Risk of Bell's Palsy after covid vaccine?

patrickosmith · by **patrickosmith** » 2021-06-01 11:52 a.m.

Risk of Bell’s palsy following COVID-19 vaccination?

Anybody know if this is happening to brass players?

~~[url]~~https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897359/

"To the best of our knowledge, there is no mention of facial paralysis in the article describing safety and efficacy of the BNT162b2 vaccine [3], however, four such adverse events were eventually highlighted in product monographs published by the relevant regulatory bodies [1, 5]. Although FDA vaccine review memoranda do mention the occurrence of facial paralysis in the test group for both vaccines [1, 2], consumer/patient information sheets of neither of the vaccines distributed in North America warn about Bell’s palsy as a possible adverse effect [6]."

"Of the 73,868 volunteers (36,901 effectively receiving vaccine) taking part in the two large phase three vaccine trials [1–4], eight cases of suspect Bell’s palsy were reported, with a total of seven in the groups receiving a vaccine (1:5272) and one in placebo groups (1:36,938). For the BNT162b2 vaccine, there were four cases of Bell’s palsy in the vaccine group compared with no cases in the placebo group, and occurred at day 37 after Dose 1 (participant did not receive Dose 2) and days 3, 9, and 48 after Dose 2 [1]. For the mRNA-1273 vaccine, there were three reports of facial paralysis in the vaccine group (22, 28, and 32 days after Dose 2) and one in the placebo group [2, 4]. In other words, all but one cases occurred after the second dose of vaccine."

Doubler · by **Doubler** » 2021-06-01 1:15 p.m.

What are the documented/expected benefits of the vaccine compared to the possibility of adverse effects?

Burgerbob · by **Burgerbob** » 2021-06-01 2:13 p.m.

From what I understand, there were actually fewer cases of Bell's palsy in the test group than would occur in a similarly sized portion of the population normally.

patrickosmith · by **patrickosmith** » 2021-06-01 4:28 p.m.

7 cases in the groups receiving a vaccine (1:5272) versus 1 case in placebo groups (1:36,938). Not good odds.

The report states these facts:

"Of the 73,868 volunteers (36,901 effectively receiving vaccine) taking part in the two large phase three vaccine trials [1–4], eight cases of suspect Bell’s palsy were reported, with a total of seven in the groups receiving a vaccine (1:5272) and one in placebo groups (1:36,938). For the BNT162b2 vaccine, there were four cases of Bell’s palsy in the vaccine group compared with no cases in the placebo group, and occurred at day 37 after Dose 1 (participant did not receive Dose 2) and days 3, 9, and 48 after Dose 2 [1]. For the mRNA-1273 vaccine, there were three reports of facial paralysis in the vaccine group (22, 28, and 32 days after Dose 2) and one in the placebo group [2, 4]. In other words, all but one cases occurred after the second dose of vaccine."

BGuttman · by **BGuttman** » 2021-06-01 4:39 p.m.

These are still pretty rare occurrences. Much like the blood clots reported. You will have more likelihood to catch COVID and have worse problems than to take vaccine and risk a very small chance of Bell's (which, incidentally, is caused by another virus).

Peacemate · by **Peacemate** » 2021-06-01 4:43 p.m.

[quote="patrickosmith"]7 cases in the groups receiving a vaccine (1:5272) versus 1 case in placebo groups (1:36,938). Not good odds.[/quote]

Do we need to be reminded of the odds of dying if you aren't vaccinated? Realistically, even if you are forced to quit playing, you will survive.

I know which odds I'll take.

Doug_Elliott · by **Doug_Elliott** » 2021-06-01 5:32 p.m.

It seems to me that reports of adverse reactions should also include reports of the recovery from those adverse reactions. Maybe the Bell's palsy only lasts for 24-48 hours like the chills that are a typical reaction.

I know people who got covid and still have no taste or smell after 3 or 4 months.

spencercarran · by **spencercarran** » 2021-06-01 5:45 p.m.

Can't play trombone if you're dead.

Doubler · by **Doubler** » 2021-06-01 6:12 p.m.

If you don't die from the virus featured in this pandemic, there's a 100% chance of your dying from something else, and it probably won't be any prettier, either. Plus that something else could happen before you're even exposed to this virus. Life is not without risk. Live your life reasonably intelligently, and enjoy it; you're gonna die anyway. As my father-in-law used to say: "Nobody gets out of this world alive."

JLivi · by **JLivi** » 2021-06-01 7:54 p.m.

[quote="Doug Elliott"]It seems to me that reports of adverse reactions should also include reports of the recovery from those adverse reactions. Maybe the Bell's palsy only lasts for 24-48 hours like the chills that are a typical reaction.

I know people who got covid and still have no taste or smell after 3 or 4 months.[/quote]

I got COVID back in March of 2020. I was the first person most people know who had the virus. I still have altered tastes and smells. I'm glad there's been no other side effects.

patrickosmith · by **patrickosmith** » 2021-06-02 9:05 a.m.

[quote="Peacemate"]<QUOTE author="patrickosmith" post_id="149685" time="1622579300" user_id="226">
7 cases in the groups receiving a vaccine (1:5272) versus 1 case in placebo groups (1:36,938). Not good odds.[/quote]

Do we need to be reminded of the odds of dying if you aren't vaccinated? Realistically, even if you are forced to quit playing, you will survive.

I know which odds I'll take.
</QUOTE>

Yes, this is a good point. Risk assessment is an individual decision. And informed consent requires that information should be made available, i.e., not be suppressed/censored.

My risk of death (*if* I were even to catch covid-19) can be calculated:

https://www.covid19survivalcalculator.com/en/calculator

My risks from an experimental injection with emergency use authorization? They cannot be calculated and they are in fact unknown. Anybody who claims otherwise probably already drank the Kool aid.

Wilktone · by **Wilktone** » 2021-06-02 9:13 a.m.

[quote="Burgerbob"]From what I understand, there were actually fewer cases of Bell's palsy in the test group than would occur in a similarly sized portion of the population normally.[/quote]

"Bell's palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime. Worldwide statistics indicate a frequency of about .02% of the population."

