Joe Biden: polls of approval and favorability

[pbrower2a]

(01-10-2022, 06:26 PM)Classic-Xer Wrote:

(01-09-2022, 01:23 AM)pbrower2a Wrote: ...as if you ever go by statistical evidence or science at any point, Clasic X'er.  Many of the differences on any social science between those who disagree on the most divisive issues disagree on moral values. You seem to believe in such a principle as "He who owns the gold makes the rules" and that people unlike you do not merit your trust. I am convinced that most of the ethical values that make life tolerable are well established, and deviations that we have accepted have been accepted only upon careful reflection that weighs consequences of the alternatives. The rightful relationship between asset-owners and people in need due to their humanity has yet to be fully solidified. A few centuries ago such was settled in this way: that the poor have responsibilities to the rich (the aristocrats who owned everything and had the power of life and death over everyone) and the aristocrats have none to the peons who are 100% expendable. When such was no longer enforceable only the aristocrats and their intellectual flunkies believed that -- if they were so inclined. Then came the French Revolution that shook the aristocratic ethos at its core, and finally the chaos of the Russian Revolution and the Second World War that led to the the annihilation of the aristocracy as a class. Some people thought that people could be literal possessions of others -- before the American Civil War made such an obvious absurdity.    

What do you mean? I've been going by statistics, the opinions of real doctors, real scientists, real experts and so forth who have been working on COVID, treating COVID, learning about COVID since the beginning and my own personal knowledge/experience related to COVID  the entire time.

This isn't easy reading, but I can derive only one conclusion from it: get yourself inoculated. This comes from the Journal of the American Medical Association, the industry group of genuine physicians, I don't know what doctors and scientists you consult, but I would stay clear of medical quackery. This article is available free, so try reading it.

Quote:As the US enters the third year of the global coronavirus pandemic, vaccination remains the most effective tool against infections and symptomatic illness. Layered on other public health mitigation tools such as testing and masks, vaccination is central to a larger strategy of control and management of COVID-19 as the pandemic shifts toward endemicity.1 However, emergence of new variants of concern, vaccine hesitancy, and barriers to global vaccine equity have created challenges to containing the pandemic.

While initial studies demonstrated that 2-dose schedules of both the Pfizer-BioNTech BNT162b2 and the Moderna mRNA-1273 vaccine had more than 90% effectiveness for preventing symptomatic COVID-19 infections, breakthrough infections due to the Delta variant of SARS-CoV-2 began to emerge in the summer of 2021.2 The more-recently identified Omicron variant is characterized by immune evasion with frequent symptomatic infections occurring among fully vaccinated individuals, prompting broad recommendations for booster doses to help counter waning immunity.3 Understanding how much protection vaccination provides against Omicron can help inform the need for other mitigation measures.

In this issue of JAMA, Accorsi and colleagues4 report findings from an observational study that estimated the association of receipt of 3 doses or 2 doses of mRNA vaccines (BNT162b2 or mRNA-1273), compared with each other and with no vaccination, with symptomatic SARS-CoV-2 infection, stratified by the Omicron and Delta variants among individuals in the US. This Centers for Disease Control and Prevention–led study used a test-negative, case-control analysis of 70 155 tests from symptomatic adults 18 years or older with COVID-like illness tested December 10, 2021, through January 1, 2022, by a national pharmacy-based testing program (4666 COVID-19 testing sites across 49 US states).

The study sample (mean age, 40.3 years; 60.1% women) included 23 391 cases (13 098 Omicron; 10 293 Delta) and 46 764 SARS-CoV-2–negative controls. Receipt of 3 mRNA vaccine doses was reported for 18.6% (n = 2441) of Omicron cases, 6.6% (n = 679) of Delta cases, and 39.7% (n = 18 587) of controls; prior receipt of 2 mRNA vaccine doses was reported for 55.3% (n = 7245), 44.4% (n = 4570), and 41.6% (n = 19 456), respectively; and being unvaccinated was reported for 26.0% (n = 3412), 49.0% (n = 5044), and 18.6% (n = 8721), respectively. The study results demonstrated that the likelihood of vaccination with 3 mRNA vaccine doses (vs unvaccinated) was significantly lower among both Omicron cases (adjusted odds ratio [OR], 0.33 [95% CI, 0.31-0.35]) and Delta cases (adjusted OR, 0.065 [95% CI, 0.059-0.071]) than among SARS-CoV-2–negative controls; a similar pattern was observed with 3 vs 2 doses of mRNA vaccines (Omicron adjusted OR, 0.34 [95% CI, 0.32-0.36]); Delta adjusted OR, 0.16 [95% CI, 0.14-0.17]). The relatively higher odds ratios for the association with Omicron infection suggested less protection (ie, corresponding with lower estimated vaccine effectiveness) for Omicron than for Delta, underscoring the ongoing need for a layered public health approach to prevention of SARS-CoV-2.

