Category Archives: Coronavirus

My Personal COVID-19 Vaccination Decision

The patient is wise to look away. If you watch the needle go in, it’ll hurt more.

I’m not a anti-vaccine. I’ve been vaccinated against polio, influenza, measles, mumps, rubella, and hepatitis B. I’m due for a Tdap booster (tetanus, diphtheria, pertussis) and will take it without reservation. Same with the flu shot this Fall.

I’m COVID-19 vaccine-hesitant. Regardless of what the Food and Drug Administration and CDC may say, all the available COVID-19 vaccines are still experimental because we don’t have long-term safety data. And judging from the recent Israeli experience with the Pfizer product, efficacy is also coming into question.

By “long-term data,” I mean at least two or three years comparing experimental groups with control (non-vaccinated) groups. And we need those data for children, pregnant women, and fertile women. Nicki Minaj would say we need studies on male fertility, too (a cousin’s friend got vaccinated, his testicles swelled and he became impotent, then his fiance called off the wedding).

I’ve been working full-time as a hospitalist for the last 20 years. I’ve been admitting and treating COVID-19 patients for the last 18 months. I was a “healthcare hero.” The hospital system in which I work plans to revoke treatment privileges of physicians who are not fully-vaccinated by November 1, 2021. Without such privileges, I can’t work in the hospital. I have seriously considered voluntarily relinquishing privileges or letting the system revoke them. If that happened, here are the options I considered:

  • Take a hospitalist job in another system (but all of them where I live have a vaccine mandate)
  • Look for a hospitalist job elsewhere, where the vaccine is not mandated
  • Take a few months off, hoping a shortage of physicians would induce hospitals to rescind the mandate and allow me to work
  • Monetize my blogs
  • Write more books (I have several ideas)
  • Start podcasting and monetize that
  • Work as an office-based internist, working for others or starting my own practice (many employers will have a vaccine mandate)
  • Concierge medicine
  • Direct Primary Care
  • Telemedicine (some employers would still mandate the vaccine)
  • Claim the religious exemption (but my hesitancy is all medical/science-based)
  • Retiring (BTW, I’m 66-years-old)

I love the work I do, I’m good at it, and it pays well.

I have health insurance via my employer. Although I could go on Medicare for my health insurance, I have several dependents that are insured through my employer. If I took several months off or retired, perhaps my dependents could get insurance if my very smart and capable wife took a job. She was offered a job that would pay 1/4 of what I make, and would require two hours of commuting, five days a week. We have some debts that must be paid.

I took the Pfizer/BioNTech jab on Sept 15, partly because I couldn’t get excited about any of the options above. Second dose will be Oct 6. I’m ambivalent about my decision. It’s practical, but I wonder if I simply lack the courage to take the freedom-fighter position of letting the system revoke my privileges and then facing the consequences. I believe adults should have the freedom to take or not take the vaccine after weighing the pros and cons. If I have a serious adverse effect from the vaccine, I hope it’s death and not long-term disability and being a burden to my wife and children. I’ll probably be OK. Pray for me.

Steve Parker, M.D.

FDA Advisory Panel Recommends Against Routine Pfizer/BioNTech Booster Shot

elderly man, face mask
To boost or not to boost, that is the question

The Pfizer COVID-19 vaccine primary series is two shots, three weeks apart. Since the vaccine is not as effective as hoped, the question before the committee was whether to give a booster at least six months after the primary series to everyone 16 years of age and older. The advisory panel, which does not set FDA or CDC vaccination policy, said “No.” The vote was 16 to 2.

The question for the panel thereafter was whether a booster would be OK or recommended (I”m paraphrasing) for 1) those 65 and older, and 2) those individuals at high risk for severe disease (e.g., one or more comorbidities). The answer was a unanimous “Yes.”

The 18 voting panelists were predominantly professors and/or physicians at well-known universities and medical schools.

For all the details of the Sept 17 meeting, see the eight-hour long affair on YouTube. I much appreciate the transparency. The committee is called The Vaccines and Related Biological Products Advisory Committee. Despite all the data presented, I recall no mention of p value.

The voting members considered two primary sources of data before voting on the two questions.

One source was a Pfizer study of only 330 vaccinated subjects who got the booster. Forty-four subjects were eventually excluded from analysis for various reasons. I would have rejected the study simply for the small sample size. We shouldn’t set policy for 330 million American citizens based on a study of 330 subjects unless the results are strong and unequivocal. IIRC, the average follow-up time of this study cohort was just 2.6 month. We got no report on how many infections, hospitalizations, or deaths were avoided by use of the booster. There wasn’te even a control group. Vaccine effectiveness was judged simply and only by a rise in neutralizing antibodies in the blood compared pre- and post-booster. Pfizer did monitor for short-term adverse effects, and they were no worse (maybe a little better) than with the primary series.

