I contacted the CDC and all I got was this lousy form letter.

Thank you for contacting CDC-INFO. 

We hope you find the following information about the current guidelines for receiving an additional dose of the COVID-19 vaccine helpful.

People are not recommended to receive more than one complete COVID-19 vaccination series. The need for COVID-19 booster doses has not been established. No booster doses are recommended at this time for anyone, including immunocompromised people or any other group of people with underlying medical conditions. Revaccination is not recommended for people who received COVID-19 vaccines during chemotherapy or treatment with other immunosuppressive drugs.

Antibody testing is not recommended to check for immunity following COVID-19 vaccination. If you got an antibody test after you were fully vaccinated, you are not recommended to receive additional doses of the same or different COVID-19 vaccine, regardless of the antibody test results. If you got an antibody test after the first dose of an mRNA vaccine, you should still get your second dose on schedule regardless of the antibody test results.

This was followed by a bunch of links to pages on the CDC site. I am sure they get a lot of calls and emails, but the above reply basically says nothing. I can summarize in one sentence: Don’t get second vaccination and don’t test for antibodies. What is missing is why, and what the fuck am I supposed to do now? I will bet that my message was not even read by a human but processed by a computer. It was probably programmed to wait a day so it seems that someone looked at it instead of replying with the form letter right away.

There was a survey link at the end of their email reply. I basically gave them the lowest score possible. They also asked why and my reply was that there is no trust for the CDC. From the mixed mask message early on, to conflicting mask mandates, and treating the public like idiots by not explaining any of their recommendations.

In this case, there are several countries that are giving out third or booster vaccine shots. This article has a list: United Arab Emirates, Israel, Britain, Germany, Cambodia, Thailand, France, Russia, Switzerland, Singapore, and Indonesia. Are their country’s CDC wrong or taking irresponsible risks? No idea.

I am getting more and more pissed off every time I hear a “get vaccinated” PSA.

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Our work used to offer weekly vaccinations, but stopped awhile ago since the rate of vaccinations dropped. I remember seeing the email announcing the last vaccination opportunity at work. Today, another email came out offering vaccinations on-site again. I guess the case count is bad enough that we brought USC Pharmacy back to give employee vaccine shots this Friday. I signed up online to see if they will give me the vaccine or reject me. The form did ask for a lot of information, including whether I have had a vaccine shot, what type, and the last vaccination date. I am hoping that they will just give me the shot since it is just for our employees. If I do get rejected, hopefully they will tell me before Friday so I will not get rejected in-person after driving an hour to work.

I am really frustrated at the FDA and CDC for not letting immunocompromised people get an additional COVID shot, when study after study has shown that it improved protection against the virus. Meanwhile, I am seeing a lot of commercials (public service announcement) asking people to get vaccinated. If the risk of getting seriously sick from COVID is greater than the risk of a third vaccine shot, why is the government not giving me the option to choose?

There was a contact form on the CDC website, so I sent this message:

So with the delta variant, the CDC is asking all unvaccinated people to get the shot. I am a recent kidney transplant recipient and received my Moderna shots right after the transplant while taking anti-rejection medication. Likely I have little or no protection from COVID. Many studies say that a third shot will improve my situation, and some countries allow this third shot. However, I checked with my pharmacy today and they said it is not allowed by the FDA emergency use authorization. Why can’t immunocompromised people get an additional shot? Are the risks higher than actually getting a COVID infection? It seems inconsistent that you are asking unvaccinated people to get the vaccine, yet denying millions of people that are in more danger from infection and serious symptoms from protecting themselves. Please help me understand.

Of course, I an not naive enough to expect a response. I doubt it will even be read by a live human. Right now on the news, they are reporting many government organizations requiring vaccination for all employees since it is common sense. Yet I have to wait months for the FDA and CDC to get around to the safety of 10+ million immunocompromised people.

Second appointment with my local nephrologist, as opposed to UCLA transplant nephrologists. There was not too much in the test results. Creatinine and potassium was a bit high, but likely due to not enough fluid intake, so she was not worried. Tacrolimus readings were a bit low, so she added another 1 mg pill to my evening dose. So now I am taking 3 mg in the morning and 4 mg in the evening.

We spent a lot of time talking about COVID and what kidney transplant recipients should do. She mentioned some of the studies that I read about as well. She agrees that getting a third shot seems to improve immune response to the virus, but there is no approval in the US for multiple vaccinations yet. She did say that she could not officially “recommend” me to get a third shot, but it will definitely give me more protection. So, in addition to dealing with a plethora of medications and trying to stay safe, I have to find a clinic that will not ask too many questions when I show up this late for a COVID shot.

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Weird. I guess I never published this post. I will just continue instead of starting another post.

It does appear that COVID cases are getting worse, not better. I saw a news story on NBC (TV is stuck on channel 4 for Olympics) that tsaid there we are at over 70,000 cases per day now. I also heard that he Delta variant case spike in the UK lasted from May to July. If the US follows the same trajectory, then we are looking at mid-September for infection rates to start dropping. My doctor friend at Harbor-UCLA hospital basically said they are preparing for this latest surge to last into September.

