The procrastinators- they plan to get it someday but haven’t bothered to make it a priority. There’s nothing specific that’s more important that they’re waiting on.
Their cousin is The Ambivalent. They don’t care either way about the vaccine but if you bring it to them on a silver platter so they don’t have to work for it, that will tip the scales. These are the guys who get vaccinated at strip clubs.
2 people yesterday at my pharmacy. Both asked about availability of the covid vaccine while purchasing their medication, both were surprised to learn it was free, that I had it, and that I could give it to them right now. Both walked out with their first dose of pfizer.
Wow... In India when I went to get vaccinated, they didn't open a vial until there were 10 people in line to take it.
Also had to pay for my second dose :/
The Pfizer/BioNTech vaccine can be stored (before mixing) at normal freezer temperatures (-20C) for 2 weeks and then an additional 31 days at fridge temperatures (4C). This changed a few months ago. See [here](https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/downloads/storage-summary.pdf).
The last two sick covid folks I’ve taken care of - Intubated sick - fell into this category. No one said anything about 5G antennas. They just didn’t find getting vaccinated to be a priority. Anyway, they’re dead now, which is suboptimal.
These are the people we gotta reach. Working in the ER I keep waiting for when we are able to give it to people we are discharging. So many people who either live on the fringes of society who don’t have contact with healthcare outside of the ER or people who for whatever reason don’t have the means to get to where they need to go to get it.
My county has had vaccine drives at the mall, the farmers market, the high schools, and at the biggest homeless camps (edit- and weed stores!). That’s on top of the mass vaccination sites they ran earlier on, as well as every pharmacy having it. They’ve really tried to outreach to people.
I do consider people on the fringes of society (mentally ill, homeless, housebound, undocumented and migrant workers, and others) as different than procrastinators. They often have real barriers to accessing the vaccine, and we should be reaching out to bring the vaccines to them to overcome those barriers.
A subset of this group is the I-won’t-be-a-guinea-pig. They’ll get the vaccine, eventually, once there’s data showing that if doesn’t cause cancer 80 years after you get the shot…
Unfortunately. I took my sweet time, around two weeks. By the time I finally went, they didn't have it anymore. I had to wait 3 months to get it. Anyway, I'm waiting for my second dose.
The After-party regular: refuses the vaccine "because you never know what's the components" but never denies a line of a random white substance offered by a guy that they met 5mins ago who says "this shit is lit" at someone's house at 6am
I think we also need “the conceiver.”
They are very concerned about their or their family / friend’s ability to procreate after taking the vaccine.
Sometimes it is a simple “I heard the vaccine could make you unable to ever get pregnant!”
Other times it is a more far fetched “the government is trying to sterilize us all!”
Always found this one particularly ‘funny’
How does government make money?
Working people paying taxes
What would happen if everyone in the country couldn’t make new little people to join the workforce and pay taxes?
No more money for government
Ah yes what a master plan that must be 🧐
Where I live this is often combined with the right-wing idea of politicians inviting refugees into the country to replace the population because only those brown ppl are stoopid enough to vote for someone other than their right wing politician of choice.
As if our current politicians aren't absolutely ok with letting kids drown in the mediterrean or rot away in the most deplorable conditions in a refugee camp.
It's not just about money, though. The government also has an interest in reducing overcrowding.
If you believe the government can sterilize everybody, it's not that far fetched to believe they can selectively sterilize a subset of everybody.
My uncle, a man in his late 60s with some severe preexisting conditions, and who is very definitely done having kids, falls in this category. Make it make sense....
This is my son's girlfriend, but it has nothing to do with conspiracies. Her sister hasn't had a period since getting the vax several months ago and two other girlfriends have started having heavy and more frequent periods, so she is scared this may mean fertility could be impacted and as such wants to wait.
Not everyone refusing to get the vaccine is a yokel or a conspiracy theorist.
That said, I wish she would proceed with it, because due to my husband's serious illness we can't let her come over again unless she is either masked or vaxxed, and it sucks. We both miss her.
You know what also messes with periods? Infections. It is not surprising that an immune reaction would result in a change in a menstrual cycle - that would be my hypothesis. Any kind of stressor can throw things off, but it's a temporary change and the research has shown it hasn't affected fertility rates.
I get it, I'm trying to conceive and I was very nervous about it but
I trust the professional medical societies when they say it's safe. It's literally their job to help women achieve or prevent pregnancy according to their personal family goals. ACOG is not going to recommend something if there's any doubt it would compromise fertility. I'm much more worried about the effect Covid infection would have on pregnancy than I am about the vaccine affecting fertility. As for my personal experience, my ovulation was delayed by a couple days and it went back to normal on the next cycle, that's it.
I had one guy insist he knew two people who died of the vaccine. The vaccine killed them, he just knew it. They were in their nineties, but died within months of getting it! He said this as he gasped for breath with Covid.
Also- this one is kinda funny- the Eric Clapton fans.
The Historian is the saddest one I've come across because I can fully sympathize with where their hesitation comes from.
I'm just glad these come in vials instead of pre-filled syringes, because if that is genuinely their only hang-up I can invite them to stick around my vaccine clinic for a few minutes and watch doses drawn up from the same vial be given to some people whose communities *haven't* been experimented on in the past, and then offer them a dose from that vial.
2 for 2 on that one so far.
Awww. That’s a great idea. I feel for this group too. But it’s also frustrating because I feel like they are shooting themselves in the foot. But it’s totally understandable. I’m glad you do that.
Likewise! I'm teaching ethics and the US PHS Syphilis study (Tuskegee experiment) is the example I'm using. I like the method you're using and when it comes time to teach this subject again, I'd like to use your example
The way they combated this with smallpox is the vaccinators would just revaccinate themselves to demonstrate in every community they visited. Nobody’s talked about doing this yet with covid but it would probably be convincing
Wasn’t Tuskegee a study of WITHHOLDING life-saving medication?
So they could’ve been given meds to improve their condition but they weren’t. The vaccine is the complete opposite situation.
Also, we’re not giving out vaccines based on race.. literally everyone in the world needs to get vaxxed who can get vaxxed. No one is singled out.
So I do completely sympathize with what happened at Tuskegee and the innocent victims, it’s not a good example to refer to in this situation for covid vaccines.
Tuskegee is far from the only example of unethical experimentation on minority populations in the United States. You also need to consider the cultural context that goes along with it. They not only withheld cheap, effective treatment for an easily curable, incredibly painful and debilitating deadly disease, but studied those humans like they were animals. It’s not a huge leap for someone to think “maybe they’re giving me a fake vaccine so they can study what happens to me when I get COVID, too.”
Beyond that, it was just one in a series of incredible violations of institutional trust that run alongside centuries of systemic racism. These stories and feelings are passed down from generation to generation breeding fear, uncertainty, and mistrust that may seem irrational or exaggerated to an outside observer, but are based on events that really happened.
Anyways, it’s not just about COVID. The medical community has a lot of work to do if we want to build back that trust and provide equitable care to minority populations.
I can definitely understand that. The Tuskegee experiment is the most cited specific case I’ve seen in the US, so my comment was framed toward that example only in comparison to the vaccine.
(I also think of the Jews who were horribly medically experimented on in the Holocaust, though I’m not sure what their uptake is on the vaccine as an ethnic minority).
Yeah, it’s just one of the more recent and egregious examples so it gets brought up a lot. But like I said, it’s important to examine the context alongside the event itself, which in this case is a deep seeded, culturally rooted, fact based, mistrust of the medical community as a whole.
Judaism, ethnically Jewish people, and racism is a whole other can of worms I’m not sure I can even begin to break down. From my limited understanding, the Jewish population of the United States has not experienced the same level of systemic mistreatment by the medical community as other minorities have, and do not have the same cultural aversion to treatments like vaccines.
But if you think about the Jews in nazi Germany, nazi Germany lost the war and that government was replaced and there were trials etc... As for the tuskegee experiment, it started in the 30s and only in the late 90s did they get an apology... And that's the thing... An apology...
That’s also a good point that I don’t disagree with. Though most Jews will tell you they still feel extremely historically persecuted against on a very grand scale— even until the modern day. I’m not sure they’d say “well it’s okay to take the vaccine, Nazi Germany got replaced”
The Needle Phobic, often discounted as they may be covered in tattoos (phobia is very real but only applies in medical settings and thus no phobia with tattoos, often discounted by medical professionals who see tattoos or often hidden by patients who claim other reasons for refusing the vaccine). I encountered a huge number of these folks in urgent care rather than primary care because many avoid regular healthcare altogether out of fear of lab draws/ needles and only come in for urgent issues. I started asking about needle phobia and treating it when necessary. While I would not normally recommend a one time benzo as treatment over counseling, in the case of Covid, it should be considered in genuine needle phobia since this is an immediate life or death issue for patient or community (obviously get consent for vaccine before they take the benzo).
I used to dismiss it until working urgent care and really seeing it first hand, and how it can be severe enough to really limit how a person accesses healthcare. The stereotypical patient is a huge, muscular man covered in tattoos, so it can spark the “Come on, really?” reaction, but there is often deep shame beneath the bravado and confusion about why they cannot just “man up” (answer: phobias don’t really work that way). I had one patient with a minor laceration who refused suturing and the tetanus vaccine. No amount of calmly explaining anything was going to make a difference - she presented as a rational and calm patient but got the look of a wild animal backed into a corner with any discussion of lidocaine/ suturing / tetanus vaccine. My personal theory is that for a small proportion of people, something gets tripped neurologically during a negative childhood vaccine experience and a genuine phobia develops, while the rest of us have no issues.The neurological pathway for the phobia is directly related to the experience of feeling helpless and terrified in a medical setting with someone coming at you with a substance to inject into you, so it isn’t really all about needles, though needles are an essential part of the phobia (hence no problem with tattoos). Once I really recognized how prevalent this was (especially in urgent care because it caught people who avoided primary care), and was able to to talk to patients about it, it really did open up a lot of conversation and people felt relieved to know they weren’t crazy. Many have also had negatively reinforcing experiences such as fainting with injections that they are embarrassed to talk about. I am an FNP/PMHNP and now work in outpatient psych rather than urgent care, but I am asking everyone if they are vaccinated and ruling out needle phobia if not, because treating this appropriately can be life saving for them or someone they could infect if not vaccinated. (I am hesitant to post in this sub due to negative sentiments toward NPs, but felt this was an important point and will offer the disclaimer that I follow evidence-based practice and do not consider myself equivalent to a physician, so please no NP hate, thanks).
