IM Doc on the Corruption of Public Health and the Breakdown of Medical Practice in the US

IM Doc has been e-mailing with reports of what he sees as the increasing moral and literal breakdown of the practice of medicine in the US. The latter is the result of more and more resignations by seasoned and often highly competent doctors before normal retirement who have had it. They are sick of the increasing regimentation, the administrative demands (mainly the result of insurance), the lack of guidance as to what to do under Covid (unlike past infectious disease outbreaks), the dismissal of adverse findings for the Covid vaccines (declining efficacy and injuries) and now burnout due to thinned ranks of doctors and nurses as a result of the elevated quitting rates.

We are hoisting some of his patient and community data and anecdata from other sources on declining efficacy of the Covid mRNA vaccines, a topic that is apparently (finally) becoming less verboten in the medical community.

One reason IM Doc is particularly qualified to comment since he has maintained meticulous and extensive records of patient outcomes. For instance, he can pull out how many retina detachments he has had each year among his patients and their age when it happened.

An example of the sort of data he has been keeping since the start of Covid (this from a Sept 17 e-mail):

47 calls today. Zero unvaxxed. Zero J&J, 11 three shots, 8 4 shots, 28 5 or more shots. All but three patients have had Covid before, and an entire 21 patients have had three or more episodes.

of that 28, 18 are from 2 superspreader events…..both of these events were vaxx only parties late last week.

One of IM Doc’s themes is that (increasingly) recent vaccination by the Covid vaccines is correlated with a new infection not long after. This outcome has become so frequent that it is leading to outrage among patients who got a booster and then in fairly short order got Covid, and to patient rejection of advertising and MD pressure to get a Covid booster (although per below, the latter is waning).

Before you think this is nuts, local officials have admitted to that pattern. From an e-mail on September 26:

The health department people spoke to the doctors today. “Since the new boosters were started, we are seeing large numbers of cases again very rapidly in the vaccinated – so expect an influx this week.” This has happened every time we have a new booster – so why expect it to be any different now? Absolute deer in the headlights when they were asked what could possibly be the cause of this every time?

From an e-mail of September 21:

I was emailed last night by a former student now working at the FDA…. I called him today at lunch at his request – he is wanting a reference letter – “I am done. I cannot work here anymore. What they have done is immoral. They ALL know the problems. They all know how unethical all of this is. You cannot comprehend the deceptive shit going on here. I need to get out of here. I can no longer face my kids at night. I want them to respect their father. I do not even respect myself.” I find myself being forced into the elder position – I guess I have achieved that age. That does not make any of this easy.

I am now being informed by multiple patients daily that their subspecialists – cardiologists, oncologists, etc – are demanding that they NOT take these boosters. I am having to do far less counseling because they have already received marching orders from the specialists.

This is exactly how it happened with Vioxx and then again with opiates. For months/years we just talked amongst ourselves as docs. The quickening phase started when I began to notice the other docs talking to the patients or the press. The rage is on the way.

From August 31:

Another cluster has occurred. I call it the “Spit and Whittle” Club. A group of 15-20 old guys who sit out in the park in the summer or in a local restaurant in the winter. They spend about an hour or two together in close quarters every AM. There was a big BRUHA last year because 6 of them refused to be vaxxed, the other 10-15 did get vaxxed and boosted – and then refused to let the unvaxxed participate any further. Lots of anger and hard feelings for about a year. Then around the time of the 5th booster, they relented and let the unvaxxed join in again. One of them died last week. They had a big get-together in a local restaurant in his honor on Saturday of this week. Big COVID event. Remember yesterday how the young people with COVID are still going to work as waiters, etc? Well it happened. The 6 unvaxxed are not ill nor positive at all. Nothing. There were 12 vaxxed – 11 of them are sick and positive, 1 has been negative so far. 1 had to be admitted last night for a severe coughing pneumonia ( these are all very old guys).


One comment after another.

If there is a reason why this is happening, or if there is some rational explanation for the whole chain of events, our authorities need to be front and center in discussing this. They of course are not. They are not addressing this in any way shape or form. I guess that tells us all we need to know. It is obvious they would rather have wild speculation and intense anger be the response than a rational discourse. I am so so glad my father and so many of my mentors are not around to see this happening.

This is not going well at all. I am done holding water for these people in any way. The trust in the institutions that has been a mainstay of my life and my fellow citizens is completely and totally breached.

The anger is mounting and I just cannot see how this ends well at all.

From yesterday:

Let me share with you the tale that has been going on all week here. A large Catholic family of 11 kids from all over the East have rented a mansion here. They all arrived last weekend. 11 kids aged 58-80 and every one has a spouse. 22 people in total. Some kind of family reunion. 4 of them – 2 couples were unvaxxed. Accordingly, they were not allowed to stay in the house – but had to get hotel rooms. All of the other 18 are in the mansion. Of those 18, 7 of them have already had the new vaxx in the past 2 weeks – all in their home states. Would not want to travel without protection don’t you know. So every last one of the 18 in that house have become positive for COVID in the past few days. The 4 unvaxxed not staying in the house are just fine. All of their activities together have been outdoors. I have now had to admit 3 of these elder family members to the hospital. All mild but hypoxic – we just want to keep an eye on them. All 3 have received the recent booster.

Because these people are all genetically related, and we have such stark exposure profiles, and an obvious outbreak, this would be the perfect situation to do intense epidemiologic studies. I called the FDA – they literally laughed at me on the phone.

In any type of issue in the past, I have been connected with an investigator or a physician and listened to intently. In every situation before, I was faxed or emailed a confirmation, and a written plan, and then weeks later a report. Not this time or any time since these came out. Just LOL from a clerk on the phone.

The questions are important……

What variants are we dealing with here? Whatever we are dealing with clearly can jump the vaccine…..should we be taking this seriously?

What immunologic status are these patients? Why did some have to be admitted? Why are the sickest ones almost perfectly correlate with the number of shots? Half of them are from the same bloodline – so there would be much less confounding in the cohort.

Again – laughed off the phone line. Literally. By a clerk. Never allowed to talk to a nurse or MD.

I spoke with my contact there in the upper echelons of the FDA – His response – “It is all a lie. They do not want to know anything about these types of problems. You have no idea the deception.” This is the same guy I told you a few weeks ago looking to make his exit. He can no longer handle it.

I am slowly realizing that our federal officials are now totally corrupted. There will be no change. We are just going to have to learn to deal with it until the detonation is so bad it cannot be ignored. They have no interest or care in dealing with these issues being seen by the front line docs……why should any site put their reputation on the line? They will just lie and equivocate about that too…..

The humiliation of the entire profession is now complete. I am now, along with many colleagues I know across the country, coming to terms with this. And most importantly, how this will affect the rest of our careers. And what we need to do. The resignations and retirements before age 60 are now starting to happen at an accelerating pace monthly.

Mind you, there is plenty more where that came from. The press is mystified as to why large swathes of American patients have become vaccine averse generally due to the Covid vaccine mandates followed by widespread evidence of poor performance (even before getting to Covid vaccine injuries). But that’s because the “poor performance” part is still depicted as conspiracy theory, to the extent the media even acknowledges doctor and man on the street conflicting experience.

And let’s not forget the number of doctors who were attacked and threatened with loss of their licenses for questioning the vaccines or merely calling out signals in data that warranted further examination. 1

The CDC and the FDA have done irreparable damage to public health and trust in the medical profession in the US. Yet they seem to believe that their messaging can overcome reality.


1 I do think there was a case for the vaccines pre and even somewhat into Delta. First, if you got a severe case of Covid and had to be hospitalized, you tied up a bed for 2-3 weeks and were highly likely to die. So the vaccines preserved hospital capacity (which includes being able to treat strokes and heart attacks and accident victims). IM Doc’s meticulous data through showed more severe cases among the unvaxxed at least late summer 2021…and in his deep blue county, there were way more vaxxed than unvaxxed. But it was utterly inexcusable not to track injuries (among other things, doing so would enable doctors to identify sub-populations where the risk/return tradeoff was poor, and to determine if batch quality and/or poor administration played a role, like not aspirating the needle first, or vaccinating someone while they had a asymptomatic case). It’s also made it very hard to pick apart poor outcomes resulting from Covid infection versus (remember, even under wild type and Delta, many cases were asymptomatic, so there are likely vastly more people who have had Covid multiple times than is known or acknowledged).

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  1. IM Doc

    I am asking for this just one more time.

    To the CDC FDA and Pharma companies.

    Announced in the past month since the new CDC director came on board was at least a slight acknowledgement of the credibility problems along with a push to gain back trust and be more transparent.

    I beg each of you for the sake of the entire healing profession going forward to do something that would be the most transparent of all.

    Release every scrap of raw data. Anonymized and in its raw form. Cutdowns and summaries and biased studies that you have been releasing are just not going to cut it anymore if you want to regain trust. Release the raw data. No more 75 years and biased summaries. Let armies of epidemiologists and medical stasticians in every university get out their pencils and pore over it. Let them publish and publicly discuss and debate their findings. It is the only way. This is the way of American medicine for generations. When we all know the great minds have evaluated and concluded and most importantly debated, we will lose so much of our angst.

    We need answers to questions urgently out here on the front lines. What are the risk benefit analyses for every demographic? It appears the Europeans have done this and concluded no one under 65. Release the raw data. We can then determine instantly what is the correct course.

    What is the true incidence of all these side effects and problems? What age groups and demographics are being more affected? Release the data. Let all of our experts be involved in looking over it.

    Are the vaccinated more likely to be infected? It sure seems that way from my experience. Do we see some kind of imprinting happening? Release the data.

    Are these shots currently helping hospitalization? Or do we have some kind of healthy vaccinee bias? Release every scrap of raw data. The issues will be debated and we will have a much clearer picture.

    I would guess there is about 10-15% of the population who are going to line up for these next boosters. That is it. I would guess 70% are inhabited with varying degrees of distrust, anger, disbelief, frustration. I would add even hate. That is what I deal with every day. And now it is spilling over into not just other vaccines but all kinds of other medical interventions. I have never dealt with this in my life.

    Please do what you said you wanted to do to regain trust. Release the raw data. Admit past mistakes. Talk to people like they are adults. Knock off all the ridiculous pandering advertising. To the FDA in particular. Apply this to all the other drugs you are approving. We have not just had flimsy regulatory maneuvers with Covid. We cannot allow any more Aduhelm like disasters.

    In my past not long ago, I have in person and up front seen the CDC in action. I was so proud to be an American doctor during those times. How I would love to be able to say that again…..

    1. dave -- just dave

      What are the risk benefit analyses for every demographic? It appears the Europeans have done this and concluded no one under 65.

      Spouse and self are scheduled for the new Pfizer booster tomorrow – she is 66, I am 76 with chronic lymphocytic leukemia [still in the “watch and worry” phase]. I guess we’ll go through with it – we have not been diagnosed with covid yet and we are fully boostered so far. We continue to mask and minimize social occasions.

      Into this house we’re born
      Into this world we’re thrown
      Riders on the storm

    2. Bsn

      Doc, we’re sure you are busy as all get out, but quick question. How would you propose a patient should approach a doctor that would help this situation. I know doctors have to “tow the line”, but among the like minds in your profession, are you seeing a trend wherein patients can help doctors in their struggle? Best to you and your cohorts in these times!

      1. GF

        As a non-medical person I may be off base here, but here goes. It appears to me that the new boosters are the equivalent of bees being attracted to honey. They seem to attract the virus and make it easy for it to multiply within the body. Has this possibility been examined? Just a layman’s observation.

        1. SG

          I wonder if it just isn’t a false sense of security at work: if people who are vaxxed and boosted mask less and socialize more out of a belief that they’re protected more than they are – rather like someone believing it’s okay to drive drunk because their car has airbags. This is, of course, the sort of thing that could be detected by the kind of rigorous and public analysis that IMDoc is advocating

    3. jake

      You write “It appears the Europeans have done this and concluded no one under 65.”

      Where can this advisory — if it is one — be found?

      1. Phil

        In the UK NHS staff, over 65s and people in the ‘vunurable’ category are being offered Covid shots. No one else

      2. anonymous

        “All 30 EU/EEA countries recommended booster vaccination as part of their autumn/winter 2022 campaigns. The age cut-offs for recommendations for booster vaccination (whether it was a second, third, seasonal booster, or repeat vaccination) for the autumn/winter vaccination strategy differs between countries and was between 50 years and above to 80 years and above, with the majority of countries (14) recommending vaccination to those 60 years and above, following by nine countries recommending vaccination to those 65 years and above.”