Here is a chart of hospitalization for Los Angeles county:

This is an interesting chart for Orange County:

I think you can see that as more people were vaccinated, the weekly new cases for unvaccinated people were dropping as well. However, as the Delta variant becomes prevalent, new cases for both groups show an increase, especially the unvaccinated. Since I am basically in the unvaccinated group even though I got two shots of the Moderna vaccine, I am super worried. I mentioned my boss’s annual track day party that I was planning on attending next weekend earlier. Well, I emailed them to say I feel it is too risky for me to be indoors with a large group of people, so I am stuck at home.

Data for all of United States. There were 123k cases on July 30th. That is early November 2020 numbers and that surge overwhelmed many hospitals and nearly delayed my transplant for several more months. If you are confused by politicians and the CDC, just look at the case data. I cannot understand why people still will not get vaccinated.

My uncle fell down over the weekend. I made a post about his story awhile back. He suffered from a pretty major stroke several years ago. It did look like he was making slow progress on recovery, but has deteriorated quite a bit in the past few years. Initially, my aunt took him to the ER after his fall, and they did not find anything. For some reason, they took a second look and found he fractured a vertebrae, and sent him to a physical therapy clinic (since I am overhearing this from a conversation between my parents, it is a bit unclear). While he was there, he fell again, and we do not know if there was further injury. My dad went to see him today at the clinic and sent some photos. My uncle was sitting on a wheelchair by himself in front of a table. He was wearing a face shield because he is still unvaccinated. He looked confused and sad. My dad said my uncle probably did not recognize him, and all he could say was “hurt” (probably 痛 in Chinese).

I understand life must be tough for my aunt, having to take care of him for the past several years. They did get an in-home care person, but she quit after a few days. His two sons (my cousins) are in Asia, though I heard one of them is coming back, not sure how long. His daughter was married a few years ago and currently pregnant so likely not much help. My mom said the son-in-law is a nurse, and is helping when he can. I guess my frustration is him not being vaccinated, With his poor health and the prevalence of the delta variant of COVID, I firmly believe if he gets infected, he will die. Since my uncle cannot make decisions, it is totally up to my aunt. Whenever my parents ask about COVID vaccination, she comes up with an excuse why they are not vaccinated. I do not know if she is hardcore anti-vaxx or just confused by all the disinformation out there, but the whole situation sucks.

It appears that the number of positive cases of COVID-19 is on the rise again in Los Angeles and Orange counties. Of course, this is all due to the idiots that will not get vaccinated, excluding those that have a valid medical reason. The last article I saw, Los Angeles county is again seeing a huge increase (relatively) of new COVID cases.

California opened up in mid-June because the it appeared we were headed for herd immunity, and the number of new cases was steadily decreasing. However, the vaccination rate stalled as most everyone that wanted the vaccine got their shots. Now the much more infectious delta variant is taking hold in the unvaccinated population. For most vaccinated people, the impact may be minor if any. For me and other immunocompromised people, this could be deadly, again. Also, with more people infected, it increases the chances of further mutation with unknown results.

Here is Orange County showing a similar trend:

The absolute numbers in OC are lower than LA since the population is lower, but it shows a similar trend. Everything looked good near the end of May, but since the state removed restrictions and the mask mandate, cases are increasing again. Seems like common sense but I guess common sense is uncommon. Also, because of these selfish and irresponsible anti-vaccination idiots, I still cannot go to work or out to restaurants. I wish California or Orange County would implement a vaccine passport so there are consequences for refusing to help end the pandemic.

So, after 15 months of COVID lockdowns and social distancing, California is lifting most restrictions today. Looking at recent cases and deaths data, it does seem that the vaccines are working, and the pandemic is under control, in California anyway.

This is cases data for Los Angeles and Orange counties. The trend is very similar to statewide results.

As for vaccinations, data shows 55% of California population are fully vaccinated with an additional 11% partially vaccinated. Assuming that there is some protection with partial vaccination, that is 66%. Not sure if this part is legit but if you add the total number of COVID cases, that gives another ~11%. Of course, there are likely many people that are vaccinated who previously contracted COVID, but maybe we are at 70% “immunity” already? Is that enough for herd immunity?

Personally, due to the anti-rejection medications, I will still need to wear a mask in most situations. Since most people will not be wearing masks, I need to start using the KN/N95 masks. I have been using a KN95 mask more and more, and it is not too bad. The only thing I am worried about is being harassed by anti-vaxx/anti-mask idiots that are harassing people that are still wearing masks.

Actual domestic Chinese KN95 masks from China. Employees from my friend’s company in Chengdu sent a bunch over when there was a huge shortage in the US.

So what is going on in Michigan? For awhile, it looked like COVID cases were dropping in the US with people getting vaccinated. It certainly looked like that in California and Orange County.

It appears that things are under control, and California is set to be fully open on June 15.

This is Michigan during the same time period.

