterGirl
@cope: My turkey pot pie turned out okay. I used one of my spicy peppers from last summer (from the freezer) and that added some zing.
Turns out that I MUCH prefer chicken to turkey, so it was just okay. I only used half the turkey that I had in the freezer, and i decided that the kitties will get the rest of the turkey.
It’s one thing if you can eat turkey with homemade stuffing to make it interesting, but apparently pot pie doesn’t have that same ability.
Oh well. Now I know that making pot pie is not that complicated.
debbie
@WaterGirl:
Turkey tetrazini!
Another Scott
@JoyceH:
Yeah, there are too many stories like that. Exceptions are news-worthy, and the details matter.
E.g. Reuters:
Cheers,
Scott.
Ruckus
@debbie:
The expertise of the person can make a difference but the biggest reason is that, as someone up thread pointed out, you can’t see the nerves, so you can’t miss them other than by luck, although the size of the needle does help, smaller being better. Also getting a local anesthetic does help for the real big pokes, like an angiogram port into your upper leg.
debbie
@Ruckus:
Right. I figured the second guy hit something that the first hadn’t. I’ve had some really bad blood tests. I had to get them monthly and one nurse just sucked at finding a vein. If they can’t find it after a couple of tries, I demand a butterfly syringe.
Ruckus
@Argiope:
For shots maybe, but there are a lot of people I really, really, really do not want to see the insides of. Hell, some I don’t want to see the outsides either, little teddy from TX, lg from SC, either mg politicos, the one from FL or the one from GA
Winston
@trnc: I hope it’s working, but looking at statistics in Florida, for instance, I don’t see it yet. Here are a couple links. Maybe you can see something I don’t.
http://ww11.doh.state.fl.us/comm/_partners/covid19_report_archive/cases-monitoring-and-pui-information/county-report/county_reports_latest.pdf
http://ww11.doh.state.fl.us/comm/_partners/covid19_report_archive/vaccine-county/vaccine_county_report_latest.pd
Maybe you can explain why vaccines are going up as well as cases are going up?
Ruckus
@debbie:
I was put into a navy hospital, got there about 8pm had passed out on the parade ground at about 7:45am with a 105 fever. Got a new medic, he had never drawn blood before, although he had drawn orange juice from a piece of fruit. He stabbed me several times without hitting anything but nerve and I told him, go get someone else or you are going to have to pick me up off the floor, real soon. And I may throw up first. He got the senior medic who proceeded to use me as a practice dummy for the guy. With the help he actually hit home with no pain, on the first try. That was the first of nine days in the hospital. It didn’t go up from there, till day nine. BTW I’ve never had anyone else miss a vein before or since.
Ruckus
@Winston:
Vaccine effectiveness doesn’t hit till enough people are vaccinated, and with this type of virus, that is very easily transmitted and no one has any real defense against, the curve will go up rapidly until a reasonable number get vaccinated, especially if no one is even making the minimum attempt of hunkering down and masking up. Is FL doing that? Or the exact opposite? CA is doing a lot better but masking is required in public indoors and highly encouraged everywhere and vaccines are going into arms at a high rate. Our new curve is still positive, because not enough have been vaccinated and not everyone seems to be able to exist without their heads up the exit orifice. But it’s down to 1.5%, not 4.5 to 8%
Another Scott
@Winston:
Because the people getting vaccinated aren’t the people getting infected.
TheAtlantic:
(via Helen Branswell)
HTH.
Cheers,
Scott.
Major Major Major Major
Ha, thanks! Was thinking about doing a post on this.
JaySinWA
One pot per pie. It’s a one pot meal.
Major Major Major Major
@Winston: sounds like a waste of doses
Mel
@SiubhanDuinne: You are already being braver than brave by confronting your fear. If having a friend with you lessens the stress even a little, by all means, do so!
Thank you for your courage.