    4. John Beech

      IM Doc, respectfully, are you skipping or taking the newly release booster . . . I mean you, yourself?

      1. Merf56

        I’d like to know that as well please!
        I’m 67 yr old female scheduled next week for the new booster.
        No health issues and I’d certainly like to know what the author is doing her/himself after posting all this info

      2. Yves Smith Post author

        You have no business asking that question. It is tantamount to a backdoor request for medical advice. It would be a violation of medical ethics for him to advise you as a non-patient.

    5. RM

      It’s too late for atonement. The institutions have exposed themselves – that is a good thing. Unfortunately they have caused death and misery for many, in the process. Kudos to the unvaccinated. For the vaccinated believers, some questions:

      Why wouldn’t we expect a rapidly mutating RNA virus to simply evolve to evade vaccinal antibodies (as it has)?

      Why have we never been able to create effective vaccines against viruses causing self limiting respiratory infections?

      Why wasn’t the ADE observed with SARS1 vaccine candidates seen as a serious cause for concern during SARS2 vaccine development?

      What are the possible consequences of taking the unprecedented step of vaccinating on a mass scale in the middle of a pandemic?

  2. James E Keenan

    One thing I do not understand from IMDoc’s comments: What would be the institutional motivation for the FDA (or, more precisely, higher-ups at the FDA) to refuse to investigate complaints such as those made by IMDoc?

        1. Louis Fyne

          —Why is the CIA involved?—

          (I hope that this is an approved comment, not meaning to peddle anything outlandish)

          The hypothesis, as I understand it, is that EcoHealth was a way to see how smart the Chinese virologist were.

          Essentially give an EcoHealth grant to Wuhan Institute for Health for X. See if they can do X. if China can do X for civilian purposes, then they probably can do Y, Z for military purposes.

          Obviously this hypothesis can’t be tested cuz everything is obfuscated by everyone in DC, which itself smells fishy

          1. Whiteylockmandoubled

            I’d put nothing past our national security ghouls, but there’s also a more pedestrian form of neoliberal corruption at work.

            U.S. post docs, grad students and wet lab techs have been fighting outsourcing to China for years. Chinese academic labor is just a lot cheaper than US, so the agencies and big med schools ship work overseas. I mean it’s totally not fair for manufacturers to exploit labor when poor little (multi-billion dollar endowed) universities can’t, right?

          2. Bsn

            Whitney Webb has disclosed the many connections between the military and surveillance capitalists and Pfizer/Moderna. She documents their history of deceit and connections to proponents of eugenics. Look her up (before she’s disappeared).
            Here’s a starting point:

          3. podcastkid

            X.1 would be making it work on humans (military and/or 1st phase of X.2). X.2 would be making the vaccine (we may have seen how well that worked out with one coronavirus (I see little data on not-mRNA jabs)). The way I pictured it it was a race to get the product before China gov/army slipped in the lab and got a little product themselves. Maybe China never would have because they’ve got so many sites to monitor? Anyway, if such a bug made at Wuhan was THE one in question and there was an accident, someone got plenty of data on how fast in warfare it would do a boomerang thing. Course during war travel for many would be more restricted.

            Nope, can’t be tested; cuz the US would never reveal it was giving biowarfare agents away, and China wouldn’t want folks to know the US was contracting out (to China) creation of
            dual-use stuff (that would be like China loaning us money to send to Ukraine).

            I was reading (scanning) something the other day by unacceptable Jessica about the omicrons. Pretty wild, and I’m nowhere near thinking it through to where it seems credible or not credible. Involved, might be beyond my kin.

        2. Carolinian

          Why are politicians involved? Is Joe Biden a doctor? How does he get to insist that people take these shots of an experimental product?

          To some of us, who may seem excessively contrarian, the question is why would you trust any of these people with your health decisions or those of your loved ones. When IM Doc says

          I am slowly realizing that our federal officials are now totally corrupted

          that’s across the board. It’s not just about medicine.

          1. flora

            Whatever happened to the “Pure” part of the Pure Food and Drug Act? really. A 1906 consumer protection act. Whatever happened to the “Pure” part?

    1. ArkansasAngie

      Gee … culpability? Fraud? Lying? Messes with their plans to mandate this that and another. They don’t want to deal with push back from pesky conspiracy theorists.

      Hey we’re trying to re-elect Biden … no rocking the boat

      1. Allourproblemsstemfrom2008

        “I am slowly realizing that our federal officials are now totally corrupted”

        IM a Doc mentioned how they refuse to look at the data, reminds me of something else they refuse to look at from 2020. This ball of yarn is much bigger then most suspect.

    2. GramSci

      They’re all in it for themselves, as in rats leaving a sinking ship, hanging on for one more year or IRA match. This is how people survive in DC. From Congress on down through the presidency and the courts, this is how the ‘game’ is played. If you don’t play along. your salary gets cut in half. so you have to move to some rust belt backwater and play the same game for less money.

    3. Louis Fyne

      Cash rules everything thing around me. C.R.E.A.M.

      Get the dollar!

      And my pharma industry is a clean ESG-approved industry, not like those grimy steelmakers.

    4. Kurtismayfield

      Complete regulatory capture by industry and PMC indoctrination to never admit wrongdoing.

      Whenever the US officials point out corruption in other countries, I just laugh now

    5. The S

      Because of the obscene amount of money pharmaceutical companies will make by letting people catch covid and develop long term health problems. Some people will have to start buying insulin when they didn’t need it before. Some people will need blood pressure medications and statins. Some people will develop cancer and have to buy all the super expensive cancer drugs. Just anecdotally, the owner of my favorite salvage store developed auto-immune issues after covid and now has to take prednisone for the rest of her life for alopecia and gut issues. My brother-in-law has to take anti-fungals because his body stopped fighting off his athlete’s foot after his severe covid bout. My mother had covid twice and wound up with polycythemia and has to have blood drawn every two weeks. Capital will always kill people for profit.

    6. zapster

      Our libertarian-inclined leaders long ago had the bright idea that these agencies should be funded by the companies they’re supposed to supervise. That’s why.

    7. Ignacio

      Because higher-ups at the FDA follow political and economic guidance instead of medical? Because they do not depend on good health outcomes but on total vaccine sales, therapeutic MAb sales etc? Because their positions and careers depend on political figures who are calling for vaccine, vaccine, vaccine! like crazy?

    8. square coats

      They’re trying to maintain a narrative that is almost certainly totally false. The FDA as an institution is a key powerful actor in maintaining the narrative.

    9. Raymond Sim

      I think once a certain degree of institutional decay has been reached “institutional motivations” become very difficult to discern, and may not even be a thing. Shibboleths and sacred cows become the reason for being.

  3. John R Moffett

    It almost sounds like the virus lives dormant in some cells in the body, and the boosters are bringing it back out. I can’t see any other logical explanation for these observations. You can’t have everybody who got vaccinated get magically infected within a week of the booster. It must be a reservoir of virus in the body that is somehow stimulated by the boosters.

    1. Samuel Conner

      Just speculating, but there might be correlation between receiving the vaccine booster and subsequent relaxation of other aspects of “layered defense”, in keeping with the officially-promulgated idea, from 2021 onwards, that vaccination is an effective substitute for NPIs.

      Correspondingly, if people who refuse the boosters maintain NPIs (I am one of those), that would contribute to correlation of “not boosted” with “reduced likelihood of CV infection”.


      US govt statistics for cancer incidence for 2021 will come out in a few weeks. I am uneasy about what they may show, and possible long-term implications of CV-induced immune dysregulation. We’ll know soon.

      1. Yves Smith Post author

        I agree that behavioral confounders could play a big role. Look at all the vaxxed people who proudly started going to restaurants and weddings and other parties, and generally believed they were “protected”. That protection became less effective over time due to more variants and potentially the immune responses having been tuned to the original vaccination, meaning the wild type variant.

        1. Allourproblemsstemfrom2008

          Yes but that assumes that they uh were never lying from the start. Why would they lie about the jabs, but not everything else?

          1. Yves Smith Post author

            They are lying about everything else. The continued insistence on droplet theory, continuing to not recommend masking or when they do, they show photos of surgical masks that are useless under Omicron and later variants.

      2. Ghost in the Machine

        I have received the vaccine and the booster, but that is it. Like you I will not get more Covid vaccinations and maintain NPIs. So I will also fall in that category. I thought the same thing about the altering of behavioral patterns.

      3. maipenrai

        Except that we first saw that happen in Nursing homes in Scandinavia and Scotland where there would be little to no difference in MPIs. The data is out there but I don’t have time to dig for it right now…

      4. CP

        Yes, and maybe because people are being vaccinated in unventilated pharmacies full of unmasked people, often including the pharmacists themselves.
        So they’re being infected at the same time they’re getting “boosted.’

    2. Yves Smith Post author

      I have heard at least two theories. May be others.

      One is antibody dependent enhancement, aka ADE: From Scientific Reports at Nature in Sept 2022:

      Many therapeutic antibodies (Abs) and mRNA vaccines, both targeting SARS-CoV-2 spike protein (S-protein), have been developed and approved in order to combat the ongoing COVID-19 pandemic. In consideration of these developments, a common concern has been the potential for Ab-dependent enhancement (ADE) of infection caused by inoculated or induced Abs. Although the preventive and therapeutic effects of these Abs are obvious, little attention has been paid to the influence of the remaining and dwindling anti-S-protein Abs in vivo. Here, we demonstrate that certain monoclonal Abs (mAbs) approved as therapeutic neutralizing anti-S-protein mAbs for human usage have the potential to cause ADE in a narrow range of Ab concentrations. Although sera collected from mRNA-vaccinated individuals exhibited neutralizing activity, some sera gradually exhibited dominance of ADE activity in a time-dependent manner. None of the sera examined exhibited neutralizing activity against infection with the Omicron strain. Rather, some ADE of Omicron infection was observed in some sera. These results suggest the possible emergence of adverse effects caused by these Abs in addition to the therapeutic or preventive effect.

      A layperson description:

      Immune responses to pathogens involve many cells and proteins of the immune system. Early during an infection, these responses are non-specific, meaning that although they are directed at the pathogen, they are not specific to it. This is called innate immunity. Within a few days, adaptive immunity takes over; this immunity is specific to the invading pathogen. Adaptive immune responses include antibodies. A major goal of antibodies is to bind to the pathogen and prevent it from infecting, or entering, a cell. Antibodies that prevent entry into cells are called neutralizing antibodies. Many vaccines work by inducing neutralizing antibodies. However, not all antibody responses are created equal. Sometimes antibodies do not prevent cell entry and, on rare occasions, they may actually increase the ability of a virus to enter cells and cause a worsening of disease through a mechanism called antibody-dependent enhancement (ADE).

      ADE occurs when the antibodies generated during an immune response recognize and bind to a pathogen, but they are unable to prevent infection. Instead, these antibodies act as a “Trojan horse,” allowing the pathogen to get into cells and exacerbate the immune response.

      That article points out that getting infected after vaccination is not proof of ADE and gives other scenarios.

      A second theory is T-cell exhaustion, more informally called immune fatigue. In I hope not overly simplified terms, B cells are the first line of defense against viruses. T cells are a second line of defense. You do not want to be taxing T cells because as an adult, you only have so many.

      But a theory is that both repeat Covid infections and overly frequent Covid vaccination (they are rough, witness how many people are sick for a day or two after them) can deplete or weaken T cells. This is particularly bad because T cells also run around the body and stop cancers before they get far along enough to be dangerous (people are actually growing cancers all the time but they normally get kiboshed or grow so slowly you will die with them rather than of them).

      1. IM Doc

        I am not a virologist but I have been to lots of conferences the past three years.

        I have heard much discussion about this issue from experts especially early on.

        This was particularly visible early on in the vaccine effort because of the rollout timing. Everyone was getting vaxxed all at once. Now that the timing is more diluted and we continue to be in an ongoing pandemic, it isn’t so obvious. I recall multiple discussions of this in places like Gibraltar where there are just not that many people, they had not really had a big wave yet and many patients got sick with Covid in the days/weeks after they vaxxed everyone almost all at once.

        I have heard the ADE description as Yves points out above.

        I remember one individual wondering if it actually was not Covid but maybe the very sensitive PCR tests were picking up fragments produced by the vaccines and the patients were really just having a vaccine reaction. Of course, that was instantly shot down because at the time it was certain there was no migration outside of the injection area. We all know now that is not the case. I have seen two excellent papers just this week describing mRNA fragments in breast milk and myocardium. I cannot fathom the mechanism of this idea and I will be talking to colleagues about this soon.

