How has the Pandemic affected you as a cancer patient/survivor

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  • chisandy
    chisandy Member Posts: 11,408

    Whose fault is it that American pharmacies have had to discard doses? Blame the COVIDiots. Don't penalize those of us who need those third shots by insisting we sacrifice them to other countries that don't have the ethics, personnel & mechanisms to equitably distribute them before they spoil. The effect would be the same as discarding them (though I suppose there'd a "feelgood" element of being able to say we altruistically and nobly tried and failed). We have plenty of doses to share, have been donating more of them than most nations of the First World combined, and are sending half a billion more. International moralists can't have it both ways: they can't tell us not to intervene in other conflicts abroad (especially in countries about whose cultures and traditions we are woefully naively ignorant) yet insist we take on the vaccine responsibilities other First World nations are shirking. Again, how do the ethicists and WHO propose we be able to divert the doses that the anti-vaxer "maskholes" are refusing, ship them abroad before they spoil, and get them into the arms of those in dire need of their first shots? I don't see them volunteering to do the "dirty work" much less subsidize it.

    Talk is cheap. Altruism without action is meaningless.

  • chisandy
    chisandy Member Posts: 11,408

    And the ideal should not be the enemy of the possible...but unfortunately (in both international public health and politics), for now it is.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    I didn't call for sacrificing third shots for those in need, altruism, or diverting doses.

    I didn't agree with you stating that other countries don't deserve help. Pandemic won't end without it.

    https://jamanetwork.com/journals/jama/fullarticle/...

    image

  • chisandy
    chisandy Member Posts: 11,408

    I never said the people of those countries "don't deserve" help. What I said was getting the doses to them, evading the corrupt dictators & warlords who control them, and into the arms of the involuntarily unvaccinated pose a logistical nightmare that may well be as of yet an insurmountable obstacle. And while we argue about and study & implement those measures, doses will continue to spoil and benefit nobody.

    Some may call me cynical--I prefer "pragmatic." It's pointless to flail around with no concrete plan as to how (nor the physical resources) to achieve results. Until we get the entire globe to herd immunity (preferably via vaccination), we will never defeat the pandemic. It's a noble goal, but may not be achievable. It sucks. It's cruel. But it's also reality.

  • chisandy
    chisandy Member Posts: 11,408

    Today The Lancet came out and said that giving first shots to the unvaccinated would be more effective than giving third shots to healthy adults. Well, duh. But how are those first shots going to be given to the vaccine-refusers & COVID deniers--round them up, hold them down, and jab them? And again, how would those first shots get to poor countries where they are so desperately wanted & needed? Are we to draft our healthcare personnel and send them over there--especially in light of our own shortage of nurses, certified assistants, pharmacists, and ICU doctors?

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    Getting vaccines into people in developing countries seems to have worked for polio and measles. Why not COVID? Rich countries are limiting exports.

    https://www.nature.com/articles/d41586-021-01762-w


  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    The vaccine mandates have increased the number of first doses. We need more mandates. No one is getting held down for the vaccine.

  • chisandy
    chisandy Member Posts: 11,408

    Overnight, the IL QANut woman who hung banners over highway overpasses while yelling died of COVID. While in the ICU she demanded ivermectin--and her followers picketed and made death threats against the hospital that refused to give it to her. Their leader, a notorious local anti-mask anti-vax attorney, is accusing the hospital of "medical murder" for not giving it to her. He's threatening to sue but--like the potential "bounty hunters" under the new Texas abortion law--he and that mob lack standing because they have no cause of action.

    Meanwhile, which heart attack patient or trauma victim could have put that ICU bed to better use? In Idaho, hospitals are preparing to have to triage--with willful unvaccinated status a possible disqualifier for COVID patients. And in another state, one county's hospital system has stopped delivering babies--not for a lack of beds but because their anti-mandate nurses are walking off the job rather than get vaccinated or even tested.

  • chowdog
    chowdog Member Posts: 190

    I hope Biden's vaccine "mandate" works. I love travel, but this has been the 2nd year that I sat out. My mother and I have this tradition of an annual mother daughter trip that we started when I was diagnosed with early stage BC. I hate to sit out another year. I was talking to a college friend last night, and he was saying " you can go to Canada now!" I was like "hmm, I really don't think Canadians want us to go. Scared".