MizPurple
@SiubhanDuinne: I was a needle scaredy cat till my luck ran out in my mid 50s – first, intestinal surgery, then a year later ovarian cancer. Four years later, the immunotherapy that saved my life destroyed the beta cells of my pancreas and led to type 1 diabetes(!) By then I had gotten so desensitized to needles that giving myself injections 3x daily was no problem. But I do have a tip for you in this situation. Look away from where the injection is happening and dig your fingernails of the opposite hand into your leg (or pinch yourself hard). Distraction really helps when scary medical things are happening.
Josie
@SiubhanDuinne:
I can feel the anxiety in your poem. I have a different phobia, but I totally understand. Matt is right, at least about the Pfizer. I did not feel a thing. If you make a determined effort to look away before the person gets the needle in their hand, you won’t even know when the shot is given. I wish you all the best.
Nym hidden for now
@SiubhanDuinne: I was just about to suggest Valium or other tranquilizer pill, and let someone drive you there.
I used to be bothered quite a bit by needles and then I had to learn to give myself many injections. I was sure I could never do it. The clinic actually gave a class where we practiced on ourselves with plain saline. I thought I would fall out of my chair.
The first couple of times on my own, I had a friend who was a nurse come over and do them.
After that I cringed every time, until the first several dozen times and now it doesn’t bother me at all. It WOULD bother me if the n*****e were bigger, but modern tiny ones are really frictionless and painless and frankly, cannot be felt.
Having a relaxed arm really helps with that too. Obviously the sad result of that is that the very people with phobias or just ordinary tension are going to “feel something” more than those who don’t care — only increasing their fear of the experience.
I know phobias are not subject to rational analysis, so it probably doesn’t help at all to remember that the physiological process is extremely minor from your body’s perspective.
I don’t know at all if the vax can be given in the thigh or glute, but possibly would it help if the object of concern were not so close to your head and face?
If you take a friend, could they advocate on your behalf and check with the nurse if you could receive it other than in your upper arm?
And having a friend an advocate there, makes it easier to present your phobia reality to the medical professionals that you’re interacting with. One, because they can advocate for you better than you can in your fear, and two, because if you have an ally with you, it makes it much harder for an unsympathetic person to tell you to just get over it. Just because frankly they’re outnumbered 2 to 1by you and your friend. Humans being such weird monkeys.
Betsy
@J R in WV: Some of Bluefoot’s assertions are dead wrong. I read the studies.
something fabulous
@SiubhanDuinne: I am in what I consider to be the “normal” cohort of just hating needles and having to look away. Un-fun, that is, but manageable. I AM, however, very afraid of heights, all while everything you mention– even when it is unreasonable, when it is objectively safe, no one else is bothered, etc.
I wonder, in problem-solving mode, if you could do something with my why my best friend is my best friend anecdote? Many many years ago, went on a tour of our local lighthouse (Evanston beach since I seem to recall you are originally also from Chicago-ish?). Anyhoo, turns out the stairs inside were a spiral staircase of OPEN IRONWORK WITH NO RISERS–e.g., you could see right down, and as the stairs got narrower, you could put your foot straight through. Now, there was a railing, and it had been safely used for 100+ years… and none of that mattered. halfway up, I froze. Unfortunately, it was single-file wide, and several Brownie Troops etc were already walking up in front and behind me, so no way down, or even to stop. My dear friend twigged to what was going on with me, scootched around to be the one ahead of me rather than behind, turned and WALKED BACKWARDS THE REST OF THE WAY UP, so that I could look at and talk to her, and keep going. When we all made it to the top, had our tour, and started back down, she did the same.
Could a (masked, already vaccinated) friend go with you? Hold your hand a sing a song while you look them in the eye? I’m sure the vaccinators have seen it all by now, and would likely be sympathetic to any solutions! I am doing that with you now, virtually, in solidarity, in any case! All the luck and good thoughts to you for it
@WaterGirl: ETA: had not seen your response yet. Yes!!
