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I think one thing this thread doesn't touch on enough is the regionality of the way we think about health in this country. I touched on this last year after my move, but it was shocking going from an Ann Arbor office to Charleston the difference in health measures. Almost all of my coworkers in Michigan were in some sort of fitness regimen (crossfit, pilates, long distance running, biking, etc.), salad bar with tons of options & wipes at the desk to help cut down on germs during flu season. I move here and absolutely no one is in any of those things, they eat fried chicken & BBQ regularly, and almost everyone dips. They're professional and college educated, but it's obvious health is not a priority except among young people who want to keep their beach body. It's hard to pass those kinds of public safety measures and expect widespread vaccine use when health just isn't the priority you see in other areas of the country.

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20 minutes ago, nwohweather said:

I think one thing this thread doesn't touch on enough is the regionality of the way we think about health in this country. I touched on this last year after my move, but it was shocking going from an Ann Arbor office to Charleston the difference in health measures. Almost all of my coworkers in Michigan were in some sort of fitness regimen (crossfit, pilates, long distance running, biking, etc.), salad bar with tons of options & wipes at the desk to help cut down on germs during flu season. I move here and absolutely no one is in any of those things, they eat fried chicken & BBQ regularly, and almost everyone dips. They're professional and college educated, but it's obvious health is not a priority except among young people who want to keep their beach body. It's hard to pass those kinds of public safety measures and expect widespread vaccine use when health just isn't the priority you see in other areas of the country.

In my experience you can get as granular as you want with that. There is definitely regional differences but also city by city, office by office, group by group differences as well. Where I am now (Carmel) is definitely more active than OKC was but not nearly as much as NWA (Fayetteville) was. 

But I do agree with you. There is definitely a... difference of priorities? across different areas of the country. Even in regards to being work centric vs leisure centric, etc. 

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1 hour ago, schoeppeya said:

Lol. Because all black people are too poor to have cars and access to the internet, right? The mental gymnastics people do to make "inequality" an excuse for any race related stat is impressive.

It's far more complicated than that, but your racism is showing loud and clear.

Here's some relevant info that's a little dated (2006):

Quote

African Americans have the lowest car ownership of all racial and ethnic groups in the country, the researchers say, with 19 percent living in homes in which no one owns a car. That compares to 4.6 percent of whites in homes with no car, 13.7 percent of Latinos, and 9.6 percent of the remaining groups combined.

Reference: internet, the graph below speaks for itself:

254550924_ScreenShot2021-03-16at9_09_53AM.png.ffc4081978ebe168a51dd034791ffc93.png

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19 minutes ago, purduewx80 said:

It's far more complicated than that, but your racism is showing loud and clear.

Here's some relevant info that's a little dated (2006):

Reference: internet, the graph below speaks for itself:

254550924_ScreenShot2021-03-16at9_09_53AM.png.ffc4081978ebe168a51dd034791ffc93.png

You're going to pretend that even the worst smartphone somebody has in their pocket hasn't eliminated the case you're trying to make? You don't need home internet or a computer to make an appointment to get the vaccine. 

You forget about apps like Uber on those smartphones that also make the case you're trying to make irrelevant?

There are actual studies within the the last month that show African American's aren't getting the vaccine at higher rates because they distrust the vaccine/government. Here is one of them. A quick google search will turn up dozens more. 

https://www.psychiatrictimes.com/view/black-americans-distrust-covid-vaccine

What is incredibly degrading is that you really think African Americans aren't capable of setting up an appointment to get the vaccine and then coordinating a way to get there if they actually want it. So who is racist?

 

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31 minutes ago, dta1984 said:

Absolutely, if you are in the high risk category, you should be weighing the vaccine risk.   

No question, and I do think the slight risk of the vaccine is worth it for higher risk people because the virus is a tremendous threat to higher risk people. We've seen how many people have died. The statistics are overwhelming is showing that most people that get sick enough with Covid to go to the hospital have overweight/obesity/underlying health conditions. And unfortunately, that's the majority of the population in this country. So this vaccine is a great and extremely important thing. But we do have a smaller percentage of the population that's at much lower risk, and for those people it's worth weighting the vaccine risk vs the Covid risk.