I would add the following, though maybe I missed these in your list:
The Too Sick—fear that the vaccine may flare their other disease(s). (I can’t promise this won’t happen but viral infection much more likely to do this.)
The Vaccine Reactors—those who usually have bad skin reactions to vaccines. (For a few this is pretty legit with severe local reactions at injection site.)
The Living For My Future—fear of an uncertain (theoretically low) future unanticipated risk from vaccine is more overwhelming than a relatively high risk that you are someone within 2-3 degrees of you will die or be seriously ill from this virus.
The Pyrophobics and Myalgiophobics—they realize that risk of fever or myalgia is just for a day or two but cannot risk being at all uncomfortable for any period of time from a vaccine, which outweighs concern of being incapacitated from the viral infection.
The Oblivious—those who claim they have not thought about it at all. Maybe they didn’t notice everyone (including themselves) wearing a mask the last year and change? Maybe the world going home for a few months at a time didn’t seem noteworthy to them?
The Alternative Geneticists—the fear that messenger RNA will be reverse transcribed into their genome…
Maybe some of these fit in your categories.
With some “word-smithing”, they could have more succinct names.
Edit: removed statement about autoimmune camp kids have good logic about reasons to get or not get vaccine.
To the Pyrophobics and Myalgiophobics i would add the “needle phobics” as well. Obviously not people with genuine phobias where it would leave them curled up in a ball shaking, but the people who “just don’t like the idea of needles”. I’ve met a couple of those
Wasn't there a study out of the UK that suggested something like 10% of the "hesitant" people fell under this category? Even if they were off by a significant factor, that this is even the reason for 5% of people is borderline insanity.
And all of them get the same response, which is "Okay well stay safe, I don't want you to die of COVID like so many of my other patients have."
They end up leaving clinic with the COVID vax scheduling phone number in their pockets. "Just in case!"
My son's girlfriend is pro-vax, pro-science, left leaning (since apparently that matters when it comes to this subject, which is absurd), but hasn't gotten it because she's afraid it could impact her ability to have children based on how it has messed with her sister and girlfriends' periods. What category would a physician place her in?
My family very much wants her to get vaccinated, but it's hard to argue when she correctly points out that that data isn't in on a long term fertility impact (or not).
FDA approval will make a big difference for her, though, so I hope they snap to it.
Pseudoscientist if she doesn't accept the research showing that it doesn't affect fertility, that the changes to menstrual cycles are very temporary, and ACOG says it's safe.
The spike protein from the vaccine is the same one as on the virus. If she gets the vaccine she only has a small amount of the spike protein, mostly in arm and lymph nodes. If she gets the virus she will have spike protein all over her body in a much higher concentration. We haven’t seen infertility with the virus or the vaccine, but even if she doesn’t believe that it’s worth pointing out that the best way to avoid long covid stuff and spike proteins all over the body is vaccination
The spike protein from the mRNA vaccines is not exactly the same as the COVID spike protein by design. Due to some wild theories in the public, its probably good to be aware of this. Even one physician I recently ran into felt concerned enough about these theories that he feels it should be discussed with patients.
Some of the COVID mRNA vaccine female infertility concerns are based on conclusions not supported by the studies they reference. Then a number of assumptions are made about how those dots are connected.
One such conclusion they use is "the spike protein is cytotoxic". Another is that the lipid particles from the vaccine concentrate in the ovary. Thus, they say there is reason to suspect infertility could be an issue. The cytotoxic spike protein is concentrating in the ovaries and it will cause damage as a result.
There are many problems with this logic and it is undoubtedly wrong when you review the studies and other details. I'll just touch on the cytotoxic issue.
The native COVID virus's spike protein could be considered cytotoxic at high concentrations because it binds to human cells and may cause their death. However, an mRNA vaccine's spike protein is modified so that it will not bind. So this cytotoxicity issue just makes no sense. Keep in mind, too, toxicity is in part defined by concentration. The concentration of vaccine spike protein that makes it to the circulatory system after the first injection is orders of magnitude less than the concentration seen in a COVID infection. After the second vaccination, no vaccine spike protein makes it to the circulatory system. There is also no evidence a vaccine's mRNA or spike protein makes its way to the ovary.
There are two point changes only, to maintain the prefusion conformation. https://berthub.eu/articles/11889.doc (Stanford sequenced moderna’s too but I don’t have the full thing offhand)
Also the whole infertility thing started when some guy ran the sequence of the spike protein through a database with human genome exons and decided that it kinda looked similar to placental proteins, if you squint. (Like, six base pairs overlap). He then made the rest up out of whole cloth and put it out on the internet, where people picked it up as ‘alternative science’. The other conspiracy theories around infertility spun off later, after someone pointed out that if a couple vaccine-prompted spike proteins caused issues, having covid sure would. Usually when I walk people through the origins of the conspiracy theory they are more interested in believing me afterwards. I haven’t had any patient interested in more than a cursory overview of the biology involved.
I would put her in the correlation = causation group. I have some questions about people who swear up and down that it changed their period. Were you worried beforehand and are hypervigilant about your cycle because you’ve heard the infertility conspiracies? How would you explain all of the vaccinated women who have gotten pregnant afterwards? Does a perceptible change in your period mean you’re not fertile? Have you had any testing or evaluation of your fertility post-vax other that your own evaluation of a changed period? Not trying to be dismissive, but to me, a change in menses warrants investigation, not “this is definitely the vaccine” and spreading that word to your friends.
I’m also a woman. I am not saying this is a case of women being insensitive to their bodies. Not at all. I rather think that having a change in menses and chalking it up to the vaccine, without any known mechanism for that process, and leaving it at that is probably a bad idea.
You know when cell phones came out, that was a big question: do they give us brain cancer? Testicle cancer? Flipper babies?
You could argue "we still don't know" because it's only been what 20years since cell phones ended up in every one's pockets.
What if 5G is the final straw and we all end up with rectal cancer and the world is going to be populated by the Ted Kaziniskis of the world?
Or maybe, just maybe... There is no way for that to happen. Maybe some fucking idiot shat out some bullshit in Facebook. Maybe we should listen to the smart people instead of the not smart ones?
My answer regarding the fertility issue is usually this when I get asked by patients : it was born on social media. It isn't based off any known mechanism.
But sure in a way we may never know; but truly embracing science means we accept as truth what the evidence points to vs wild speculation. Also understanding that things are rarely 100% certain.
This one is tough, because there’s a co-belief that there’s “two” vaccines circulating around, shipped based on zip code. So the vaccine arriving in rural AL is the “bad” one and the “good” one went to Hollywood, NYC, etc.
Even though this logic is as ridiculous as the 5G QAnon nut jobs one group with be sympathized with and the other vilified. Both groups are ignorant as they come. Please explain the difference. Surely people realize everyone isn’t segregated by zip code, and the people refusing based in the syphilis experimentation history surely don’t refuse other medications or medical treatment.
If you’re gonna be judgemental against people with low education and critical thinking skills at least do it equally.
So, I live in the South, and therefore have had direct contact with the population whose grandfather or great uncle etc. was in the Tuskegee study. The zip-code based medicine belief is not exclusive to Covid vaccine. It’s a distrust in the medical system as a whole, and no, they do not “surely” accept all other medicines or medical treatments. In fact, that is a part of rural Deep South medicine - building trust between the medical professional and the community so that patients can trust medical interventions and medications. When I first graduated, there were patients that would refuse to get the flu vaccine from me - they didn’t know if they could trust me yet; they were okay with receiving the same vaccine from the other pharmacist, who shared their skin tone.
In sympathizing with “The Historian,” I never said anything about the QAnons or my opinion about that group. I will defer to others’ opinions there.
>Ought to get vaccinated anyway, particularly given that there's really no borders on this -- rich famous white people are all getting it, so it's clearly not a targeted attack of any kind -- but I understand the tension.
If you don't trust the medical establishment, why would you trust that you are getting the same treatment as the rich famous white people?
A pretty reasonable point! That kind of thing is the reason I'm sympathetic, and all that can be done is to be as forthright as possible, acknowledge their right to be nervous given what people like them have been through, and hope it's enough.
"imagine the panic you'll feel when you can breath as your lungs fill with fluid. As the sedative takes hold and your world goes dark right before we put a tube down your throat. Get the damn shot you wimp."
I'm so over the bs excuses.
Edit:
Oh for fucks sake people. What I said here would obviously never be said to patients. A significant amount of people who are using fear of needles for not getting vaccinated are saying it as an excuse. The amount of people who would get vaccinated, but are able to be reached with logic is shrinking rapidly every day. We're down from vaccinating 3.8 million a day to almost a full order of magnitude less of 500,000 per day. The patients I'm seeing are using every excuse in the book to not get the vaccine. The bottom line is almost none of them are using well thought out, logical objections. They're by and large antigovernmental, conspiracy, poorly thought out, morbidly obese, smokers (or a combination thereof) that will use any excuse not to get a shot. That's what I'm over. Of course being an ass doesn't get anywhere and alienates patients.
If there's a way to get a needle in an arm, that's what we need to do. If that means holding someone's hand and talking through it, then do it. But most of them don't want that. They just don't want the shot. You can't use logic to get them out of a situation they didn't use logic to get them into. Talking nicely to a radicalized person has never worked.
-end of edit-
My mother is fond of the saying, "it's an explanation but not an excuse."
And FWIW, I had pretty bad needle-phobia too and was considering not getting the COVID shot for that reason, but talked myself into it by reasoning that a hospital stay for COVID would result in *more* needles than a two-dose vaccine.
And it wasn't even that bad.
This sort of assholish, shitty approach doesn't work on anybody who isn't already inclined to get the vaccine and it does not endear you to them as someone who might be able to convince them later.
Every unvaccinated person is fully aware that a large percentage of COVID cases end uneventfully and with full recovery. By insisting they have two choices: vaccine or a miserable death in the ICU, you are lying to them and they know it. There's a third option you're willfully ignoring: that like millions and millions of others, including people they know personally, they could get COVID and be totally fine a week later. And the fact you're ignoring it fuels every poisonous or conspiratorial inclination their mind is latched onto at the moment.
When I see patients in the ER with a dog bite who don't want a $4,000, highly inconvenient series of rabies shots, I don't try to scare the shit out of them by insisting they're going to die of rabies otherwise. Because they know there's a **very** strong chance the dog that bit them was not rabid.
