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Sunday, May 23, 2021

Covid 38, Dr. Agbayani debunks Dr. Salvana vax pushing

I am reposting here a Viber post by Dr. Benigno “Iggy” Agbayani Jr., President of the Concerned Doctors and Citizens of the Philippines (CDC PH, https://cdcph.org/). 

A few days ago, Dr. Edsel Salvana, the most high profile medical consultant of IATF on indefinite lockdown and vaccines, posted 10 points about the vaccines. This meme is from one of the lectures of Doc Iggy. 

Doc Iggy and his former Professor at the UP College of Medicine, Dr. Romy Quijano, have a great discussion about herd immunity, vaccines, lockdowns, Ivermectin, other medical and non-medical treatment and prevention of Covid – “Health updates May 21, 2021”, https://www.youtube.com/watch?v=3jFHUm9_5T0

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A CRITIQUE OF EDSEL SALVANAS UPDATE ON VACCINES
By Dr. Iggy Agbayani
May 23, 2021 

I’M NOT A VACCINE EXPERT BUT I’M A DOCTOR TOO, AND LIKE ALL CITIZENS HAVE THE RIGHT TO VERIFY AND CRITICIZE ANY SHARED INFO ON HEALTH.

Edsel Salvana (ES): “1. ALL approved vaccines work well against severe COVID-19 infection. All people who are in the vulnerable population should get ANY properly approved vaccine as soon as possible.”

ME: There is No study that has shown evidence to predict that all approved vaccines will work well against severe infection. Covid -19 vaccines have not shown any long term safety studies to be highly recommended especially in the elderly with many comorbids.

ES: “2. FULL vaccine protection kicks in 2 weeks AFTER the 2nd dose (except for J&J). There is already partial protection from the first dose. For Astra with the 2nd dose at 12 weeks it can be up to 80%.”

ME: “Full vaccine protection” is often not achieved. You can be fully vaccinated but not fully protected. It’s an intentional play of words and half truth to convince us that we get full protection with every vaccination even if we don’t.

ES: “3. DO NOT SKIP the 2nd dose. While many studies are now showing that ALL EUA vaccines incite ROBUST antibody responses, the second dose will be ESSENTIAL to ensuring LONG-LASTING protection.

ME: The second dose is needed to allow a vaccine to gain its potential of providing prevention but no one knows if it can provide “LONG LASTING” protection because there are no long periods of testing for efficacy for any COVID-19 vaccine.

ES: “4. Vaccine mixing studies are underway, and a recent Astra + Pfizer study shows good antibody response. Take note that UNLIKE clinical trials, this data is PRELIMINARY at best and only measures antibody production. The TRUE test of a vaccine (or rather a mix) is its ability to PREVENT clinical disease - these studies are still ongoing. DO NOT MIX vaccines at this time. There is also data that mixing vaccines can lead to more INTENSE systemic reactions, and so we still need more data on which vaccines are compatible and work best from a safety and efficacy standpoint.“

ME: Mixing vaccines must clearly prove that it is both safety and efficaciousbefore being approved for EUA. It is unauthorized and unethical to promote it at this time. Any suggestion to allow it is unethical.

ES: “5. DO NOT start a second vaccine course with another vaccine if you already completed one. Aside from unknown data on safety and efficacy, you will be DEPRIVING someone of their vaccine shots because the supply is still not enough for everyone.

ME: A second vaccine is asked because of doubts on the protection of COVID -19 vaccination. Vaccine companies should provide some determination of vaccine efficacy for confirmation or as part of an on going clinical trial through a neutralizing antibody test. A USFDA approved neutralizing test is available in the some test labs in the Philippines.

ES: “6. Boosters are NOT YET a done deal. Most clinical trials have only observed efficacy for 6 to 8 months and the responses are STILL ROBUST. DO NOT get a "booster" until there is sound clinical data. Aside from unknown safety and efficacy, you will also steal someone's shot.”

ME: Agree. COVID-19 infection also provides ROBUST immunity.

ES: “7. There is more and more evidence that ALL approved vaccines also substantially decrease transmission. Recent data for Pfizer, Moderna, Sinovac and Astra among others point to substantial transmission risk reduction. This INCLUDES variants. The data is so compelling that the US CDC has stated that fully vaccinated individuals (see #2) can safely remove their masks even indoors. We are NOT THERE yet in the Philippines since our % vaccinated population is still low and we are still recovering from our latest surge.”

ME: Although I agree that vaccines can substantially decrease risk of transmission, the mentioned CDC recommendation is half true, “You still need to show a negative test result or documentation of recovery from COVID-19 before boarding an international flight to the United States.

You still get tested 3-5 days after international travel. You still need to follow guidance at your workplace and local businesses. If you travel, you should still take steps to protect yourself and others. You will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States. You should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others.” Apparently the data is not compelling.

ES: “8. The data on decreased transmission following vaccination is persuading many countries to gradually open up to fully-vaccinated tourists. The most liberal policies do away with testing and quarantine completely for fully vaccinated travelers. Germany and Saudi Arabia have already done this and more countries are at least lowering their testing and quarantine requirements when dealing with fully vaccinated travelers. This will really help the economy recover. We will continue to study this for local consideration and recommend as appropriate. One more reason to get vaccinated.

ME: There is data that show vaccination can be often associated with an increase of cases. The reason for countries opening up for tourist is mainly due to economic pressures and lowering case numbers in some countries and not necessarily of vaccination. Travel still requires testing and symptom free status.

ES: “9. Don't worry about the brand of vaccine for travel. All available vaccines are expected to eventually get WHO Emergency Use Listing and it is expected that most countries will recognize this as sufficient to admit travelers.

ME: Optimistic but of weak basis.

ES: “10.You DO NOT need to check antibody levels after vaccination. While a recent study showed that neutralizing antibodies seem to correlate with SYMPTOMATIC protection from COVID-19 following vaccination, this DOES NOT mean you need to have demonstrable antibodies to have protection. The types of kits being used vary, and different vaccines have different target antigens and the antibodies may not show up on some tests. These also do not measure cell-mediated immunity (T-cells) which are very important for clearing virus that are inside infected cells.”

ME: ES placed the most contentious statement for last. It is important to get confirmation of efficacy under phase 3 trials. The most objective way to do this is by a neutralizing antibody and IgG testing. It cannot be done feasibly for all vaccinated patients due to massive cost of testing everyone hence it is done randomly to a significant percentage of vaccinees. This US FDA approved test can help determine immunity of past COVID-19 infection too. It will help reveal the real efficacy of vaccs and herd immunity better.
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See also:
Covid 35, Dr. Rafael Castillo letter to HPAAC, May 06, 2021
Covid 36, CDC PH new website, FB disabled-restored again the group page, May 13, 2021 
Covid 37, Facebook deletion of CDC PH page, Doc Iggy at Congress Committee hearing, May 18, 2021.

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