The various available vaccines likely have different adverse effect profiles

The other data considered by the panel were presented by two Israeli scientists or public heath officials (Ministry of Health), who spoke about the Israeli booster experience. Remember that Israel got about a three-month start on extensive population vaccination compared to most countries, yet they have very high delta variant numbers now starting around May, 2021. IIRC, the Israelis started boosting 60+ year olds only six weeks ago and soon thereafter added those 50 to 60, regardless of comorbidities. The Israelis shared data supporting the idea that the booster is effective against infection and severe disease, especially in those 60+. After 2.8 million booster doses, there were only 19 “serious reports” of adverse events (not necessarily related to the booster).

Only one person brought up the lack of long-term safety data, simply mentioning that some experts (even the FDA) recommend five to 15 years of follow-up for autoimmune disease and cancer for gene therapy products.

I don’t know how this advisory committee voted on the original Emergency Use Authorization (EUA). Surely the lack of long-term safety data would have come up then.

Approval of a therapy under EUA requires that no other safe and effective therapy is available. If ivermectin, fluvoxamine, or hydrochloroquine proved effective the EUAs for Moderna vaccine, J&J vaccine, and future EUA for the Pfizer booster would be invalid. No one uttered the words ivermectin, fluvoxamine, or hydroxychloroquine at this meeting. I guess that’s water under the bridge for them.

If the emergency vaccines turn out to be a huge mistake, I’m sure the committee members are immune to liability.

Steve Parker, M.D.

PS: Here’s an interesting video from Russell Brand:

U.S. Military Warrior Looking to Avoid the Jab? Listen to This

At JeffreyPrather.com. You have lots of company and many options.

Biden’s New COVID Control Plan Already Working!

It was a mere four days ago that Joe Biden announced his new plan to fight COVID-19. And it’s working like a charm. He scared that virus and it’s on the run. Way to go, Dear Leader Joe!

Here are the CDC’s daily case numbers since the start of the pandemic:

By my reckoning, the recent downtrend in daily cases started around August 31. Biden announced his new plan on September 9.

Steve Parker, M.D.

It’s a Small Club and You Ain’t In It: Biden Exempts Special People From Vax “Requirement”

The patient is wise to look away. If you watch the needle go in, it’ll hurt more.

From The Epoch Times:

On Thursday evening, President Joe Biden unveiled two executive orders that could mandate vaccinations for the CCP (Chinese Communist Party) virus for millions of working Americans in both the public and private spheres. But absent from these mandates are similar requirements for members of Congress, federal judges, or their staffers.

Biden’s executive orders would unilaterally require vaccination for federal employees, the military, and government contractors. The president also asked Occupational Safety and Health Administration (OSHA) to require that firms with over 100 employees either mandate vaccination or weekly CCP virus tests. In total, these mandates could affect over 100 million American workers, making it one of the widest-reaching vaccine mandates in world history.

Steve Parker, M.D.

Stop Worrying So Much About Delta Variant of COVID-19

A few days hence, the Biden administration will be announcing their plan to get the delta variant of COVID-19 under control. But look at the graph of “cases” published by the CDC and you’ll see that delta variant has already peaked. The fed.gov will be taking credit for the decline a couple weeks from now. That’s called leading from the rear.

Also from the CDC, this graph of deaths from March 1, 2020, through Sept 4, 2021. Either the virus is less virulent or we’re learning better how to treat it.

This virus is endemic now. The vaccines will not result in herd immunity because vaccinees catch the virus and spread it to others. That is, vaccinees are not immune. At best, the vaccines still prevent severe disease and death, but I await clinical proof of that. (Israel, Iceland, and Gibralter: share your numbers!) Expect another viral peak in December-January 2021-2022 in the U.S. We may even see a bump after the Labor Day gatherings.

Steve Parker, M.D.

h/t William M Briggs

Ohio Judge Compels Hospital to Give Ivermectin to COVID-19 Patient on Ventilator

intubation, mechanical ventilation, ventilator
Not Mr Smith

For Details, see Ohio Capital Journal on Aug 30, 2021:

A Butler County judge ruled in favor of a woman last week who sought to force a hospital to administer Ivermectin — an animal dewormer that federal regulators have warned against using in COVID-19 patients — to her husband after several weeks in the ICU with the disease.

Butler County Common Pleas Judge Gregory Howard ordered West Chester Hospital, part of the University of Cincinnati network, to treat Jeffrey Smith, 51, with Ivermectin. The order, filed Aug. 23, compels the hospital to provide Smith with 30mg of Ivermectin daily for three weeks.

A number of taxpayer-funded state authorities would not comment on the case. But don’t worry, they won’t miss a paycheck.