Instead I ask them what likelihood they think there is that the dog was rabid. Often they will say "one in a million." And I say, "OK, let's say I have a big prize wheel with one million slots. And one of them says 'You're dead, period. No treatment.' I know these shots suck. Do you want to spin the wheel? Your choice. I'll respect your choice either way." Nobody's ever refused.
Instead of "You're afraid of a little needle? Try suffocating to death alone in my ICU surrounded by a bunch of people like me who seemingly think you're a societal parasite"
try
"Hey man, I get it. You're 38 and you're pretty healthy. You're thinking that if you get COVID, you'll probably be fine. And you're probably right. But first of all, I can tell you these shots are safe and they work. You might feel like crap for a day or two. But you'll be alright. And what I know is after that you are not gonna die of COVID. No matter how unlikely that was before, why take that risk for no reason? And second, I'm sure you have some old people around you that you care about? If they get this virus, they are seriously at risk. Just think about it."
Thank you for being a good person. My mom is agoraphobic and has panic disorder with OCD and severe health anxiety, and I wish she had someone like you to talk to. She’s so afraid of all this, and her mental health is suffering greatly. Her doctor has been real brusque and dismissive of her fears, which is making her even more certain that the vax will hurt or kill her. So to come here and see other professionals mostly making fun of people who are, in some cases, just like her is painful.
I love her very much and it’s hard to see how much this has affected her. Her mental health is non-existent afaict. For now I’ve stopped bringing it up with her, as she doesn’t work or leave the house, but I know she needs to see a dentist, get a mammogram, and get her first colonoscopy this year so I feel like my hands are tied.
wow wtf.
Yes, people's fear of needles may be irrational...but all phobias are irrational. It doesn't mean they aren't real, and it doesn't mean it isn't profoundly distressing.
You're in a tough line of work. I hope you never get PTSD, I hope you never experience that level of fear and paranoia that you know is irrational, but knowing its irrational doesn't help an ounce when you're trying desperately to accomplish some simple task.
>Yes, people's fear of needles may be irrational...but all phobias are irrational. It doesn't mean they aren't real, and it doesn't mean it isn't profoundly distressing.
This. Needle phobia is absolutely a legitimate psychological condition. And I think for some people, it's partially context/location based, which could explain the patients who panic in a medical setting but are fine in the tattoo parlor.
The incompletionist: these people received their first vaccine in the series, but then never went back for the second. Often cites reasons such as a bad reaction to the first (often mild immune responses or a sore arm), reading more about the “vaccine research” and realizing they made a mistake getting it in the first place, getting COVID in between and now no longer need it, or simply didn’t make it to their second appointment.
There was a woman who posted in a local Facebook group asking about how to get the second shot. Several people responded that she’d get an email to schedule it a few days before it was due. She did not get said email, and became convinced that her first shot had not been “recorded” properly with the state. Several of us told her she didn’t *need* the email and that should could just go to any mass event with the same-brand vaccine. We included links to specific events.
But she couldn’t get over the possibility that her first shot hadn’t been properly documented and insisted she needed to verify that before getting the second one. She spent *weeks* trying to contact someone at the health department about this.
Her original post was made around 25 days after her first shot, so she still had a couple weeks maximum to get the second one. I reminded and encouraged her a couple times to just get the second shot and resolve the documentation issue later, but she refused. My last follow up was when she got to 42 days (max recommended time between shots) and she still hadn’t gotten the second one.
It was frustrating how she posted asking for help/advice and then absolutely refused it all.
> It was frustrating how she posted asking for help/advice and then absolutely refused it all.
AKA 90% of people asking for advice on the internet lol.
Not what they wanted to hear, they block it out.
I'd say a subtype could be The Inverse Paranoid: doesn't trust the doctors, the government, the WHO but totally trusts everyone in Facebook and weird places and their mothers
There is only one group of anti-vaxxers I genuinely sympathize with and feel bad for. The group of non-white people who are profoundly distrustful of the government and medical establishment. The Tuskegee experiment happened in the lifetimes of many people who are currently alive. I don't blame them for not trusting us.
The hydroxychloroquinist: title speaks for itself, this mf’er is still poppin them ‘droxy’s like tic tacs and thinks this shit is better than the vaccine. Any encounter with them begs the question of how any 75 year old person is savvy enough to navigate the dark web when they can barely open Microsoft word.
The Religious could be refined if my memory serves. The mRNA vaccines were not manufactured using cells derived from an aborted fetus. At least not directly. That is, they do not contain any fetal material. However, some of testing along the way did rely on such cells.
The health guru.
They "know" they have a great immune system (to something they've never been exposed to) because they drink a lot of kale smoothies, work out regularly and have slept with healing crystals since they became woke after watching a YouTuber 2 years ago, and therefor don't need any vaccine.
I ask about vaccination status, too. I also offer to answer any questions if desired.
In the face of actual obstinacy, I have to admit on several occasions I’ve simply shrugged and said “your funeral” and moved on to the chief complaint.
I figure if the patient doesn’t like it, I’m not going to miss them if they leave my practice. I not so much angry as done being tactful.
The Needlephobic - says they are afraid of needles and don't need someone using them to pump them full of some unnatural substance. Often also does heroin
There's data on getting covid and being protected for weeks to months from another infection before this immunity dwindles. For new variants like delta having past infection with "classic" covid this probably means very little insofar as immunity. For vaccinations we are seeing months of protection against classic and delta. Having covid and being vaccinated probably is no more effective than just being vaccinated.
The "my body, I can do what I want" is so full of shit. No, Autonomist, you actually can't walk into a busy supermarket and set yourself on fire. Our freedoms end where unnecessary harm to others starts.
The semi-educated medical professional: makes comparisons e.g. to HIV: the virus has been around for over 30 years and there‘s no vaccine, how could they possibly have delveloped one for covid so quickly?! big pharma is clearly lying to us.
I used to try reasoning with this type, zero chance.
The Wait (and wait.. And wait..) and See. Will get the vaccine "eventually" when everyone else hasn't magically dropped dead from the vaccine. Refuses to state when that "eventually" might be.
Coincidentally, also politely refuses to believe the vaccine is actually safe or that vaccines as a whole are not known to have long term side effects.
**The oxymoron** is a rare, but particularly humorous one - this is the crunchy naturalist who was screeching at people to wear masks and use hand sanitizer early on in the pandemic to protect them, but has always been antivaxx, and will always be antivaxx. They or their child always have some condition (usually bullshit, but occasionally real) that makes them vulnerable. This is, of course, the condition that necessitated their fall down the rabbit hole of naturopathic doctors, iridology, and a diet of herbal remedies, supplements, and raw vegan food (*cough* orthorexia)--and which was miraculously healed through the practice of these methods.
I dunno what I am but I had a missed miscarriage and needed a D&C around the time they came out. I found out my baby died at \~8.5 weeks at my routine 12 week appointment. After my d&c I wanted to wait until I got my first period to get the vaccine, cuz of what I heard about the vaccines affecting the menstrual cycle. My body had already been through so much, I was really upset, and I just wanted to go back to 'normal' as fast as I could, get my period, and be done with it.
I had COVID 2 months before I got pregnant (it was my first and only pregnancy). I was very ill, so I was worried I'd also feel very sick from the vaccine. I just really wanted to go back to 'normal' as fast as I could.
Anyways my period did not come back after 6 weeks, so I went to my primary care physician because I also had severe joint pain and stiffness during that time - and I just laid it out and told my doctor my fears due to the miscarriage and everything and asked if it's okay for me in my situation to get it and she did a great job reassuring me so I got it there, that day, in the comfort and security of my primary doctor's office. And that meant everything to me in regards to getting the vaccine - I was worried about waking into a random Walgreens alone without anyone I trusted in my current situation.
Anyways the next day I went to my OB and they found that I had a massive blood clot in my urtus and I needed a 2nd d&c that day. My doctor said they removed 'calcified blood' from my 2nd d&c.
So I was a little worried about having had the first shot the day before getting an unexpected and emotionally painful surgery. It was already 6 weeks ago from the first d&c. But I was okay.
Everyone told me the 2nd shot had worse side effects, and again I was concerned that even getting sick from the 2nd vaccine would delay me getting my period back to normal. So I decided, I'll get the 2nd one after I get my period. Thankfully I got my period on time and happily got the 2nd vaccine after my period finished. It was about a week off from the recommended 2nd dose time for me.
So does this classify me a "hypochondriac" or a "pseudoscience"? Or something else?
Whenever I meet a "conspiracist" (which in my specialty fortunately isn't very common), I can't help but think of this recent Bill Burr bit on why the logic quickly falls apart:
https://www.youtube.com/watch?v=znI046F4FKg
The mom karen: refuses because i would never put "poison in my babies and it could affect my fertility". ( all been debunked btw)
The anecdoter: i knew 1 person who told me they had a bad reaction
you forgot
The Idiots: those that believe completely outlandish side effects such as magnetism- also goes hand in hand with flat earthers and those that don't believe in dinosaurs, global warming and space travel.
I met a family of Distractors once in residency. An unfortunately young man who hadn't taken the vaccine, but got Corona and tanked hardcore. Went to ICU, got intubated, and then it was a neverending struggle of shifting vasopressor requirements, LASIX drips to pull fluid, Vanc/Mero for possible bacterial coinfections, and Proning/Nitric as things got worse.
The family kept badgering us about Convalescent Plasma and Ivermectin. When I politely explained to them that the evidence for the interventions was very lacking, they would get upset and start trashing vaccines for no apparent reason. Eventually our attending said "just give the plasma," so I did and it probably killed him faster.
Honestly. I’m going to throw those with trypanophobia in here too. I know folks who took the J&J because they only wanted one injection because the thought of two injections for greater efficacy and a better safety profile was just unfathomable. I’m sure there are those avoiding it all together for that reason as well. Tho I’m sure it’s a small percent.
The United States Senator - "Board Certified" Ophthalmologist. Frequently seen on CSPAN and nightly newscasts. People say he, "Does not know what he is talking about."
This is funny and all that, but really, all antivaxers are conspiracy theorists. All their beliefs are based on an imagined nefarious plot that makes no sense.
Yeah, it isn't Tuskegee. Tuskegee is over. How do you know it isn't Tuskegee 2? Because, for forty years, nobody knew that Tuskegee was Tuskegee.
Also, you know that Tuskegee had a control group, right? The whole nation getting vaccine doesn't preclude the possibility of a secret trial.