- http://www.neurocntr.com/bells-palsy.php

The 2021 U.S. population is about 332,000,000. 40,000 people who are affected with Bell's palsy in a year means that about 0.0001% of the population is affected by Bell's palsy in a year.

[quote="patrickosmith"]"Of the 73,868 volunteers (36,901 effectively receiving vaccine) taking part in the two large phase three vaccine trials [1–4], eight cases of suspect Bell’s palsy were reported, with a total of seven in the groups receiving a vaccine (1:5272) and one in placebo groups (1:36,938).[/quote]

7 out of 36,901 is 0.0001%.

The researchers noticed that the control group had a lower incidence of Bell's palsy than the test group, but that looks like statical noise. It's being investigated seriously because that's what medical scientists do, just to be safe. But I'm not a medical doctor, so don't trust me.

[quote="patrickosmith"]My risks from an experimental injection with emergency use authorization? They cannot be calculated and they are in fact unknown. Anybody who claims otherwise probably already drank the Kool aid.[/quote]

The available COVID vaccines have been studied quite thoroughly, but the only advice that I'm qualified to give you here is that you should certainly ask your doctor about this if you're concerned. As others have pointed out, your risk from COVID seems much higher than from any adverse side effects from the available vaccines.

Doubler · by **Doubler** » 2021-06-02 9:21 a.m.

Part of one's decision should include <LINK_TEXT text="https://www.cdc.gov/coronavirus/2019-nc ... n:PTN:FY21">https://www.cdc.gov/coronavirus/2019-ncov/vaccines/keythingstoknow.html?s_cid=10536:%2Bcovid%20%2Bvaccinations:sem.b:p:RG:GM:gen:PTN:FY21</LINK_TEXT> .

Anecdotal evidence demonstrates that predictions are nothing more than predictions. Among atypical situations, I knew a 35-year-old with zero risk factors who passed away quickly from the virus, whereas a 92-year-old with multiple risk factors experienced mild-to-moderate symptoms and recovered within days. As they say, YMMV.

Peacemate · by **Peacemate** » 2021-06-02 9:25 a.m.

[quote="patrickosmith"]My risks from an experimental injection with emergency use authorization? They cannot be calculated and they are in fact unknown. Anybody who claims otherwise probably already drank the Kool aid.[/quote]

Ignoring how I disagree with this statement, what do you mean unknown? They quite literally wrote the risk in plain numbers. And Bell's Palsy is, from what I can find, mostly non-permanent.

patrickosmith · by **patrickosmith** » 2021-06-02 9:37 a.m.

Long-term risks are unknown as would be expected (there hasn't been the time to collect data). For the first time in the history of man a majority of the population is receiving an experimental injection with unknown long-term effects.

timothy42b · by **timothy42b** » 2021-06-02 9:58 a.m.

[quote="patrickosmith"]

My risks from an experimental injection with emergency use authorization? They cannot be calculated[/quote]

I think that is an exaggeration.

Your risks from an experimental injection with an unknown chemical might be hard or impossible to calculate, although we could probably make some order of magnitude guesses from similarities to other compounds.

But we've been doing vaccines for a very long time. Chinese did some in 1000 AD, smallpox was in 1796, rabies in 1885, and then they really took off in the 1930s. So our knowledge of reaction to vaccines has grown, and that means the error bands for prediction have shrunk.

It's worth reading Nassim Taleb, books like Fooled by Randomness, The Black Swan, etc. He does a good job of explaining probability and why humans are so very bad at understanding it.

BGuttman · by **BGuttman** » 2021-06-02 11:02 a.m.

[quote="patrickosmith"]Long-term risks are unknown as would be expected (there hasn't been the time to collect data). For the first time in the history of man a majority of the population is receiving an experimental injection with unknown long-term effects.[/quote]

We didn't have vaccines for the Flu of 1918 and we wound up having successive waves of mortality through the next 3 years. The path of COVID was looking to duplicate this. Nobody wants to shut down the planet for 3 years. Imagine having to look at another two years of no gigs.

It would have been nicer if this disease had never become a pandemic, but it's here.

The people testing the vaccines have done a spectacular job of finding something remarkably effective and trying to predict long term effects, but it's a choice of allowing another 10 million deaths or taking a 1 in 10 million chance of you getting Bell's Palsy.

Even if you get COVID and don't die, there are lock-on effects that can sideline you for decades.

elmsandr · by **elmsandr** » 2021-06-02 11:55 a.m.

[quote="patrickosmith"]Long-term risks are unknown as would be expected (there hasn't been the time to collect data). For the first time in the history of man a majority of the population is receiving an experimental injection with unknown long-term effects.[/quote]

Most vaccine developments take much longer due to the inability of funding and volunteers to get large enough data sets to review and enough eyes on the data to catch all the small conditional probabilities that need to be evaluated. The data set for these vaccines and the scrutiny has been orders of magnitude higher than what would normally occur. So far these seem safer and more effective than almost all the vaccines you have received for generations. I cannot even imagine the craziness of the debate if these were "only" as effective as the Polio vaccine.

It is hard to work with conditional probabilities, especially when looking at rare occurrences, but do some thought experiments on things looking at these large sample sizes and you can realize how little signal to noise there is available. Especially when looking at the diagnostics... if a test is only 99% accurate and you test 10,000 people, you will get a LOT of positives (1% there is 100 people!). How many in 10,000 are actually affected? If it is a 5 in 10,000 type of effect, if there are only 5 "true" cases and 100 positives, what are the other 95? Adding in more medical conditions with unclear causation is even worse, so I try to avoid calculating more than I know. Doctors are famously bad at being able to work out the math here, too. I do agree with Tim's reading recommendations, those are absolutely fantastic to try to get a better handle on the probabilities involved.

From the data presented I do not think it can be clearly stated whether risk of Bell's Palsy is higher, lower, or the same after a vaccine than before... Again with all the confounding this would be a terrible case to have to define, especially without a causal link. I am glad they are devoting resources to it, however.

Cheers,

Andy

Dennis · by **Dennis** » 2021-06-02 6:00 p.m.

