Covid 19 vaccine

[elkoholic]

FYI.  In case you are planning to get vaccinated here is some food for thought.

Some info on the Pfizer vaccine and storage requirements which could affect whether or not it is going to have the desired results and/or safety.  There are very few facilities that have the required freezers capable of storing the vaccine at the recommended temperature of minus 94 degrees Fahrenheit (-70 degrees Celsius).  Dry ice would work short term but since sublimation occurs below minus 109.3 Fahrenheit (-78.5 Celsius) it does not provide long term storage.  In fact, very few facilities have the thermometers that can register that cold of a temperature.  It can be kept in a refrigerator up to five days and can not be refrozen.  Room temperature and it is garbage after two hours.

The Moderna vaccine on the other hand remains stable for up to 30 days at 36 to 46 degrees F and long term storage at -5 to -13 F (-15 to -25 C).

Both vaccines require two doses, with the second dose at 21 days for the Pfizer vaccine and 28 days for the Moderna vaccine.  Neither prevents one from getting the virus but instead the hope is to reduce symptoms, and you could still be a carrier.  At least it won't cost you anything directly as it is your tax dollars hard at work.

[wtnhunt]

Thanks for sharing Dave. 

So, have you got yours? 

Still on the fence here, Catrina says she will probably take it.  Her building gets it next week.  My cardiologist recommended getting it. 

Saw a story earlier today that 240 Israelis that had first dose of the pfizer vaccine had contracted covid.

[im your huckleberry]

With this mutated version that's  going around now and they are still testing to see if this vaccine will work on the next generation of covid kind of makes me wonder. New Years in Wuhan had streets pack full of celebrators so I'm  still not sure.

Edited January 2, 2021 by im your huckleberry

[elkoholic]

3 hours ago, wtnhunt said:

So, have you got yours?

I have not and will not get the vaccine.  I am not a fan of injecting a foreign substance into the body with no guarantee it will work and/or have no debilitating side effects.  Vaccines targeting viruses tend to have low success rates, possibly due to mutations in the viruses.  These vaccines are being pushed out to the public with little oversight in production and incomplete/inadequate testing.  The mRNA being used to trigger the immune response is very unstable and immunity (if any) takes weeks to develop and is apparently short lived.  At least it is being produced in the USA.

4 hours ago, wtnhunt said:

Catrina says she will probably take it.

Catrina may be forced by her employer to get the vaccine as will most healthcare workers.  If her building is receiving the Pfizer vaccine I hope they are also getting the special ultra-cold freezer required, which will cost between $10,000.00 to $15,000.00.

If one is not forced by their employer to get the vaccine they should make an informed decision and not just blindly accept recommendations.  Consider the fact that after a decade of the CDC pushing the yearly flu vaccine and millions of injections given, the morbidity and mortality from influenza has not declined.

[wtnhunt]

8 hours ago, elkoholic said:

Catrina may be forced by her employer to get the vaccine as will most healthcare workers.  If her building is receiving the Pfizer vaccine I hope they are also getting the special ultra-cold freezer required, which will cost between $10,000.00 to $15,000.00.

They are not forcing her to take it.  She said that most nursing homes in this area are using pharmacies like walgreens to administer the vaccine.  I would hope they do it right, but who knows.

With my heart situation declining a little faster than I expected and knowing I am likely looking at time in the hospital before covid is under control I am at a bit of a dilemma.  Go back to my cardiologist in January to setup heart cath of both sides of my heart to be done at Vanderbilt. 

Read that more than 1/3 of the patients at the local hospital now are covid patients.  They ran out of vents.  So major concerns of exposure risks at hospitals.

Cardiologist thinks the carvedilol I am on is fudging the imaging results from echo and ct.  Kinda sobering when lv ejection fraction has gone from 63 July 2019 to 50 back in early December 2020.  Root aneurysm has grown in the same time from 4.4 to 5 cm.