 

The other week there was a debate on here about anaphylaxis reactions to the vaccine. Well since then, a new study came out that was published in JAMA on March 8th. It showed that anaphylaxis reactions were 22 times higher than what the previous CDC report had showed. In this study, on average 1 out of every 4000 people had an anaphylaxis reaction. That is SO much higher than other types of vaccines. Yeah I know they inject you with the epinephrine to save you, but it's still a horrible experience to go through. That is one of the reasons I am leaning towards not getting the vaccine when I become eligable. I have severe allergies with a history of bad reactions to things. I am allergic to penicillin and many medications and have broken out in hives and had my lips swell. So combine that with the fact that I'm at very low Covid risk, and not getting the vaccine can be considered a logical option. I talked with my primary care physician about this a few days ago actually, and she agrees with me. She talked about how I already had Covid and my body handled it easily (very mild symptoms that went away quickly) and that I continue to be at extremely low Covid risk due to much stronger than average heart/lungs and immune system due to the exercise program I'm on, and also that I have to be concerned about the higher amount of anaphylaxis reactions they're seeing with this vaccine since I have severe allergies. So she said I should consult with the allergist if I do consider getting the vaccine and I can weight the risks/benefits, and it's not a big deal if I decide to not get vaccinated since I'm at very low Covid risk and I don't have to worry about my parents since they're vaccinated.

 

So I definitely don't like hearing that people are selfish if they decide to not get vaccinated. There are plenty of people that have legitimate reason to not get vaccinated. People in the low risk group group can make a decision and it's not a big deal because most high risk people will be getting vaccinated. The pandemic will be coming to an end whether the 30% or so of people that are at low Covid risk get vaccinated or not. It will be going to a low level situation (an endemic similar to flu) that will not be a big deal and we'll be able to get back to normal life with a low amount of Covid circulating.

 

The thing that people that are not Covid vaccinated or concerned about other dangerous viruses popping up in the future can do is, simply get into shape. Because we know the studies are absolutely overwhelming on this. You look at a place like Vietnam, where they have a super low 18.3% overweight/obesity rate, and they have only 0.04 Covid deaths per 100,000. While the United States has one of the very highest overweight/obesity rates, 67.9%, and we have 152.49 Covid deaths per 100,000. You can go on and on with examples of countries with high obesity rates vs countries with low obesity rates. The statistics are absolutely overwhelming. Here is a quote from Dr. Tim Lobstein of the World Obesity Federation...

"We now know that an overweight population is the next pandemic waiting to happen," said Lobstein.

 

It's very sad that something like this horrific pandemic happened that didn't have to happen if most people kept themselves in shape, but of course tons of people die of heart disease for the same reason. Hopefully more people will take their health seriously in the future.

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14 minutes ago, winterwx21 said:

No question, and I do think the slight risk of the vaccine is worth it for higher risk people because the virus is a tremendous threat to higher risk people. We've seen how many people have died. The statistics are overwhelming is showing that most people that get sick enough with Covid to go to the hospital have overweight/obesity/underlying health conditions. And unfortunately, that's the majority of the population in this country. So this vaccine is a great and extremely important thing. But we do have a smaller percentage of the population that's at much lower risk, and for those people it's worth weighting the vaccine risk vs the Covid risk.