        Regardless, I have seen this repeatedly. Patients get acute Covid and positive tests within days of the vaccine.

        It must be said about the patients above. They had all been boosted within 3-5 days of getting ill. They had very mild pneumonia/bronchitis issues and got better very quickly. This is NOT the Covid hospital stuff we were seeing in 2020. To be fair, it is generally assumed the protection from the boosters takes 14 days. The past year or so, the cohorts getting the boosters seem to fall in two big groups only. The very healthy elderly and that can bias toward a healthy vaccinee effect. The other group is the very severely chronic ill that are high risk no matter what you do. These seem to be a lot of the admissions we are having. That would predispose the vaccinated group to bias toward the severely ill. Again, the acute illness is really quite minimized now compared to earlier for the vast majority.

        No one knows what is causing this.

        One of my concerns is that no one will ever know anything if we keep up the official SAFE AND EFFECTIVE mantra. We must start admitting mistakes, asking questions, and having vigorous debates.

        1. Societal Illusions

          and keeping transparently available, accurate and consistent data. From the outside it seems there is no serious effort underway to get to the bottom of anything. Only reliable and available data will allow for understanding.

          1. anonymous

            Exactly. Pharmacies and medical offices are often crowded and poorly ventilated, and full of unmasked people, often including those administering the vaccine.

        2. Adam1

          Yes someone has a lot of explaining to do.
          I was watching a video discussing deaths in the UK and that it was looking like the all cause deaths were higher if you were vaccinated versus unvaccinated.
          I went to their source data and if you look at the last year… most months for age groups under 50 they are dying at a higher rate if they have been vaccinated vs. unvaccinated! And here we are recommending everyone get another vaccination (booster).

          Deaths occurring between 1 April 2021 and 31 May 2023 edition of this dataset

          National flu and COVID-19 surveillance data report: 6 July 2023 (week 27)
          You want to use the tab labeled Figure 19. COVID Vac Uptake

        3. Hana M

          An important paper in Vaccines showed that repeated mRNA vaccines induced IgG4 antibodies that may generate immune tolerance to the covid spike protein and hence to the virus, allowing repeated infections.

          The authors also speculate that “Increased IgG4 synthesis due to repeated mRNA vaccination with high antigen concentrations may also cause autoimmune diseases, and promote cancer growth and autoimmune myocarditis in susceptible individuals.”

          Another key paper from the Cleveland Clinic (a large retrospective cohort study of over 50,000 CC employees) corroborates IM Doc’s observation that multiple mRNA vaccinations and boosters are associated with higher risk of Covid. The authors bury the lede but see the startling figure on page 21 of the PDF

          1. Ignacio

            Thank you for this Hana. I believe it is important. I had read some time ago that repeated COVID infection resulted in induction of subclass 4 IgGs but didn’t know the same was happening with repeated booster though I had the suspicion in my mind. The different subclasses have different effector domains and subclass 4, if I recall correctly, does not induce highly inflammatory responses (this was regarded by the ultra-positive vaccine, vaccine, vaccine! types as hurray!) but also fail to recruit NK cells that play an important role in COVID infection. I think IM Doc said once in a email he had talked to other physicians who were worried about the NK issue.

            I have argued in emails within the CBT that the constant focus on NAb titres induced by boosting might be missing other important aspects of the response to vaccines: we have now subclass IgG switch by repeated boosting, decreased responsiveness of certain immune cells and downregulation of both innate and adaptive immune pathways.

        4. John R Moffett

          I have been reading more about the persistence of Covid virus, for example this article goes over some of the evidence.

          If Covid finds shelter in some tissues and remains dormant, then I can imagine mechanisms whereby strongly stimulating the immune system with the vaccine could cause a resurgence. It seems too coincidental that so many breakthrough infections occur within days of the booster. This is especially true if T cell exhaustion turns out to be a major factor in some Covid patients.

        5. Carla

          IM Doc — do you have or know of any evidence that the Novavax non-mRNA vaccine approved by the CDC would be more efficacious than the mRNA ones?

          Does anyone know if there’s been any movement on FDA approval of Novavax?

          1. Yves Smith Post author

            I don’t know what you mean by “approved”. J&J, Moderna and Pfizer were all sold under the EUA. Pfizer continued to sell the EUA version of its Covid vaccine even after Comirnaty was approved and Cominarty was pharmaceutically identical to the EUA vaccine. So practically speaking, getting the conventional approval v. the EUA approval is a non-event.

            Novavax’s original vaccine got an EUA in July 2022 ( and its XBB vaccine got an EUA (

            A web search will tell you Novavax is LESS effective than the mRNA vaccines. That is why the authorities push them and attempt to discourage use of Novavax. It has 90% efficacy v. 95% for Pfizer and Moderna.

      2. Ignacio

        Let me add a “light” discussion on the issue of ADE. I will avoid entering onto details. IMO, if ADE was involved we could expect more severe outcomes rather than higher infection rates. That is why I believe ADE is not probably the cause for the seemingly higher numbers of infected among the multiple vaxxed and/or infected. But it might explain higher hospitalization rates among those infected with history of multiple vaccination/infection episodes compared with unvaxxed, vaxxed long ago and or rarely or never infected. If such difference exists. The T-cell exhaustion story has IMO more explanatory power to explain IM Doc observations.

        Another observation that has been made before (Preprint published in May 2021) using the Pfizer vaccine is a persistent effect of the vaccine in immune cells, including lower responsiveness to viral infection and downregulation of certain pathways related with innate and adaptive immunity. The paper is quite interesting but IMO it tries to avoid any negative feeling on the Pfizer vaccine in its tortured discussion. I would like to discuss this with KLG to see if he has the same feeling i have while reading the paper. IMO this paper gives a good rationale to higher susceptibility to Covid and other infections after mRNA-Covid-Spike vaccination.

        1. Skip Intro

          The combination of persistent infection with ADE should cause a rise in reported cases, at least among those with previous infections.

        2. kareninca

          Ignacio, I wonder what you think of this study:

          The researchers distinguished between the spike from the virus and the spike from the vaccine. This is apparently not hard to do, but seems to be rarely done.

          It looks like some vaccinated people just keep producing the vaccine spike, for as long as half a year (and maybe continue to). The researchers speculate reverse transcription, or that perhaps bacteria pick up the modified mRNA and produce spike using it. I wish people who understand this better than I do, would comment on it.

          1. Ignacio

            I would check it later but I have concerns other that these about the mRNA vaccines. In the end it might result that the fast track given to mRNA vaccines was a mistake but I need careful checks.

            1. Ignacio

              To expand a little bit on this we have most sensed the short term adverse effects of the vaccines including systemic effects such as fever and head-ache, clotting that are indications of a highly inflammatory response to the mRNA, or virus-delivered spike protein in vaccines. These, I haven’t felt so hard with any other vaccine. Such highly inflammatory response might induce systemic down regulation in immune cells of pathways as described in the paper linked above resulting in a somehow “muted” immune state. Then, there is the humoral response that we have focused too much on showing production of NAbs that should be protective. Yet, these NAb levels aren’t readily so high when analysing currently circulating variants (original sin here?) and the resulting combination could be that after boosting we might not become more protected but, on the contrary, more susceptible to COVID and other infectious diseases as well. Just mumbling ideas.

              1. kareninca

                Thank you for responding. I’m worried that anything that vaccine might do that is harmful, will be made that much worse if it keeps pumping out spike indefinitely. So I am hoping this Italian study will be a fluke.

      3. Raymond Sim

        I think its worth noting that the T-cell effects may well be the result of viral persistence, with the coronavirus version of ‘persistence’ being different from what’s seen with, for example, HIV. If I understand this at all correctly, there’s scope here both for severe reactions, and paradoxical responses, to vaccines.

    3. redleg

      Perhaps the mRNA part of the vax is amplifying any virus exposure, or allowing entry into cells?
      I’m no expert in virology or immune systems, not even close, so I’m just brainstorming.

      I’m not anti-vax but I am definitely and completely done with any new vaccines using mRNA technology.

    4. speedy

      I’ll admit right away that there are too many confounding factors to ever prove this, but I believe the case of pericarditis I was dx’d with this past spring was due to a re-emergence of something. I’m 59 and in otherwise solid health, vaxxed three times (one booster). Had some side effects after the shots, including “hot needle” pain near my belt line. Mercifully, it didn’t develop into shingles, but I’ve often wondered if there is some aspect of the Covid virus or the vaxx that lies dormant, like the herpes zoster virus.

  4. Samuel Conner

    Well, at least they aren’t prescribing, off-label, the anti-helminthic medication that must not be named.

  5. Terry Flynn

    Thanks. I find it ironic that so much anecdata has appeared this week which perfectly aligns with my experience. My educational background approach frowns on anecdote so I generally pipe up only when my anecdote accords with a sufficient number/quality of reports that SHOULD be prompting bodies like the NiH to be funding formal research.

    I’ve long suspected that my second “episode” of profound ill health during the pandemic was related to a covid vaccination. Always being “pro-vax” I’ve been loathe to voice my concerns, particularly given what I saw “posh 2088 people” (it’s a postcode that Rev Kev and others may recognise) did during my years in Sydney. Not a single person I know is going to accept any future COVID vaccination. These are people who’ve all had 3 or 4 vaccinations. They’ll take their flu vax when called up – 2 or 3 of my Sydney friends had nasty bout during this last winter so we’ve got a nasty wave coming our way. But local surgeries in Nottingham are not even mentioning covid vax in their callup texts. They clearly know which way the wind is blowing and would much rather maximize flu vaccination.

    1. Yves Smith Post author

      I don’t think that it is “anecdata appeared” in the sense you mean. IM Doc has been showing the Covid Brain trust data from his practice and proving lots of individual patient outcomes that point to both more serious and frequent side effects than admitted and declining efficacy (I confess to not going through his e-mails to see when that worm started to turn, that he was seeing too many breakthough infections, particularly the attention-getting ones close to getting the jab). It is that it’s become sufficiently widespread that it is no longer a career-endangering move for a medical professional to talk about it in a pretty open manner.

      1. Terry Flynn

        Yeah thanks, I was being sloppy in terminology. I just get a lot of stick around here (including verbal abuse in the street) concerning what is and isn’t going on/masking/vaccination. It’s hard when you’ve spent 2+ decades in evidence based medicine only to see how quickly a gradual erosion in standards can suddenly speed up once a tipping point is reached due to politicisation of medicine.

    2. Jeff

      “I’ve been loathe to voice my concerns”

      Outside of the incessant lying and bs’ing by the medical establishment and our government and its public health leaders, this quote fully illuminates the other nature of this problem – the lack of courage in most of us, myself included.

      The fear of being labeled an anti-vaxxer or Trump supporter or whatever fear is rattling around the rocks in our heads…. well, it’s counterproductive and has prevented honest reporting on the fraud that has been perpetrated. Like many, I have lost all trust in pharmacy companies, CDC and FDA. Before 2020, I believed we had functioning public health institutions. That’s the damage these people have done.

  6. flora

    Thanks for this post and for IM Docs insights. Frightening to think the medical profession is losing some of its best docs and nurses. Frightening to look at the reinfection rates in conjunction with boosters and wonder what real effect those are having on the body.

  7. flora

    re: ” They have no interest or care in dealing with these issues being seen by the front line docs…”

    That is reminiscent of the AIDS epidemic in the ’80s and ’90s.

    1. roxan

      Yes it does, Flora. During nursing school, I had a rotation in an inner city ER in 1993, and asked if they were seeing a lot of HIV? (The population was 95% poor black.)They said a study had just been done and was ‘not as bad as we expected–only 40% of patients were positive’. To my knowledge, this was never publicized or even talked about much. Around that time, most of the hospitals in Philly closed their general wards as they became populated almost entirely by uninsured street people, many with HIV.

  8. The Rev Kev

    The CDC is beyond redemption right now and you could abolish it and have medical authority devolve to the 50 States and you may get better results. But the sad thing is that all the trust that has been built up over generations of doctors and medical staff has been totally thrown away during the past three years. It is not so much the loss of faith in Covid boosters but in all vaccines, even those for people’s pets. Vaccines that have been themselves tried and tested for decades. Trust has been broken as more and more people learn that the medical authorities have sold them down the river with false promises which they are still refusing to back down on. And there is the inevitable realization that this was done due to a mixture of political expediency and to ensure the future profits of Big Pharma rather than something that was done in good faith. And not just in America either. Can it get worse? Well, yeah. We could see a totally new virus arise that is also spread as an aerosol but because of all the political effort in discounting aerosol spread for Covid, it will also be applied to the response to this new virus.