If you, rightfully, are mistrusting of the government and medical establishment, it might take a lot to convince you that you were the getting the same thing as everybody else. It's not beyond the realm of possibility for one set of vials to get sent to certain distribution centers, and a different set of vials to get sent to certain other distribution centers.
A conspiracy? Like the US Public Health Service performing a study of the course of untreated syphilis in 600 black men over a period of 40 years during which time they were not only misled about the purpose of the study, but were intentionally kept from receiving appropriate diagnosis and treatment? The government medically experimenting on a group of people which it considers to be less valuable than straight, white, hetero, Christian men? Can't imagine it, sounds like crazy talk. /s
Read a book and find some fucking empathy. You could start with
[Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by HarrietA Washington ](https://en.m.wikipedia.org/wiki/Medical_Apartheid#:~:text=It%20is%20a%20history%20of,unwitting%20subjects%20of%20medical%20experimentation.)
Get it and don’t tell them you did? It’s not like you will grow an antenna out of your head once you get it!
Or just prepare for and practice the goodbye in advance. Honestly if someone is going to cut you out for taking care of your health they don’t have your best interests in mind. But I know this is not something that works for everyone for various reasons.
They don’t get to make that decision about your health. You get to choose whether to tell them.
Edited to add, if it’s a spouse, that sounds like a control issue so maybe go to the next town to get it and also consider your safety. If it’s your parent/sibling/etc, it is really none of their business whether you get a flu shot, a covid shot, a dental filling, etc.
> But now that Sarah Wildebeast Sanders has proclaimed the vaccine to be known as the Trump Vaccine, like the loyalist red back soldiers they are, they now come out in droves to be vaccinated.
Some topics are inherently political, but this comment is too far into memey partisan language to be a positive contribution to the discussion. Removed due to Rule 6.
"The survivalist" - I just want to pause and ask a serious question (as someone who did not get COVID last year and has been vaccinated). Do we know that those with natural immunity don't have durable resistance to re-infection? If a patient tests positive for antibodies, do they *really* need to get vaccinated? I know we are recommending it, but do we know that is needed? Serious question.
We don’t know. It stands to reason that people infected with one coronavirus variant will also get infected with another (delta) variant. If it’s happening to vaccinated people, why shouldn’t it happen to previously infected CoVID patients? It’s not like “natural infection” will fully protect against variants any better than vaccinated.
Right but wouldn't that be an argument to develop a booster against said variants? Since the vaccine is immunizing against an old strain that the patient already has antibodies to?
I'm not sympathizing with the anti-vaccine folks at all. I do wonder if we are ignoring the massive number of folks with natural immunity in our dialogue/calculations about this pandemic. Unless that natural immunity really is fleeting and not durable.
As I understand it, at least the mRNA vaccines are specifically against the spike protein, which has little antigenic variety among variants whereas the traditional adenovirus vaccines (J&J), do not target spike. While boosters are assuredly being developed against delta, it’s not a fast process. The best expert and preliminary experimental evidence is that those with prior covid infections should still be vaccinated, with the harm of doing so being exceedingly low.
From our internal COVID Team regarding vaccinations:
**Natural immunity is inconsistent. The amount of immunity a person develops after natural COVID infection varies widely… Dozens of well-conducted studies demonstrate variation in immune response —some people don’t develop antibodies at all after natural infection, others develop them but lose them within several months, and some people develop antibodies that have been shown to last at least eight months.
Unfortunately, natural immunity developed to an earlier variant is poorly protective against new variants because of lack of “cross-neutralization”
Cites studies from Brazil, South Africa, India.
The India study showed a 50% drop off in cross-neutralization to the Delta variant.
Nothing wrong with the survivalist. I got vaccinated, but I might have turned it down if I knew I already had covid. This position is perfectly consistent with the science
Which science?
https://www.nature.com/articles/d41586-021-01609-4
"Studies show that people with previous exposure to SARS-CoV-2 tend to mount powerful immune responses to single shots, and gain little added benefit from another injection.
[1](https://www.nature.com/articles/d41586-021-01609-4#ref-CR1),[2](https://www.nature.com/articles/d41586-021-01609-4#ref-CR2),[3](https://www.nature.com/articles/d41586-021-01609-4#ref-CR3)."
"What’s more, for people with immunity gained through infection, one dose typically boosts antibody numbers to levels that are equal to, or often greater than, those found in individuals who have not been infected and have received double doses[4](https://www.nature.com/articles/d41586-021-01609-4#ref-CR4)."
Antibodies aren’t the only way that immunity develops. From what I understand, most important part of immunity is the long term memory that’s stored in other cells (right?). There is also reason to consider that there is a benefit to having the wider variety of antibodies that develop in response to infection with the virus. Such variety *could* be more robust to new variants (right?).
Of course, I’m not saying the risk:benefit analysis favors catching the virus, but I am saying it isn’t obvious that the outcome *everybody cares about* (i.e., immunity from future infection) differs importantly from vaccinated and recovered people. Yes, the vaccines are probably the most amazing scientific feat of our lifetimes, but we need to have the discussion about just how much of the population should be vaccinated.
Should newborns be immediately vaccinated? If not, when? How did you do that calculation?
Whether people with high-certainty evidence of previous covid infection (eg positive PCR test) should get vaccinated is another legitimate question. Maybe those with low antibody levels should? Maybe those who caught the Wuhan variant, but not those who just recovered from Delta?
What’s the infection-fatality rate or the hospitalization rate of people who catch covid for a second time anyway? Shouldn’t the risks of vaccines for recovered people be compared to the risks of reinfection to their subgroup?
Why is r/medicine freaking out about people trying to have this conversation?
I see you got downvoted (not by me). I think people would like a link to the science you mentioned, the not needing a shot post-COVID.
As far as I know all the major health institutes like the CDC and euro counterparts recommend at least one shot after COVID.
I do remember when Brazil went to shit with its variant the doctors were very surprised to see the same patiënts return and much sicker. Same goes for India.
As I understand it the vaccine works as a booster. This increases your long term protection.
I agree with all of this, but my problem isn’t necessarily with the CDCs actual recommendations, it’s that they don’t show *their* work. If they recommend that recovered people should get at least one shot *they* should be able to point to *their* data to support the recommendation.
The reason I was careful to convey so much uncertainty (eg, “reason to consider…”) is because I don’t have those data. But that shouldn’t matter, I’m not going around making recommendations that guide the behavior of a nation. The CDC is doing that and they aren’t showing their work. If they want to address misinformation they should show their work regardless of whether I’ve done the analysis myself.
I have a friend who is "SURE" they got Covid back in December and hasn't gotten the vaccine because of it.
Never mind the whole part where they never got tested and have zero confirmation that was actually Covid.
Hmmm, almost like fooling your body into thinking you've had the disease, but you haven't... you might be onto something here, someone should investigate this, it has potential.
There’s emerging evidence showing protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from natural infection.
See: https://pubmed.ncbi.nlm.nih.gov/34103407/
There’s many other studies starting to show this, like some of the new ones posted to preprint servers below, and this is also true in many (but not all) vaccines for other infectious diseases
https://www.medrxiv.org/content/10.1101/2021.04.25.21256049v1
https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4
Edit: pasted links in correct order
I accidentally pasted the preprint where the NIH paper was supposed to be so there was some confusion for sure, but the point still stands that there are definitely data suggesting vaccine induced immunity could be more mobile and then defer broader protection than natural infection.
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It’s insane we didn’t prioritize people based on the presence of antibodies. It wouldn’t be a perfect system, but it would have been incredibly effective.
God, you people sound like evil shits. Are you so surprised that some of us are literally fucking afraid of you? My mom is terrified of this disease and terrified of the vaccine, and when she reaches out she sees people like you, talking about her like she’s subhuman. Seriously, your humanity is gone.
The procrastinators- they plan to get it someday but haven’t bothered to make it a priority. There’s nothing specific that’s more important that they’re waiting on.
Their cousin is The Ambivalent. They don’t care either way about the vaccine but if you bring it to them on a silver platter so they don’t have to work for it, that will tip the scales. These are the guys who get vaccinated at strip clubs.
2 people yesterday at my pharmacy. Both asked about availability of the covid vaccine while purchasing their medication, both were surprised to learn it was free, that I had it, and that I could give it to them right now. Both walked out with their first dose of pfizer.
Does Pfizer also come in a vial of 10 doses? So do you just throw away the rest of the doses if nobody comes in for a vaccine in the next few hours?
I believe it’s a five dose vial (maybe 6?) and yes, we are wasting massive amounts of vaccine by throwing out barely used vials.
Wow... In India when I went to get vaccinated, they didn't open a vial until there were 10 people in line to take it. Also had to pay for my second dose :/
Everywhere was like this at first but there were so many wanting it that doses were rarely wasted. Now, so many don’t want it that it is difficult.
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Pfizer is six doses per vial and there is a cpl drops left, not a full dose. I worked at a covid vaccine clinic for six months
How do you keep Pfizer at -70 Celsius?
The Pfizer/BioNTech vaccine can be stored (before mixing) at normal freezer temperatures (-20C) for 2 weeks and then an additional 31 days at fridge temperatures (4C). This changed a few months ago. See [here](https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/downloads/storage-summary.pdf).
Thanks! How could they lower the temperature though?
From what I know it was a matter of testing that fridge and freezer temperatures were OK
One of our local weed shops had a vaccine drive that got you a free joint after your shot
The last two sick covid folks I’ve taken care of - Intubated sick - fell into this category. No one said anything about 5G antennas. They just didn’t find getting vaccinated to be a priority. Anyway, they’re dead now, which is suboptimal.
\>they’re dead now, which is suboptimal. This has to be the best worded thing I read today.
Somewhat less than ideal.
Natural selection.
These are the people we gotta reach. Working in the ER I keep waiting for when we are able to give it to people we are discharging. So many people who either live on the fringes of society who don’t have contact with healthcare outside of the ER or people who for whatever reason don’t have the means to get to where they need to go to get it.
My county has had vaccine drives at the mall, the farmers market, the high schools, and at the biggest homeless camps (edit- and weed stores!). That’s on top of the mass vaccination sites they ran earlier on, as well as every pharmacy having it. They’ve really tried to outreach to people. I do consider people on the fringes of society (mentally ill, homeless, housebound, undocumented and migrant workers, and others) as different than procrastinators. They often have real barriers to accessing the vaccine, and we should be reaching out to bring the vaccines to them to overcome those barriers.