 

The other week there was a debate on here about anaphylaxis reactions to the vaccine. Well since then, a new study came out that was published in JAMA on March 8th. It showed that anaphylaxis reactions were 22 times higher than what the previous CDC report had showed. In this study, on average 1 out of every 4000 people had an anaphylaxis reaction. That is SO much higher than other types of vaccines. Yeah I know they inject you with the epinephrine to save you, but it's still a horrible experience to go through. That is one of the reasons I am leaning towards not getting the vaccine when I become eligable. I have severe allergies with a history of bad reactions to things. I am allergic to penicillin and many medications and have broken out in hives and had my lips swell. So combine that with the fact that I'm at very low Covid risk, and not getting the vaccine can be considered a logical option. I talked with my primary care physician about this a few days ago actually, and she agrees with me. She talked about how I already had Covid and my body handled it easily (very mild symptoms that went away quickly) and that I continue to be at extremely low Covid risk due to much stronger than average heart/lungs and immune system due to the exercise program I'm on, and also that I have to be concerned about the higher amount of anaphylaxis reactions they're seeing with this vaccine since I have severe allergies. So she said I should consult with the allergist if I do consider getting the vaccine and I can weight the risks/benefits, and it's not a big deal if I decide to not get vaccinated since I'm at very low Covid risk and I don't have to worry about my parents since they're vaccinated.

 

So I definitely don't like hearing that people are selfish if they decide to not get vaccinated. There are plenty of people that have legitimate reason to not get vaccinated. People in the low risk group group can make a decision and it's not a big deal because most high risk people will be getting vaccinated. The pandemic will be coming to an end whether the 30% or so of people that are at low Covid risk get vaccinated or not. It will be going to a low level situation (an endemic similar to flu) that will not be a big deal and we'll be able to get back to normal life with a low amount of Covid circulating.

 

The thing that people that are not Covid vaccinated or concerned about other dangerous viruses popping up in the future can do is, simply get into shape. Because we know the studies are absolutely overwhelming on this. You look at a place like Vietnam, where they have a super low 18.3% overweight/obesity rate, and they have only 0.04 Covid deaths per 100,000. While the United States has one of the very highest overweight/obesity rates, 67.9%, and we have 152.49 Covid deaths per 100,000. You can go on and on with examples of countries with high obesity rates vs countries with low obesity rates. The statistics are absolutely overwhelming. Here is a quote from Dr. Tim Lobstein of the World Obesity Federation...

"We now know that an overweight population is the next pandemic waiting to happen," said Lobstein.

 

It's very sad that something like this horrific pandemic happened that didn't have to happen if most people kept themselves in shape, but of course tons of people die of heart disease for the same reason. Hopefully more people will take their health seriously in the future.

Holy hell you mean you took the time to come to a thoughtful, researched, and doctor informed decision on whether you should take the vaccine or not? Somebody fry this man. 

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Just now, schoeppeya said:

Holy hell you mean you took the time to come to a thoughtful, researched, and doctor informed decision on whether you should take the vaccine or not? Somebody fry this man. 

All the biting sarcasm aside, that is a reasonable, educated decision to not get vaccinated. In fact, during the check-in process (at least locally) each individual is asked if they have had any reactions to medications or vaccines in the past and advise of the greater risks to those that have had past problems.

I think most of vitriol is aimed at those, and there are hundreds of thousands, whose only reason is political. 

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1 hour ago, dta1984 said:

It's pretty clear who is living in fear. 

4q5InYDvBTWgQRcQPRsoh1QzFUcu1-h3lgTuszGeXl8.jpg

At last check, I wasn't aware of anyone who was following the science and doing their part to combat the most severe pandemic in 102 years who was also wearing gas masks and holding up signs saying "The End is Nigh." I'll let you know if I see any.

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2 hours ago, schoeppeya said:

You're going to pretend that even the worst smartphone somebody has in their pocket hasn't eliminated the case you're trying to make? You don't need home internet or a computer to make an appointment to get the vaccine. 

You forget about apps like Uber on those smartphones that also make the case you're trying to make irrelevant?

There are actual studies within the the last month that show African American's aren't getting the vaccine at higher rates because they distrust the vaccine/government. Here is one of them. A quick google search will turn up dozens more. 

https://www.psychiatrictimes.com/view/black-americans-distrust-covid-vaccine

What is incredibly degrading is that you really think African Americans aren't capable of setting up an appointment to get the vaccine and then coordinating a way to get there if they actually want it. So who is racist?