    1. .human

      I have a thought that the impugning of the national (un)health establishment will likely result in weakened support for a national, universal care system.

      1. Lysias

        Government control of medicine enabled the medical malpractice of the last three years. Those years have persuaded me that the old AMA was right to oppose “socialized medicine”, even though I myself depend on Medicare and Tricare.

        1. Piotr Berman

          With similar wages, Australian spending on healthcare is ca. 50% of that in USA per capita, and health outcomes are better (I would need to dig, but USA experiences mortality increase). Socialized medicine can be better, but it is a bit like with cooking. You can have vague recipe for a very good dish, and some people would indeed get good results, and some not. Skill, experience etc.

          I would guess that American lobbies are much better developed that in Australia, and as health care, in aggregate, is the largest source of “excess profit” (sverkh-prybyl’ in Russian, a term they use in economic policies), lobbying is particularly sophisticated. In the case of Covid, Australian polices were a mixed bag (I know only about hysteria with a tennis player and obligatory vaccination in schools that makes no sense IMHO), in part because politicians “had to do something”, ignorant as they are.

        2. RonR

          Youir conclusion is wrong. I Canada gov. finances but does not control in the sense you infer. With M4A you would be far better off, believe me.

    2. flora

      Even long-standing veteranarian vaccines are being remade to the mRNA platform. Is the mRNA platform itself part of the problem? Are we allowed to ask the question?

      1. marku52

        To my mind, YES. Probblems:
        1. You can’t control the amount of antigen created. Different people will respond differently
        2. You can’t control where it goes. As we now know, it goes everywhere.
        3. Where it accumulates, it infects cells to make antigens
        4. Wherever those antigens are made, the immune system will attack (heart, ovaries, testes, liver, kidneys)

        It seems these problems are endemic to the technology. Might be worth the risk for a cancer cure. Not for a vaccine.

    3. richard rosenthal

      Sad to see how limited and narrow the thinking is here, from the top down, as to the interests served by having gain-of-function SARS-CoV-2 and an unsafe, ineffective, largely untested vaccine, years in the patenting, created, financed, contracted for, and administered by NSA/US Dept of Defense and “defense” contractors as a bioweapon countermeasure that also helps increase command and control over populations via vax passports, CBDCs, social credit systems, and other globalist goals.
      I also note egregious failure to seriously address results of VAERS and other adverse events reporting systems, huge numbers of suddenly unexpectedly dead (especially among the young vaccinated), excess deaths globally following vax rollout, and skyrocketing incidence of turbo cancers, (not to mention the role Eugenics and Depopulation ideology play for elite thought leaders).
      How obtuse and disconnected from reality can ostensibly smart people be?

      1. Yves Smith Post author

        The sudden deaths, unless in close proximity to being vaccinated, are MUCH more likely to be due to Covid. See for instance:

        COVID behaves like HIV, damaging your immune system. Only airborne. The damage may not be seen for months or even years.heart disease, blood clots, sudden death…

        There absolutely is a choice to mitigate and protect. It is a long term gain for everyone.

        Except 1 in 5 get long term damages to their system and there has been significant increases in cardiac arrest, strokes and sudden death post covid. 99% of HIV is “mild” in the first 5 years of infection.

          1. Yves Smith Post author

            McCullough misrepresented his academic affiliations, promoted hydroxychloroquine, and complete made up numbers for deaths he claimed were due to the vaccine. I don’t consider him credible.

        1. maipenrai

          if this were the case, (and it could be) then why hasnt CDC shown it to be the case with solid data?
          It should be possible with large enough datasets to tease this out

            1. maipenrai

              Large health systems like Kaiser and Cleveland absolutely have data on vaccine status…is it perfect? No, data never is.
              ICD 10 code: I46.1: “Sudden cardiac death, so described
              The person had a cardiac arrest. It was not possible to resuscitate them.”

              1. Yves Smith Post author

                I am getting tired of your Making Shit Up.

                Looks like you have not dealt much with dead people. You will get that coding only if the person died at a hospital or in the office of an MD in the system. If they died in an office or at home, the death is not a medically billed event and not coded by the medical system because they weren’t involved. It is provided on a death certificate in words by a coroner (see Ohio: And the nature of these sudden deaths is that they will happen where people are, and not-apparently-sick people are not spending a lot of time in a hospital or an MD’s office.

                And even in a hospital I would not bet on good coding in the event of a death. There is reluctance to be specific since it creates liability. My mother, who died in a hospital of a pulmonary embolism, had it listen on her death certificate as “natural causes” and I guarantee that the hospital did NOT list it as a PE because they did not diagnose her or treat her correctly (not that you can treat a PE but they acted as if she merely had pneumonia, when her symptoms and Xrays were inconsistent with that, and the second Xray to try to prove up the pneumonia she did not have killed her). They didn’t even list it as pneumonia. They listed it as “natural causes”. And that is what a coroner would be concerned about, foul play or not.

                IM Doc has many patients from California and doubtless some in the Kaiser system. I can see if he found their vaccine status to be accurately recorded. The reason it might not be is that most people got their shots in pharmacies, so that information would go into the billing system and might not be transferred back out and appended to the medical records. We have posted extensively about how MDs complain of the deficiencies and gaps in electronic health records, how they are designed for billing, not patient care.

  9. Betty

    Giving the scientific statement//summary followed by the lay version is extremely helpful. Thank you everyone.

  10. Acacia

    It’s impossible for a layman like me to really understand what IM Doc and his colleagues are going though, but my heart goes out and deepest respect for their strength and this very lucid call to action.

    Not holding my breath that CDC, FDA, and Pharma companies will do the right thing. It’ll likely be CYA at the top levels, but maybe somebody somewhere in the institutions will “leak” all the documents and some exceedingly brave journo will grab them and run with it. It’s just incredible that this is the world we’re in, but here we are.

    Perhaps I’ve internalized the “every crumb fer himself” Zeitgeist, but I recall IM Doc saying back in 2021 that it has been settled science for decades that herd immunity is simply not possible with coronaviruses. And then we’ve seen a variety of studies showing how the putative efficacy of the SARS-CoV-2 vaccines is very short. At some point, a commenter here at NC opined “they’re not vaccines — they’re just shots”, which really hit home how Orwellian the discourse has become. Between all of this, the repeated lies and outright gaslighting on the part of our public health “authorities”, and the total lack of transparency w.r.t. data on the trials, side-effects, injuries, and performance of the “vaccines”, my conclusion going into last year was that there was no reason whatsoever to get any boosters. I have been relying on NPIs — masks, Xlear, drastically reduced socializing, etc., and have thus far avoided SARS-CoV-2.

    Meanwhile, I am in constant social contact with those who have drunk the kool-aid. They make dismissive comments about the epidemic to the effect of “oh, that’s all history”. It’s almost like living in a zombie film.

    It’s pretty clear that the public has been lied to repeatedly about this epidemic.

    With their health at stake, and literally the life and death of those closest to them, people have every right to be mad as hell about this.

    1. JBird4049

      >>>With their health at stake, and literally the life and death of those closest to them, people have every right to be mad as hell about this.

      A mistake is forgivable for most, but deliberate harm especially for profit or mere convenience, not so much, the probable consequences of this betrayal has actually cost me some sleep. This is the problem as most people do not want to believe all this. Who would?

      A dysfunctional political system, an extremely corrupt government, an very likely major recession or depression, the collapsing medical system, and now this with all of it probably colliding between the summer and this time next year. The rage will be horribly vast and I believe the blowback will be very, very epic with violent protests and even more violent repression almost a given.

      Really, I think I understand why so many people refuse to see. It is not just the state propaganda, nor is the lack of critical thinking, although both are involved, but the scale of it all that is making it nearly impossible to be believed. It is something whose very ugliness is its own camouflage.

      Then again, programs like Aktion T4, which were precursors to the Final Solution were helped by the sheer darkness of it all.

  11. Jhallc

    I got the 1st booster January 2, 2021 and tested positive for Covid via PCR test 3 days later. I thought the initial symptoms post booster were related to the shot. Then my girlfriend called that she was positive. Worst 3 days of fever, sore throat and head congestion but , it stayed out of my lungs. No apparent “long term” effects, but the reference in the footnote to “or vaccinating someone while they had a asymptomatic case)” worries me. I find little information out there about the potential outcome for getting the shot and having COVID at the same time. Doesn’t make me feel warm and fuzzy!
    Now my daughter is facing the question of having her son vaccinated for COVID at 9 months. Just one more thing to worry about. So…like many of IM doc’s patients, would I like to insert my size 9 in Fauci’s posterior, you bet!
    Can’t say enough about how I appreciate IMdoc and this site for what it does.

    1. Sea Sched

      You are definitely lucky you didn’t have long term effects. A patient of mine got her initial covid vaccine…a few weeks later caught covid but recovered fine…and then her doctor insisted she get her 2nd shot on schedule 2 weeks later. She went from being an extremely active yoga instructor to having debilitating chronic joint pain and fatigue which she never had before. Her doctor was an idiot for sticking to a pamphlet schedule instead of using the appropriate critical thinking skills which would’ve led to the conclusion that after she caught covid, she did not need the 2nd shot- or at the very least could have postponed the 2nd shot for 3-6 months.

      A good practice would be that before anyone gets their booster, they get tested first to make sure they do not already have covid. Otherwise you risk the cytokine storms/immune system going haywire etc…

  12. Sardonia

    While I would never assign homework, I would ask a question that I would love to hear comment on from anyone here:

    When talking to one’s doctor, what is a good 3 or 4 sentence statement that one can say, to explain their hesitancy for getting any of these shots, without immediately having the doctor think “Uh-oh, anti-vaxxer kook”? (and ideally with a couple of links to good, cogent, to-the-point studies that justify this hesitancy)

    I ask because I am again looking for a new internist (I have had 3 retire in the last 3 years), and previously got that “kook” reaction from them – a bad way to start a new relationship. It would be good to be pre-armed with a few sentences and supporting articles that make the point, in a concise way, and in language that makes any new doctor “get it” and take it my hesitancy seriously.

    Any and all suggestions greatly appreciated. Actually, I think many of us might have good use for such a statement.

    1. Objective Ace

      I don’t think it matters what you say. if your doctor wont listen to your concerns and continues to try to force these on you there’s no way to have a good relationship going forward.

      1. ambrit

        That is the perfect way to weed out the fools and incompetents in one’s personal medical practitioners list.
        If he or she does not treat you with some respect, run in the other direction. Because generally, this is a sign that he or she will treat you like a dog. (Many Vets treat their canine patients with more care than do human Medicos their patients.)
        If alternatives are available, use them. If you are stuck with an authoritarian medico, push back hard. Your life is on the line.

    2. scott s.

      I’m unvaxxed and don’t need 3 or 4 sentences. I just say it’s my decision. I have got some pushback, but mostly back when the first shots came out. Even at the VA, where you expect them to push the gov’t line.

      1. britzklieg

        Before getting the first vaccine, and because I have low platelets, I was told (via a telemedicine doctor) to “wait for a nasal vaccine, which they are surely working on(!)” and I am grateful to have lucked out with an astute physician before the “pandemic of the unvaccinated” BS/mandates started. I remain unvaccinated, uninfected and still waiting for the nasal vaccine… and waiting… and waiting… and waiting…

        Knowing that a nasal vaccine will probably be mRNA based has curbed my enthusiasm for that as well.

        Everyone I know who has gotten covid was vaccinated. I and the 3 holdout friends of mine, who’ve endured untold disdain from vaccinated “friends,” remain covid-free.

    3. salty dawg

      You could ask your doctor what is the Number Needed to Vaccinate (how many people need to be given a shot to prevent one hospitalization) for a covid booster. It’s a fair question that anyone pushing the shots ought to know the answer for.

      The answer for the bivalent booster was in Links 8/4/2023, Bivalent COVID booster protects against poor outcomes better than 1-strain 4th dose Center for Infectious Disease Research and Policy .

      The number needed to vaccinate to prevent one hospitalization was 1,488 people in the COVID-naïve group and 3,808 in the previously infected group.

      With numbers like that, why would anyone want to take a vaccine that is also known for it’s side effects?

    4. Lysias

      What is wrong with being an anti-vaxxer kook? The past three years have persuaded me that I was wrong to dismiss the kooks’ concerns.