[quote="patrickosmith"]

My risks from an experimental injection with emergency use authorization? They cannot be calculated and they are in fact unknown. Anybody who claims otherwise probably already drank the Kool aid.[/quote]

Let's be clear about something. These are not experimental vaccines: they have been made available under an emergency use authorization (EUA), because there is an actual emergency going on.

The technology (mRNA vaccines) used in the Pfizer/BioNTech and Moderna vaccines has been used in at least one actual experimental vaccine (for Ebola hemorrhagic fever) and has been under development for years. They have received thorough safety testing in clinical studies comparable in size (or larger at least in the case of the Pfizer/BioNTech vaccine) to the studies that would be used in the approval of a vaccine under regular order.

The shortcuts that have been taken have been in the internal review process and in the manufacturing start-up process. Ordinarily, manufacturers would not set up for production until the vaccine was approved. The one thing the US government did right was to indemnify the manufacturers to get them to prepare for vaccine production prior to EUA and eventual licensing.

We have seen less long-term followup than we would in a more usual course of approval, because the internal review processes were shortened and trials were run in parallel to a degree (meaning that the Phase 2 trial started as soon as reasonably possible after the start of the Phase I, and the Phase 3 trial started as soon as possible after the Phase 2 trial). I would prefer to see more long-term followup, but vaccine adverse events almost always occur within a few days of vaccination.

Trials are not (and cannot be) designed to detect extremely rare adverse events. The size of a trial necessary to reliably detect a 1:1000000 adverse event associated with the vaccine would be impractically large.

Pfizer has submitted an application for regular licensure of its vaccine. I expect that Moderna will follow shortly if they have not already.

These vaccines are more effective than I had dared to hope: in excess of 95% in real-world use. We are able to re-open and figure out what our new normal will be because these vaccines are so effective.

The decision to be vaccinated or not is a personal matter of risk assessment. I believe that the risks associated with the mRNA vaccines are small: the data collected to date bear out my assessment. The risks associated with SARS-CoV-2 infection are well-known: we have nearly 600,000 deaths in the US attributable to the pandemic. COVID-19 will be the leading cause of death in the US for 2020. It is not the case that only the elderly are vulnerable to this virus.

Your risks from the various vaccines are not unknown: they are documented in the clinical study reports and in the applications for EUA (and now the applications for regular licensure). Are there extremely rare adverse events that are not described in the applications? It's possible. But by definition these are extremely rare. We do know what the common risks are, and we know some of the rarer risks (the thrombocytopenia associated with the chimp adenovirus vaccines are a good example of this).

My advice has been and remains: get vaccinated as soon as you can with whatever vaccine is available to you. It is not risk-free, but going unvaccinated is not risk-free either. No one has died of vaccination (to date), but nearly 600,000 Americans have died as a result of SARS-CoV-2 infection.

patrickosmith · by **patrickosmith** » 2021-06-02 7:23 p.m.

[quote="Dennis"]<QUOTE author="patrickosmith" post_id="149743" time="1622639138" user_id="226">

My risks from an experimental injection with emergency use authorization? They cannot be calculated and they are in fact unknown. Anybody who claims otherwise probably already drank the Kool aid.[/quote]

Let's be clear about something. These are not experimental vaccines: they have been made available under an emergency use authorization (EUA), because there is an actual emergency going on.
</QUOTE>

I did not call them "experimental vaccines." You did. So let's be clear about *that*. The term I used was "experimental injection with emergency use authorization." These are not vaccines in the traditional sense; rather they are "mRNA" injections. They have indeed received emergency use authorization. The population at large seems to constitute the "lab rats" regarding any long-term effects. Therefore my term ("experimental injection with emergency use authorization") seems entirety appropriate.

spencercarran · by **spencercarran** » 2021-06-02 7:41 p.m.

[quote="patrickosmith"]<QUOTE author="Dennis" post_id="149771" time="1622671239" user_id="175">

Let's be clear about something. These are not experimental vaccines: they have been made available under an emergency use authorization (EUA), because there is an actual emergency going on.[/quote]

I did not call them "experimental vaccines." You did. So let's be clear about *that*. The term I used was "experimental injection with emergency use authorization." These are not vaccines in the traditional sense; rather they are "mRNA" injections. They have indeed received emergency use authorization. The population at large seems to constitute the "lab rats" regarding any long-term effects. Therefore my term ("experimental injection with emergency use authorization") seems entirety appropriate.
</QUOTE>
This is not at all scientifically accurate.

Not sure how much use there is in engaging with someone who's repeating Q-adjacent nonsense, but for the sake of anyone else reading: mRNA-based vaccines (such as the Pfizer and Moderna vaccines for COVID) are not "experimental" nor is there a basis to expect they would carry any measurable risk of long-term effects. They do not alter your DNA as some have claimed, and in fact all the components in the vaccine will completely break down and exit your system after a short time. What remains are the antibodies to the coronavirus spike protein which your body will assemble based on the instructions in the mRNA. Similar antibodies will be made by your immune system if you are vaccinated by a different type of vaccine (eg J&J or AstraZeneca) or if you survive COVID infection. The safety profile of an mRNA-based vaccine is extremely favorable, and regulators would not have approved any plan to use the general public as "lab rats."

BGuttman · by **BGuttman** » 2021-06-02 7:55 p.m.

You could get hit by a bus crossing the street. You could get hit by lightning. Both have similar probabilities to your getting Bell's Palsy after an injection of COVID vaccine.

If you live in Massachusetts, you currently have a 1% chance of getting COVID. If you do get COVID, you have about a 3% chance of needing hospitalization, and something like a half percent chance of dying. There have been 17,500 COVID deaths of a population of 7,000,000, so you have a probability of 2.5 in 1000 of dying if you don't get vaccinated.

elmsandr · by **elmsandr** » 2021-06-02 9:31 p.m.

[quote="patrickosmith"]<QUOTE author="Dennis" post_id="149771" time="1622671239" user_id="175">

Let's be clear about something. These are not experimental vaccines: they have been made available under an emergency use authorization (EUA), because there is an actual emergency going on.[/quote]

I did not call them "experimental vaccines." You did. So let's be clear about *that*. The term I used was "experimental injection with emergency use authorization." These are not vaccines in the traditional sense; rather they are "mRNA" injections. They have indeed received emergency use authorization. The population at large seems to constitute the "lab rats" regarding any long-term effects. Therefore my term ("experimental injection with emergency use authorization") seems entirety appropriate.
</QUOTE>
You are trying to play semantics when you clearly have no idea what you are talking about.