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    There were anti-mandate protests called for in each province at a hospital today. My hospital was the protest site in QC. News report said there were 10 people. Losers. 🤣


  • alicebastable
    alicebastable Member Posts: 1,957

    Maybe the Covid distribution to underserved countries can be coordinated and distributed through Doctors Without Borders.

  • moth
    moth Member Posts: 3,293

    Doctors Without Borders/MSF is involved in covid care but there is already an intenational agency for the vaccine distribution to underserved countries. It's called COVAX. Canada donated a bunch of vaccines (but we still have spares - I think Canada contracted 10 doses/person)

    https://www.who.int/news/item/08-09-2021-joint-cov...


  • alicebastable
    alicebastable Member Posts: 1,957

    Thanks, Moth.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    The lack of vaccines is the main problem. No vaccines will be distributed to areas without the infrastructure to distribute them. Some countries are isolated enough with few cases that they can wait. Others have more demand than supply. Target those.

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,318

    I sadly must agree with Sandy’s gloomy outlook on vaccines donated to third world countries. And I am equally pragmatic. Afghanistan was the second country to host the Peace Corps in the early 1960’s. Many of them were involved in large scale vaccination programs especially in the provinces.Smallpox was still common at that time. Over the years the vaccination programs dwindled as local health authorities took over these functions. Manyin the provincial areas saw the vax programs fall apart completely or become major income sources for those administering the programs! Of course those vaccine preventable diseases came roaring back. Recent refugees have had to be quarantined due to a small measles outbreak. My heart hurts for those who yearn for change but Afghan society has to evolve on its own. I left my heart in Kabul.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    Ok. So no to Afghanistan. That sucks. How about this place?

    https://apnews.com/article/africa-kenya-atlanta-co...

    image

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    I've had a moment to think about giving up on vaccinating the world to beat the pandemic. Then I remembered that none of us is an infectious disease specialist or a vaccine expert. Dr. Peter Hotez is. He thinks it's important and vital, so I'll go with the expert opinion.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    To expand:

    We tell anti-vaxxers to listen to experts and cite our sources.

    I've cited the pandemic expert on vaccine diplomacy to beat the pandemic.

    exbrnxgrl - I applaud your Peace Corp service in Afghanistan, but it doesn't make you an expert in vaccinating all developing countries.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    I failed to mention this when I posted that there were 10 anti-mandate protesters outside my hospital in Montreal. In normal times there is always a protest here about something. Big protests. It's pathetic that they could only muster 10 people to protest the vaccine mandate for HCWs.

  • exbrnxgrl
    exbrnxgrl Member Posts: 5,318

    I agree however I have done some fairly extensive traveling through quite a few third world countries on almost every continent. Sadly, the essential structure of many are the same, i.e. authoritarian rule, graft and corruption at almost all levels of both the public and private sector. small upper class, minimal middle class, most in poverty and all of the attendant inequities that go along with such wealth imbalances.

    Though I wish that reality was different, and I am always hopeful it might be, there is an uglier side to humanity that I have been both horrified and privileged to know first hand.This is not negative, simply pragmatic.

  • Speattle
    Speattle Member Posts: 2

    Ugh, I am so sorry about the busted ankle! 3 years before my Cancer dx, I had a bad break in my foot. it too 2 major surgeries and a lot of hardware to put it together again, and about a year of my life was spent in a cast, and another year to get back to normal ambulation. I feel for you. it is very rough having that kind of mobility issue, and with the cancer and pandemic at the same time????? You have my totally sympathy.

  • aram
    aram Member Posts: 320

    In one third world country, yesterday, 1 million doses were administred. Not every third world country is Afghanistan without a stable state. And not every third world country is asking for donations or handouts. Rich countries are paying more to secure more vaccines and hoard them. Remember at the beginning US was not even giving Vaccines to Canada and Canada had planned and purchased all those vaccines well in advance. The result? While I was in chemo and vulnerable my healthy young US coworker got the vaccine and went to Hawaii.

  • Aram, yes, good point.

    On a per capita basis, Canada placed more orders for vaccines than any other country in the world. Canada got a lot of flack about that, but those orders were placed with the stated plan to donate all excess vaccines to COVAX. Where things got messed up early on was that Canada didn't get any vaccines. This was thanks to Trump, and then Biden, who continued what Trump had started. Trump mandated that all vaccines manufactured in the U.S. had to be distributed only to the U.S.. Sounds reasonable, right? Wrong, because this is not how global companies are set up. Global companies, including pharmaceutical companies, consolidate manufacturing to a limited number of sites which are each designated to supply a region, or to supply particular drugs or manufacturing components globally. Early on, there was a lot of angst in the Canadian media about the fact that we didn't have manufacturing sites for Covid vaccines (we do have sites that produce flu, diphtheria and tetanus vaccines but those use a different manufacturing process) and yes, political policy and decisions over the years may have had something to do with that, but it's also just how these companies work.