An important secondary outcome of the study by Accorsi et al4 was cycle threshold values among case patients, which is an imperfect but useful proxy for infectivity. Median N-gene and ORF1ab-gene cycle threshold values were higher among cases with 3 doses vs 2 doses for both Omicron and Delta (Omicron N gene: 19.35 vs 18.52; Omicron ORF1ab gene: 19.25 vs 18.40; Delta N gene: 19.07 vs 17.52; Delta ORF1ab gene: 18.70 vs 17.28). While the differences met statistical significance, it is unclear whether these small absolute differences are clinically meaningful.

The findings reported by Accorsi et al4 support the 3-dose schedule for mRNA vaccines currently recommended in the US for anyone older than 12 years (specifically, individuals 12 years or older can receive a booster dose of BNT162b2 and those 18 years or older have the option of receiving mRNA-1273 as their booster). However, the authors did not estimate the absolute effectiveness of the 2-dose schedule in their main analysis. This is important, as many countries continue to have an insufficient supply of vaccine. If a 3-dose schedule is indeed more effective, it would be informative for these countries to know whether a 2-dose schedule may still provide considerable protection against severe disease when vaccine supplies are limited. Accorsi et al4 do provide the ORs for the 2-dose schedule for symptomatic SARS-CoV-2 infection by month since second dose. These ORs indicate limited to no effectiveness of the 2-dose schedule against the symptomatic Omicron infection by 4 to 6 months after the second dose.

While the research on the Omicron variant is emerging, early studies suggest a few patterns. Several studies have estimated the effectiveness of various vaccines used around the world against the Omicron variant for the primary series as well as booster dose.5-8 However, only a subset of these studies had a hospitalization end point for the primary series and booster dose.5,6 In studies that compared the estimated vaccine effectiveness against the Delta variant with the effectiveness against the Omicron variant, the estimated vaccine effectiveness was lower against Omicron compared with Delta.6 For studies in which both primary series as well as booster vaccinations were evaluated, the estimated effectiveness of vaccination schedules with a booster dose was higher.5,7 The results from Accorsi et al4 extend this evidence to the US population.

While the data from the current study by Accorsi et al4 on vaccine effectiveness against symptomatic COVID-19 are informative, the report lacks data on clinical presentation and disease severity. From a public health planning standpoint, understanding vaccine effectiveness against clinically meaningful outcomes such as hospitalization, admission to the intensive care unit, and death in the Omicron era will be essential. Moreover, in many countries, including the US, the pandemic continues to be substantially driven by unvaccinated individuals. While it is useful to provide booster vaccinations, particularly to high-risk groups, only vaccinating those who are not yet vaccinated will result in sustainable control of COVID-19 and prevent additional morbidity and mortality. Moreover, the message that vaccines are indeed effective against severe outcomes, even with breakthrough cases of COVID-19, has gotten lost in recent weeks as the incidence of Omicron cases continues to rise.

The emerging evidence on the utility of booster vaccinations has global implications because booster recommendations likely mean diversion of additional supplies to high-income countries. If the evidence suggests that a booster vaccination is needed for protecting populations in high-income countries such as the US, which has seen catastrophic levels of COVID-19–related morbidity and mortality, ethical reasoning supports delivering boosters to populations in these countries.9 However, countries’ right to protect their own populations does not absolve them from their responsibilities toward global vaccine equity. Adequate vaccine supplies must be made available to ensure a high level of protection against SARS-CoV-2 worldwide. Not doing so maintains the circumstances to promote ongoing emergence of new variants of concern.

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Article Information
Corresponding Author: Preeti N. Malani, MD, MSJ, 4135F University Hospital South, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (pmalani@umich.edu).
Published Online: January 21, 2022. doi:10.1001/jama.2022.0892
Conflict of Interest Disclosures: None reported.
References

1.