With all that being said, I am not eligible until March.  By then age group 55-65 are eligible, I will be 52 this year.  Seems there is little preferential towards cardio comorbidities when looking at the cdc guidelines and this states plans for distribution.  Strange to me since cardio and pulmonary are the primary places this virus is attacking that is fatal. But what should we expect from a cdc run by idiots like Robert Redfield....

[Turkeygirl]

I received mine and will be receiving my second dose in the next week or so. No one was forced to receive the vaccine at my facility. Also the concept of the virus mutating is not new...the flu virus mutates as well along with other viruses..it's just that this virus is so new and not much is known about it still...I dislike that social and televised media only create panic over concepts not new to medicine and healthcare.  I definitely understand the skepticism out there with the vaccine; make your choice based on what you are comfortable with but please make sure to listen to or read reputable resources as there is a lot of false information floating around on the internet and social media. I had my concerns as well BUT I did it if it means protecting my family, co-workers, patients, and community. Getting the vaccine or not getting the vaccine, there's some sort of risk no matter what.

[elkoholic]

5 hours ago, Turkeygirl said:

I had my concerns as well BUT I did it if it means protecting my family, co-workers, patients, and community.

I like that thought, but the vaccine does not prevent one from being a carrier, or from getting the virus.  It may reduce the severity of symptoms, but studies are showing very short term gain in immunity.  One thing is sure, there has been a lot of information put forth that has proven to be wrong.  Even creditable sources are presenting information based on incomplete/inadequate testing.

 

6 hours ago, wtnhunt said:

Cardiologist thinks the carvedilol I am on is fudging the imaging results from echo and ct.

Strange thinking there.  Carvedilol would change the imaging, but not in the direction it is headed.  It would slow the heart rate which should increase the ejection fraction and improve valve function.  That would lead to better cardiac output.  I would think that with the decreased ejection fraction you must feel fatigued a lot.  With the increase in aneurysm size along with decrease in ejection fraction I would suspect a down stream issue impeding blood flow, which put pressure on the aneurysm (increasing size) and decreasing the amount of blood that can exit the ventricle.  I would leave heart failure out of the equation based on the thought that if it were to weak to pump the blood from the heart it would not have the pressure to expand the aneurysm.   How's that for thinking?   

I do think you would be a prime candidate for the vaccine.  Hope it all works out for you.

[wtnhunt]

3 minutes ago, elkoholic said:

I like that thought, but the vaccine does not prevent one from being a carrier, or from getting the virus.  It may reduce the severity of symptoms, but studies are showing very short term gain in immunity.  One thing is sure, there has been a lot of information put forth that has proven to be wrong.  Even creditable sources are presenting information based on incomplete/inadequate testing.

 

Strange thinking there.  Carvedilol would change the imaging, but not in the direction it is headed.  It would slow the heart rate which should increase the ejection fraction and improve valve function.  That would lead to better cardiac output.  I would think that with the decreased ejection fraction you must feel fatigued a lot.  With the increase in aneurysm size along with decrease in ejection fraction I would suspect a down stream issue impeding blood flow, which put pressure on the aneurysm (increasing size) and decreasing the amount of blood that can exit the ventricle.  I would leave heart failure out of the equation based on the thought that if it were to weak to pump the blood from the heart it would not have the pressure to expand the aneurysm.   How's that for thinking?   

I do think you would be a prime candidate for the vaccine.  Hope it all works out for you.

We discussed changing back to a toprolol to try to put less strain on the root, but that increases strain to the heart.  Blood pressure on Metoprolol was a lot more erratic. The aortic valve on imaging was at 1.2 cm.  It is bicuspid.  The way I understand how carvedilol works, it increases how strong the heart beats while also lowering heart rate.  More blood moved with each beat, higher pressures.  That pressure is forcing the valve to open more than it naturally would if not medicated.  He thinks off medicine the valve would be closer to .9.  Time for replacement of the valve is typically at 1 cm and under.  It made sense to me the way he explained it.  Not in heart failure yet, but yes I stay fatigued.

