Port Reopenings After Vaccine?

[donaldsc]

13 minutes ago, Hlitner said:

You sound well informed on vaccines and I do not disagree with most of what you said.  We could add that the research done on HIV/Aids vaccines has led to a lot of newer understanding of viruses and anti-virus vaccines/drugs.  That being said, many viruses are very difficult to prevent.    In recent days we have already heard about a potentially huge problem with a COVID-19 vaccine.  We simply do not know enough how the body reacts to COVID-19 antibodies.  Vaccines generally work by creating antibodies but now there is new concern that the antibodies might actually be causing some kind of immune reaction that is just not understood.  It is feared that this is what is happening to the children who develop Kawaskai-like syndromes and some adults who later present with heart damage.  There are a lot of unknowns which normally would demand lots of additional testing and study.  But we keep hearing from politicians (and some scientists) that we may have a vaccine within a few months.  My reaction is that those are the first folks that should get that vaccine and then we can watch and wait.  A bad vaccine could do a lot more harm then the actual virus so we need to be sure.

 

Hank

 

I will add to this statement and be more specific.  The people who allowed Covid to spread faster and further than it had to should be required to be the test group to validate any vaccine that is developed.  Let them be the guinea pigs.

 

DON

[leck57]

4 hours ago, Daniel A said:

I personally think most (not all) cruisers are likely to wait until there is an effective vaccine available and there are ports to sail to and assurances that they won't be quarantined on the ship because one crew member/passenger has a cough...

 

I agree Daniel. Furthermore the first cruise ship that gets virus cases and the associated press coverage that will bring, I think that cruise line is a gonner. A massive risk for the cruise companies and I'm waiting to see who goes first.

Myself, I will not be cruising until the virus is almost fully contained/eliminated or there is a vaccine. I also have no desire to travel on ships with distancing rules etc. I'll just wait until things get back to close to normal.

[MISTER 67]

9 hours ago, Daniel A said:

I think there are two main factors that need to be addressed before cruising gets back to 'normal' - availability of a vaccine and open ports to sail to. After a vaccine becomes available to the masses, how long do you think it will take for ports to reopen?

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

[npcl]

22 minutes ago, Hlitner said:

You sound well informed on vaccines and I do not disagree with most of what you said.  We could add that the research done on HIV/Aids vaccines has led to a lot of newer understanding of viruses and anti-virus vaccines/drugs.  That being said, many viruses are very difficult to prevent.    In recent days we have already heard about a potentially huge problem with a COVID-19 vaccine.  We simply do not know enough how the body reacts to COVID-19 antibodies.  Vaccines generally work by creating antibodies but now there is new concern that the antibodies might actually be causing some kind of immune reaction that is just not understood.  It is feared that this is what is happening to the children who develop Kawaskai-like syndromes and some adults who later present with heart damage.  There are a lot of unknowns which normally would demand lots of additional testing and study.  But we keep hearing from politicians (and some scientists) that we may have a vaccine within a few months.  My reaction is that those are the first folks that should get that vaccine and then we can watch and wait.  A bad vaccine could do a lot more harm then the actual virus so we need to be sure.

 

Personally I am very pro vaccine.  We ran out and got the Shingles vaccines (both of them) ASAP, the various pneumococcal vaccines, etc.  I am among the first to get the boosted senior dose flu shot every year.  But I am not so sure I want to among the first to get a relatively untested COVID-19 vaccine even though I am in one of the higher risk groups.   The difficult decision will be whether 6 months or even a year of testing is long enough!  Darned if I know, but it is a concern.

 

Hank

I think you and I are on the same page.

 

To cover all bases they would need a year or two to study the infection, immunity, loss of immunity, re-infection, aspects. By the time we get into early 2021 there may be enough time for those that got infected early to have their immunity wear off, and potentially get infected again.  Have not heard of any monitoring studies aimed at that aspect.  

 

For that matter you need that long to even see how the antibodies drop off over time from those in the trials. I would expect that monitoring to take place in those participating in the trials.

 

I expect that you are going to see phase III trials that are going to involve medical professionals and other high risk (public facing professions) that is going to push the envelope even more. Kind of expanded access prior to actual approval.

[AnyMajorCruiseDude]

13 minutes ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

This is what everyone should worry about.

[Hlitner]

47 minutes ago, AnyMajorCruiseDude said:

This is what everyone should worry about.

The anti-vaccine movement (for lack of a better term) is something those of us who worked in healthcare have known for decades.  It is almost weird how many of the developed countries seem to only get approximately 50% participation in vaccines (unless it is mandated).  One bummer is that a 50% participation rate for COVID-19 would be well below what is needed to achieve herd immunity.  About 3-4 years ago we had a resurgence in whooping cough (easily prevented by the basic D-Tap shot) that caused a lot of grief (and some deaths) among children.   About that time our DD had a new grandchild and we were required to get a new d-Tap shot if we wanted to visit at her NYC hospital.   I recall there was also a problem with new measles cases (which can be very serious) because folks were not getting MMR vaccines.  When will we learn!