Emanuel  EJ, Osterholm  M, Gounder  CR.  A national strategy for the “new normal” of life with COVID.   JAMA. 2022;327(3):211-212. doi:10.1001/jama.2021.24282
ArticlePubMedGoogle ScholarCrossref

2.

Del Rio  C, Malani  PN, Omer  SB.  Confronting the Delta variant of SARS-CoV-2, summer 2021.   JAMA. 2021;326(11):1001-1002. doi:10.1001/jama.2021.14811
ArticlePubMedGoogle ScholarCrossref

3.

Del Rio  C, Omer  SB, Malani  PN.  Winter of Omicron—the evolving COVID-19 pandemic.   JAMA. Published online December 22, 2021. doi:10.1001/jama.2021.24315
ArticlePubMedGoogle Scholar

4.

Accorsi  EK, Britton  A, Fleming-Dutra  KE,  et al.  Association between 3 doses of mRNA COVID-19 vaccine and symptomatic infection caused by the SARS-CoV-2 Omicron and Delta variants.   JAMA. Published online January 21, 2022. doi:10.1001/jama.2022.0470
ArticleGoogle Scholar

5.

Collie  S, Champion  J, Moultrie  H, Bekker  LG, Gray  G. Effectiveness of BNT162b2 vaccine against Omicron variant in South Africa.  N Engl J Med. Published online December 29, 2021. doi:10.1056/NEJMc2119270

6.

UK Health Security Agency. SARS-CoV-2 Variants of Concern and Variants Under Investigation in England: Technical Briefing 34. Published January 14, 2022. Accessed January 18, 2022. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1048395/technical-briefing-34-14-january-2022.pdf

7.

Ferguson  N, Ghani  A, Cori  A,  et al. Report 49: Growth, Population Distribution and Immune Escape of Omicron in England. Imperial College London. Published online December 16, 2021. Accessed January 19, 2022. https://spiral.imperial.ac.uk/bitstream/10044/1/93038/32/2021-12-16%20COVID19%20Report%2049.pdf

8.

Andrews  N, Stowe  J, Kirsebom  F,  et al.  Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant of concern.  Preprint. Posted online December 14, 2021. medRxiv. doi:10.1101/2021.12.14.21267615

9.

Emanuel  EJ, Buchanan  A, Chan  SY,  et al.  On the ethics of vaccine nationalism: the case for the fair priority for residents framework.   Ethics Int Aff. 2021;35(4):543-562. doi:10.1017/S0892679421000514PubMedGoogle ScholarCrossref

https://jamanetwork.com/journals/jama/fu...le/2788487

This is what peer-reviewed material looks like.
 

Quote:You guys have been going by whatever is being fed to you by those on  the Left, whatever looks good, sounds  or whatever viewed as beneficial agenda wise, whatever lowers fears or concerns relating to dying from it or whatever you think is beneficial to you or your life and so forth.

This time the Left is more reliably correct about a dangerous disease than you are. OK, from what I hear, physicians have their prejudices -- mostly about people whose habits get them into medical calamity. Smoking, alcoholism, drug use, severe obesity, unprotected sex with anything that moves... it's particularly difficult to get young physicians to specialize in liver ailments because most of those result from heavy drinking. I had an uncle by marriage who had stories about places that he went, and although the place-name changed, the last words of the story were "did I get drunk!" If I am in a strange place, then I certainly don't want to get drunk! (OK, that is cheap on my part because I don't hold liquor well anymore.  When I was in college I could have five drinks on a Saturday...one at 3, one at 5, one at 7, one at 9, and one at 11. That is over. 

Quote:PB, you are a partisan hack Left Wing  Democrat and that's about all you are and will ever be  at this point.

So? What does the current GOP have to offer me? I'm getting Social Security and disability payments that Democrats largely sponsored and voted for. I'm an industrial accident waiting to happen if I did industrial work. The GOP is for low wages and monopolistic organization of the economy, a raw deal for the vast majority of the American people.

On the other hand you are a typical crank.

Quote:BTW, you guys have done nothing to earn my/our trust the entire time you've been posting. I mean be honest, look/listen to all the crap you've been going along with or not questioning and supporting for your own benefit. You're kind of lucky that the entire American Right has been relatively patient and largely non violent so far.

Need I convince you?