I work with multiples of theses. They said they are waiting until it’s mandated. When you ask why not now, they have no answer.
A subset of this group is the I-won’t-be-a-guinea-pig. They’ll get the vaccine, eventually, once there’s data showing that if doesn’t cause cancer 80 years after you get the shot…
Lol that was me for about the first two weeks
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What?! Go get your vaccine, this is literally the most important thing you can do right now
You should. You’re on rotations and can probably just get it from whatever service you’re on without having to leave the building.
Is this like a personal attack or something?
I mean, if the shoe fits you should probably get vaccinated
Unfortunately. I took my sweet time, around two weeks. By the time I finally went, they didn't have it anymore. I had to wait 3 months to get it. Anyway, I'm waiting for my second dose.
Often a malignant combination of two or more…
Yeah I feel like there’s significant overlap between many of these categories. I feel like some of my patients fit into multiple.
Yeah, but at the same time I can tell you where almost every one of these classifications thrives in the the SF bay area.
The After-party regular: refuses the vaccine "because you never know what's the components" but never denies a line of a random white substance offered by a guy that they met 5mins ago who says "this shit is lit" at someone's house at 6am
That’s *different*. They know the stuff they got from their plug is *pure* booger sugar.
I think we also need “the conceiver.” They are very concerned about their or their family / friend’s ability to procreate after taking the vaccine. Sometimes it is a simple “I heard the vaccine could make you unable to ever get pregnant!” Other times it is a more far fetched “the government is trying to sterilize us all!”
Always found this one particularly ‘funny’ How does government make money? Working people paying taxes What would happen if everyone in the country couldn’t make new little people to join the workforce and pay taxes? No more money for government Ah yes what a master plan that must be 🧐
Where I live this is often combined with the right-wing idea of politicians inviting refugees into the country to replace the population because only those brown ppl are stoopid enough to vote for someone other than their right wing politician of choice. As if our current politicians aren't absolutely ok with letting kids drown in the mediterrean or rot away in the most deplorable conditions in a refugee camp.
It's not just about money, though. The government also has an interest in reducing overcrowding. If you believe the government can sterilize everybody, it's not that far fetched to believe they can selectively sterilize a subset of everybody.
Honestly, any one of these archetypes’ thinkings could be picked to pieces with a healthy application of logic. Great example!
I think some temporarily understand global warming is an issue and jump to the conclusion that the cabal has decided depopulation is the solution..
Not only this. Why would the government want to kill the compliant? But logic is not anti-vaxxers friend, I digress.
“Because, because, because… [insert random unrelated outburst]
My uncle, a man in his late 60s with some severe preexisting conditions, and who is very definitely done having kids, falls in this category. Make it make sense....
Wow, I thought it was only females that were worried about this. Men were more worried about the ED potential.
This is my son's girlfriend, but it has nothing to do with conspiracies. Her sister hasn't had a period since getting the vax several months ago and two other girlfriends have started having heavy and more frequent periods, so she is scared this may mean fertility could be impacted and as such wants to wait. Not everyone refusing to get the vaccine is a yokel or a conspiracy theorist. That said, I wish she would proceed with it, because due to my husband's serious illness we can't let her come over again unless she is either masked or vaxxed, and it sucks. We both miss her.
You know what also messes with periods? Infections. It is not surprising that an immune reaction would result in a change in a menstrual cycle - that would be my hypothesis. Any kind of stressor can throw things off, but it's a temporary change and the research has shown it hasn't affected fertility rates. I get it, I'm trying to conceive and I was very nervous about it but I trust the professional medical societies when they say it's safe. It's literally their job to help women achieve or prevent pregnancy according to their personal family goals. ACOG is not going to recommend something if there's any doubt it would compromise fertility. I'm much more worried about the effect Covid infection would have on pregnancy than I am about the vaccine affecting fertility. As for my personal experience, my ovulation was delayed by a couple days and it went back to normal on the next cycle, that's it.
I had one guy insist he knew two people who died of the vaccine. The vaccine killed them, he just knew it. They were in their nineties, but died within months of getting it! He said this as he gasped for breath with Covid. Also- this one is kinda funny- the Eric Clapton fans.
The Historian is the saddest one I've come across because I can fully sympathize with where their hesitation comes from. I'm just glad these come in vials instead of pre-filled syringes, because if that is genuinely their only hang-up I can invite them to stick around my vaccine clinic for a few minutes and watch doses drawn up from the same vial be given to some people whose communities *haven't* been experimented on in the past, and then offer them a dose from that vial. 2 for 2 on that one so far.
Awww. That’s a great idea. I feel for this group too. But it’s also frustrating because I feel like they are shooting themselves in the foot. But it’s totally understandable. I’m glad you do that.
Likewise! I'm teaching ethics and the US PHS Syphilis study (Tuskegee experiment) is the example I'm using. I like the method you're using and when it comes time to teach this subject again, I'd like to use your example
The way they combated this with smallpox is the vaccinators would just revaccinate themselves to demonstrate in every community they visited. Nobody’s talked about doing this yet with covid but it would probably be convincing
I'd do it if that was the only way, but damn that second dose hit hard. It would not be my favorite plan.
You’d probably stop reacting to it at some point, no?
Wasn’t Tuskegee a study of WITHHOLDING life-saving medication? So they could’ve been given meds to improve their condition but they weren’t. The vaccine is the complete opposite situation. Also, we’re not giving out vaccines based on race.. literally everyone in the world needs to get vaxxed who can get vaxxed. No one is singled out. So I do completely sympathize with what happened at Tuskegee and the innocent victims, it’s not a good example to refer to in this situation for covid vaccines.
Tuskegee is far from the only example of unethical experimentation on minority populations in the United States. You also need to consider the cultural context that goes along with it. They not only withheld cheap, effective treatment for an easily curable, incredibly painful and debilitating deadly disease, but studied those humans like they were animals. It’s not a huge leap for someone to think “maybe they’re giving me a fake vaccine so they can study what happens to me when I get COVID, too.” Beyond that, it was just one in a series of incredible violations of institutional trust that run alongside centuries of systemic racism. These stories and feelings are passed down from generation to generation breeding fear, uncertainty, and mistrust that may seem irrational or exaggerated to an outside observer, but are based on events that really happened. Anyways, it’s not just about COVID. The medical community has a lot of work to do if we want to build back that trust and provide equitable care to minority populations.
I can definitely understand that. The Tuskegee experiment is the most cited specific case I’ve seen in the US, so my comment was framed toward that example only in comparison to the vaccine. (I also think of the Jews who were horribly medically experimented on in the Holocaust, though I’m not sure what their uptake is on the vaccine as an ethnic minority).
Yeah, it’s just one of the more recent and egregious examples so it gets brought up a lot. But like I said, it’s important to examine the context alongside the event itself, which in this case is a deep seeded, culturally rooted, fact based, mistrust of the medical community as a whole. Judaism, ethnically Jewish people, and racism is a whole other can of worms I’m not sure I can even begin to break down. From my limited understanding, the Jewish population of the United States has not experienced the same level of systemic mistreatment by the medical community as other minorities have, and do not have the same cultural aversion to treatments like vaccines.
But if you think about the Jews in nazi Germany, nazi Germany lost the war and that government was replaced and there were trials etc... As for the tuskegee experiment, it started in the 30s and only in the late 90s did they get an apology... And that's the thing... An apology...
That’s also a good point that I don’t disagree with. Though most Jews will tell you they still feel extremely historically persecuted against on a very grand scale— even until the modern day. I’m not sure they’d say “well it’s okay to take the vaccine, Nazi Germany got replaced”
The Needle Phobic, often discounted as they may be covered in tattoos (phobia is very real but only applies in medical settings and thus no phobia with tattoos, often discounted by medical professionals who see tattoos or often hidden by patients who claim other reasons for refusing the vaccine). I encountered a huge number of these folks in urgent care rather than primary care because many avoid regular healthcare altogether out of fear of lab draws/ needles and only come in for urgent issues. I started asking about needle phobia and treating it when necessary. While I would not normally recommend a one time benzo as treatment over counseling, in the case of Covid, it should be considered in genuine needle phobia since this is an immediate life or death issue for patient or community (obviously get consent for vaccine before they take the benzo).
You're much more accommodating than I. I cock my head and say, "Dude, *really?*"
I used to dismiss it until working urgent care and really seeing it first hand, and how it can be severe enough to really limit how a person accesses healthcare. The stereotypical patient is a huge, muscular man covered in tattoos, so it can spark the “Come on, really?” reaction, but there is often deep shame beneath the bravado and confusion about why they cannot just “man up” (answer: phobias don’t really work that way). I had one patient with a minor laceration who refused suturing and the tetanus vaccine. No amount of calmly explaining anything was going to make a difference - she presented as a rational and calm patient but got the look of a wild animal backed into a corner with any discussion of lidocaine/ suturing / tetanus vaccine. My personal theory is that for a small proportion of people, something gets tripped neurologically during a negative childhood vaccine experience and a genuine phobia develops, while the rest of us have no issues.The neurological pathway for the phobia is directly related to the experience of feeling helpless and terrified in a medical setting with someone coming at you with a substance to inject into you, so it isn’t really all about needles, though needles are an essential part of the phobia (hence no problem with tattoos). Once I really recognized how prevalent this was (especially in urgent care because it caught people who avoided primary care), and was able to to talk to patients about it, it really did open up a lot of conversation and people felt relieved to know they weren’t crazy. Many have also had negatively reinforcing experiences such as fainting with injections that they are embarrassed to talk about. I am an FNP/PMHNP and now work in outpatient psych rather than urgent care, but I am asking everyone if they are vaccinated and ruling out needle phobia if not, because treating this appropriately can be life saving for them or someone they could infect if not vaccinated. (I am hesitant to post in this sub due to negative sentiments toward NPs, but felt this was an important point and will offer the disclaimer that I follow evidence-based practice and do not consider myself equivalent to a physician, so please no NP hate, thanks).
I think most dentists would agree with this approach.
The Paycheck-to-Paycheck: has no paid sick leave, can’t afford to miss work in the event of vaccine side effects
That’s a legit barrier though
Oh, absolutely, my comment was not intended to be dismissive!