    5. Skip Intro

      I would ask how well the vaccine protects against infection exactly, and what is the basis for whatever answer you get. If a doctor can’t answer that, how can she reasonably recommend a treatment?

  13. Kiddoc

    Lay review you can share with friends: 9/23 (Note, vaccine author Paul Offit MD @72yo not taking more boosters) June 12, 23 Uptodate on vaccine were more likely to get infx than those not uptodate – using definition of having had one bivalent. Cleveland Clinic study, using their own data. Several references of others who had similar findings. Cleveland Clinic, looked at variants and infection, using their data. Risk of COVID- 19 increased with time since most recent prior COVID-19 episode and with the number of vaccine doses previously received.

    At least through 2021, our local Covid public health team counted infections with exposure less than 2 wk from vaccination, as if the (not yet “fully effective”) vaccine had not been given. We saw lots of them, even before Omicron. Sure wish they evaluated that subgroup separately, before merging the data. It may not be too late to study, since vax dates and exposure dates were routinely input. A few got vaccinated because of potential or known exposure, but that information was not routinely sought.

  14. antidlc

    Thank you, Yves, Lambert. IM Doc, GM, the COVID brain trust — all who have contributed to this site.

    You all have my utmost respect and gratitude.

  15. earthling

    Thank you for your courage in speaking out. Courage is needed from medical and science leaders everywhere.

    Found an excuse to pass on a gathering this month, one I had hoped to attend for years; boosters and testing required. It occurred to me if the organizers (in a large eastern metro) were so adamant about this, they might be dealing with the reservoir of people who keep passing covid around, getting infected over and over, and I would be putting myself at more risk than in my usual low-population-density life.

    Especially sad about frail elderly I know, who have been cowering in their homes for years, venturing out for very little, and to get boosted over and over again. They will recite their long list of boosters, are so proud that they have made themselves and everyone else ‘safe’, but they keep getting covid anyway, and they are getting frailer.

  16. pjay

    Thank you very much for this Doc, and thank you Yves for making such a discussion available. As IM Doc has emphasized many times, the damage done to public trust by the repression of information and dialogue has been incalculable. Although most people lack the expertise to follow high-level medical discussions, they understand public manipulation and duplicity when it is so obvious. I find it ironic that often the last to recognize the contradictions are some of my most highly educated friends and former colleagues. While they may have no more relevant specialized knowledge than the rest of us, they have been well-trained to respect the authority of Science and Expertise, which for them are represented by institutions like the CDC and the NY Times. It doesn’t matter that what they present as Truth one day may be (meekly and quietly) walked back the next.

    1. Jeff

      pjay, it’s all ego. These people got bamboozled and can’t bring themselves to admit it. So they lie to themselves and then lie to others. They’re much more comfortable eyes closed shut with fingers planted firmly in the ear canal.

      1. Val

        Out of 3 geezer brothers-in-law, two strokes (one this very weekend, in ICU right now) and one crippling case of heart inflammation. The two mega-vaxxed and stroked MSNBC/CNN bros will not process, the MAGA bro-in-law freely admits his bamboozlement. Jeff, honestly surprised your comment got through.

        There’s 1) phenomena and the limited empirical means to try to understand them, which takes a whole lot of reading, then there’s the 2) state/corporate propaganda operations related to the particular phenome– with the constantly changing absolute certainty and thought-policing, and 3) there are people’s psychological reaction to the info operations and group identity maneuvers.

        Let me suggest that there is no productive way to analyze these three simultaneously. Maintaining three separate analytical tracks (actual data, propaganda, and subsequent freakout) on hot topics means you have moved into a Connecticut zip code and are functionally deplorable, so try to decide if you are all that into reality or not. Depends on your own mind and motivations.

        “What they have done is immoral. They ALL know the problems. They all know how unethical all of this is. You cannot comprehend the deceptive shit going on here.”

        Some cranky old mol bio sequence gazers comprehended the deceptive shit going on in Jan 2020, starting early with the “virus no one has ever seen before yadda yadda” to “why are they cork-screwing people’s nasal epithelia/why 40 cycles” to “WTF they’re using the intact spike for the vax?” to the eternal droplet goons, continuing daily unto our present moment. None of the recent facts slowly drip-dripping, clinical or bureaucratic, are surprising. Sequence analysis with time series here strongly suggests the nature of the project is larger than people can admit. We continue to keep our own council.

  17. Paul

    While I would love to see the raw data, I fear that it has been hopelessly corrupted at the source. You might get a few practitioners who have their own data sets, but getting raw data on a broader scale that has the requisite integrity is likely impossible. And yes this was done with intent.

    I would also humbly ask that those of us that possess the required critical thinking skills, to stop referring to this particular medical intervention as a “vaccine”. Words are powerful, and I believe the changed definition of this word was a lever used to bludgeon the general population, as prior to 2019, that word had a strong positive connotation for most people. So why not use it as a weapon. One of the early contradictions I discovered was in Pfizer’s 10K…even they refer to it as a “gene therapy” product. Lying on a 10K is one of the few remaining crimes that still has a cost, fwiw.

    After doing my own research, I was willing do die on this hill, and accepted job loss as part of the cost of my health. Fortunately I worked for a company at the time that was open to religious exemptions, and they took any reason as valid, as long as you were willing to do the paperwork and follow the process. I realize that not everyone could take these steps and I have a great deal of empathy for those who were forced into medical interventions against their will.

  18. Walter

    Thanks very much for this post, and the discussion.

    Does anyone have any opinion about the Novavax booster, its likely effectiveness, its approval process, and, especially, its availability? The CDC website shows nearby pharmacies where it is “in stock,” but then the pharmacy websites that I have checked offer only mRNA vaccines. I think I will go to nearby drugstores and ask if they will have it.

    I believe Lambert recently posted a link that praised the Novavax vaccine (possibly a booster?), but I don’t remember its origin.

    Again, thanks.

        1. Verifyfirst

          You can’t get original Novavax if you have already had two mrna shots plus an mrna booster. That’s why we are waiting for approval for the new Novavax, which hopefully will be available for all, regardless of prior vax types.

          1. MaggieNC

            Thank you for this important aspect –> limits the availability of a protein based “vax” for those of us currently mRNA primary plus boost. I missed the “fine print” when reading the recent approvals…

          2. Yves Smith Post author

            That is false. Novavax is approved under the EUA as a booster and “I want it and not an mRNA booster” is included in the authorization.

            Authorized Use
            The Novavax COVID-19 Vaccine, Adjuvanted is authorized for use under an Emergency Use Authorization (EUA) to provide a two-dose primary series for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 12 years of age and older. The Novavax COVID-19 Vaccine, Adjuvanted vaccine is also authorized to provide a first booster dose at least 6 months after completion of primary vaccination with an authorized or approved COVID-19 vaccine to individuals 18 years of age and older for whom an FDA-authorized mRNA bivalent COVID-19 booster vaccine is not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Novavax COVID-19 Vaccine, Adjuvanted because they would otherwise not receive a booster dose of a COVID-19 vaccine.


            And if you are dealing with an uninformed pharmacist, the records are so bad you could just assert you are unvaxxed and it would be unlikely to be checked. Just go to a different vendor than where you got your earlier shots.

            1. Tom67

              I heard a very interesting interview with a German ex-pharma scientist about the mRNA vax and novovax. For those who know German here the interview:
              The upshot: the mRNA vax induces cells to produce the spice protein for an unknown length of time in any number of different cells. Hence all the auto immune problems after the vax. And then there are the lipid nanoparticles in which the mRNA is coated and whch has huge problems of its own.
              Mr. Kirchner, who has worked in Pharma all his life reckons they chose the mRNA platform as they (Gates a.s.o.) already have sunk Billions into the technology and wanted their money back. In his view the mRNA is already obsolete. In the Eighties, when it was discovered, there was no way to manufacture certain proteins on scale. Now the situation is totally different. You could easily have manufactured the spike protein. But is was chosen not to. Now to Novovax: Mr. Kirchner himself is immunocompromised after a botched cancer treatment and fears Covid. But he forewent the Vax for the above reasons. About Novovax he says that they have the tiny dose of 5 Mikorgrams of spike and use a natural adjuvant (made from the tree Sapindus mukorossi) as adjuvant.
              I myself am unvaxxed, had great trouble for it and will not go for Novovax. But anybody here reading IM docs article should very seriously consider Novovax if he or she has reasons to fear a covid infection. I would if I was immunocompromised.

            2. Carla

              Yves, from the press release you linked “Upon regulatory approval, Novavax’s COVID vaccine would be the only protein-based non-mRNA vaccine option available in key markets for the fall season.”

              So far, all I have been able to find online is that CDC has approved, but new Novavax will not be available this fall until FDA approved, which as far as I can see has not happened.

            3. Walter

              The language is *really* funny there: 1) get NV if the mRNA “is not accessible or clinically appropriate,” 2) well, if you totally refuse (“elect to receive… because they would otherwise not receive a booster dose”) the mRNA, I guess you can have Novavax… dummy! My translation “Please don’t get it, but, OK, if you insist…”

              BTW, the find-a-vax sites (CDC and both led me to nearby Walgreens, which then sent me to the Walgreens site, with zipcode screw-ups, out of date availability (said it had been updated in June :-) :-)), etc. After selling my immortal soul’s contact info to Walgreen’s, they offered me appointments for Pfizer and Moderna, not Novavax. I will keep looking, also try the county health department, and ask in person in drugstores and doctor’s office. Thanks.

            4. Verifyfirst

              That is correct for the FIRST booster (third shot). Read my comment–you cannot get Novavax after two primary mrna and one booster mrna–so for the fourth shot.

              “However, Yancey noted that the Novavax booster is not available for children or for people who have already had one booster.”


              Doesn’t make sense, of course. Hre in Michigan the state keeps a pretty robust database for vaccinations, so a pharmacist could call up your name and see your history. You could try getting a script for Novavax from your provider, that might work. Or you could go to another state and lie, which I’ve been thinking about.

          3. Walter

            That did seem to be the message I got a few months ago. Recently, at least on NV’s website, I saw a pretty explicit “You can get it after any of the others” message, in addition to the “Authorized Use” statement that Yves quotes below (which I assume ultimately comes from the FDA?).

        2. PaulA

          Novavax covid vaccine is available, however FDA authorization for the updated protein based XBB candidate hasn’t been provided to date.

          1. Yves Smith Post author

            Not correct. Approved on EUA basis in August. Why do you guys keep Making Shit Up and force me to use a search engine to make up for your lapses? I should just delete comments like that rather than waste my time.

        1. Walter

          After checking dates, and searching for “FDA approval” (limiting the search to the last week), it’s not clear to me that the most recent Novavax booster has been FDA approved yet. I think there is confusion with announcements and news from June. Novavax’s website also doesn’t make this clear either. Sorry for getting it wrong previously.

          Yahoo has a report from 4 days ago that says it’s not done yet, but notes that Novavax says the vaxx is “prepositioned in our U.S. distribution hub,” which is good I guess.

          Two days ago, Deepta Bhattacharya says in an interview (Medical Express) “Novavax has a protein-based vaccine I anticipate will also get approved soon, and it is also targeting the XBB variant.”

          1. Yves Smith Post author

            You don’t understand the status. It has an EUA, both the original vax and the XBB booster. That is all that is needed for it to be administered.

    1. Efmo

      My sister received the 2 Novavax shots last year and did not have any side affects. She’s planning on getting it again (not sure about their most recent booster and how that ties in). I haven’t had any, but am planning on getting Novavax as soon as it’s available locally for me (I think it may be now). We both feel Novavax works well enough and without all the accompanying mRNA concerns

      1. Yves Smith Post author

        The reason the officialdom has discouraged Novavax is its efficacy is somewhat lower, 90% v. 95% for the mRNA vaccines. But it’s a much more traditional vaccine design and on that basis, good reason to expect fewer side effects.

  19. chuck roast

    I just got the bug for the first time. Two J&J shots early in the plague years. I visited a dying friend in the hospital. He was out cold with “double pneumonia”. Three days later I get a slight cough deep in my throat, diarrhea and a slight fever. Low energy. Night sweats for four days. I test + three days after onset.

    My nephew was with me during incubation. We are joined for a night by his half-brother. They leave before the test. Subsequently, the nephew claims no ill effects. His brother has “a slight cold.” My sister-in-law comes and goes during this period. Never got the shots. Thinks it’s all bogus. She says she is fine and has no ill effects.