 

I saw a post here on CC where a person said he/she had gotten through a bout with the flu by simply "spending a week in bed" so he/she was not concerned about COVID-19!  What a fool.  We know about a young (40s) man who did fine with his case of COVID-19 except he has completely lost his sense of smell and taste.  It has now been 2 months and they now wonder if the damage is permanent.  And yet young folks seem to think they are not at risk.  Going through life without being able to smell or taste is not fun.  This poor guy is really upset because he can no longer taste wine and bourbon.

 

Hank

[Ken the cruiser]

I'm in no way medically savvy, but saw this article today on another thread about what AstraGenica is planning and it gave us some hope we'll be cruising again sometime soon. Well, maybe by the end of the year anyway. Hey, what can I say. I'm an optimist -  https://www.bbc.com/news/business-52917118 

[portiemom]

1 hour ago, PrincessLuver said:

What I would really like to see before a vaccine is an effective form of treatment.  I would have no problem getting on a ship if I knew that if I contacted COVID-19 that there was a readily available treatment that did not require hospitalization.  The fact that they have not even come up with any kind of effective treatment makes me think that a vaccine is going to be even more challenging. 

 

 

 You've got this backwards. For any viral illness, there is always a better chance of developing an effective vaccine than creating a treatment. There are precious few examples of anti-viral drugs. The notable exception is HIV which being a retrovirus has proved difficult for vaccine makers. A vaccine is preferable anyway. Much better to prevent an illness than to contract it and treat it.

[portiemom]

1 hour ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

I'm not surprised. I've been saying this all along, based on the general anti-vaccine sentiment. Drives me nuts!

[Daniel A]

2 hours ago, Hlitner said:

 We know about a young (40s) man who did fine with his case of COVID-19 except he has completely lost his sense of smell and taste.  It has now been 2 months and they now wonder if the damage is permanent.  And yet young folks seem to think they are not at risk.  Going through life without being able to smell or taste is not fun.  This poor guy is really upset because he can no longer taste wine and bourbon.

 

Hank

A good friend had a 'mild' bout and lost his sense of taste and smell.  That was 7 weeks ago.  He can distinguish between sweet and savory but cannot taste and he says if he cooks bacon he can't smell it cooking.  His doctors are also concerned that the virus did permanent nerve damage.   He is also in his late '40s.

Edited June 6, 2020 by Daniel A

[Daniel A]

3 hours ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

Doesn't surprise me either.  How many people on these boards refused to wash their hands when entering the buffet or dining room?  Do you think they're doing 'washy washy' now?

[npcl]

4 hours ago, portiemom said:

 You've got this backwards. For any viral illness, there is always a better chance of developing an effective vaccine than creating a treatment. There are precious few examples of anti-viral drugs. The notable exception is HIV which being a retrovirus has proved difficult for vaccine makers. A vaccine is preferable anyway. Much better to prevent an illness than to contract it and treat it.

 

 

Most viruses that have major effects tends to be well handled by vaccines (cheaper way to deal with the disease)  A lot of the viruses, have mild enough symptoms that neither a therapeutic or a vaccine is worth the effort. 

 

Influenza    vaccine and therapeutic

Measles vaccine

Mumps vaccine

chicken pox  vaccine  and therapeutic

Hepititis  A/B  vaccine  (also a therapeutic for Hep B)

Hepititis  C therapeutic

Polio   Vaccine

Rabies    Vaccine used as a therapeutic

HIV therapeutic

Dengue   Fever    Vaccine (limited usefulness, only for those that have already had Dengue prior, otherwise bad things can happen)

Hantavirus    neither

Herpes   therapeutic

Zika  neither

 

The interesting thing these days is that the development of a antiviral therapeutic often goes together with vaccine development.  After all if you can identify the antibodies that are effective in creating immunity, you can usually identify the antibodies that are used by the body to fight the disease and make a corresponding monoclonal antibody.

 

THe main reason therapeutics are likely to be developed first is the safety hurdle,  therapeutics are given to sick people so while they need to be safe, they can be approved with a higher level of risk, as long as the benefits justify it.  Vaccines on the other hand are given to healthy people so they must have a very very high safety profile.

Edited June 6, 2020 by npcl

[npcl]

6 hours ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

Would be interesting to see the over lap between the set of all people that would not take a vaccine and the set of all people that will not wear a mask or social distance.

[caribill]

6 hours ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

 

Maybe some of that 47% are anti-vaxers, but many are people who will not take a vaccine that is not proven to be safe. And there is no way to prove a vaccine is safe in a few months time.