 

I'm not pretending anything. This is all well-documented. I see your random internet article and raise you another random internet article with many, many valid counterpoints. 

https://fivethirtyeight.com/features/why-fewer-black-americans-are-getting-the-covid-19-vaccine-no-its-not-hesitancy/

 

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4 hours ago, dta1984 said:

Ya not sure he quite understands the distrust of the african american community against vaccines.  The vaccine mistrust is for a good reason.  Stan van gundy had an excellent response in an interview about this a few days ago.  I'll see if I can find. ..

As far as being selfish..... it's just weird to me that so many (non at risk) people are rushing to take the vaccine.  Vaccines have a typical 10yr trial period. You are now participating in a vaccine trial.    https://www.historyofvaccines.org/content/articles/vaccine-development-testing-and-regulation

So we all of a sudden develop a vaccine for a coronavirus that we have never vaccinated against in record time using a new method?  Hmm, just seems like being cautious about it should be the common sense thing to do.  Not being "selfish.".  

I understand that there has been a narrative about vaccine hesitancy in the black community which is why I found the survey results that I posted interesting.  It turns out that only 25% of black people in the poll linked above don't intend to get vaccinated vs 30% of white people.

This would support the primary issue being an access problem rather than a hesitancy  problem.

 

Back to the discussion of why people that have access to the vaccine choose not to. It's one of fear, selfishness or poor comprehension of risk vs benefit calculation which goes back to fear. And I suppose there's a handful of people deep in conspiracy land. 

@winterwx21 can you link to the JAMA article that you referenced about the anaphylaxis rates.

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4 minutes ago, mattb65 said:

I understand that there has been a narrative about vaccine hesitancy in the black community which is why I found the survey results that I posted interesting.  It turns out that only 25% of black people in the poll linked above don't intend to get vaccinated vs 30% of white people.

This would support the primary issue being an access problem rather than a hesitancy  problem.

 

Back to the discussion of why people that have access to the vaccine choose not to. It's one of fear, selfishness or poor comprehension of risk vs benefit calculation which goes back to fear. And I suppose there's a handful of people deep in conspiracy land. 

@winterwx21 can you link to the JAMA article that you referenced about the anaphylaxis rates.

Perhaps I missed it, but my issue with that poll, besides it being a small sample size, is the categories.  You're not capturing every african american in that "black" category right?  What about african american republicans or trump supporters or rural dwellers etc.  You can fit into multiple categories.  I didn't see how the "primary" category is determined. 

https://www.npr.org/sections/coronavirus-live-updates/2021/03/12/976172586/little-difference-in-vaccine-hesitancy-among-white-and-black-americans-poll-find

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8 minutes ago, dta1984 said:

Perhaps I missed it, but my issue with that poll, besides it being a small sample size, is the categories.  You're not capturing every african american in that "black" category right?  What about african american republicans or trump supporters or rural dwellers etc.  You can fit into multiple categories.  I didn't see how the "primary" category is determined. 

https://www.npr.org/sections/coronavirus-live-updates/2021/03/12/976172586/little-difference-in-vaccine-hesitancy-among-white-and-black-americans-poll-find

The poll I linked above said 35% wont take it or are hesitant. The one @purduewx80 quoted says 61% will get it. You start digging into the data on some of these and you can present it any way you want to, but its pretty obvious black people distrust the vaccine AT LEAST as much as white people, on average. The people who are upset about that are upset because it doesn't fit their narrative that the only people who distrust the vaccine are on the right. 

 

 

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Looking at case trends many states are either basically flat or dropping slowly at this point. A couple of states are up a bit (Michigan being the most notable). I am guessing there may be a few states with short term jumps in numbers like Michigan, but the combination of greater vaccine uptake and moving into Spring should result in further downward case trends in about a month. Hospitalizations/deaths should keep falling even if cases jump a bit in the short term.

