Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Ahh, pathophysiology. Thanks.

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Interestingly enough both my husband and daughter got toes like this last year. No illness. We didn’t further investigate. I’m curious now.

Here is a study of vaccine effectiveness over time and by product in New York.

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I was very excited to hear the Molnupiravir results. It apparently works by introducing catastrophic mutations into dividing Covid19 viral particles, stopping them from propagating. However, I was a little concerned when I read that we need to be a little cautious as it could conceivable introduce mutations into dividing mammalian cells and cause cancer. Is this fake news? Any possibility that this could be true? If Tamiflu works the same way I would be less concerned.

Too early to say for sure. Luckily, vaccines are safe!
Merck says it does not cause genetic changes in human cells, but as you noted, there is potential to be mutagenic to host DNA, and requires further investigation. Merck asked heterosexual men in the study to abstain from sex and women of reproductive age to use reliable birth control while in the study. It may have teratogenic effects.

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Should add that I think this is standard for studies. But if there is a potential to be mutagenic to host DNA, I wouldn’t want to introduce to a developing fetus.

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I can’t help but be curious. Why do the men have to totally abstain from sex, while the women can continue with sex but just use good birth control? Why wouldn’t they both be asked to abstain, or both be asked to use good birth control? Seems funny.

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Interesting that they had to tell people being treated for COVID-19 that, since sexual activity means close proximity and therefore increased risk of giving the virus to the other person. One would think that people with COVID-19 would want to avoid giving such an unwanted gift to someone else.

I haven’t read the study, but I know it was a relatively small number of participants. Maybe single blind or double blind, so you don’t know which arm you’re in. Either way, I’m pretty sure people are still having sex during the pandemic.
The deleted post earlier was a letter I tried to attach from the American Red Cross sent to transfusion centers and hospitals in the US today. There’s a severe shortage of red blood cells and platelets nationwide. The Red Cross tried to get the word out and do blood drives but got only a modest bump, partly due to staffing issues. They’re suggesting that hospitals cut back on surgeries by 10%. Again this is nationwide, and expected to last at least through the end of 2021. Another casualty of the pandemic. Posting here to hopefully encourage donations.

Yes, but isn’t there a difference between having sex with someone who has no indications of having COVID-19 (though they might have it due to COVID-19 being contagious before symptoms) versus having sex with someone known to have COVID-19?

Well thank god I can’t speak to this personally but a significant number of people with COVID probably don’t want to have sex at some point anyway.
We don’t know but can assume that a large percentage of participants probably were having sexual encounters with people that were concurrently infected.

It would have nothing to do with giving Covid to another.

A teratogen is something that can cause or raise the risk for a birth defect in a baby.

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P09519

For men, sperm replace each other frequently. Any affected will soon die. For women, ovaries are always at risk so “no risk” isn’t possible, but only one egg develops each month (short of twins, etc).

If the medicine affects dividing cells, mitosis and meiosis could both be affected.

At least that’s the way I read it
 Of course, no sex during drug use is still better than birth control even on the woman’s side, so that’s odd.

A study about mixing and matching vaccines:

Page about mixing and matching vaccines, not specifically about the above study:

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A letter regarding a small study of immune responses (against the early WA1/2020 strain) over time for the three COVID-19 vaccines available in the US:

https://www.nejm.org/doi/full/10.1056/NEJMc2115596

So might it be a good idea to get a J&J booster after the initial round of Pfizer or Moderna
???

There is some speculation that, due to the varying effects on immune response that different vaccines give*, getting a different booster may stimulate a broader immune response. But that is mostly speculation.

*For example, the letter linked in post #3796 indicates that the mRNA vaccines appear to give better initial antibody response (but which declines substantially over time), while the J&J vaccine appears to give better CD8+ T-cell response. Of course, it is based on a very small study (by J&J people).

As mixing boosters appears that it might be approved soon, H and I are very heavily leaning toward Team Moderna this time (Pfizer first time). We just got our flu shots today, so the “next” one is on our mind.

Anyone have any thoughts or other news sources we ought to consider?

We’ve been contemplating the whole booster or not thing and have come down pro-booster for “this round,” as has our medical son. He got Pfizer as that was his only option.

Now it’s just “which one” for us? Our local pharmacy offers both. (J&J isn’t appealing to us.)

I gotta admit, one thing we like will be the different “chip” that should allow us access to all 5G towers rather than just Pfizer’s so the government can find us anywhere in the event we lose our cellphones. :sunglasses: (Creeklanders look at all aspects when considering something - and love humor.)

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Moderna is fairly similar to Pfizer, but with a bigger dose, which may be related to Moderna doing better recently against the Delta variant:

  • Moderna standard dose: 100 ”g of mRNA.
  • Moderna half dose: 50 ”g of mRNA.
  • Pfizer dose: 30 ”g of mRNA.

J&J is different in using the Ad26 vector virus. It appears to stimulate the immune system differently, with stronger CD8+ T-cell response, but lower initial antibody response. Medium to long term immune response may be more durable than with Pfizer or Moderna. However, people who were previously infected with actual Ad26 common colds (rare in North America, but more common in some parts of the world) may not get as much protection due to immune response destroying the vector virus before it can deliver its payload that induces SARS-CoV-2 spike protein production.

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I didn’t realize “mix and match” included mixing Pfizer and Moderna. The articles I see seem to be referring to following J and J with Pfizer or Moderna. I am still waiting for my 6 months to be up and if following Pfizer with Moderna is possible, I might consider it. The booster for Moderna will be half dose, 50mcg, versus 30mcg Pfizer.

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