The seven day average is finally decreasing but there was definitely another spike in early April. I do not follow Michigan news so I do not know what could have caused this. Is the state not getting enough vaccines? Did their governor open up the state already? Things are improving but we are still in the midst of the pandemic with new and more infectious variants popping up all the time.

I spoke to my cousin who is an ICU nurse in Toronto. She has many stories of anti-mask and anti-vaccine idiots there too. I thought it was just a crazy California thing.

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From this article, it appears they relaxed restrictions too early, and do not seem ready to apply them again. Own goal, I guess.

Looking at the data for Orange County, it definitely looks like the number of cases have dropped to very low levels. People are still testing positive, but the daily number of deaths have been in single digits for all of March. However, if you look at the entire US, there seems to be a slight increase in cases recently, and the infection rate has remained steady at 50k+ for the past month.

Since the weather was so nice, I went for a walk to the local park. There must have been over 200 people in the small park, and hardly anyone had a mask on. I don’t know… seems like everything the numbers get better, a bunch of people start socially gathering right away without any precautions, and the number of cases shoot up. I am still being careful since I am still taking two anti-rejection medications. Hopefully we do not have another COVID spike with the new variants, or this mess will never end.

I heard on the news that Disneyland is going to be used as a vaccination site. Also, the vaccination criteria has been updated to include medical workers and people aged 65+. There is a detailed list at this website. We’re still in Phase iA.

Phase 1A

Healthcare workers

Individual 65 and over

Emergency services

Phase 1B/Tier 1

Food and agriculture

Education and childcare

Phase 1B/Tier 2

Individuals 65-74 years of age

Incarcerated

Homeless

Essential business employees

Phase 1C/Tier 1

Individuals 50-64 years of age

16-49 years and have underlying health conditions

Utility and government workers

Phase 2 (?)

Everybody else

I’m sure it’s a difficult task trying to coordinate the vaccination of millions of people who all want to go first. I think medical workers should go first, including nursing home patients. Then going by age tranches makes sense since the mortality rate correlates with age. This is data from Orange County:

Makes sense, no? However, there are studies that show the mortality rate for dialysis patients who are infected with COVID-19 are as high at 20%, though that number seems to be dropping over time. It would be interesting to see more detailed analysis on those death cases by age. If the distribution is similar, then the current vaccination plan is probably fine. If the high death rate is more correlated to dialysis, then they should probably move the entire group up in priority. Since I’m in the 50-64 group, I’m in Tier 1C either way.

Also, why the strange naming convention? Why have so many Phase 1 subdivisions? It it to make it look like everyone is priority #1? Why not just go down the groups sequentially, as in Group 1, 2, 3, etc?

I was about to comment that the case count at my work has been pretty steady this week at 435 cumulative cases. Then I get the update from yesterday and it jumped to 447. Maybe HR wasn’t tallying the cases from this week until yesterday. Anyway, I was hoping that we were past the holiday spike but that’s probably wishful thinking.

This is the hospitalization graph for Los Angeles County. It appears that the growth in hospitalizations have slowed or stopped. It’s either good news that the worst (this time) is behind us, or bad news that the hospitals are maxed out and sick people are being turned away, hence no change in number of patients.

Still no word from UCLA…

Not good. It’s definitely getting a lot worse. This is probably the inevitable spike in cases from people getting together irresponsibly over Christmas and New Year. The case count went from 379 to 406 yesterday at my work site. Starting this week, HR is also letting us know where and when the infected employee was onsite. There is nothing currently in my department area but the cases are pretty much all over. I am sort of pissed off at everyone getting sick. I had to stay pretty isolated for the past nine months, but the situation has gotten worse for me (and my transplant surgery) because selfish people can’t follow public health instructions.

I believe my company is still working on getting vaccines for our workers. I don’t know if the essential business covers everyone or just those that have to work onsite. Probably 50% of the employees can work from home. It’s a race to see what designation will get me vaccinated first: essential worker, immuno-compromised (post-transplant), medical history (diabetes + heart surgery), or just being over 50 years old.

Why is our government so incompetent? Is it because they have a monopoly in whatever they do? There doesn’t seem to be any sense of urgency or accountability to anything that they do.

I was talking to my sister on the phone, comparing notes between our two transplant coordinators, when the topic of the COVID-19 vaccine came up. It would probably be a good idea for both of us to receive the vaccination before going into surgery since there are a lot of sick people in hospitals. Anyway, we were trying to determine when I would be vaccinated based on the “Dialysis Centers” bullet point in Tier 1A. With me on the phone, she called the Orange County Health line and actually talked to someone. However, the customer service representative (CSR) basically told her to go look at more websites, including the California Department of Public Health. My sister was also told to call 211 to get our public agency help line for more information. That turned out to be a 10 minute trip through a massive automated answering system. I gave up and said I would ask the social worker at the dialysis center, but eventually she spoke to someone and I’m actually in phase 1C, using a totally different distribution system mandated by the state. So confusing.

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Under the state system, I would be in phase 1C, which is where I would be dialysis or no dialysis.