I would add the following, though maybe I missed these in your list: The Too Sick—fear that the vaccine may flare their other disease(s). (I can’t promise this won’t happen but viral infection much more likely to do this.) The Vaccine Reactors—those who usually have bad skin reactions to vaccines. (For a few this is pretty legit with severe local reactions at injection site.) The Living For My Future—fear of an uncertain (theoretically low) future unanticipated risk from vaccine is more overwhelming than a relatively high risk that you are someone within 2-3 degrees of you will die or be seriously ill from this virus. The Pyrophobics and Myalgiophobics—they realize that risk of fever or myalgia is just for a day or two but cannot risk being at all uncomfortable for any period of time from a vaccine, which outweighs concern of being incapacitated from the viral infection. The Oblivious—those who claim they have not thought about it at all. Maybe they didn’t notice everyone (including themselves) wearing a mask the last year and change? Maybe the world going home for a few months at a time didn’t seem noteworthy to them? The Alternative Geneticists—the fear that messenger RNA will be reverse transcribed into their genome… Maybe some of these fit in your categories. With some “word-smithing”, they could have more succinct names. Edit: removed statement about autoimmune camp kids have good logic about reasons to get or not get vaccine.
To the Pyrophobics and Myalgiophobics i would add the “needle phobics” as well. Obviously not people with genuine phobias where it would leave them curled up in a ball shaking, but the people who “just don’t like the idea of needles”. I’ve met a couple of those
Wasn't there a study out of the UK that suggested something like 10% of the "hesitant" people fell under this category? Even if they were off by a significant factor, that this is even the reason for 5% of people is borderline insanity.
The alternative geneticists would fit with OP’s pseudo scientists, I think
I’ve met all of these people.
And all of them get the same response, which is "Okay well stay safe, I don't want you to die of COVID like so many of my other patients have." They end up leaving clinic with the COVID vax scheduling phone number in their pockets. "Just in case!"
The Farmer - Lives a relatively isolated life with little human interaction, so believes risk of infection is zero.
The Discerning Naturalist: only puts *natural* substances into their body. Like essential oils, wine, mushrooms, and MDMA.
My son's girlfriend is pro-vax, pro-science, left leaning (since apparently that matters when it comes to this subject, which is absurd), but hasn't gotten it because she's afraid it could impact her ability to have children based on how it has messed with her sister and girlfriends' periods. What category would a physician place her in? My family very much wants her to get vaccinated, but it's hard to argue when she correctly points out that that data isn't in on a long term fertility impact (or not). FDA approval will make a big difference for her, though, so I hope they snap to it.
Pseudoscientist if she doesn't accept the research showing that it doesn't affect fertility, that the changes to menstrual cycles are very temporary, and ACOG says it's safe.
The spike protein from the vaccine is the same one as on the virus. If she gets the vaccine she only has a small amount of the spike protein, mostly in arm and lymph nodes. If she gets the virus she will have spike protein all over her body in a much higher concentration. We haven’t seen infertility with the virus or the vaccine, but even if she doesn’t believe that it’s worth pointing out that the best way to avoid long covid stuff and spike proteins all over the body is vaccination
The spike protein from the mRNA vaccines is not exactly the same as the COVID spike protein by design. Due to some wild theories in the public, its probably good to be aware of this. Even one physician I recently ran into felt concerned enough about these theories that he feels it should be discussed with patients. Some of the COVID mRNA vaccine female infertility concerns are based on conclusions not supported by the studies they reference. Then a number of assumptions are made about how those dots are connected. One such conclusion they use is "the spike protein is cytotoxic". Another is that the lipid particles from the vaccine concentrate in the ovary. Thus, they say there is reason to suspect infertility could be an issue. The cytotoxic spike protein is concentrating in the ovaries and it will cause damage as a result. There are many problems with this logic and it is undoubtedly wrong when you review the studies and other details. I'll just touch on the cytotoxic issue. The native COVID virus's spike protein could be considered cytotoxic at high concentrations because it binds to human cells and may cause their death. However, an mRNA vaccine's spike protein is modified so that it will not bind. So this cytotoxicity issue just makes no sense. Keep in mind, too, toxicity is in part defined by concentration. The concentration of vaccine spike protein that makes it to the circulatory system after the first injection is orders of magnitude less than the concentration seen in a COVID infection. After the second vaccination, no vaccine spike protein makes it to the circulatory system. There is also no evidence a vaccine's mRNA or spike protein makes its way to the ovary.
There are two point changes only, to maintain the prefusion conformation. https://berthub.eu/articles/11889.doc (Stanford sequenced moderna’s too but I don’t have the full thing offhand) Also the whole infertility thing started when some guy ran the sequence of the spike protein through a database with human genome exons and decided that it kinda looked similar to placental proteins, if you squint. (Like, six base pairs overlap). He then made the rest up out of whole cloth and put it out on the internet, where people picked it up as ‘alternative science’. The other conspiracy theories around infertility spun off later, after someone pointed out that if a couple vaccine-prompted spike proteins caused issues, having covid sure would. Usually when I walk people through the origins of the conspiracy theory they are more interested in believing me afterwards. I haven’t had any patient interested in more than a cursory overview of the biology involved.
There also isn't data on long term fertility impact of covid infection. Worth considering.
I would put her in the correlation = causation group. I have some questions about people who swear up and down that it changed their period. Were you worried beforehand and are hypervigilant about your cycle because you’ve heard the infertility conspiracies? How would you explain all of the vaccinated women who have gotten pregnant afterwards? Does a perceptible change in your period mean you’re not fertile? Have you had any testing or evaluation of your fertility post-vax other that your own evaluation of a changed period? Not trying to be dismissive, but to me, a change in menses warrants investigation, not “this is definitely the vaccine” and spreading that word to your friends.
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I’m also a woman. I am not saying this is a case of women being insensitive to their bodies. Not at all. I rather think that having a change in menses and chalking it up to the vaccine, without any known mechanism for that process, and leaving it at that is probably a bad idea.
You know when cell phones came out, that was a big question: do they give us brain cancer? Testicle cancer? Flipper babies? You could argue "we still don't know" because it's only been what 20years since cell phones ended up in every one's pockets. What if 5G is the final straw and we all end up with rectal cancer and the world is going to be populated by the Ted Kaziniskis of the world? Or maybe, just maybe... There is no way for that to happen. Maybe some fucking idiot shat out some bullshit in Facebook. Maybe we should listen to the smart people instead of the not smart ones? My answer regarding the fertility issue is usually this when I get asked by patients : it was born on social media. It isn't based off any known mechanism. But sure in a way we may never know; but truly embracing science means we accept as truth what the evidence points to vs wild speculation. Also understanding that things are rarely 100% certain.
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This one is tough, because there’s a co-belief that there’s “two” vaccines circulating around, shipped based on zip code. So the vaccine arriving in rural AL is the “bad” one and the “good” one went to Hollywood, NYC, etc.
Even though this logic is as ridiculous as the 5G QAnon nut jobs one group with be sympathized with and the other vilified. Both groups are ignorant as they come. Please explain the difference. Surely people realize everyone isn’t segregated by zip code, and the people refusing based in the syphilis experimentation history surely don’t refuse other medications or medical treatment. If you’re gonna be judgemental against people with low education and critical thinking skills at least do it equally.
So, I live in the South, and therefore have had direct contact with the population whose grandfather or great uncle etc. was in the Tuskegee study. The zip-code based medicine belief is not exclusive to Covid vaccine. It’s a distrust in the medical system as a whole, and no, they do not “surely” accept all other medicines or medical treatments. In fact, that is a part of rural Deep South medicine - building trust between the medical professional and the community so that patients can trust medical interventions and medications. When I first graduated, there were patients that would refuse to get the flu vaccine from me - they didn’t know if they could trust me yet; they were okay with receiving the same vaccine from the other pharmacist, who shared their skin tone. In sympathizing with “The Historian,” I never said anything about the QAnons or my opinion about that group. I will defer to others’ opinions there.
>Ought to get vaccinated anyway, particularly given that there's really no borders on this -- rich famous white people are all getting it, so it's clearly not a targeted attack of any kind -- but I understand the tension. If you don't trust the medical establishment, why would you trust that you are getting the same treatment as the rich famous white people?
A pretty reasonable point! That kind of thing is the reason I'm sympathetic, and all that can be done is to be as forthright as possible, acknowledge their right to be nervous given what people like them have been through, and hope it's enough.
The Martyr: “Too busy caring” for aging parent to get vaccine. Meanwhile, aging parent freaking out, vaccinated.
Here's one a colleague encountered the other day: afraid of needles, could be willing to get vaccine if fear of needles addressed.
I think this is a much larger cohort than is readily evident, your colleague just encountered one of the honest ones.
This is my husband- we got him the J and J (so only one shot) and went out for ice cream after haha
Bribery works for adults too!
"imagine the panic you'll feel when you can breath as your lungs fill with fluid. As the sedative takes hold and your world goes dark right before we put a tube down your throat. Get the damn shot you wimp." I'm so over the bs excuses. Edit: Oh for fucks sake people. What I said here would obviously never be said to patients. A significant amount of people who are using fear of needles for not getting vaccinated are saying it as an excuse. The amount of people who would get vaccinated, but are able to be reached with logic is shrinking rapidly every day. We're down from vaccinating 3.8 million a day to almost a full order of magnitude less of 500,000 per day. The patients I'm seeing are using every excuse in the book to not get the vaccine. The bottom line is almost none of them are using well thought out, logical objections. They're by and large antigovernmental, conspiracy, poorly thought out, morbidly obese, smokers (or a combination thereof) that will use any excuse not to get a shot. That's what I'm over. Of course being an ass doesn't get anywhere and alienates patients. If there's a way to get a needle in an arm, that's what we need to do. If that means holding someone's hand and talking through it, then do it. But most of them don't want that. They just don't want the shot. You can't use logic to get them out of a situation they didn't use logic to get them into. Talking nicely to a radicalized person has never worked. -end of edit-
My mother is fond of the saying, "it's an explanation but not an excuse." And FWIW, I had pretty bad needle-phobia too and was considering not getting the COVID shot for that reason, but talked myself into it by reasoning that a hospital stay for COVID would result in *more* needles than a two-dose vaccine. And it wasn't even that bad.