    My nephew and his brother go up to Portland and stay with my wife who believes every word uttered from the sainted PMC mouths. She is a pin-cushion. Seems to have a mild case.

    I scored Zimectrin (known to liberals as horse paste) a while back at an animal feed store. Upon + test took 200 lb. doses once a day from the dispenser for a week and exhausted the dosage for a 1250 lb. horse. Been taking zinc since the beginning of the plague. Eleven days after onset my energy level is up, cough diminished and fever long gone. Hate that I got those spiky bugs lurking around me now.

  20. flora

    In a possibly related aside: I just received a mailed notice that my next year’s health insurance premiums are increasing 30%.

    1. antidlc

      After missing mid-year financial expectations, here are the ways big health insurers are going to get back into Wall Street’s good graces
      Hint: it will be at the expense of patients and taxpayers.

      Last week, I wrote that the big for-profit insurers made more than $40 billion in profits during the first six months of this year but that Wall Street doesn’t consider that nearly enough. Investors have been shifting money away from those companies, which, I can assure you, has set off alarm bells in the C-Suite.

      Because top executives’ compensation is tied to meeting specific financial metrics, including shareholders’ return on investment, the CEOs are especially motivated to right the ship and reduce the percentage of revenues their companies pay out in claims to provider groups and facilities the companies don’t own. You can be certain they’ll be pulling all the levers they can think of.

  21. Synoia

    I am slowly realizing that our federal officials are now totally corrupted.

    yes,a portability, but why? What do they gain?

    Is some group of US and/or Chinese officials evil, mendacious, reckless, or just plain stupid?

    Who in the US and who in China China authorized the Wuhan lab?

    Where is the Congressional inquiry?

    Where is the Chinese inquiry into the Wuhan lab?

    Is this some attempt to reduce the size of the Planet’s population?

    1. Allourproblemsstemfrom2008

      “What do they gain?”

      Power, money is trumped by power. Its all they care about and that has been evident since 2008. Otherwise they wouldn’t have changed the rules in 2008 like they did.

  22. Sea Sched

    How much of the “vaccinated getting covid” is related to how once people are vaccinated they behave more recklessly because they are under the mistaken impression the vaccine protects them- so now that they are vaccinated they take off their masks, go to parties, travel, etc.??
    I do think vaccine efficacy is overblown and there is potential harm with the mrna versions that will never be acknowledge by big pharma…
    but also some of this can be tied to social behavior right?

    Vilifying the unvaccinated also makes zero sense since it has much more to do with risky behavior than vaccine status…early on a lot of colleagues wanted to ban the unvaccinated in their practice- this made absolutely no sense to me- I would much rather treat an unvaccinated person who stays home than a vaccinated one who just got back from air travel to attend a wedding!

    I have also noticed how many people love blaming the vaccine for everything and anything… someone young dies of a heart condition- oh it was the vaccine! But they were vaccinated over 2 yrs ago…so what is more likely? It was a vaccine reaction- or it was the fact they thought they were “safe” after getting vaccinated and went out unmasked and caught covid 3-4 times and the repeated infections strained the heart-
    why are people more inclined to blame the vaccine than covid itself?

    1. Allourproblemsstemfrom2008

      “early on a lot of colleagues wanted to ban the unvaccinated in their practice- this made absolutely no sense to me-”

      Is it ok to say now that covid was political from the beginning? Or is that still taboo?

      1. Sea Sched

        Political but interestingly enough from both ends! These colleagues chose to feel superior rather than using logic during those times and felt glee almost at the idea of banning what must have been in their mind right wing antivax deplorables is my guess… not realizing there are plenty of left wing antivaxxers as well… RFK jr is this perverted amalgamation of this- pro-environment, antivax, racist- he managed to pick up elements from both ends of the spectrum…

      1. Pat

        Let me correct that for you:

        Masks that are ill fitted, worn under the nose or chin, or made of porous materials are useless against respiratory infections. Well fitted respirators, N95 or better, worn properly are very effective against respiratory infections.

        Funnily enough many of the same people who undersell or outright deny the possibility of effective masking are either Covid deniers or those who oversell vaccines and like to pretend the only other preventative action is hand washing for an air borne disease.

        1. Sea Sched

          Thank you Pat for taking the time/energy to respond to that. I don’t have any left and never bother anymore. You are more patient than I am.

    2. Sutter Cane

      why are people more inclined to blame the vaccine than covid itself?

      I think Great Barrington Declaration types have a vested interest in blaming the vaccines rather than covid itself because if they can convince the public that the problem is the vaccines and not covid, then government/business interests don’t have to do anything about covid, which would cost money/taxes/reduce profits. With the additional benefit of further eroding trust in the public sector. There is obviously a coordinated army of bots on twitter and in online comment sections with the goal of blaming “the jab” for anything and everything whenever covid or long covid are mentioned.

      Secondly, the public wants to believe this anyway, so they eagerly embrace the propaganda. Not getting vaccinated is easier than trying to avoid covid infection, which requires behavior changes and acknowledging that it isn’t 2019 anymore.

      1. Sea Sched

        You are right about eagerly embracing the propaganda. One of my patients developed trigger finger 2 months ago…she said she thinks it is from the vaccine. I had trouble hiding my incredulous tone when I responded- you mean from the single J&J shot you received over 2 years ago? She said yes and she will never get another vaccine again. Obviously whatever media she is consuming has convinced her all of her problems are from the shot (regardless if it was mRNA or not)…
        Another patient mentioned that a UPS driver collapsed in her cul-de-sac and said perhaps he had just gotten vaccinated and that’s why. I was astounded this was her first thought- someone collapses and it must be from a vaccine reaction- not from dehydration, blood sugar issues, heat exhaustion, MI, covid itself- but no must be a vaccine reaction. The youtube videos or facebook snippets these boomers are soaking up is permeating their brains in a very thorough/systematic manner.

        Seeing so many medical professionals (sadly mostly in the alt med fields) post headline news stories about unusual deaths and then drawing the specious line between that and vaccines is exhausting and demoralizing. Oh this famous athlete or world traveling journalist died young- what was his vaccine status is their first question. Never- how many times did he have covid?

        And yes the wishful thinking of why can’t it be like 2019 again is so accurate. The inherent selfishness of people just not wanting to mask/improve ventilation so they do this whole song and dance in their head to justify it instead of just saying, I find it inconvenient and don’t care if it affects myself/others.

        I do find it ironic that vaccines are least effective with most potential for harm in the immunocompromised, children, and elderly which are the populations we request get vaccinated…and adverse vaccine reactions do happen (typically as neurological or autoimmune issues) but bringing this up labels you an antivaxxer in the conventional medical community…

        If covid creates cardiovascular problems, something mimicking covid could as well of course…but in my opinion, shouldn’t people should be much more scared of the strong immune response from actual covid raising your cardiovascular risk, than the smaller immune reaction from a vaccine raising your cardiovascular risk? That being said, I recommended Novavax to everyone I know- older technology subunit based vaccines lead to fewer side effects, especially for those with autoimmune issues. The skepticism around mRNA is legit. But does this mean every health problem cropping up now is from the mRNA vaccine? Pretty sure it is from covid itself especially since we have the data from before vaccines were even rolled out.

  23. Di Modica's Dumb Steer

    I will admit to being a bit out of the loop here, but why the mention of J&J at the beginning? Is that significant? I got the two J&J shots at the beginning of the pandemic and nothing else, so I’m not certain how that decision held up (felt like crap for a couple of days after each dose). I mask when out in public (indoors, generally), or in crowded areas.

    Not sure if I’ve caught it before, but every test I (or family that lives with me) have taken has been negative, but that doesn’t necessarily mean much. Daily zinc, Vit. D, and an Aranet 4 I try to monitor regularly.

      1. Di Modica's Dumb Steer

        Hi Yves –

        Your question had me second guessing myself, so I dug into the file folder to grab my vaccine card, just to be sure. Indeed, I got two of the J&J Janssen shots: one in early 2021, and a booster six months later. I don’t know if perhaps I wasn’t supposed to get or be given the second round, but I got them. I don’t think it was long after that they were discontinued.

        My partner got one of the mRNA ones, and I think I wanted to get something different, if only as a half-assed comparison. Far as we know, she hasn’t gotten COVID either.

      2. Rick

        One booster of J&J was allowed, I had it. No more were authorized so I caved and got two Moderna (single and bi-valent).

        For me, no more mRNA. I was skeptical from the beginning due to this being the first deployment of the technology.

        Now, it’s Novavax or nothing for me (thanks for the link, Yves).

        I’ve gotten used to my NPIs (close fitted decorated N95/KF94 indoors, meeting outside otherwise) and being isolated. I look to Montaigne in his château as my inspiration.

      3. petal

        My employer forced us to get one initial sequence(2 mRNA or 1 J&J) and then down the line forced us to get one booster of our choice(mRNA or another J&J), so I ended up with 2 J&J. For the second, figured the devil you know is better than the devil you don’t. I had refused to go near the mRNA after a warning from an MD/PhD friend and another PhD friend that I trust, along with all of the great information here at NC. Had a heck of a time after the first J&J and had massive anxiety before the booster because of the first one triggering my autoimmunity for at least a month after. So glad I never got any mRNA, though. Praying they do not force this on us again.

  24. Cat Burglar

    Pressure to maintain the current vax policy seems to be very powerful and pervasive. My guess is that it might therefore be easy to trace it upward to the ultimate source, and public attention directed there.

    We need a Covid policy Ellsberg.

  25. Arizona Slim

    Slim checking in from Tucson. And you know what? I proudly identify as…


    Yup, I am one of those people.

    I credit Naked Capitalism for having a huge influence on my decision to skip this never-ending round of shots.

    First, and foremost, there were IM Doc’s 2020 reports about the shabbily constructed clinical trials. Second, there was the much-reported fact that the manufacturers had zero liability in case of harm to the patient. And third, there was the speed to market. Usually, it takes 7-10 years before vaccine safety is confirmed to the point where it can be injected into people.

    After the shots started becoming available here in Tucson, I started hearing stories from friends. Bad reactions that happened almost immediately. People being sick for weeks. And on it went.

    That was enough to make me pass on this injection “opportunity.”

    In late 2021, one of my best friends was being coerced to take the job jab. She and her husband, who was in the same situation, took J&J. He was okay, but she still is not. On the day of the shot, she experienced hallucinations, had trouble using her legs, and then she developed tinnitus that lasted for weeks.

    Earlier this year, she told me that her legs were still not working properly. I’ve shared the name of a doctor who treats patients with vaccine injuries. I don’t know if she has consulted with him. I would imagine that simply reaching out for help is very hard to do.

  26. Laura in So Cal

    So an anecdote about my Dad’s recent experience.

    My Dad is 81 and in excellent health with the exception of advanced macular degeneration.
    He got the first 2 shots, developed Delta covid 6 months later and was sick but fully recovered in a week. No boosters.

    He went to his primary care office to get 9 stitches removed from his thumb. (He dropped a skil saw and tried to catch it. :-()

    The NP asked if he wanted the new Covid shot. After he said “no thanks” , the NP said “you probably shouldn’t get it, anyway.”

    So the NP felt compelled to ask, but once he refused, she expressed her actual opinion.

    1. ambrit

      “(He dropped a skil saw and tried to catch it. :-()”
      Ouch! I have had similar “accidents,” mainly at work, but also at home.
      One accident involved my right hand, the last three fingers of. My first reaction was to yell down to the worker below me, this was on a high rise job, “Quick! Find my fingers and put them on ice!” Luckily, I did not lose any fingers, but have scars on both sides of the hand to remind me to beware the stupidity of others. (The accident arose as the result of a previous worker being sloppy in preparing the site for the particular job I was doing. Something out of my control gave way and my hand got in the way.)
      Circling back to the subject of the Coronavirus 2019, I am still of two minds about the “stupidity” versus “evil” question concerning the virus’ genesis. It is probably a combination of both.

  27. Space Station 11

    Academic ER doc here, busy urban hospital and trauma center. This discussion is very interesting to me in that Covid, the vaccines, etc are virtually never discussed at our shop anymore; it’s become more background noise, another illness with occasional spikes, regarded in much the same way as influenza. Perhaps that’s reflective of a general malaise, especially with mid-career physicians (like myself). Evidence of burnout and ‘quiet quitting’ (i.e. showing up to clinical shifts but generally disregarding or de-emphasizing academic work, meetings, administrative updates) are absolutely increasing where I’m at, but I believe Covid is just one relatively minor cause of that. Most docs I know are demoralized from the rapacious growth of administration within medicine; frustrating EMR systems designed for billing instead of communication; noticeable spikes in violence towards healthcare workers; staggering rates of drug abuse, homelessness, and the near impossible task of caring for these patients adequately; random shift schedules leading to poor sleep and nutrition; fear of lawsuits leading to overtesting and overtreating; etc, etc. I’d quit tomorrow if I could.