WaterGirl
@something fabulous: I had to stop reading your story about the staircase partway though. :: shudder ::
Betsy
@Martin: And that’s why I come to this blog.
something fabulous
@Ruckus: @KayInMD (formerly Kay (not the front-pager)): …man, I am a mess! I ALSO have fear of closed spaces! The one time I’ve had to have an MRI, the thing that saved me is mentioning it, and they were able to reserve for me the lone one my Kaiser has for their obese patients. (I think they also had the completely open-sided kind, whatever those are called, just not at any nearby to me.) Since they thankfully did not need an image of my head, I did not have to go quite all the way in, and that extra bit of space made all the difference. still had to white-knuckle my way through it, eyes tight shut, but do-able! Lesson learned: always worth raising your issue; sometimes there are solutions!
Betsy
@bluefoot: The clinical trials measured much more than just incidence of severe disease and death.
They also evaluated vaccine efficacy against COVID-19 disease, period. That was what produced the ~85-90%+ efficacy ratings.
Disease, of *any* level, not just severe.
Disease (meaning symptoms), not infection. Those trials didn’t check purely for infection, only symptomatic disease.
The rating for prevention of death was 100% in the case of all the phase 3 clinical trials for all three vaccines now in use in the US.
As in, zero deaths.
Another Scott
@MattF:
Only 3%??
Cheers,
Scott.
Betsy
@Laura Too: There’s some misinformation there.
Betsy
@Winston: Because that’s not how this works. Cases can go up, easily, obviously, when 80% of the population is still not vaccinated or has only a limited amount of protection from 1 dose.
The cases spread among the millions of people in Florida not vaccinated.
Especially if they start dropping precautions because they “feel” that the pandemic is “over.”
Betsy
@Winston:
Meaning you don’t understand it.
Who else used to talk like this? Does anyone remember?
glc
Answer #1 seems to cover it.
The protection afforded by vaccines is mainly protection to the community. 5% of no cases is no cases, 5% of hundreds of thousands of cases is many many thousands of cases.
When a sufficient combination of vaccine efficacy and vaccination percentages is reached (depending on transmissibility of the disease) the epidemic should be over or controlled and
we can go about our business without worrying too much about the details.
The efficacy number is important for working out what level of community uptake you need to actually squash the epidemic (or, what additional measures you might need). For the individual, it’s basically a multiplier – whatever the general infection rate is, the vaccinated rate should be 5% of that — all things being equal (which, in fact, they never are, for the individual, who brings a definite age, family situation, work situation, medical history, and general behavior to the table). If the plague’s still running loose in your community, best to avoid it, if you can.
sfinny
Way late to the needle phobia discussion, but I have always had an issue with doctor offices in general and having blood taken. When I had cancer 3 years ago, I had to do a lot of both. So my method was to close my eyes during anything that bothered me, and try to sing in my head American Pie. Never could remember the whole song in the right order but it helped.
sfinny
Forgot to add that there were a few awkward moments when younger techs heard me singing “this will be the day that I die” questioned what I was doing.
randy khan
@bbleh:
Well, you know, ceteris parabus, as the economists say.
I mean, for each exposure by each vaccinated individual, it’s either effective or it’s not, so everything is a statistical average. And if you’re trying to answer the question “What does 95% effective mean?” I figure you kind of have to avoid the weeds of whether it’s really 95% effective for everyone, because that’s not really the question you’re being asked. (I am reminded of the last debate between G.W. Bush and Clinton, where someone asked a question that was nominally about the national debt (or maybe it was the deficit), and Bush gave an okay technical answer to what he thought she was asking, and Clinton figured out what she actually was asking because his emotional intelligence is off the charts.)
randy khan
@Ivan X:
I think there are two different kinds of behavior that you’re conflating.
It’s a social good to continue to wear masks, social distance in environments where it’s recommended, etc. You’re helping others by doing those things because you’re modeling good behavior. (And in some cases you’re going to be required to do them for a while anyway.) I don’t think of this as a tough sell because I want to help people do the right thing.