Do what you will, but stop being a fool in public, please.

Cheers,

Andy

patrickosmith · by **patrickosmith** » 2021-06-03 8:38 a.m.

All of my comments have been respectful and legitimate. If you can respond to my original post —no one has done that yet— that would be of interest. I provided that post for the benefit of those who may not have received informed consent on the risks of these emergency use authorization injections. I know I wasn't aware of that particular risk and the data seemed relevant and of interest. I then asked if anyone is aware of this happening to brass players? Crickets. I was then relentlessly shown a barrage of incomplete and incorrect statistical analysis (probability theory and statistics happens to be one of my specialties so I can state that as fact). If you all want to inject yourself then fine by me. It sounds like most of you have already done so. However, I remain very skeptical. And I have every right to do so. In the end we will see who the fools are. Just calling me one does not make it so. I very much doubt I will contract covid, and even if, I certainly do not expect to die from it. Therefore I personally see no benefit in voluntarily receiving an emergency use authorization injection that carries risks (known and unknown).

Wilktone · by **Wilktone** » 2021-06-03 9:07 a.m.

[quote="patrickosmith"]I then asked if anyone is aware of this happening to brass players?[/quote]

No, I haven't heard of anyone who has gotten Bell's palsy since receiving the COVID vaccine. I do know two brass players who did contract Bell's palsy years ago, and both have made complete recoveries and returned to playing near 100% within a year.

As I posted above, as best as I can tell the statistical risk of catching Bell's palsy following the vaccine is negligible and probably a similar risk as without. But statistics are not one of my specialties, I will admit. If you want more information about whether this is really a risk you should talk with your doctor.

[quote="patrickosmith"]I very much doubt I will contract covid, and even if, I certainly do not expect to die from it.[/quote]

Vaccines are like masks. They can protect you, but one of the main benefits to getting the vaccine or wearing masks is to protect the people around you. Many people cannot get vaccinated for underlying heath reasons, even though they may want to.

I doubt that you will get Bell's palsy (the risk is low under the best circumstances). If you did, I wouldn't expect you to die from it.

But virology is not one of my specialities. You really should discuss your concerns with your doctor.

[quote="patrickosmith"]Therefore I personally see no benefit in voluntarily receiving an emergency use authorization injection that carries risks (known and unknown).[/quote]

Patrick, I suspect that you've already decided what your plans are, regardless of the answers you get.

Frankly, trying to get medical advice from the internet, let alone from a trombone forum, is the wrong way to relieve any anxiety you might be feeling from getting a COVID vaccine. Talk with your doctor.

Did I mention yet that you should probably take this up with your doctor? Make a Telehealth appointment or visit in person, if you feel comfortable now.

Dave

TromboneMonkey · by **TromboneMonkey** » 2021-06-03 9:32 a.m.

For what it is worth because I am just one person so this basically constitutes an anecdote, I'm currently studying physical therapy, and while my exposure to patients so far is limited I can tell you that I have seen several covid patients with neuropathies as a result but not a single vaccinated person with neuropathies as a result.

One of the patients I have seen has covid related cranial nerve VIII neuropathology which has left him with sensorineural hearing loss. He's a professional drummer.

Studies on the relationships between covid and facial palsies are concerning: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531061/

In any case, one is much more likely to contract the virus and suffer neuropathies from it than getting them from the vaccine, the latter of which has the added bonus of protecting humanity from this threat which has already killed hundreds of thousands.

timothy42b · by **timothy42b** » 2021-06-03 9:53 a.m.

This is reminiscent of the seat belt arguments, years ago when seat belt laws were being phased in. (some of us are old enough to remember. Heck, some of us are old enough to have owned cars that didn't have seat belts.)

Some of my friends argued that a seat belt could get you killed, if you were in an accident where your car went underwater or caught fire, and you didn't have time to get out.

People in favor of seat belts would claim that didn't happen. Well, that was wrong. Those rare accidents absolutely do happen, and in some of them not wearing a seat belt would save your life. Of course in a more common accident wearing the seat belt is going to save you.

I always wondered how the antis could be so sure they would have the rare accident instead of the common one.

Where I work, safety hazards are assessed in a matrix that has probability on one axis and consequence on the other. High probability catastrophic accidents require more prevention measures than low probability minor accidents. The problem is that humans are very good at analyzing consequences and very very bad at understanding probability.

Doubler · by **Doubler** » 2021-06-03 10:04 a.m.

patrickosmith -

Q. Risk of Bell’s palsy following COVID-19 vaccination?

A. You answered your own question, and others answered it, too

Q. Anybody know if this is happening to brass players?

A. Every one of the ~7,900,000,000 people on Planet Earth who is capable of understanding your question and capable of responding and willing to respond to it has and may continue to do so.

You have your answers.

Doug_Elliott · by **Doug_Elliott** » 2021-06-03 10:31 a.m.

He doesn't want answers. He's already made up his mind.

I got the Moderna shot, and yes I had heard about the possibility of Bell's Palsy.

I have know several people who got Bell's Palsy long before covid existed, brass players and not brass players. So apparently there's always a risk of getting it whether you're a brass player or not.. It goes away.

I have gotten lots of vaccinations in my life, including all the ones they don't tell you about in Air Force basic training. And Yellow Fever for a trip to Africa, and multiple who-knows-what for a trip to China. The anti-malaria drug for a trip to South America was the only one that actually made me sick, and that's not even a vaccine.

elmsandr · by **elmsandr** » 2021-06-03 11:43 a.m.

[quote="patrickosmith"]... I then asked if anyone is aware of this happening to brass players? Crickets. I was then relentlessly shown a barrage of incomplete and incorrect statistical analysis (probability theory and statistics happens to be one of my specialties so I can state that as fact).[/quote]

You asked a very small group about an exceedingly rare event and are surprised to get no results? That could be be interpreted as answer, but I would not go there. Rare things are rare, I would think with the numbers shown I would be more surprised if we had a solid response here.