    For the record I’ve have Covid twice (both times from my toddler, who brought it home from daycare), had the first two vaccines (required as a condition of my continued employment), and spend very little time worrying about it. I won’t get any more Covid vaccines unless forced to. I had RSV last year (also from my kid) and that was way, way worse than Covid for me.

    1. Paul

      I don’t work in any kind of medical setting, but I try to get any kind of info from your profession so I can keep a pulse on overall sentiment. NC is helpful of course with all of IM Doc’s participation and others, and don’t hate me for this, but the subreddit “Medicine” is also informative. It’s highly moderated so you need to be in the profession to materially participate, but I find it interesting to lurk and read.

      Two main takeaways. Burnout/quitting seems to be a real problem. It’s also a vociferously pro gene therapy community. It’s also highly partisan so if you get easily enraged by that stuff, then stay away.

    2. Jeremy Grimm

      I moved to a new area. I have made some cursory searches for a new General Practice Doctor [GP] that works under their own shingle, but for every prospect I discovered I soon discovered affiliations with consolidated medical practices affiliated in turn with either a large private equity owned medical chain in one area or affiliated with a large Corporate medical chain in an alternate area. I went ahead and called two different practices to try to locate a GP accepting new patients. Both had doctors who were accepting new patients for appointments … in a year. I am living in a rural area not all that far from two reasonably large cities each of which was the locale for one or the other these two medical practices.

      Am I wrong to wonder whether there are more problems with medical practice in the u.s. than described in the first paragraph of this post? If current washout rates for pre-meds are anywhere near what they were when I attended college decades ago, is it wrong to wonder whether too few students are accepted into medical school and too few new doctors are being trained? I have heard that it is even more difficult to get accepted to veterinary school than medical school. If that is true, is it wrong to wonder about the criteria used select candidates for medical school and wonder whether the best candidates are chosen to practice Medicine on humans? If more and more “seasoned and often highly competent doctors” are leaving Medicine and too few new doctors are being trained by u.s. medical schools perhaps the “breakdown of the practice of medicine in the US” is proceeding at an even faster rate than contemplation of this post might suggest … and my comment does not touch on the situation in the nursing profession or that of the many technical specialties paramedics, EMTs, support staff.

      1. KLG

        Jeremy, late to the party. The problem is not necessarily the number of new physicians, it is their geographical distribution. Rural physicians come from rural areas, but rural medical students represent less much less than 10% of medical students. Some of us are working on this, which is an interesting problem. The reason it is harder to get into vet school is that there are ~32 vet schools. Last time I counted there were more than 144 allopathic medical schools in the US and an increasing number of osteopathic medical schools. A lot of Americans also attend medical school in the Caribbean.

        The washout rate has not changed since I was in college a very long time ago. For every 100 “premed students” on their first day of college, 50 remain after General Chemistry. After Organic Chemistry, there are 25. Another 5-10 run aground for other reasons, mostly because they are allergic to sitting in the library for long evenings 4-5 days a week, a trait increasingly found in medical students, too. I blame the digital transition, but I am old…

  28. TravellerHiker

    More Anecdotes –

    Seems the unvaxxed that I know based on social media posts have started to go through Covid for the second time. This is now coming up on 2.5 years from their first infections. I believe I read somewhere – that coronavirus’s come and go on a 2-3 year cycle? Maybe I’m wrong on that.

    For the vaxxed and boosted – one just had it for the second time, one for the documented first time but has been sick with other ailments off and on over the last year, most everyone else I know who’s been vaxxed and boosted has also had it just once ( that I’m aware of) .

    For myself – unvaxxed, had it back in May of 2022 ( more than likely BA2) and still haven’t been sick with anything else since. This is while going out to stadium events, concerts, bars, multiple plane trips, etc.

    Speaking of people testing positive after getting the booster or initial shot – this just happened to the WA state governor –

    1. IM Doc

      This appears to be his third infection – and if I am reading correctly his fifth injection.

      This article documents his second time and first time with a COVID infection and his vaxx history.

      This is not all that unusual and is exactly in line with what I am seeing.

      Despite having repeatedly told my patients not to receive multiple vaccinations on the same day, I have a gentleman today who got the COVID, hi-dose FLU, and new RSV vaccine at the same time on Wed. He came into the office just now SOB and fever 101. COVID test is positive. On his way to the ER.

      I would very much caution anyone on getting more than one vaccination at the same time. I see the ads in the media encouraging this all the time and just shake my head. Obviously, these ad-writers have not taken care of patients for a lifetime like I have. I have been telling adults this since I was young. Far too many times, and in unpredictable ways, it causes people to become very ill. Almost never hospital level ill – but a few days out of your life ill. I was trained back in the day to never give multiple vaccines to adults at one time. That training and advice, like so much else, has been given the heave-ho right out the window.

      Give your immune system a few weeks in between any boosters or vaccines. They used to tell us that worked better.

    2. Yves Smith Post author

      Other coronaviruses have immunity of 6 months to 34 months. MERS is the longest at 34 months….and conveniently for the purposes of memory, a 34% fatality rate.

      The problem with any claims about having been infected or not is that a ton of people got asymptomatic infections, so your unvaxxed saying they didn’t get infected are speaking beyond their knowledge. All they know for sure is they didn’t get something that looked like a symptomatic case and had it firmed up.

      The UK React data, which measured the falloff of antibody levels (they did bloodwork on 100,000 people every 5 weeks or so, the sort of thing every country of size should have done) found immunity for wild type lasted only 6-8 months.

  29. DJG, Reality Czar

    Many thanks to IM Doc and to the other commenters for insights. Naked Capitalism has allowed us individually and collectively to pull apart this problem: Yves Smith and Lambert Strether keep poking us to think better. IM Doc’s original post and the many comments are an excellent read.

    I am wondering if in the U S of A and England (yes, specifically England) there is some confounding factor.

    Here in Italy, I discovered that the figures for new cases last week were about 30,000. (Unfortunately, about a year ago, cases were down to 650 a week. So we’ve got a problem.)

    Recently, Lambert Strether posted a tweet at Water Cooler that mentioned that Paxlovid prescriptions in the U S of A in September were 250,000 a week.

    Now, Italy’s population is about one-sixth that of the U S of A. Let’s use a multiplier of 6.5.

    Italian agencies have been more meticulous about data collection, although Italians now are not required to quarantine. Just advised to. At the same time, pharmacies in Italy have more leeway, and pharmacists are the front ranks of the medical system: So you have more data.

    Let’s say Italy truly is at 100,000 cases a week as of September. That’s 5.2 million cases a year. Yikes. Let’s hope that La Befana brings us a cure for Christmas!

    But if Paxlovid prescriptions are at 250,000, what is the real weekly number in the U S of A? I have four friends who all have reported to me from Chicago that they have pretty severe Covid. Anecdote, yes. Yet none of them wants a Paxlovid prescription.

    So is the U S of A at 1 million cases a week? 52 million cases a year? That’s ten times what I’d guess for Italy. Yet the U.S. population is only 6.5 times as big. That’s 18 million “excess cases.”

    Italy was much more vaxxed than the U S of A. Rounds 1, 2, and 3 were over 90 percent. Round 4 (fall 2022) was less. Not to contradict IM Doc, but Italy isn’t seeing the same level of adverse reactions from vaccination.

    What is the confounding factor here?
    –Most obvious in my Undisclosed Region of Piedmont is that the Piedmontese weigh less. I’d put the number of morbidly obese at less that 3 percent of the population. A quarter of the population is overweight. Most Piedmontese are pretty darn wiry compared to Americans.
    –Food? Think of the anecdote reported many times by Americans: In the U S of A, they think that they have gluten intolerance or irritable bowel syndrome. They arrive in Italy for a vacation (a confounder) but also find that they can eat bread and pasta. This self-reported anecdote comes up too often to be an urban legend.
    –The structure of the health-care system. As mentioned, pharmacists are the first line of defense. Pharmacists can prescribe within limits. Pharmacies do blood work. U.S. pharmacies just aren’t that helpful.
    –Expense? My first booster and second booster for Covid were free. My pneumococcus vaccine was free. My herpes zoster / shingles vaccine was free. And so it goes.
    –Italians are hypochondriacs. (Heck, it’s a national joke and the reason everyone is constantly sautéing greens.)
    –That written, I asked my doctor if the regional health service of Piedmont planned to vaccinate people this fall. He said that he hadn’t heard. That was less than a month ago–since then, I saw something dribble out in the newspapers that anyone over 80 or immunocompromised will be vaxxed this fall.

    Okay: Tear apart my assertions. But what is the confounding factor in Anglo-America?

    1. SocalJimObjects

      Provided here for comparison, but this is the weekly data from Singapore. Seems like they had a spike sometime in April and it lasted for around 2 months. It’s also possible that they are now at the beginning of another spike. Singapore’s population is around 6 million so a lot less than the US population. I haven’t been in Singapore for a while, but according to friends masking is down to about 50 50.

    2. Yves Smith Post author

      Are most Italians outdoors more? Weather generally better than US. So perhaps less exposure.

      Perhaps more caution due to how bad the Covid wave was during wild type?

      Maybe the sugar and high fructose corn syrup in the US diet, per your comments on weight?

      Not as many people on rounds 4+ as here?

      1. MaryLand

        About being outdoors more, how prevalent is air conditioning in Europe and other countries? In US summers ac is used a lot. Indoor air conditioning with windows closed usually means less ventilation and possibly a higher chance for viruses to spread among people. While Covid can spread any time of year, more time spent indoors with poor ventilation can coincide with an uptick in cases. That’s the “seasonality” I see in the US: when the weather gives us cold temps and hot temps.

  30. ProNewerDeal

    if available, is it worthwhile getting the N0vavax injection?

    taking the I vitamin prophylactically twice per week?

    I wish there was a current how-to “best practice” on reducing Covid risk in Murica rn in 2023.

    Official US Fed Gov public health Covid directives have a Failing track record.

  31. MaggieNC

    Made a comment … didn’t show up. Never had this happen in the many years of reading and infrequently commenting…

    1. GramSci

      I’ve been a web administrator on-and-off for 30 years. Until you read the server logs, it’s hard to imagine how creepy it is out there: I’m retired now, but these days even my toy hobby sites get up to a thousand web crawlers every day, checking the locks on my back doors.

      On a popular site like NC, Lambert and Dave should run *at least* three ‘AI’ filters to weed out these crooks–and that’s even before you get to the human ‘influencers’, perverts, and trolls they have to ban in the name of civility and due diligence.

      I am grateful when the very human NC moderators usher *any* of my comments through this gauntlet of mindless but absolutely necessary ‘AI’ filters.

    2. Jeremy Grimm

      Compose your comment in a text file and save a copy before you submit. If it does not show up after 5 or 6 hours [someone can probably make a better suggestion for how long to wait before submitting again] try submitting it again and hope it does not show up twice.

  32. JM

    I wonder if I’ve missed a mention anywhere, but has IM Doc ever commented on Long COVID? I don’t think there has been a full post, maybe a reply somewhere? I quick Brave search didn’t get anything.

    I ask because there have been a number of articles in Bloomberg and the like acknowledging that it’s a real concern lately, and Jha felt the need to try and kneecap the idea yesterday. Having more info, even if it’s just additional anecdotes would be helpful I think; and IM Doc seems thorough with their head screwed on right.

  33. LAS

    IM Doc, you’re more likely to see sick people and older people than the random population. Patients are people who use doctors, but not everyone is a patient. And despite the accuracy of your records, those cases would have to be organized into an experimental or observational design with suitable controls before they’d become valid evidence for making generalizations about what is still a novel virus. You could partner with an epidemiologist who could help you do it. On the other hand, you likely can’t spare the time or energy.

    But there are a lot of confounders that should give you pause before concluding a conspiracy.

    The population most likely to be multiply-boosted are the elderly. But that’s also the population most troubled with declining immunity and chronic conditions. They also have severe covid at higher rates than random covid patients whatever their vaccine status. Healthy people rarely trouble to present to a doctor. These are confounding conditions.