But that doesn’t mean you should not do things that would have felt too risky to you before you were vaccinated. You can take a plane if you follow the rules. You can (I can, when I’m vaccinated) go to a baseball game if you wear a mask, sit in a pod like they want, etc. If you are a parent or grandparent, you can see your scions again. You can do these things because they’re not risky for you once you’re fully vaccinated.
Ken
If you mean TFG, he was more “Really hard formula, most people don’t understand it, but I do, the experts were just amazed how much I knew.”
OTOH, Bill O’Reilly said no one knows how tides work; and I could swear some RW politician said the same about magnets, though all Google shows me is Insane Clown Posse.
TomatoQueen
My young man had the J & J late on Thursday afternoon, and now seems to have come through this process with comparatively little discomfort, but as he is non-verbal, I have no way of being certain that he experienced anything beyond a bit of arm soreness and fatigue. I’ve seen little to nothing about J & J side effects, so I’d be grateful to hear from anyone else who’s had the J & J what their experience was like.
I’m next door to phobic about a lot of things mostly to do with humans and their doings, so getting me to even decide about what vaccine and when has been more than a struggle (add in two snow storms on appointment days and I shout at the clouds); trying to arrange an appointment for my son was a fraught matter until J & J came along, as my son has no receptive language so all those notions of explaining and comforting aren’t available to us in any way, and he’s too big to be held in someone’s lap. It’s always like this more or less, try to make a stressful thing as easy as possible for him, and be grateful that he’s so good natured.
rikyrah
@SiubhanDuinne:
close your eyes
rikyrah
@bluefoot:
Pre-vaccination, if I had caught COVID-19
It would have meant certain death. Period.
But, now that I am vaccinated, I have a fighting chance.
To go from certain death to fighting chance…
Means everything to me.??
Ruckus
@rikyrah:
You and me both.
And I’ve got a lot of living left to do.
SWMBO
@Martin:
I love you. Come sit a socially appropriate distance, wearing a mask, after vaccination, next to me and keep talking soothing numbers…
SWMBO
@rikyrah:
Actually if I understand this thread, your chances (and mine) go from certain death to 0% chance of dying or needing hospitalization after the vaccine. That’s a significant improvement for both of us.
Got the second Pfizer shot Friday. So did my son. I asked him how he was feeling. “Fine.” I told him my arm was a little sore. “Yeah, mine too. But it’s worth it.”
Steeplejack (phone)
@TomatoQueen:
I’m glad to hear that it went okay. I hope your shot does too.
bbleh
@randy khan: That’s true; most people are asking about “me” rather than about “the science.” The problem, then, is twofold.
First, “numbers have legs”; if a figure like “95%” is mentioned, it goes running around on its own and quickly becomes divorced from all appropriate definitions and qualifications. If it is asked — correctly IMO — “what does that really mean,” it should be defined and contextualized properly. It’s only a group average — which can be badly misconstrued (see extended example below) — and at least the initial data are limited in both time and scope (although subsequent data continue to paint a very optimistic picture).
And second, in judging risk, people discount small-probability events to the point of ignoring them, even if those events are catastrophic, and they make bad decisions as a result. “Oh 5% is so small, it’ll almost certainly never happen, so I don’t really need to worry about it.” But such events DO occur, a small percentage of the time — think car crashes — and you DO need to factor them into your decisions — you wear seatbelts, for example.
The combination of the errors — 95% applies to me, and 5% is negligible — would be an understandable way of thinking about vaccination, but it would be materially wrong.
—-
Extended example regarding 95% average efficacy. Suppose there are 3 kinds of people in the population: red, green and orange. Red people comprise 1% of the population, and they are completely vulnerable to the virus, vaccine or no; if they come into contact with it, they get COVID, no matter what. Green people comprise 80% of the population, and they are the opposite: they are invulnerable to the virus, vaccine or no. Orange people are the remaining 19% of the population, and they respond magnificently to the vaccine: they are totally vulnerable (like red people) without it, but they are totally invulnerable (like green people) with it.
