There were several comments about the Danish study that did not show efficacy for masks in preventing COVID-19. Some readers provided references to other studies that were not placebo controlled, but did show the value from wearing masks. Several readers provided a link from a New York Times critique of the the Danish study, that made similar points of my review.
I do not think anyone is suggesting not to wear masks! Creating a study to demonstrate the value is just hard to do!
As relates to several questions about the prioritization of vaccines, especially to elderly residents of care facilities, many asked if giving this vaccine to the elderly was a good idea.
Any vaccine is a risk benefit decision, and given the remarkable efficacy of the COVID-19 vaccines and the safety profile, even in individuals over 65 years old, I absolutely believe nursing care residents, regardless of age, should take this vaccine.
My only caveat is deciding whether individuals who have already been infected and have evidence of immunity should get the vaccine. This question needs to be addressed as an experimental vaccines against SARS cause enhancement of disease, and a Sanofi vaccine agains dengue caused enhanced disease in individuals who had prior exposure to virus.
Because of this I think everyone should be screened for COVID antibodies before they get the vaccine. At this point I would not deny anyone the vaccine, but those with prior infection need to be monitored for protection and side effects.
Pandemic Pondering 
This is very helpful information. Because I had covid-19 I was concerned about being possibly told I needed to get the vaccine anyway. I understand it isn’t necessary, but other’s may not. I was actually going to ask about you about this. Thanks for writing about the vaccine for those who have had the virus.
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Thanks, Jim, good thoughts. I was wondering about that (vaccinations to people who have SARS-CoV-2 antibodies). Are you aware of any studies happening now to better understand this? tnx again..
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No but I think it will be important to study. In addition, we are currently monitoring 100 Covid 19+ HCW at Michigan Medicine and comparing to 400 negatives to see if antibody truly is associated with protection from reinfection. Should do same with vaccines.
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Since they aren’t sure how long immunity lasts from the vaccine, might this cause people to feel too secure?
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After the last 9 months don’t think any of us will ever feel secure, but it will be something to monitor going forward! Thx!
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Thank you again for your valuable insights. From my understanding now, the antibody tests don’t identify everyone who has immunity. e.g. People who have another type of immunity to COVID19, as not everyone makes the antibodies. To me it seems we need to be able to accurately identify everyone with immunity for different reasons. e.g. Like the important vaccine caveat you speak of. Or maybe to avoid future crushing shutdowns – offer bonuses to those with immunity to step up and “hold down the fort”.
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You are correct some people with immunity may not have antibody. I would be using antibody to identify people who have been INFECTED with SARS-CoV-2. This group might have different responses to the vaccine. I agree anyone with immunity (also from the vaccine) should have all hands on deck to take care of things while everyone gets vaccinated!
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My 17 year old son went for a COVID test a few months ago. We had a great conversation with the doctor. Before we left he said, “I truly think it will be the strong, young people like you who will save us all.” First I thought, how ironic he said that, my son has multiple severe food allergies and he knows it. But food allergies are an invisible disease as my son is a body-builder and swimmer and looks fantastic. Even with his FA, I’m not afraid for him. I then assumed he meant because the young people are mostly unaffected by this virus and we can achieve herd immunity through them. Then I pictured everyone with immunity as our modern day armed forces. They may not be going into battle with weapons but anyone who can help by keeping their hands on deck will help us all.
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