As far as the vaccine, I am in agreement with you.  I would prefer not to take it.  But at some point have a feeling I won't have a choice.  Can hospitals make patients that will have to have a procedure done take the vaccine before admitting them.  Not far fetched to think the harris biden admin will push to make everyone take it eventually.

The cdc on their site last I looked had all cardio problems on one line.  The way I understood to meet their criteria as a person with high risk you had to meet criteria from two or more of the lines on the list.  About as clear as mud.  Will just keep doing virtual learning with our son and hope Catrina can avoid getting it.

 

[elkoholic]

6 hours ago, wtnhunt said:

The way I understand how carvedilol works, it increases how strong the heart beats while also lowering heart rate.

Carvedilol does not increase how strong the heart beats.  It blocks beta receptors to slow heart rate and it also blocks alpha receptors which allows blood vessels to relax and dilate.  Both of these actions should lower blood pressure and reduce the load on the heart.  Beta blockers can cause breathing problems, especially if a lung issue already exists.  Toprolol only blocks beta receptors to slow heart rate and allow coronary artery relaxation which would reduce strain on the heart, not increase it.  The medication used in the US to strengthen heart contractions is digoxin, and is usually used when the heart muscle is damaged and can no longer contract with enough force to push the blood out to the body.

8 hours ago, wtnhunt said:

The aortic valve on imaging was at 1.2 cm

With your ejection fraction where it's at you are certainly not moving a lot of blood out of the heart with each contraction.  It sounds like you have mitral valve stenosis as the normal valve diameter is 2.7 to 3.5 cm which would explain the low cardiac output as not enough blood is flowing from the atrium to the ventricle.  That in turn would cause pulmonary hypertension.  If stenosis is the problem then there are many factors to consider when deciding treatment.  Balloon valvotomy, if suitable, is the least aggressive, minimally invasive procedure.  I will assume you and your cardiologist have already discussed it and I am just guessing anyway.

[wtnhunt]

12 hours ago, elkoholic said:

If stenosis is the problem then there are many factors to consider when deciding treatment.  Balloon valvotomy, if suitable, is the least aggressive, minimally invasive procedure.  I will assume you and your cardiologist have already discussed it and I am just guessing anyway.

There is stenosis of my aortic valve, my reports all show my mitral valve is grossly normal.

The transcatheter valve replacement procedure was just recently approved for bicuspid valves. Won't know if I am a candidate for that until after I go to Vanderbilt.

Thank you for the explanations of how the drugs work, Dave.  I try not to overthink this stuff too much. fwiw In November 2020 I made a change from the cardiology group I had been going to, that is the same group that told me that the carvedilol makes the heart pump stronger.  I did kind of wonder how bp could drop but yield stronger pumping. New cardiologist is foreign but seems much more thorough and credible.  

By the time I am eligible to take the vaccine maybe there will be more confidence in it. Still don't know that I would take it.

Not that we have any choice, but if you had the choice and had to take one or another, which vaccine would you take?  The astrazeneca was given approval in India.

[elkoholic]

7 hours ago, wtnhunt said:

Not that we have any choice, but if you had the choice and had to take one or another, which vaccine would you take?

Based on current information I would go with the Moderna vaccine.  The reason being efficacy and storage requirements.  I am sure you will see several more options in the coming weeks.

I missed the the aorta valve part in your post, but my brain latched on to bicuspid, which would not normally be the aortic valve,which is usually tricuspid.  You are part of the less than 2% of the population with this condition.  It is better to address the problem before it progresses to the point of damaging the heart muscle beyond repair.  In other words, get it fixed!

7 hours ago, wtnhunt said:

I try not to overthink this stuff too much

As a pharmacist I would tell patients that they should know more about their medical condition than the doctor treating them, and that includes all medications prescribed as treatment.  No one can know it all, but taking ownership of what is happening in your body is the first step.  Doctors get locked in to thought processes based on what they see in practice.  Don't be afraid to ask questions.  