    When Canada placed orders with Pfizer and Moderna, under normal circumstances and with any other product, those orders would have been manufactured by Pfizer's and Moderna's plants in the U.S.. But Trump, and then Biden, put a stop to that. They interrupted the normal supply chain for those companies. So those companies had to scramble to figure out how to supply countries that normally would have been supplied from the U.S.. Canada is getting our Pfizer and Moderna vaccines from Europe - from manufacturing facilities that normally would have not supplied Canada. Naturally EU countries have priority over that supply. Unlike the U.S., the EU fortunately did not ban EU manufacturing sites from supplying countries outside of the EU - although at one point they considered it. This is the long story as to why Canada got off to such a slow start with vaccinations. The U.S. hoarded all American-based manufacturing, to the point of making it illegal for U.S. based manufacturers to ship outside of the U.S.. And of course, this didn't just affect Canadian supply of vaccines but global supply, including supply designated to go to COVAX.

    As an aside, from what I could find out, it appears that Pfizer have 42 manufacturing sites around the world, which gives them a fair bit of flexibility. Moderna have manufacturing at their site in Cambridge MA, and for all other manufacturing have contracted with a company called Lonza, who have plants in New Hampshire (which of course could only supply the U.S.) and Switzerland.

    COVAX... here is some information:

    Joint COVAX Statement on Supply Forecast for 2021 and early 2022

    "In the critical months during which COVAX was created, signed on participants, pooled demand, and raised enough money to make advance purchases of vaccines, much of the early global supply had already been bought by wealthy nations. Today, COVAX's ability to protect the most vulnerable people in the world continues to be hampered by export bans, the prioritisation of bilateral deals by manufacturers and countries, ongoing challenges in scaling up production by some key producers, and delays in filing for regulatory approval.

    According to its latest Supply Forecast, COVAX expects to have access to 1.425 billion doses of vaccine in 2021, in the most likely scenario and in the absence of urgent action by producers and high-coverage countries to prioritize COVAX. Of these doses, approximately 1.2 billion will be available for the lower income economies participating in the COVAX Advance Market Commitment (AMC). This is enough to protect 20% of the population, or 40% of all adults, in all 92 AMC economies with the exception of India. Over 200 million doses will be allocated to self-financing participants. The key COVAX milestone of two billion doses released for delivery is now expected to be reached in the first quarter of 2022."


    And here you can find a country by country status of vaccine distribution: COVAX vaccine roll-out: country updates

  • trishyla
    trishyla Member Posts: 698

    Thanks for that info, Beesie. I wasn't aware t that Biden had continued that Trump era restriction on vaccine exports.

    I will contact my representatives, both my Congresswoman and Senators, to ask them to support lifting the ban. If enough of us do that, we may get some action on it.


  • alicebastable
    alicebastable Member Posts: 1,957

    Moat of the information on supply and distribution seems to be from several months ago. I'm not sure of the issue with the vaccines coming from manufacturing plants in Europe - with any multinational company, products can come from any of their facilities on a supply/demand basis. Considering the U.S. has a vastly larger population than Canada, why wouldn't it make sense for local products to be used in the U.S. first, as long as the European facilities could keep up the supplies needed to other countries? It looks like the Canadian vaccine rate is higher than that of the U.S., so it doesn't seem like there was a shortage at any point.

    https://en.m.wikipedia.org/wiki/COVID-19_vaccination_in_Canada

  • trishyla
    trishyla Member Posts: 698

    was your comment meant for me, Speattle? If so, thanks for the sympathy. I'm doing much better after finally getting physical therapy. And I finished my active treatment in 2018, so fortunately didn't have to deal with that during the Pandemic.

    Hope everyone is doing well this beautiful Tuesday. We're finally having a break from our horrible heat. It's a lovely day here in Sunny California as we head to the polls to keep our very competent governor.

    If you haven't heard, there's an effort to recall our governor for doing all the right things during the Pandemic. He courageously shut us down early and provided a ton of financial assistance for citizens and businesses alike, as well as having the highest budget surplus in California history.