The article has a graph showing the number of ivermectin prescriptions dispensed from retail pharmacies in the U.S. from March 2019 to mid-August 2021. A large spike in prescriptions started in early July 2021, leading to almost 90,000 prescriptions in the weak of Aug 13.

Some pharmacists refuse to fill ivermectin prescriptions for COVID-19.

Steve Parker, M.D.

Ivermectin for COVID-19: What’s the Dose?

Photo by Anna Shvets on Pexels.com

Critics of the use of ivermectin for prevention or treatment for COVID-19 point out potential flaws in the supportive scientific studies. A few of these critiques are:

  • small size of experimental and control groups
  • lack of a reasonable control group; e.g., if everybody in the U.S. is vaccinated for COVID-19, we won’t have a control group to help us determine true long-term consequences of vaccination or lack thereof
  • not accounting for changes concurrent with the experiment; e.g., lockdowns, mask-wearing compliance, natural waxing/waning of viral surges
  • excessively complicated study design; e.g., using doxycycline or azithromycin or a steroid along with the ivermectin
  • the chosen doses of ivermectin are all over the map

The non-standard doses of ivermectin are maddening, but understandable. We’re trying to re-purpose a drug that’s already FDA-approved for several indications. Physicians already prescribe numerous drugs where the dose depends on age, weight, renal function, liver function, etc. Big Pharma spends millions of dollars per drug to figure this out when a drug is patent-able. But who’s going to pay for that when the drug is off-patent, like ivermectin? It’d be nice if the CDC or FDA did. We’re already a 18 months into this pandemic.

If ivermectin works at all for COVID-19, the dose for prevention may be different than for treatment. The following are some oral doses I’ve run across, mostly from positive clinical studies. “Kg” means body weight in kilograms. “Mg” means milligrams. If you can’t convert between milligrams and micrograms in your head, do it here. Many ivermectin proponents recommend starting treatment early, especially if there are co-morbidities.

Prevention of COVID-19

  • at least 150 microgram/kg per week
  • 12 mg (~150 microgram/kg) monthly or every 42 days

Treatment of COVID-19 Whether or Not Hospitalized

  • 200 to 1200 microgram/kg daily for three to seven days
  • 0.2 mg/kg (200 microgram/kg) on Day 1 and Day 3 (plus Days 6 and 8 “if not recovered”)
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)
  • 18 to 36 mg daily or every other day for between 1 and 5 doses (Drs Orient and Vliet with help from McCullough)
  • 0.4-0.6 mg/kg daily for five days or until recovered (I-MASK+ and MATH+)

Treatment of COVID-19 in Hospitalized Patients

  • 200 microgram/kg on Day 1 (plus 200 microgram/kg on Day 7 at physician’s discretion) (Broward Health hospitals study)
  • single dose of 0.15 to 0.4 mg/kg
  • 200 microgram/kg single dose
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)

See, doses vary wildly. And don’t ask me if dose should be based on ideal rather than actual body weight.

You probably know that you can often get ivermectin without a prescription. Many countries have decided it’s safe enough to sell over-the-counter.

I’m not recommending ivermectin to you or anybody else. I’m not your doctor. Only your personal physician who knows you, your lab results, your physical exam, and your medical history is in a position to recommend drug therapy.

Steve Parker, M.D.

COVID-19: Disappointing Vaccination Results in Israel

The various available vaccines likely have different efficacy and adverse effect profiles

Israel has a very high COVID-19 vaccination rate: 78% of those 12 and older are fully vaccinated, nearly all with the Pfizer/BioNTech product. Yet they’re having a major surge with the delta variant.

Remember, the EUA vaccines were sold to us originally as preventing severe disease and death. We know they don’t prevent much infection, if any.

An article at Science notes that: “As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older.”

Why the surge? One theory is that immunity conferred by the vaccine is waning over time. Israel is recommending a booster shot for those over 50 and six months past the original 2-shot vaccination.

The article concludes:

Yet boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” He says it’s also critical to vaccinate those who still haven’t received their first or second doses, and to return to the masking and social distancing Israel thought it had left behind—but has begun to reinstate.

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

Given the known and unknown risks of the vaccines, if I were one of the tyrants mandating vaccination I would rescind my order.

Steve Parker, M.D.

1976 Swine Flu Debacle: Any Parallels to the Current Pandemic?

It’s probably just a matter of time before YouTube disappears this video since it is subversive to the MSM and political narrative. Don’t focus too much on Guillain-Barre Syndrome. The important points are misleading propaganda, the hasty roll-out of the swine flu vaccine, government malfeasance, and apparent lying by a former head of the CDC. Enjoy!

I thank WordPress for not censoring me. I hope it’s not because my readership is so minuscule that I’m not on their radar screen!