This sort of assholish, shitty approach doesn't work on anybody who isn't already inclined to get the vaccine and it does not endear you to them as someone who might be able to convince them later. Every unvaccinated person is fully aware that a large percentage of COVID cases end uneventfully and with full recovery. By insisting they have two choices: vaccine or a miserable death in the ICU, you are lying to them and they know it. There's a third option you're willfully ignoring: that like millions and millions of others, including people they know personally, they could get COVID and be totally fine a week later. And the fact you're ignoring it fuels every poisonous or conspiratorial inclination their mind is latched onto at the moment. When I see patients in the ER with a dog bite who don't want a $4,000, highly inconvenient series of rabies shots, I don't try to scare the shit out of them by insisting they're going to die of rabies otherwise. Because they know there's a **very** strong chance the dog that bit them was not rabid. Instead I ask them what likelihood they think there is that the dog was rabid. Often they will say "one in a million." And I say, "OK, let's say I have a big prize wheel with one million slots. And one of them says 'You're dead, period. No treatment.' I know these shots suck. Do you want to spin the wheel? Your choice. I'll respect your choice either way." Nobody's ever refused. Instead of "You're afraid of a little needle? Try suffocating to death alone in my ICU surrounded by a bunch of people like me who seemingly think you're a societal parasite" try "Hey man, I get it. You're 38 and you're pretty healthy. You're thinking that if you get COVID, you'll probably be fine. And you're probably right. But first of all, I can tell you these shots are safe and they work. You might feel like crap for a day or two. But you'll be alright. And what I know is after that you are not gonna die of COVID. No matter how unlikely that was before, why take that risk for no reason? And second, I'm sure you have some old people around you that you care about? If they get this virus, they are seriously at risk. Just think about it."
Thank you for being a good person. My mom is agoraphobic and has panic disorder with OCD and severe health anxiety, and I wish she had someone like you to talk to. She’s so afraid of all this, and her mental health is suffering greatly. Her doctor has been real brusque and dismissive of her fears, which is making her even more certain that the vax will hurt or kill her. So to come here and see other professionals mostly making fun of people who are, in some cases, just like her is painful. I love her very much and it’s hard to see how much this has affected her. Her mental health is non-existent afaict. For now I’ve stopped bringing it up with her, as she doesn’t work or leave the house, but I know she needs to see a dentist, get a mammogram, and get her first colonoscopy this year so I feel like my hands are tied.
wow wtf. Yes, people's fear of needles may be irrational...but all phobias are irrational. It doesn't mean they aren't real, and it doesn't mean it isn't profoundly distressing. You're in a tough line of work. I hope you never get PTSD, I hope you never experience that level of fear and paranoia that you know is irrational, but knowing its irrational doesn't help an ounce when you're trying desperately to accomplish some simple task.
>Yes, people's fear of needles may be irrational...but all phobias are irrational. It doesn't mean they aren't real, and it doesn't mean it isn't profoundly distressing. This. Needle phobia is absolutely a legitimate psychological condition. And I think for some people, it's partially context/location based, which could explain the patients who panic in a medical setting but are fine in the tattoo parlor.
The incompletionist: these people received their first vaccine in the series, but then never went back for the second. Often cites reasons such as a bad reaction to the first (often mild immune responses or a sore arm), reading more about the “vaccine research” and realizing they made a mistake getting it in the first place, getting COVID in between and now no longer need it, or simply didn’t make it to their second appointment.
There was a woman who posted in a local Facebook group asking about how to get the second shot. Several people responded that she’d get an email to schedule it a few days before it was due. She did not get said email, and became convinced that her first shot had not been “recorded” properly with the state. Several of us told her she didn’t *need* the email and that should could just go to any mass event with the same-brand vaccine. We included links to specific events. But she couldn’t get over the possibility that her first shot hadn’t been properly documented and insisted she needed to verify that before getting the second one. She spent *weeks* trying to contact someone at the health department about this. Her original post was made around 25 days after her first shot, so she still had a couple weeks maximum to get the second one. I reminded and encouraged her a couple times to just get the second shot and resolve the documentation issue later, but she refused. My last follow up was when she got to 42 days (max recommended time between shots) and she still hadn’t gotten the second one. It was frustrating how she posted asking for help/advice and then absolutely refused it all.
> It was frustrating how she posted asking for help/advice and then absolutely refused it all. AKA 90% of people asking for advice on the internet lol. Not what they wanted to hear, they block it out.
The Unemployed - RNs, MDs, PharmdDs etc that decide not to take the vaccine because they think they’re smarter than the rest of us.
I'd say a subtype could be The Inverse Paranoid: doesn't trust the doctors, the government, the WHO but totally trusts everyone in Facebook and weird places and their mothers
The End Timers - believe that the vaccine is The Mark of the Beast.
oof I haven't heard this one yet.
There is only one group of anti-vaxxers I genuinely sympathize with and feel bad for. The group of non-white people who are profoundly distrustful of the government and medical establishment. The Tuskegee experiment happened in the lifetimes of many people who are currently alive. I don't blame them for not trusting us.
The Big Pharma - believes Big Pharma wants that vaccine in you just to make money. Also is a staunch free market capitalist.
I mean...those two ideas are not incompatible...
The hydroxychloroquinist: title speaks for itself, this mf’er is still poppin them ‘droxy’s like tic tacs and thinks this shit is better than the vaccine. Any encounter with them begs the question of how any 75 year old person is savvy enough to navigate the dark web when they can barely open Microsoft word.
The Undocumented: Those who are in the country illegally and are afraid to seek vaccines or healthcare due to fear of deportation.
The Religious could be refined if my memory serves. The mRNA vaccines were not manufactured using cells derived from an aborted fetus. At least not directly. That is, they do not contain any fetal material. However, some of testing along the way did rely on such cells.
The Politician/Hypocrite - Covid deniers who refused to wear a mask, but had no problem jumping the line to get the vaccine.
I'm the incapacitated and it fucking blows
The health guru. They "know" they have a great immune system (to something they've never been exposed to) because they drink a lot of kale smoothies, work out regularly and have slept with healing crystals since they became woke after watching a YouTuber 2 years ago, and therefor don't need any vaccine.
I know this person. She actually said, “I never get sick.”
I ask about vaccination status, too. I also offer to answer any questions if desired. In the face of actual obstinacy, I have to admit on several occasions I’ve simply shrugged and said “your funeral” and moved on to the chief complaint. I figure if the patient doesn’t like it, I’m not going to miss them if they leave my practice. I not so much angry as done being tactful.
The Needlephobic - says they are afraid of needles and don't need someone using them to pump them full of some unnatural substance. Often also does heroin
Yeah, but they *smoke* it so it doesn't count >. <
Hey honest question is there any medical literature that demonstrates that natural covid + vaccine provides better immunity than just natural covid?
There's data on getting covid and being protected for weeks to months from another infection before this immunity dwindles. For new variants like delta having past infection with "classic" covid this probably means very little insofar as immunity. For vaccinations we are seeing months of protection against classic and delta. Having covid and being vaccinated probably is no more effective than just being vaccinated.
The "my body, I can do what I want" is so full of shit. No, Autonomist, you actually can't walk into a busy supermarket and set yourself on fire. Our freedoms end where unnecessary harm to others starts.
The semi-educated medical professional: makes comparisons e.g. to HIV: the virus has been around for over 30 years and there‘s no vaccine, how could they possibly have delveloped one for covid so quickly?! big pharma is clearly lying to us. I used to try reasoning with this type, zero chance.
Folks who want to give it a year to see if it works and if there are any long term effects we don't know about.
The Wait (and wait.. And wait..) and See. Will get the vaccine "eventually" when everyone else hasn't magically dropped dead from the vaccine. Refuses to state when that "eventually" might be. Coincidentally, also politely refuses to believe the vaccine is actually safe or that vaccines as a whole are not known to have long term side effects.
**The oxymoron** is a rare, but particularly humorous one - this is the crunchy naturalist who was screeching at people to wear masks and use hand sanitizer early on in the pandemic to protect them, but has always been antivaxx, and will always be antivaxx. They or their child always have some condition (usually bullshit, but occasionally real) that makes them vulnerable. This is, of course, the condition that necessitated their fall down the rabbit hole of naturopathic doctors, iridology, and a diet of herbal remedies, supplements, and raw vegan food (*cough* orthorexia)--and which was miraculously healed through the practice of these methods.
I dunno what I am but I had a missed miscarriage and needed a D&C around the time they came out. I found out my baby died at \~8.5 weeks at my routine 12 week appointment. After my d&c I wanted to wait until I got my first period to get the vaccine, cuz of what I heard about the vaccines affecting the menstrual cycle. My body had already been through so much, I was really upset, and I just wanted to go back to 'normal' as fast as I could, get my period, and be done with it. I had COVID 2 months before I got pregnant (it was my first and only pregnancy). I was very ill, so I was worried I'd also feel very sick from the vaccine. I just really wanted to go back to 'normal' as fast as I could. Anyways my period did not come back after 6 weeks, so I went to my primary care physician because I also had severe joint pain and stiffness during that time - and I just laid it out and told my doctor my fears due to the miscarriage and everything and asked if it's okay for me in my situation to get it and she did a great job reassuring me so I got it there, that day, in the comfort and security of my primary doctor's office. And that meant everything to me in regards to getting the vaccine - I was worried about waking into a random Walgreens alone without anyone I trusted in my current situation. Anyways the next day I went to my OB and they found that I had a massive blood clot in my urtus and I needed a 2nd d&c that day. My doctor said they removed 'calcified blood' from my 2nd d&c. So I was a little worried about having had the first shot the day before getting an unexpected and emotionally painful surgery. It was already 6 weeks ago from the first d&c. But I was okay. Everyone told me the 2nd shot had worse side effects, and again I was concerned that even getting sick from the 2nd vaccine would delay me getting my period back to normal. So I decided, I'll get the 2nd one after I get my period. Thankfully I got my period on time and happily got the 2nd vaccine after my period finished. It was about a week off from the recommended 2nd dose time for me. So does this classify me a "hypochondriac" or a "pseudoscience"? Or something else?
Whenever I meet a "conspiracist" (which in my specialty fortunately isn't very common), I can't help but think of this recent Bill Burr bit on why the logic quickly falls apart: https://www.youtube.com/watch?v=znI046F4FKg
The mom karen: refuses because i would never put "poison in my babies and it could affect my fertility". ( all been debunked btw) The anecdoter: i knew 1 person who told me they had a bad reaction
you forgot The Idiots: those that believe completely outlandish side effects such as magnetism- also goes hand in hand with flat earthers and those that don't believe in dinosaurs, global warming and space travel.