 

Is it safe for pregnant women and soon-to-be pregnant women and their babies?  That would require at least a 10 month study with the proper statistical number of participants. Will any adverse affects show up quickly in newborns or would it be over a period of years?

 

Will kidneys or any other organ be adverse affected after a period of time?  Nothing that can be proven one way or another in a few months?

 

Will people with certain pre-existing conditions (overweight, diabetes, high blood pressure, etc.) be adversely affected over a period of time?

 

Will fertility rates be affected?

 

Will it cause problems in older people?

 

These and many more possibilities take time to prove one way or another and it takes years to do so. Four years is probably the minimum time to determine if a new vaccine is safe and for whom it might not be safe.

 

Effectiveness is another question that cannot always be evaluated quickly. When the first shingles vaccine was introduced, all those over 60 were encouraged to get it. It later proved to only be about 60% effective and now those who did get it are encouraged to get the newer shingles vaccine which is supposed to be around 90% effective.

 

4 hours ago, Ken the cruiser said:

I'm in no way medically savvy, but saw this article today on another thread about what AstraGenica is planning and it gave us some hope we'll be cruising again sometime soon. Well, maybe by the end of the year anyway. Hey, what can I say. I'm an optimist -  https://www.bbc.com/news/business-52917118 

 

That article gives no information about providing a vaccine that is proven to be safe.  Just that it might produce antibodies that will be effective for an unknown period of time.

[Steelers36]

In regards to a vaccine, if effective, is it not just going to keep me from "catching" COVID?  Could I not still be a carrier like present asymptomatic people?  Could I "catch" the virus and disperse it into the air to potentially infect others, while I remain immune to falling ill? 

 

The flu vaccines are often adjusted annually and sometimes as poor as 50% effective.  I have never taken a flu vaccine and never got it either.  I will be interested to see what comes about as a COVID-19 vaccine, assuming they can get a working one (they never did get one effective against SARS). 

 

Unless a COVID vaccine is going to also prevent a person from being a transmitter/host without getting "sick", then I am not sure how effective it will be.  Just have to wait and see.

 

 

[Roberto256]

11 hours ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

 

If there is an effective vaccine, one might have to prove innoculation prior to embarking on a cruise.

 

[Roberto256]

5 hours ago, caribill said:

Is it safe for pregnant women and soon-to-be pregnant women and their babies?  That would require at least a 10 month study with the proper statistical number of participants. Will any adverse affects show up quickly in newborns or would it be over a period of years?

 

Will kidneys or any other organ be adverse affected after a period of time?  Nothing that can be proven one way or another in a few months?

 

Will people with certain pre-existing conditions (overweight, diabetes, high blood pressure, etc.) be adversely affected over a period of time?

 

Will fertility rates be affected?

 

Will it cause problems in older people?

 

These and many more possibilities take time to prove one way or another and it takes years to do so. Four years is probably the minimum time to determine if a new vaccine is safe and for whom it might not be safe.

 

Your comments are very well thought out.

 

An ugly side-effect is that princess will probably force crew to get the vaccine prior to joining a ship.

Forcing crew to accept the risks, if they wish to work.

 

[Daniel A]

7 hours ago, Steelers36 said:

In regards to a vaccine, if effective, is it not just going to keep me from "catching" COVID?  Could I not still be a carrier like present asymptomatic people?  Could I "catch" the virus and disperse it into the air to potentially infect others, while I remain immune to falling ill? 

My thinking on this is that people need to take personal responsibility for themselves.  If a vaccine is available and I can't get it because other people refuse to get the vaccine is just wrong.  I want to protect myself against the illness.  The chance that others who didn't protect themselves could still get sick is on them.  It's kind of like saying I shouldn't get a burglar alarm for my house because my neighbor decided not to and now his house is more likely to get burglarized because mine is protected.  

[Roberto256]

7 minutes ago, Daniel A said:

My thinking on this is that people need to take personal responsibility for themselves.  If a vaccine is available and I can't get it because other people refuse to get the vaccine is just wrong.  I want to protect myself against the illness.  The chance that others who didn't protect themselves could still get sick is on them.

 

Yeah, but...

 

So far, anyway, if someone tests positive for covid-19 on a cruiseship, it affects EVERYONE on board.

 

If the ship is quarantined, the good kids are punished along with the bad kids.

Just like elementary school...

 

 

[PrincessLuver]

14 hours ago, MISTER 67 said:

Did you happen to see a poll that 47% of Americans would not take a vaccine if and when there is one. Unbelievable.

 

Do you think they would take their meds if they got COVID-19.....

[MissP22]

2 hours ago, PrincessLuver said:

 

Do you think they would take their meds if they got COVID-19.....

They sure would but in the mean time it would be passed on to a dozen others before being quarantined to their room.

We'll wait for that vaccine before venturing back on another cruise.