Before I get up on my soapbox I'll finish with:  Get the best information available and then make an informed decision.  Either a vaccine or treatment options, it does not matter, and try not to play the "what if" game.  From there, just live the best life you can. 

[wtnhunt]

27 minutes ago, elkoholic said:

Doctors get locked in to thought processes based on what they see in practice.  Don't be afraid to ask questions.  

I go with a list every time.  Next time I go in late January I will just hand him or the nurse my list.  One thing I really liked about the doctor I switched to is that he has meetings or conferences every week with other doctors to discuss cases.  He told me the names of the doctors at Vanderbilt he is sending me to for heart cath and said he will talk with them as well as cardiologists and surgeons at mayo clinic.  

27 minutes ago, elkoholic said:

Either a vaccine or treatment options, it does not matter, and try not to play the "what if" game.

Big part of what I am not overthinking.  Doing my research, but not getting myself worried over it.  I am not quite there yet, but I know aortic stenosis at severe stage has a very poor prognosis if not treated.  This doctor I am seeing now, unlike my last one, seems more aggressive than the lets just watch and wait approach.  Confidence in md's need a new thread. lol. Sorry for derailing this one a little of track.

India supposedly now has 4 approved vaccines.  Kind of interesting how these vaccines that our government says came from operation warp speed are being given in other places before here.

[Turkeygirl]

On 1/2/2021 at 3:20 PM, elkoholic said:

I like that thought, but the vaccine does not prevent one from being a carrier, or from getting the virus.  It may reduce the severity of symptoms, but studies are showing very short term gain in immunity.  One thing is sure, there has been a lot of information put forth that has proven to be wrong.  Even creditable sources are presenting information based on incomplete/inadequate testing.

 

Strange thinking there.  Carvedilol would change the imaging, but not in the direction it is headed.  It would slow the heart rate which should increase the ejection fraction and improve valve function.  That would lead to better cardiac output.  I would think that with the decreased ejection fraction you must feel fatigued a lot.  With the increase in aneurysm size along with decrease in ejection fraction I would suspect a down stream issue impeding blood flow, which put pressure on the aneurysm (increasing size) and decreasing the amount of blood that can exit the ventricle.  I would leave heart failure out of the equation based on the thought that if it were to weak to pump the blood from the heart it would not have the pressure to expand the aneurysm.   How's that for thinking?   

I do think you would be a prime candidate for the vaccine.  Hope it all works out for you.

Elkoholic...agreed, that is one of the concerns we have discussed at work in the hospital...that the vaccine does not necessarily mean one is 100% immune from the virus. and how long the vaccine immunity last, I have yet to hear a concrete time frame...I fear there could be a false sense of security with the vaccine....people need to continue to be cautious. So much yet to find out about the vaccine and questions to answer. I still take all the precautions necessary, even with having the vaccine, because we just do not know.

[wtnhunt]

2 hours ago, Turkeygirl said:

.I fear there could be a false sense of security with the vaccine....people need to continue to be cautious. So much yet to find out about the vaccine and questions to answer. I still take all the precautions necessary, even with having the vaccine, because we just do not know.

This may very well lead to more spread.  People who get the vaccine thinking they are good to visit others while being a carrier.  Sadly the cdc doesn't even know the efficacy or answers to these questions.  

[fly]

I was offered the vaccine (Moderna) by a local health facility. I'm a nursing faculty member. I'm still working on scheduling it, very limited time frames. I have not contracted COVID-19 (that I am aware of). I figure getting the vaccine may keep me from getting sick and feeling bad for a week. It may or may not reduce my chances of contracting the virus, but will likely keep me from coughing on things and thus spreading to others.