    Sequential events are not sufficient condition to prove causation. Believe it or not, I’ve heard people rightiously claim that the covid vaccine caused their sexually transmitted disease, because they weren’t sick with the STD until after they got the covid vaccine.

    Many people are burned out about the governance and institutions and control frauds. It’s just sad to have made all that investment in education and experience and feel driven to quit. There must be something other than quitting. First and foremost caring for yourself more could help.

    1. IM Doc

      I absolutely understand what you are saying. However, I think you have missed the big point. I am not able to make any conclusions alone. I am hearing much the same stories however from my colleagues all over this country. The problem and the point is that those who are indeed tasked with doing this work are simply not doing it or not releasing it to the public or not allowing it to be discussed. They are going to learn the very hard way that censoring is never an option – it just makes things worse. They are providing interpretations of data that so often have just been laughable. They are allowing “the science” to obscure and not release data for 75 years. I have so many observations. And I have so many questions about what is going on. I would love nothing more than to be able to have the entirety of whatever raw data is to be had, have that shared with the world, and have people all over this planet working on it. That is not happening. And unfortunately until it does, myself and all my colleagues have nothing else to go on but what we are seeing in front of us.

      The population most likely to be multiply-boosted are the elderly. But that’s also the population most troubled with declining immunity and chronic conditions. They also have severe covid at higher rates than random covid patients whatever their vaccine status. Healthy people rarely trouble to present to a doctor. These are confounding conditions.

      I tend to agree with everything you say here. One major point – my entire day is filled with the healthy and worried well. I see plenty of healthy people who are struggling with these same issues. I am having ever more frantic patients demanding vaccine injury workups. I am constantly accosted with all kinds of seriously crazy stuff. I have literally zero help from my federal officials. None. Why are these people struggling mentally so? Well, I would urge us all to look back in our memories from two years ago. This simply was not the message that was being presented. Rather – You get the shot, you will not get infected and you will not transmit it. You will become a dead end for the virus. This was stated over and over again by the President, Fauci, Walensky, and media figures like Maddow. Over and over again. At a time when all of us on the front lines knew this was absolutely not happening. They insult us with the “science changed” line. Just laughable. How many months did Dr. Fauci spend debating the percentage of the population would need to be required to achieve herd immunity? Anyone who knew the first thing about this virus family or bothered to do even the most minimum of research would know that was a fools errand. This is the cause of the rage and frustration I am dealing with in so many of these patients.

      I am not concluding any conspiracy as you suggest, I am living a bad dream that I never thought would happen. We are now learning that our federal health officials were informed early in the summer of 2021 that there were some very significant safety issues related to the heart……and yet proceeded with a nationwide mandate months later. Is that a conspiracy? And now this very week, officials from OSHA got up in front of the Congress and with a straight face declared that no one was fired from these mandates. Is that a conspiracy? The problem is that as a PCP and all kinds of colleagues all over this country had to look these people in the eyes who did lose their job, who did take a big hit, who did have kids to take care of. Is that a conspiracy?

      I am feeling the burnout and depression in a big way. My wife and kids worry about me all the time. Believe me. But you also have to believe me that I do care for myself. I vowed as a young physician to one day be the happy warrior that so many of my 80something mentors were. And I will not let them down. But that does not mean I am absolutely sickened by what is going on all around me. And believe me, it is not just COVID.

  34. Pat

    I also wanted to thank IM Doc and the NC moderators and community. This is a very confusing and stressful time that the people here have helped provide information that helps navigate it. I, for one, am incredibly grateful.

  35. Bri Guy

    What I find very strange is that I, as a layman, was able to sort through medical information early in the “pandemic” and decide not to take any experimental mRNA shots, which I saw as dangerous, in spite of the pressure from medical and government authorities for me to conform.

    What took the medical doctors so long to understand, and why do most still follow the government dictates?

    Unfortunately, I have lost most of my confidence in the allopathic medical system and our government.

  36. Jeremy Grimm

    I have given up on trying to understand the Corona flu, the mRNA vaccines and given up on trying to guess what the CDC, FDA, and WHO think they are doing. We are in the middle of a major pandemic. Far too little is known about the effectiveness or safety of the vaccines, and the mRNA vaccines in particular. Time tested tools for handling pandemics are being rejected for reasons I do not understand. The long term effects of the Corona flu are only slowly becoming evident and remain poorly understood. The pandemic continues progressing by fits year by year, and bad as it is and may prove to be in the future — I am frightened that the Corona flu is not the worst pandemic Humankind may face in this century. I believe the handling of the Corona flu has been worse than abysmal and hints at dire threats to the future of Humankind if this is the best we can do.

    1. redleg

      Unless and until a flu can adversely affect most organs (heart, kidneys, liver, nerves, taste , smell, etc., having experienced these first-hand), don’t call it a flu. It’s also a Corona virus, not an influenza virus, so it’s biologically false in addition to being symptomatically false. It’s not a flu, so stop referring to it as such.

  37. skippy

    @IM Doc …

    Sir, I can fully relate to your experiences and that of your Fellows. I watched as neoliberal economic and social agendas/polices from University Indoctrination, prominent ideological think tanks, and a vast array of industry media slowly corrupted everything since my L.A. Calif 80s. I know how these others feel and how hard done they are by trying to do the correct thing in the discharge of their duties, fully known the broader social ramifications and the injury to ones proverbial soul forever. I left high paying and high reward career paths because it was just all to egregious. I am one of the classic 80s sorts that made packet and then when things became too much took off to seek a better life/work balance elsewhere at a loss of future income and status.

    But then again I have watched this from birth in the early 60s and saw all the men and women of high standards get turfed out if not compliant to the neoliberal agenda. This is why I have always seen the Raygun quip about Trickle Down as not being about manna from heaven via Rich to Poor – but the dominance of the inherent world/social view neoliberalism foist on society, with ratchet like effect, with each generation and crisis.

    Best bit is I got to see it all happen again here in Australia having immigrated in the mid 90s – we were the nation that was comically described as 20 years behind the best American practices. That has sped up a wee bit since then. Like watching a movie the first time and then see it again years later whilst the entire audience is seeing it for the first time. WOW attempting to inform people where this would all end up and then have them look at you like your from another planet or worse a Commie ….

    Alas … it is a great personal joy to know that there still are men like you around, take solace in know some still exist. Not that it means anything but you have my utmost respect and a fine addition to the NC 7 samurai club … it is a privilege to know you[.]

  38. Anon

    Jackpot! I actually am getting a bit worried. Just received notice of real and potential increases in homeowner’s insurance premiums… in the realm of 43+%. A large bag of Doritos is $7. Numerous items I regularly purchase at the grocery store are marked up $1 since the last two months. $150/barrel oil on the horizon? Things are getting dicey.

  39. Lambert Strether

    > it was utterly inexcusable not to track injuries (among other things, doing so would enable doctors to identify sub-populations where the risk/return tradeoff was poor, and to determine if batch quality and/or poor administration played a role, like not aspirating the needle first, or vaccinating someone while they had a asymptomatic case). It’s also made it very hard to pick apart poor outcomes resulting from Covid infection versus (remember, even under wild type and Delta, many cases were asymptomatic, so there are likely vastly more people who have had Covid multiple times than is known or acknowledged).

    It’s very hard to see how one could perform a “personal risk assessment” under such conditions.

  40. Eclair

    IM Doc writes: I am living a bad dream that I never thought would happen.

    That perfectly describes my experience as well. And, it is not just CoVid and, as IM Doc emphasizes, the mendacious statement by the authorities that : You get the shot, you will not get infected and you will not transmit it. You will become a dead end for the virus. . Learning that there was no Santa Claus and that trusted adults had been lying to me for years, was less of a shock than the gradual realization that the so-called vaccine was not sterilizing. (And, I am a pro-vaccine person, remembering the immense relief when the polio vaccine was administered to us school kids and polio was stopped in its tracks.)

    I get that bad dream feeling over an increasing number of other happenings: from the almost certain US involvement in the Nordsteam Pipeline destruction, to the almost complete silence about the slowing (since 2000) and now declining US life expectancy, first reported by Case-Deaton in 2015. And, then there are the hard-to-ignore effects of global warming, which has definite effects on health and life expectancy, as well as on insurance rates, but which the power of profits and corporate greed force prevent us from stopping. To top it all, there is the increasing belligerence of the US government regarding Russia and China, which, if brought to fruition, will cause that life expectancy line to take a cliff dive.

    A few things keep me sane: growing veg, planting native trees and bushes, sharing fresh peas and cucumbers and new potatoes with neighbors, hanging out with Amish friends.

  41. VH

    Where is J&J in all this? Did they not have a differently developed vaccine? And no boosters from J&J ever as far as I know. And why do we not have a nose spray vaccine as I believe other countries have? Is that not more effective and potentially less dangerous? I have never had a booster, had the J&J now several years ago and never been sick to my knowledge. Stayed home more than usual throughout the worst of it but not entirely. Husband and I went out a lot and masked. All of this info is disturbing but also very interesting. I always thought about the regular old flu vaccine that it was weirdly hyped every year when its effectivity was acknowledged to be very low and whatever was developed the year before couldn’t possibly tackle whatever new flu season came up with. So it’s been a long time of pharma and government BS but lately it’s enormously misleading and just getting worse. I will not get any booster or vaccine unless I am threatened with getting fired by my company which is unlikely. I’m 65 and have not had the flu or anything like it in 20 years. I think any vaccine or medicine mass produced with so much pharma pressure is not going to be properly tested. I worked in med device for years. I know these companies all take shortcuts and hope for the best. The bottom line ALWAYS matters way more than anything else and no government brakes on this. The medical industry scares the crap out of me and I hope I don’t need it for anything serious.

  42. Joe Well

    Someone should track the corruption of information in all the fields of endeavor today, from medicine to engineering to education to the military to retail to literally everything. Is accurate information being provided anywhere? How do we know anything now?

  43. playon

    Thank you once again, IM Doc. I have felt ill for most of the last two years with at least three COVID infections. I am disappointed with myself for being a good sheep and getting two “experimental” MNRA shots and a booster. My trust in any government agency has now been reduced to zero (and it wasn’t that high before, but I mistakenly thought at least our public health agencies were still trustworthy). Not only were the MNRA vaccinations pushed on everyone, other types of vaccinations that were possibly more effective and more safe were actively suppressed. (Note the continuing refusal of the feds to greenlight Novavax.)

  44. Sue inSoCal

    Late to the party, but the whole Covid situation imho is a flipping mess. I am one with several comorbidities who took the original Moderna. That seemed fine. It was the booster that was a flaming nightmare. I was on ivig at the time, and if iirc, there were instructions to wait a month off of it before taking the booster. No one advised me. I was seriously ill, chills, soaring fever – and then, (like Eric Clapton) I was covered with awful esonophilic eczema, that has never resolved. I had not had active eczema for 50 years. No more of these mRNA vaccines or boosters for me. Done. I appreciate all of your information – Yves, the physicians, Lambert (who keeps track of the virus variants) and everyone who follows this sh!tshow. I’ve become less angry, as I accept that the US is running on corruption at what seems to be every level. Thank you Yves especially for the information regarding Novovax. In the meantime, given my lousy health status, I still mask and distance. Particularly at medical centers where no viruses exist anymore. It’s all over dontcha know?

  45. dave -- just dave

    Report from covid booster shot experience yesterday:

    Held at a Kaiser Permanente Mid-Atlantic facility

    This was the first day of administering the new Pfizer booster shot at this facility

    Patients showing up were a mix of middle-aged and older [spouse and self are in the latter category]

    Some of the middle-aged patients were not masked, to my surprise – perhaps 25% of the crowd in all had bare faces – once in the vaccination area all the staff were masked, but the security guard in the lobby was not

    Although the earlier notice we were sent asked us to bring our covid vaccination record cards, they were not examined or updated – they are apparently de facto obsolete

    we were asked about heart issues before we got the shot

    no co-pay

    no post-shot symptoms for us in the first 24 hours

  46. juno mas

    Here’s a link related to this discussion:

    It’s an opinion piece written by a Doctor/Professor. In part, it says American healthcare has evolved into a train wreck and the solution is more internal medicine doctors (IM Doc) available to the healthcare system to prevent disease before having to treat it. Well worth the read.

    The LATimes is behind a paywall, but if you have the FireFox text reader function it will sidestep the paywall. Other browsers may have the same function. In FireFox, you need to use the text reader symbol (square with horizontal lines) that is to the right of the URL and then use the reload page symbol (near circle w/arrow on circumference) to get beyond the first page of the opinion piece.

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