We've cruised so much in recent years it's time to explore some different adventures for a while until the dust settles. 😉

[donaldsc]

10 hours ago, caribill said:

 

Maybe some of that 47% are anti-vaxers, but many are people who will not take a vaccine that is not proven to be safe. And there is no way to prove a vaccine is safe in a few months time.

 

Is it safe for pregnant women and soon-to-be pregnant women and their babies?  That would require at least a 10 month study with the proper statistical number of participants. Will any adverse affects show up quickly in newborns or would it be over a period of years?

 

Will kidneys or any other organ be adverse affected after a period of time?  Nothing that can be proven one way or another in a few months?

 

Will people with certain pre-existing conditions (overweight, diabetes, high blood pressure, etc.) be adversely affected over a period of time?

 

Will fertility rates be affected?

 

Will it cause problems in older people?

 

These and many more possibilities take time to prove one way or another and it takes years to do so. Four years is probably the minimum time to determine if a new vaccine is safe and for whom it might not be safe.

 

Effectiveness is another question that cannot always be evaluated quickly. When the first shingles vaccine was introduced, all those over 60 were encouraged to get it. It later proved to only be about 60% effective and now those who did get it are encouraged to get the newer shingles vaccine which is supposed to be around 90% effective.

 

 

That article gives no information about providing a vaccine that is proven to be safe.  Just that it might produce antibodies that will be effective for an unknown period of time.

 

Remember thalidomide.  .  It was a well tested perfectly safe drug used to control morning sickness in pregnancy by many many women - until we found out the hard way that that wasn't.

 

DON

[BigGuy25]

I think that the real challenge for the cruise industry will come after the “first wave” of those who just can’t wait to get back on a ship have sailed. Early sailings may likely be filled. But, after those folks have taken their voyage, the next rush of passengers may be a long way off ... after vaccine is available and worldwide numbers have gone down.

[npcl]

10 hours ago, caribill said:

 

Maybe some of that 47% are anti-vaxers, but many are people who will not take a vaccine that is not proven to be safe. And there is no way to prove a vaccine is safe in a few months time.

 

Is it safe for pregnant women and soon-to-be pregnant women and their babies?  That would require at least a 10 month study with the proper statistical number of participants. Will any adverse affects show up quickly in newborns or would it be over a period of years?

 

Will kidneys or any other organ be adverse affected after a period of time?  Nothing that can be proven one way or another in a few months?

 

Will people with certain pre-existing conditions (overweight, diabetes, high blood pressure, etc.) be adversely affected over a period of time?

 

Will fertility rates be affected?

 

Will it cause problems in older people?

 

These and many more possibilities take time to prove one way or another and it takes years to do so. Four years is probably the minimum time to determine if a new vaccine is safe and for whom it might not be safe.

 

Effectiveness is another question that cannot always be evaluated quickly. When the first shingles vaccine was introduced, all those over 60 were encouraged to get it. It later proved to only be about 60% effective and now those who did get it are encouraged to get the newer shingles vaccine which is supposed to be around 90% effective.

 

 

That article gives no information about providing a vaccine that is proven to be safe.  Just that it might produce antibodies that will be effective for an unknown period of time.

The most of the things you listed get tested as part of the clinical trial process.  The biggest gap will be long term impacts (usually not an issue with vaccines) and if there are any issues with infections after the vaccine wears off (Dengue fever example).  

 

The following document goes over the requirements for clinical trials for vaccines.  While this is a document from the European Medicines Agency (EMA) , the FDA requirements are similar. There is a group (International Conference on Harmonization, ICH) which is made up of the Regulatory Authorities (FDA, EMA, Japanese MHW), Pharmaceutical Industry Groups (PHRMA, JPMA, EFPIA) with WHO and Canadian HPB participating as observers.  This group has been abd still is actively working to harmonize drug approval requirements in the 3 regions.  I have represented the FDA and PHRMA to one of the ICH working groups for a total of 8 years.

 

 If you go down to the safety section you can see a list of special populations that are required as part of the process for any vaccine that will apply to them.

 

Guideline on clinical evaluation of vaccines

https://www.ema.europa.eu/en/documents/scientific-guideline/draft-guideline-clinical-evaluation-vaccines-revision-1_en.pdf

 

 

[npcl]

42 minutes ago, muffydawg said:

I think people who are too afraid to cruise until they themselves have had a vaccine should stay home  and stop forcing the entire cruise industry to come to a complete standstill. The riots and looters have shown the entire notion of the CDC, masks & staying six feet apart is a complete scam and sham.

Wait about 2 weeks and see if the counts go up.

 

Last time I looked cruisers are not part of the decision making process concerning the cruise lines.  That is in the hands of regulatory authorities in the various countries, many of which are even more restrictive when it comes to cruise ships than the US.