    The Trumpers behind the recall want to replace him with an anti mask, anti vaccine, whackadoodle radio talk show host. And they wonder why they can't win statewide in California.

    What a crazy, mixed up world we live in.

    Trish

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    There was a huge shortage before April. It was very frustrating to wait until the middle of April before we could get our first shots.

    image

  • sadiesservant
    sadiesservant Member Posts: 1,875

    And there were some longer term impacts due to policies, as there was another shortage of Pfizer in Canada in June at the time that I was approved for my second shot. As a result, I had Pfizer and then Moderna. While they say the coverage will be equivalent, there are many places that will not recognize my mixed dose status including much of the US. I had hoped that if things settled down I would be able to celebrate my 60th birthday in New York but that remains uncertain unless I get a third dose.

  • SerenitySTAT
    SerenitySTAT Member Posts: 3,534

    wrenn - The optimal delay between the first two doses of the mRNA vaccines is greater than the original recommended 3-4 weeks. According to this, it's around 9 weeks.

    https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001211

  • "I'm not sure of the issue with the vaccines coming from manufacturing plants in Europe - with any multinational company, products can come from any of their facilities on a supply/demand basis. Considering the U.S. has a vastly larger population than Canada, why wouldn't it make sense for local products to be used in the U.S. first, as long as the European facilities could keep up the supplies needed to other countries?"

    No, it wouldn't make sense, not if the American plants were designated within Pfizer and Moderna as being the supply sources for Canada. The American plants were built with capacity to supply the U.S., Canada, and maybe Mexico and some Latin American countries. The mandate by Trump/Biden put extra pressure on the EU sites, which were not supposed to be supplying Canada (and possibly these other countries) and couldn't keep up. Early on - February, March, April, even into May - Canada and many EU countries were significantly behind the U.S. in % vaccinated because of lack of supply. At a time when only those 65+ could get vaccines in Canada and many places in Europe, the U.S. had enough supply to open up vaccinations to all ages (of course, since they had all the vaccine production that should have gone to Canada and other countries normally supplied by the U.S. plants), and they were flooding drugstores with supply. I would watch the U.S. evening news every night with steam coming out of my ears.

    wrenn, yes, the reason that Canada's vaccination rate eventually (in May/June) jumped past other countries was the decision to give out as many first doses as possible before starting in on second doses. To be honest, I think that worked in our favour. From my reading, it's my understanding that a 3-4 month window between vaccine doses is generally believed to be optimal. With the Pfizer and Moderna vaccines, the recommended interval between doses was much shorter, but this was driven solely by the fact that they were rushing to market; in the clinical trials, to save time, they only tested the shorter interval. AstraZeneca did test both 4 week and 12 week 2nd dose intervals in their clinical trial, and 12 weeks was far superior. I seem to recall reading recently that a trial result came out on Pfizer at 12 weeks, and the results were improved versus having the 2 doses at the shorter (and officially recommended) interval. So despite not having specific information about Pfizer and Moderna vaccines, Canadian officials made their decision to delay second doses based on a lot of vaccine history. With AstraZeneca, they made the decision on 12 weeks for second doses based on the AZ clinical trial results.

    I don't know this for fact, but I suspect that part of the reason why the efficacy of the vaccines is fading so fast in Israel and U.S., both countries where they got 2nd doses into people quickly, is because those second doses were given at 3-4 weeks, versus a more optimal extended timeframe.

    Despite the major mess-up that was the vaccine roll-out in Canada, in the end I think I got lucky. At a time when only those 80+ could get a Pfizer or Moderna vaccine in Ontario, AstraZeneca (which did not have enough seniors in their clinical trial) was made available to those aged 60-65. That allowed me to jump the line and get my first dose sooner. 12 weeks later, by the time I was eligible for my second dose, I had the choice of AZ, Pfizer or Moderna. Based on several clinical trials that found that AZ followed by Pfizer was more efficacious than 2 doses of AZ or 2 doses of Pfizer, I opted for Pfizer as my second dose. Mixed doses appear to be better than 2 doses of the same. Check. 12 weeks between doses appears to be better than 3-4 weeks. Check. A double win for me, but only after a lot of frustration, thanks to the supply issues and very slow roll-out.



    Edited to add:
    SerenitySTAT, I had not seen that study. Very interesting. It appears that they are saying that the interval should be "at least" 9 weeks, with delays of anywhere from 9 weeks to 15 weeks being optimum. This is consistent with my earlier reading about intervals on other types of vaccines.