Just calling me one does not make it so.

To borrow your semantics above, I did not call you a fool. I do think your comments here are a bit foolish, simply as you have a conclusion in place and bias being shown, but that does not make one a fool. Why, for example, do you insist on playing the dance between vaccine/injection? Is that worth a semantics debate? On this forum, I would say certainly not, but we all get to put that line where ever we want.

...

I very much doubt I will contract covid, and even if, I certainly do not expect to die from it. Therefore I personally see no benefit in voluntarily receiving an emergency use authorization injection that carries risks (known and unknown).

Death is not the only option, and from every side effect study I have looked at in detail, the COMBINED chance of contracting COVID and experience the SAME effect has been greater than the side effect prevalence. That is, multiply the chance of getting COVID by the chance of getting that effect with COVID still higher than from the vaccines... Haven't done all the math on every listing, but did do it on a several before I got the shot.

All the numbers on these say they are more effective and safer than most any other vaccine in current use... I still wonder what the debate would look like if it were only as good as some of those.

Cheers,

Andy

ithinknot · by **ithinknot** » 2021-06-03 12:10 p.m.

I'll add one point - purely at the logical level, don't assume you're comparing a known risk (covid) with an unknown one (vaccine).

You're concerned about unlikely but theoretically possible long-term risks from a vaccine? Fine. You don't know what the long-term effects of covid might be either, even if your initial illness is relatively trivial or even asymptomatic. Will there be a predisposition to a rare blood cancer? Will one of your eyes suddenly drop out ten years from now? If an absence of absolute knowledge is sinister when applied to the vaccine, why not for the disease also?

This is not an appropriate place to seek medical advice (nor to evangelize against it).

As Dave says, please discuss your concerns with your doctor.

patrickosmith · by **patrickosmith** » 2021-06-03 12:14 p.m.

[quote="Doug Elliott"]He doesn't want answers. He's already made up his mind.[/quote]

I haven't decided.

I actually *did* want to know if anyone on this forum knows a brass player who got Bell's Palsy *after* the second injection (as the report seemed to indicate). It is true the sample group is small but important/relevant to brass players.

I didn't necessarily want to be dragged into conversations (i.e., get medical advice, statistical analysis, opinions from trombonists, and the like) about the personal individual choices for receiving the injection. While I do not have to agree, I am able to listen and respond respectfully. I do make what I consider to be valid arguments. I do remain skeptical about the risk/benefit of receiving these injections given the limited duration of time to study and consequently the unknown long-term effects. For the time being I choose to "wait and see."

spencercarran · by **spencercarran** » 2021-06-03 12:43 p.m.

[quote="patrickosmith"]<QUOTE author="Doug Elliott" post_id="149799" time="1622730669" user_id="51">
He doesn't want answers. He's already made up his mind.[/quote]

I haven't decided.

I actually *did* want to know if anyone on this forum knows a brass player who got Bell's Palsy *after* the second injection (as the report seemed to indicate). It is true the sample group is small but important/relevant to brass players.</QUOTE>
Well, ok then. I know a bunch of brass players, myself included, who've gotten two doses of an mRNA vaccine and haven't suffered Bell's Palsy. Hooray for anecdotes.

[quote="patrickosmith"]I do make what I consider to be valid arguments.[/quote]
You don't though.

[quote="patrickosmith"]I do remain skeptical about the risk/benefit of receiving these injections given the limited duration of time to study and consequently the unknown long-term effects. For the time being I choose to "wait and see."[/quote]
You claim to be a specialist in statistics but don't know the basics of how clinical trials work? Or somehow you think the response to any novel disease (of which there will be plenty more) should require decades-long safety monitoring for purely speculative effects before any new vaccine or therapeutic can be deployed for general use?

Peacemate · by **Peacemate** » 2021-06-03 1:13 p.m.

[quote="patrickosmith"]I actually *did* want to know if anyone on this forum knows a brass player who got Bell's Palsy *after* the second injection (as the report seemed to indicate). It is true the sample group is small but important/relevant to brass players.[/quote]

But there are two simple answers to this.

1. Yes, somebody did get it.

2. No, nobody got it.

Obviously these are the two options. What is different enough about brass players to alter the risk of Bell's Palsy? This is like walking into a room and randomly asking if there are any left handed people. There is no path from that which leads to anything reasonable, since it's such a weird question that people are just dumbfounded by it. The way everything is stacked it makes you seem scared of the vaccines, and your defense to all criticism is just "but I didn't say that". No, but it is probably what you meant.

In my opinion this thread is either badly worded or should be a part of the big thread on COVID-19.

brassmedic · by **brassmedic** » 2021-06-03 2:07 p.m.

[quote="patrickosmith"]probability theory and statistics happens to be one of my specialties[/quote]
<ATTACHMENT filename="thor.jpg" index="0">~~[attachment=0]~~thor.jpg</ATTACHMENT>

robcat2075 · by **robcat2075** » 2021-06-03 2:52 p.m.

If the non-traditional nature of the "mRNA" style vaccine is what is alarming, consider that the traditionally-created vaccines have turned out to be quite poor.

The Chinese went the traditional route and they've got a vaccine that is only modestly effective.

~~[url=https://apnews.com/article/china-gao-fu-vaccines-offer-low-protection-coronavirus-675bcb6b5710c7329823148ffbff6ef9]~~Top Chinese official admits vaccines have low effectiveness

(He claims he was speaking of overall results of all vaccines but... it seems like the Chinese vaccine is the reason the overall numbers are poor)

~~[url=https://www.bbc.com/news/world-latin-america-55642648]~~Sinovac: Brazil results show Chinese vaccine 50.4% effective

I'm not sure I'd line up for 50%. How do you get to herd immunity with 50%?

BGuttman · by **BGuttman** » 2021-06-03 3:59 p.m.

The only saving grace for such a vaccine is if it mitigates the effects from contracting the disease. A 50% vaccine that eliminates fatalities if you get the disease is a good bargain.

patrickosmith · by **patrickosmith** » 2021-06-03 7:38 p.m.

