COVID19 mini-update, January 22, 2021: Israel vaccination progress; Pfizer side effects study; WHO quietly issues caution about RT-PCR with high replication counts

(1) Israel’s vaccination drive proceeds apace, with nearly 2.5 million people having gotten the first dose, and 900,000 having gotten the second dose. Progress by age bracket can be seen below, light green representing people who got both doses and dark green those who got first doses and are awaiting their second shots (3 weeks after the first).

Unless you are medical personnel, have pre-existing conditions that put you at risk (Hebrew uses the interesting term machalot reqa, “background diseases”), etc. the lower age limit for vaccination is 40. However, two HMOs, Clalit and Meuchedet, have informally lowered the age limit to 35 as their vaccination staff and logistics can handle the extra load; and hints have been dropped in the press that next week vaccination may be opened to all comers above 16. (Screening for allergies will continue, and wisely so.)

As we now have a significant cohort with two vaccination doses, I am awaiting hard numbers on protection effectiveness from a vastly larger sample than the Phase III trial. Stay tuned in about 3-4 weeks.

(2) Concerning side effects of the 2nd shot (generally stronger than the 1st), Ichilov Hospital released the results of a study on 1,735 of its own medical personnel.

Out of a sample of 1,735 medical workers, the hospital said nearly 37 percent of those vaccinated felt side effects. Of those who did [emphasis mine, NA], the most common was light pain in the injection area, which was reported by 51%. Another 32% said they felt localized pain that limited their movement, while 11% reported slight swelling, 5% localized redness and 1.5% paresthesia in the area of the injection. 86% did not take off any time from work.

Just over 3% contacted a doctor about side effects, and 0.28% (which would be 5 out of 1,735) visited an ER. 0.06% (i.e., one individual) reported temporary facial numbness.

Anecdotally, of the people in our social circle who’ve had 2nd shots, one was enough under the weather that she took a day’s sick leave. Pain at the injection site persisting 2-3 days seems to be fairly common, as is mild fatigue setting in several hours after administration. Mrs. Arbel had the pain but not the fatigue; I have another week and a half to go to my second shot.

In general, people who show up for vaccinations are screened for allergic reactions here — both by questioning and by checking their HMO records (which are fully online here and shared between the HMOs). This may account for our “adverse event”[*] count being lower than what has been reported from the USA and Norway.

There was earlier a report that former Chief Rabbi Israel Meir Lau (age 82) tested positive despite having gotten both shots — but the timeline appears to indicate he was likely already infected (by his wife, who contracted the active disease) when he got the 2nd. His son reported the rabbi is doing fine, not feeling ill. Did the vaccine block active COVID, or was he just lucky and would have stayed asymptomatic regardless? Beware of extrapolations from a single data point.

(3) Via a source on MeWe: To my surprise, the WHO issued revised guidelines for RT-PCR testing, and in particular caution against taking ‘positive’ results with very high Ct values [from my POV, anything over 32] as evidence of infection. (Testing centers here routinely go as high as Ct=40.) The revised guidelines also recommend that testing centers report the Ct value together with any positive result. This revision is long overdue and may bring back the ‘casedemic’ we have been seeing to somewhat more realistic proportions.

[*] In medical lingo, an adverse reaction that requires significant medical intervention — e.g., anaphylactic shock requiring an EpiPen.

UPDATE: with things in the US as hyper-politicized as they are, I understand Tom Knighton’s suspicion that the recent change in the way COVID19 cases in the US are counted, is just a little too conveniently timed .

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