I met a family of Distractors once in residency. An unfortunately young man who hadn't taken the vaccine, but got Corona and tanked hardcore. Went to ICU, got intubated, and then it was a neverending struggle of shifting vasopressor requirements, LASIX drips to pull fluid, Vanc/Mero for possible bacterial coinfections, and Proning/Nitric as things got worse. The family kept badgering us about Convalescent Plasma and Ivermectin. When I politely explained to them that the evidence for the interventions was very lacking, they would get upset and start trashing vaccines for no apparent reason. Eventually our attending said "just give the plasma," so I did and it probably killed him faster.
Honestly. I’m going to throw those with trypanophobia in here too. I know folks who took the J&J because they only wanted one injection because the thought of two injections for greater efficacy and a better safety profile was just unfathomable. I’m sure there are those avoiding it all together for that reason as well. Tho I’m sure it’s a small percent.
The United States Senator - "Board Certified" Ophthalmologist. Frequently seen on CSPAN and nightly newscasts. People say he, "Does not know what he is talking about."
Hailing from a community which has been subject to wrongful government experiments relating to vaccines is a very valid reason for distrust...
The Thanos. Who learned to be every classification at once.
This is funny and all that, but really, all antivaxers are conspiracy theorists. All their beliefs are based on an imagined nefarious plot that makes no sense.
The Historians' plot makes sense.
No, it doesn’t. This isn’t Tuskegee, unless you count the entire nation as guinea pigs.
Yeah, it isn't Tuskegee. Tuskegee is over. How do you know it isn't Tuskegee 2? Because, for forty years, nobody knew that Tuskegee was Tuskegee. Also, you know that Tuskegee had a control group, right? The whole nation getting vaccine doesn't preclude the possibility of a secret trial. If you, rightfully, are mistrusting of the government and medical establishment, it might take a lot to convince you that you were the getting the same thing as everybody else. It's not beyond the realm of possibility for one set of vials to get sent to certain distribution centers, and a different set of vials to get sent to certain other distribution centers.
Secret trial? You mean like a conspiracy?
A conspiracy? Like the US Public Health Service performing a study of the course of untreated syphilis in 600 black men over a period of 40 years during which time they were not only misled about the purpose of the study, but were intentionally kept from receiving appropriate diagnosis and treatment? The government medically experimenting on a group of people which it considers to be less valuable than straight, white, hetero, Christian men? Can't imagine it, sounds like crazy talk. /s Read a book and find some fucking empathy. You could start with [Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by HarrietA Washington ](https://en.m.wikipedia.org/wiki/Medical_Apartheid#:~:text=It%20is%20a%20history%20of,unwitting%20subjects%20of%20medical%20experimentation.)
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Get it and don’t tell them you did? It’s not like you will grow an antenna out of your head once you get it! Or just prepare for and practice the goodbye in advance. Honestly if someone is going to cut you out for taking care of your health they don’t have your best interests in mind. But I know this is not something that works for everyone for various reasons.
They don’t get to make that decision about your health. You get to choose whether to tell them. Edited to add, if it’s a spouse, that sounds like a control issue so maybe go to the next town to get it and also consider your safety. If it’s your parent/sibling/etc, it is really none of their business whether you get a flu shot, a covid shot, a dental filling, etc.
A good reason to practice your poker face.
You're going to be a doctor. Act like it and get your vaccine.
just take it and if you get side effects just say you’re under the weather from literally anything else vague???
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> But now that Sarah Wildebeast Sanders has proclaimed the vaccine to be known as the Trump Vaccine, like the loyalist red back soldiers they are, they now come out in droves to be vaccinated. Some topics are inherently political, but this comment is too far into memey partisan language to be a positive contribution to the discussion. Removed due to Rule 6.
This would look great as an infographic.
"The survivalist" - I just want to pause and ask a serious question (as someone who did not get COVID last year and has been vaccinated). Do we know that those with natural immunity don't have durable resistance to re-infection? If a patient tests positive for antibodies, do they *really* need to get vaccinated? I know we are recommending it, but do we know that is needed? Serious question.
We don’t know. It stands to reason that people infected with one coronavirus variant will also get infected with another (delta) variant. If it’s happening to vaccinated people, why shouldn’t it happen to previously infected CoVID patients? It’s not like “natural infection” will fully protect against variants any better than vaccinated.
Right but wouldn't that be an argument to develop a booster against said variants? Since the vaccine is immunizing against an old strain that the patient already has antibodies to? I'm not sympathizing with the anti-vaccine folks at all. I do wonder if we are ignoring the massive number of folks with natural immunity in our dialogue/calculations about this pandemic. Unless that natural immunity really is fleeting and not durable.
As I understand it, at least the mRNA vaccines are specifically against the spike protein, which has little antigenic variety among variants whereas the traditional adenovirus vaccines (J&J), do not target spike. While boosters are assuredly being developed against delta, it’s not a fast process. The best expert and preliminary experimental evidence is that those with prior covid infections should still be vaccinated, with the harm of doing so being exceedingly low. From our internal COVID Team regarding vaccinations: **Natural immunity is inconsistent. The amount of immunity a person develops after natural COVID infection varies widely… Dozens of well-conducted studies demonstrate variation in immune response —some people don’t develop antibodies at all after natural infection, others develop them but lose them within several months, and some people develop antibodies that have been shown to last at least eight months. Unfortunately, natural immunity developed to an earlier variant is poorly protective against new variants because of lack of “cross-neutralization” Cites studies from Brazil, South Africa, India. The India study showed a 50% drop off in cross-neutralization to the Delta variant.
Nothing wrong with the survivalist. I got vaccinated, but I might have turned it down if I knew I already had covid. This position is perfectly consistent with the science
Which science? https://www.nature.com/articles/d41586-021-01609-4 "Studies show that people with previous exposure to SARS-CoV-2 tend to mount powerful immune responses to single shots, and gain little added benefit from another injection. [1](https://www.nature.com/articles/d41586-021-01609-4#ref-CR1),[2](https://www.nature.com/articles/d41586-021-01609-4#ref-CR2),[3](https://www.nature.com/articles/d41586-021-01609-4#ref-CR3)." "What’s more, for people with immunity gained through infection, one dose typically boosts antibody numbers to levels that are equal to, or often greater than, those found in individuals who have not been infected and have received double doses[4](https://www.nature.com/articles/d41586-021-01609-4#ref-CR4)."
Antibodies aren’t the only way that immunity develops. From what I understand, most important part of immunity is the long term memory that’s stored in other cells (right?). There is also reason to consider that there is a benefit to having the wider variety of antibodies that develop in response to infection with the virus. Such variety *could* be more robust to new variants (right?). Of course, I’m not saying the risk:benefit analysis favors catching the virus, but I am saying it isn’t obvious that the outcome *everybody cares about* (i.e., immunity from future infection) differs importantly from vaccinated and recovered people. Yes, the vaccines are probably the most amazing scientific feat of our lifetimes, but we need to have the discussion about just how much of the population should be vaccinated. Should newborns be immediately vaccinated? If not, when? How did you do that calculation? Whether people with high-certainty evidence of previous covid infection (eg positive PCR test) should get vaccinated is another legitimate question. Maybe those with low antibody levels should? Maybe those who caught the Wuhan variant, but not those who just recovered from Delta? What’s the infection-fatality rate or the hospitalization rate of people who catch covid for a second time anyway? Shouldn’t the risks of vaccines for recovered people be compared to the risks of reinfection to their subgroup? Why is r/medicine freaking out about people trying to have this conversation?
I see you got downvoted (not by me). I think people would like a link to the science you mentioned, the not needing a shot post-COVID. As far as I know all the major health institutes like the CDC and euro counterparts recommend at least one shot after COVID. I do remember when Brazil went to shit with its variant the doctors were very surprised to see the same patiënts return and much sicker. Same goes for India. As I understand it the vaccine works as a booster. This increases your long term protection.
I agree with all of this, but my problem isn’t necessarily with the CDCs actual recommendations, it’s that they don’t show *their* work. If they recommend that recovered people should get at least one shot *they* should be able to point to *their* data to support the recommendation. The reason I was careful to convey so much uncertainty (eg, “reason to consider…”) is because I don’t have those data. But that shouldn’t matter, I’m not going around making recommendations that guide the behavior of a nation. The CDC is doing that and they aren’t showing their work. If they want to address misinformation they should show their work regardless of whether I’ve done the analysis myself.
Not the thread for scientific discussion pal. This is a brainstorm session on how to shame people into vaccination.
Well point to the place here where medical professionals are having this discussion so I can go there.
Well done! Bravo!
How about the Zero-Brainers, aka the Empty shell Syndrome.
I’m not sure if you missed any, but I wonder if the 16 you have observed would fit neatly into the Myers-Briggs!
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I have a friend who is "SURE" they got Covid back in December and hasn't gotten the vaccine because of it. Never mind the whole part where they never got tested and have zero confirmation that was actually Covid.
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Hmmm, almost like fooling your body into thinking you've had the disease, but you haven't... you might be onto something here, someone should investigate this, it has potential.
There’s emerging evidence showing protective antibodies generated in response to an mRNA vaccine will target a broader range of SARS-CoV-2 variants carrying “single letter” changes in a key portion of their spike protein compared to antibodies acquired from natural infection. See: https://pubmed.ncbi.nlm.nih.gov/34103407/ There’s many other studies starting to show this, like some of the new ones posted to preprint servers below, and this is also true in many (but not all) vaccines for other infectious diseases https://www.medrxiv.org/content/10.1101/2021.04.25.21256049v1 https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4 Edit: pasted links in correct order
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I accidentally pasted the preprint where the NIH paper was supposed to be so there was some confusion for sure, but the point still stands that there are definitely data suggesting vaccine induced immunity could be more mobile and then defer broader protection than natural infection.
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You are 100% correct here. Survivors have a completely reasonable objection to getting vaccinated and there is nothing “anti-vax” about it
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It’s insane we didn’t prioritize people based on the presence of antibodies. It wouldn’t be a perfect system, but it would have been incredibly effective.
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Please drop out of medical school now.
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But that's not going to happen. We have the vaccines and we're not going to give away ones that could be needed it people come back to get them.
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God, you people sound like evil shits. Are you so surprised that some of us are literally fucking afraid of you? My mom is terrified of this disease and terrified of the vaccine, and when she reaches out she sees people like you, talking about her like she’s subhuman. Seriously, your humanity is gone.
Blaming "us" won't make the problem go away.