[quote="Peacemate"]<QUOTE author="patrickosmith" post_id="149807" time="1622736877" user_id="226">
I actually *did* want to know if anyone on this forum knows a brass player who got Bell's Palsy *after* the second injection (as the report seemed to indicate). It is true the sample group is small but important/relevant to brass players.[/quote]
This is like walking into a room and randomly asking if there are any left handed people. There is no path from that which leads to anything reasonable, since it's such a weird question that people are just dumbfounded by it.
</QUOTE>

I like your use of analogy but it should more closely mirror the data in the subject report. Given the veracity of the responses, it seems like almost all of you have recently been vaccinated. So maybe the more proper analogy would be something like this:

'This would be like walking into a room (of people who have all had their second injection between a few days and a few months ago) and asking them if they knew anybody who had contracted Bell's Palsy after receiving their vaccine?'

Admittedly the sample size in the report was in the 40,000 range. If this trombonechat site has 10,000 or so active members (?) then the "room of people" would still be too small to validate the report. However I did ask if *anyone knows of any brass players* in this category. So a much larger population.

Why do you think my simple question is "weird?" Why do you think the average trombonist might be "dumbfounded" by such a simple question?

Peacemate · by **Peacemate** » 2021-06-03 8:00 p.m.

[quote="patrickosmith"]<QUOTE author="Peacemate" post_id="149812" time="1622740396" user_id="9017">

This is like walking into a room and randomly asking if there are any left handed people. There is no path from that which leads to anything reasonable, since it's such a weird question that people are just dumbfounded by it.[/quote]

I like your use of analogy but it should more closely mirror the data in the subject report. Given the veracity of the responses, it seems like almost all of you have recently been vaccinated. So maybe the more proper analogy would be something like this:

'This would be like walking into a room (of people who have all had their second injection between a few days and a few months ago) and asking them if they knew anybody who had contracted Bell's Palsy after receiving their vaccine?'

Admittedly the sample size in the report was in the 40,000 range. If this trombonechat site has 10,000 or so active members (?) then the "room of people" would still be too small to validate the report. However I did ask if *anyone knows of any brass players* in this category. So a much larger population.

Why do you think my simple question is "weird?" Why do you think the average trombonist might be "dumbfounded" by such a simple question?
</QUOTE>

I haven't been vaccinated. In fact, probably won't be for a good while either. It's out of my hands. Also, this is the internet? The most elderly aren't on here, meaning most people who would be vaccinated aren't here to be asked. People just don't like when you throw around seemingly science-hostile statement.

I strongly doubt trombonechat has 10,000 active members. It doesn't even have 9000 registered accounts, and how many of those are active? Maybe 10%? How many of those have been vaccinated? Wouldn't bet on more than 50%, but I am going to say 50% have been fully vaccinated, so even taking into account that everybody has 20 brass friends, that's still only about 9000 brass players who have been vaccinated remotely related to the forum.

Why do I think your simple question is "weird"? Because it is so mind boggling. Does it matter more if any brass players have experienced Bell's Palsy any more than if anybody else experiences it? NO! I am left dumbfounded by the fact that anybody would ask the question, because the risk would be the same.

I do appreciate how much you assume things. 10 000 active members, everybody is vaccinated, experimental injections. I love the confidence, even though I dislike its manifestation.

Also, consider reading my signature. Student in Sweden, a country with a low vaccination rate that has yet to reach the youngsters of the population. Quite obvious I wouldn't be vaccinated. But hey, you're well versed in statistics, so the chances that I am vaccinated should be calculable, right?

patrickosmith · by **patrickosmith** » 2021-06-03 8:07 p.m.

[quote="brassmedic"]<QUOTE author="patrickosmith" post_id="149790" time="1622723910" user_id="226">
probability theory and statistics happens to be one of my specialties[/quote]
thor.jpg
</QUOTE>

I admit I don't have a clue regarding your image of Thor. But I assume this is your way of being disrespectful and/or showing contempt. If not my apologies. If so ...

BGuttman · by **BGuttman** » 2021-06-03 8:26 p.m.

Peacemate, you should come here to New Hampshire. We have approved the Pfizer vaccine for 12 year olds and up. There is an active effort to vaccinate all High School students (ages 14-18) before the start of the 2021-2022 school year.

I know only one person with Bell's Palsy and she got it long before there was COVID. Unfortunately she had to stop playing trombone because of it.

I have had my two doses of Pfizer vaccine and it's now several months later. I have not developed any kind of palsy. I would suspect Patrick Smith will suffer the same fate (i.e. not getting Bell's Palsy) from his second shot. And the odds are with me: 1 in 7,000 or so. That's called a "long shot" bet to get Bell's.

brassmedic · by **brassmedic** » 2021-06-03 8:29 p.m.

[quote="patrickosmith"]<QUOTE author="brassmedic" post_id="149815" time="1622743635" user_id="4102">

thor.jpg[/quote]

I admit I don't have a clue regarding your image of Thor. But I assume this is your way of being disrespectful and/or showing contempt. If not my apologies. If so ...
</QUOTE>
It's a meme. Look it up. I am questioning the veracity of your claim that probability theory and statistics are your specialty. If I had a nickel for everyone on the internet who has claimed to be a specialist in the field they happen to be arguing about...

robcat2075 · by **robcat2075** » 2021-06-03 8:29 p.m.

How does the small risk of Bell's Palsy from a vaccine outweigh the larger risk of long-term lung damage from COVID?

About 5% of COVID cases are the "severe" ones with lung damage.

Or how does it outweigh the other long-term problems...

~~[url]~~<LINK_TEXT text="https://www.medpagetoday.com/infectious ... id19/91270">https://www.medpagetoday.com/infectiousdisease/covid19/91270</LINK_TEXT>

Early in 2021, researchers in Wuhan, China, reported that 76% of hospitalized COVID-19 patients had at least one symptom that persisted 6 months after acute infection, mostly fatigue or muscle weakness. "Studies of non-hospitalized patients have shown that anywhere from 35% to 50% of non-hospitalized patients had symptoms 2 to 4 months later," Navis noted.

Fatigue, breathing issues, and cardiac concerns like chest pain are common findings, as are neurologic symptoms, she pointed out. Of patients at the Center for Post-COVID Care at Mount Sinai with neurology referrals, "about 65% come in with cognitive complaints or brain fog," Navis said.