[elkoholic]

19 hours ago, wtnhunt said:

People who get the vaccine thinking they are good to visit others while being a carrier

Along with that thought there is the possibility that one was exposed to the virus before or after vaccination as it takes several weeks for the body to develop resistance to the virus and even then they can get the virus and be a carrier.

Also, the high rate of resistance reported is only after receiving both doses at the proper intervals.  The production of these vaccines is already falling behind schedule and if you received the first dose and due to a shortage could not get the second dose as required/recommended, you would have to start over with the first dose.  That scenario happened with the shingles vaccine, Shingrix.  At the pharmacy I worked at we would save the second dose with the patients name on it and call them when they were due for it.  Hence, you have to double production for each patient.

If you wondered why so many companies are working on a vaccine, well, it comes down to money.  Guaranteed payment from the government for each vial distributed, with Pfizer alone getting a reported 1.9 billion dollars.

[fly]

I received the COVID-19 vaccine yesterday at 9am. My arm is a little sore today (similar to a flu shot). No other symptoms experienced in the last 24 hours. Interesting that a physician in his 50s died about 2 weeks after receiving the vaccine. I believe it was thrombocytopenia (inability to clot blood). Will be interesting if they link this to the vaccine.   

[wtnhunt]

11 hours ago, fly said:

Interesting that a physician in his 50s died about 2 weeks after receiving the vaccine. I believe it was thrombocytopenia (inability to clot blood). Will be interesting if they link this to the vaccine.   

That is interesting.  Had not heard about that yet.  Did he have any underlying issues or on any meds that could have interacted?

It was the pfizer vaccine, and he was hospitalized within just 3 days of taking the vaccine https://www.miamiherald.com/news/local/community/miami-dade/miami-beach/article248337525.html. 

[fly]

Looks like he was pretty healthy William. Well, If I develop any bleeding issues I'll be sure to let everyone know.

https://childrenshealthdefense.org/defender/healthy-florida-doctor-dies-after-pfizer-covid-vaccine/

[wtnhunt]

57 minutes ago, fly said:

Looks like he was pretty healthy William. Well, If I develop any bleeding issues I'll be sure to let everyone know.

https://childrenshealthdefense.org/defender/healthy-florida-doctor-dies-after-pfizer-covid-vaccine/

Read a couple different articles about that Dr.  Would seem really unusual that this problem arose as total coincidence right after he got the vaccine.

Catrina gets her vaccine tomorrow, she said it will be the moderna.  

[fly]

The moderna has a 94.1% effectiveness while the pftizer has 95% (both after the second shot). However, the moderna is the preferred vaccine in my opinion. The temperature range it must be stored is wider than the pfitzer. If the vaccine is not temperature controlled it is not as effective.

[RangerClay]

I got my first Moderna shot the 7th.  Except for a sore arm I feel pretty good.

[Ravin R10 man]

Interesting listen;  Dont think I'm getting a shot after hearing this Dr.

https://radiopublic.com/-Wke5l8/s1!9719f

Edited March 27, 2021 by Ravin R10 man

[hoosierhunter]

There is a reason nearly every medical professional in the world has gotten the vaccine.
 

 It’s because vaccines work.

 

 I’m as conservative as it gets, but there’s way too many conspiracy theories out there about these vaccines running throughout the Republican Party...  This virus is like russian roulette and nobody knows who it’s going to get next.  Do your family and friends a favor and don’t be the naive one that doesn’t get vaccinated and then gets them sick or killed!
 

[Ultradog]

 

10 hours ago, hoosierhunter said:

"There is a reason nearly every medical professional in the world has gotten the vaccine.
 

 It’s because vaccines work.

  Do your family and friends a favor and don’t be the naive one that doesn’t get vaccinated and then gets them sick or killed!"

 

Now there is a dichotomy for you.

Let's say all of Mr. Jones' friends, family and neighbors get the vaccine but Mr. Jones does not.

If the vaccine actually works, how can he be putting them at risk?

 

 

 

Edited March 29, 2021 by Ultradog