Without the vaccine, red and orange people — 20% of the population — get COVID. With the vaccine, only red people — 1% of the population — get COVID. Average efficacy = 100[1-(1/20)] = 95%. But only the orange people are helped by the vaccine; the others — 81% of the population — are unaffected.
Now this is a cartoon, and even so, you might say that IF you are at risk (red or orange) but don’t know what type you are, then there is a 95% chance (19/20) that it will help, so in that sense the 95% could apply to you individually. But it illustrates that a 95% average efficacy can result from very different individual efficacies. And in reality, the world is a much more complex combination of very many different types of people, and absent other information, you may not know what type you are.
WaterGirl
@bbleh: This is super helpful. Thank you!
Platonicspoof
Re-posting from Anne Laurie’s 04/04 COVID-19 post.
@Laura Too:
In WaterGirl’s thread I haven’t seen any mention of challenge trials, which answers a different question than the vaccine efficacy trials, which answers a different question than effectiveness (“real world”).
The efficacy trials were for prevention of particular sets of reported symptoms. So in the Lancet article quoted by Kristine at comment 2:
The efficacy trials used two groups of people, one vaccinated and one given placebos.
Challenge trials use one group of people and deliberately infect everyone to directly answer the question “does the vaccine prevent infection?”. Everyone gets repeatedly tested.
Even though the purpose of the efficacy trials was not to measure prevention of infection, as Betsy at comment 146 in WaterGirls post said:
But that info comes from data created after the trials. This article lists three studies from England, Israel and Moderna that try to indirectly calculate prevention of infection, but they are not challenge trials.
Likewise, this CDC report used weekly testing for infections (not just symptoms) of vaccinated and not vaccinated people to measure effectiveness. Important qualifications in “Discussion” section.
This Feb. 17 BBC article reports the world’s first vaccine challenge trial. People will be deliberately infected after vaccination to most directly answer the question “Do vaccines prevent infection? “.
Edit to limit already too much oversimplification.
Chris T.
Ugh, that’s my own nightmare scenario for stairs. (Have not tested this sort of thing since getting those tiny little pills that made it possible for me to climb a ladder again.)
I did discover earlier that this sort of freezing thing is based on visual cues. Not sure if that’s true for everyone, but it matches your experience. If you can hide the drop-off from your eyeballs, you can move again.
Chris T.
Par-i-bus, please, with the i. It’s how the declension of
pars, par-
(equal) goes. See http://www.cultus.hk/Latin_vocab/adject3/pars.html for instance (but why do we have to go to Hong Kong to learn our Latin?). Anyway, the -ibus ending is the plural dative and ablative (object, object-of-preposition, etc).Chris T.
Just so. That’s why I said that these numbers aren’t really relevant to thinking about what you (the person reading this: the individual) should do. Just get whatever vaccine you can. It either doesn’t do anything, or helps you immensely. Heads you win, tails you don’t lose.
(If the vaccine cost, say, $100 grand a pop, that would change things, but since it’s free modulo the cost of your waiting-time, go get it!)
something fabulous
@Chris T.: Oooh it might be time to look into those little buggers! Talk therapy seems only to go so far. Thanks, more reason to think about it.
And yes! this is how my friend saved me– gave me something else to look at. Just staring at the back of the coat of the person who had been in front of me was not enough. Too passive, maybe? Took some real engagement to get me going again.
bbleh
@Chris T.: I agree! That calculation is simple: the risk of getting the vaccine is FAR less than the risk of NOT getting it, so of course you should get it. All I’m saying is, don’t make the mistake of thinking its benefits for you are SO great (“95%”) that you stop taking precautions afterward. That’s not what the 95% means.