How much quality trombone practicing are you going to get done with fatigue, breathing issues, cardiac concerns... and brain fog?

Dennis · by **Dennis** » 2021-06-03 10:09 p.m.

[quote="brassmedic"]If I had a nickel for everyone on the internet who has claimed to be a specialist in the field they happen to be arguing about...[/quote]

You could retire in comfort, and build wowza sackbut replicas...

patrickosmith · by **patrickosmith** » 2021-06-03 10:27 p.m.

[quote="brassmedic"]<QUOTE author="patrickosmith" post_id="149844" time="1622765254" user_id="226">

I admit I don't have a clue regarding your image of Thor. But I assume this is your way of being disrespectful and/or showing contempt. If not my apologies. If so ...[/quote]
It's a meme. Look it up. I am questioning the veracity of your claim that probability theory and statistics are your specialty. If I had a nickel for everyone on the internet who has claimed to be a specialist in the field they happen to be arguing about...
</QUOTE>
I enjoyed probability theory in undergraduate school (top in a class of about 200 engineers at Univ of Illinois, Champaign-Urbana). It made getting my Masters Degree a cinch when all of my peers were struggling with stochastic processes and queueing theory. I then used that knowledge over the decades in real world engineering designs (like designing satellite systems, rockets and the like). I also taught a 4 day course to industry for a number of years on statistics. I'm a bit rusty on it nowadays. But I can spot errors and omissions in almost any amateurish reporting/analysis (typically peddled on the trusting pedestrian population). I'm not at all intimidated by others analysis. Most of the time I either learn something or find it amusing. So in closing, I retract my apology and move to the alternate ending "if so ... ____ ____." You can fill in the blanks.

Bach5G · 2021-06-03 10:39 p.m.

Sad the way this thread has gone.

Probability and statistics? What are people going to argue about next? Real analysis?

patrickosmith · by **patrickosmith** » 2021-06-03 10:50 p.m.

Here's the appropriate tune to cheer you up: Twisted Sisters "We're Not Gonna Take It."

<YOUTUBE id="ZqOp76R12DM"><LINK_TEXT text="https://music.youtube.com/watch?v=ZqOp7 ... ture=share">https://music.youtube.com/watch?v=ZqOp76R12DM&feature=share</LINK_TEXT></YOUTUBE>

Burgerbob · by **Burgerbob** » 2021-06-03 10:59 p.m.

[quote="patrickosmith"]Here's the appropriate tune to cheer you up: Twisted Sisters "We're Not Gonna Take It."

<YOUTUBE id="ZqOp76R12DM"><LINK_TEXT text="https://music.youtube.com/watch?v=ZqOp7 ... ture=share">https://music.youtube.com/watch?v=ZqOp76R12DM&feature=share</LINK_TEXT></YOUTUBE>[/quote]

Well, you'll take all the Covid-19 symptoms and aftereffects, apparently.

patrickosmith · 2021-06-03 11:05 p.m.

I haven't been affected to date. I'm well traveled. Have 4 kids in public schools. Gone to international swim meets in Tampa for weeks at a time with 800+ swimmers. No masks and no covid. Maybe I already got it and don't know about it. I could be one of those fortunate people with "no symptoms" (sarcasm here).

Burgerbob · by **Burgerbob** » 2021-06-03 11:12 p.m.

[quote="patrickosmith"]I haven't been affected to date. I'm well traveled. Have 4 kids in public schools. Gone to international swim meets in Tampa for weeks at at time with 800+ swimmers. No masks and no covid. Maybe I already got it and don't know about it. I could be one of those fortunate people with no symptoms.[/quote]

Jesus christ.

Welp, I'm done here.

Posaunus · by **Posaunus** » 2021-06-04 1:15 a.m.

[quote="patrickosmith"]I haven't been affected to date. I'm well traveled. Have 4 kids in public schools. Gone to international swim meets in Tampa for weeks at a time with 800+ swimmers. No masks and no covid. Maybe I already got it and don't know about it. I could be one of those fortunate people with no symptoms.[/quote]

Now that is a true, informed, statistical analysis. Great supplement to the data and guidance provided by the medical and public health experts. I now feel so much safer! :horror:

brassmedic · by **brassmedic** » 2021-06-04 1:44 a.m.

[quote="patrickosmith"]<QUOTE author="brassmedic" post_id="149847" time="1622766562" user_id="4102">

It's a meme. Look it up. I am questioning the veracity of your claim that probability theory and statistics are your specialty. If I had a nickel for everyone on the internet who has claimed to be a specialist in the field they happen to be arguing about...[/quote]
I enjoyed probability theory in undergraduate school (top in a class of about 200 engineers at Univ of Illinois, Champaign-Urbana). It made getting my Masters Degree a cinch when all of my peers were struggling with stochastic processes and queueing theory. I then used that knowledge over the decades in real world engineering designs (like designing satellite systems, rockets and the like). I also taught a 4 day course to industry for a number of years on statistics. I'm a bit rusty on it nowadays. But I can spot errors and omissions in almost any amateurish reporting/analysis (typically peddled on the trusting pedestrian population). I'm not at all intimidated by others analysis. Most of the time I either learn something or find it amusing. So in closing, I retract my apology and move to the alternate ending "if so ... ____ ____." You can fill in the blanks.
</QUOTE>
Oh, I didn't realize you took a probability class as an undergrad. Yes, now I see that you're qualified to second-guess all the experts in the world. :lol:

BGuttman · by **BGuttman** » 2021-06-04 4:00 a.m.

I guess Patrick outranks me as well. After all, I only spent a 40 year career doing statistically designed experiments and statistical quality control. Shame on me for considering a 1 in 7000 a less likely outcome than 1 in 300 ;)

patrickosmith · by **patrickosmith** » 2021-06-04 7:06 a.m.

Two words for all the experts out there: conditional probability

https://en.m.wikipedia.org/wiki/Conditional_probability

WilliamLang · by **WilliamLang** » 2021-06-04 10:29 a.m.

some people are either dumb or acting stupid on purpose.

robcat2075 · by **robcat2075** » 2021-06-04 11:06 a.m.