 

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20 minutes ago, mattb65 said:

I understand that there has been a narrative about vaccine hesitancy in the black community which is why I found the survey results that I posted interesting.  It turns out that only 25% of black people in the poll linked above don't intend to get vaccinated vs 30% of white people.

This would support the primary issue being an access problem rather than a hesitancy  problem.

 

Back to the discussion of why people that have access to the vaccine choose not to. It's one of fear, selfishness or poor comprehension of risk vs benefit calculation which goes back to fear. And I suppose there's a handful of people deep in conspiracy land

@winterwx21 can you link to the JAMA article that you referenced about the anaphylaxis rates.

You must be in a pretty successful position in life seeing as how you have all the answers to why strangers make the decisions they do.  

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3 hours ago, schoeppeya said:

You must be in a pretty successful position in life seeing as how you have all the answers to why strangers make the decisions they do.  

I'm a physician,  it's literally my job to review the medical information and assess the risks and benefits or a particular intervention to make a treatment recommendation. Ultimately it's the individual's decision to follow the advice or not. 

I think the @winterwx21 scenario is interesting.  Since he already had covid I would say putting off the vaccine is a reasonable decision considering all of his individual factors but once we know more about the durability of the immune response to infection it'll be important to consider making a different recommendation if vaccine boosters are needed. I'm a little curious why his medical recommendation changed from it coming from his cardiologist to now coming from his primary care.

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4 minutes ago, mattb65 said:

I'm a physician,  it's literally my job to review the medical information and assess the risks and benefits or a particular intervention to make a treatment recommendation. Ultimately it's the individual's decision to follow the advice or not. 

I think the @winterwx21 scenario is interesting.  Since he already had covid I would say putting off the vaccine is a reasonable decision considering all of his individual factors but once we know more about the durability of the immune response to infection it'll be important to consider making a different recommendation if vaccine boosters are needed. I'm a little curious why guys medical recommendation changed from it coming from his cardiologist to now coming from his primary care.

Fair. I just don't specifically buy into "if someone doesn't get the vaccine it is because they are selfish/too dumb to understand risk/reward". And I don't think taking that stance promotes a healthy dialogue around the vaccine, which is something that could end up convincing somebody who actually needs the vaccine to get it. Actually,  I know for a fact that type of rhetoric stops people from getting it.  

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1 hour ago, schoeppeya said:

Fair. I just don't specifically buy into "if someone doesn't get the vaccine it is because they are selfish/too dumb to understand risk/reward". And I don't think taking that stance promotes a healthy dialogue around the vaccine, which is something that could end up convincing somebody who actually needs the vaccine to get it. Actually,  I know for a fact that type of rhetoric stops people from getting it.  

That's fair too,  I would never talk to a patient like this either. If you go back a few pages I did go through in detail the risks and benefits which is how I'd discuss it on an individual level. Ultimately it's the individual's decision. 

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Hospitalizations are starting to go back up in Michigan, so between cases/hospitalizations, they are definitely bucking the national trends.  Given increasing vaccinations, you'd hope that the number of hospitalizations would be less for a given number of cases than what it was in the past.

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29 minutes ago, Hoosier said:

Hospitalizations are starting to go back up in Michigan, so between cases/hospitalizations, they are definitely bucking the national trends.  Given increasing vaccinations, you'd hope that the number of hospitalizations would be less for a given number of cases than what it was in the past.

My county has been averaging about 20 neaw cases a day for the past week after being in the single digits for weeks prior. A lot of the local schools are having more cases lately, one has a supposed couple dozen positive cases. People locally are blaming the winter sports and the traveling school to school in spreading it. There was also confirmed uk strain in the neighboring county in a child so people are also wondering if that could be the causes of the seemingly easier spread lately. 

Our local Wal Mart tire and lube is closed also after one worker tested positive and after reviewing security can footage management determined no one in the department was following mask protocol and thus now everyone is quarantined...

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