The people with no symptoms are the reason we have an epidemic.

It's not the people in ICU who are out at the malls and the swimming meets spreading the disease. It's the people who have it but think they don't.

Wilktone · by **Wilktone** » 2021-06-04 11:15 a.m.

There was once a group of trombonists and a group of statisticians riding together. All the trombonists had tickets, but the statisticians only had one ticket between them. Inquisitive by nature, the trombonists asked the statisticians how they were going to get away with such a small sample of tickets when the conductor came through. The statisticians said, "Easy. We have methods for dealing with that." Later, when the conductor came to punch tickets, all the statisticians slipped quietly into the bathroom. When the conductor knocked on the door, the head statistician slipped their one ticket under the door thoroughly fooling the layman conductor. On train home, the statisticians and the trombonists again found themselves on the same train. Always quick to catch on, the trombonists had purchased one ticket between them. The statisticians (always on the cutting edge) had purchased NO tickets for the trip home. Confused, the trombonists asked the statisticians "We understand how your methods worked when you had one ticket, but how can you possibly get away with no tickets?" "Easy," replied the statisticians smugly, "we have different methods for dealing with that situation." Later, when the conductor was in the next car, all the trombonists trotted off to the bathroom with their one ticket and all the statisticians packed into the other bathroom. Shortly, the head statistician crept over to where the trombonists were hiding and knocked authoritatively on the door. As they had been instructed, the trombonists slipped their one ticket under the door. The head statistician took the trombonists' one and only ticket and returned triumphantly to the statistician group. Of course, the trombonists were subsequently discovered and publicly humiliated.

MORAL OF THE STORY: Do not use statistical methods unless you understand the principles behind them.

Here's an interesting web page with a number of personal stories from musicians who came down with Bell's palsy.

https://timsmithtrombone.com/bells-palsy/

vetsurginc · by **vetsurginc** » 2021-06-04 11:31 a.m.

Please note none of this discussion applies to Screw Bell's Palsy <EMOJI seq="1f640" tseq="1f640">🙀</EMOJI>

spencercarran · by **spencercarran** » 2021-06-04 11:37 a.m.

[quote="patrickosmith"]I enjoyed probability theory in undergraduate school (top in a class of about 200 engineers at Univ of Illinois, Champaign-Urbana). It made getting my Masters Degree a cinch when all of my peers were struggling with stochastic processes and queueing theory. I then used that knowledge over the decades in real world engineering designs (like designing satellite systems, rockets and the like). I also taught a 4 day course to industry for a number of years on statistics. I'm a bit rusty on it nowadays. But I can spot errors and omissions in almost any amateurish reporting/analysis (typically peddled on the trusting pedestrian population). I'm not at all intimidated by others analysis. Most of the time I either learn something or find it amusing. So in closing, I retract my apology and move to the alternate ending "if so ... ____ ____." You can fill in the blanks.[/quote]
:roll:

I see your master's-level class on stochastic processes and raise you a doctoral dissertation using Bayesian models to map susceptibility to vaccine-preventable diseases.

patrickosmith · by **patrickosmith** » 2021-06-04 3:49 p.m.

Your credentials are truly Impressive! Honestly, no sarcasm intended. But, I'm still going to "wait and see" for at least a few years until the dust settles. And it is in part because of my experience right here from my fellow trombonists. I share one little research report (that should be on interest to any brass player), I ask a few simple questions, and I get slammed for having a reasonable lived experience of no "covid" even with plenty of travel and large family. I shouldn't be allowed to share information with actual data of risks that are important to me. Because why? It might make some people question the wisdom of "jumping in." That kind of dialogue must all be suppressed and whoever shares it must obviously be a lunatic. There is just no other explanation. There is the epitome of censorship.

Burgerbob · by **Burgerbob** » 2021-06-04 3:54 p.m.

[quote="patrickosmith"]There is the epitome of censorship.[/quote]

Nope. That would be the government deleting your posts. You're free to discredit yourself as much as you want, for better or worse.

brassmedic · by **brassmedic** » 2021-06-04 4:03 p.m.

[quote="patrickosmith"]Your credentials are truly Impressive! Honestly, no sarcasm intended. But, I'm still going to "wait and see" for at least a few years until the dust settles. And it is in part because of my experience right here from my fellow trombonists. I share one little research report (that should be on interest to any brass player), I ask a few simple questions, and I get slammed for having a reasonable lived experience of no "covid" even with plenty of travel and large family. I shouldn't be allowed to share information with actual data of risks that are important to me. Because why? It might make some people question the wisdom of "jumping in." That kind of dialogue must all be suppressed and whoever shares it must obviously be a lunatic. There is just no other explanation. There is the epitome of censorship.[/quote]
Your mind was already made up before you posted, and the reactions you got here have nothing to do with it. The Bell's Palsy thing is old news. It was reported last year, and to this date there is absolutely no evidence that a Covid vaccine can cause it. The rate was commensurate with the incidence of sudden facial paralysis in the general population. You came on the forum with a decidedly non-scientific attempt to lend credence to an opinion you obviously had already formed. And you got slammed for it. And now you want to act like some kind of martyr? Get lost.

patrickosmith · by **patrickosmith** » 2021-06-04 5:41 p.m.

Saying it doesn't make it true.

BGuttman · by **BGuttman** » 2021-06-04 6:51 p.m.

The problem with these rare events, like the blood clots with AstraZenica or these Bell's, is that you are losing the statistical confidence in the hypothesis.

We can easily ascertain that the vaccine is 90% effective in preventing COVID infection: there are hundreds of vaccinated people who get breakthrough infections. When we get to an effect with single digits out of tens of thousands of subjects it becomes difficult to establish a true cause and effect.

Certainly it bears some further study. We may discover that there is a subgroup of people who are more susceptible to this problem, like the blood clots tending to be in pre-menopausal women. But we don't know yet.

If you are still concerned, maybe start a program of Ivermectin. Or if you really want to drink Kool Aid, Hydroxychoroquine.

patrickosmith · by **patrickosmith** » 2021-06-04 7:52 p.m.

I actually did already have a course of treatment with a malaria-like cocktail to treat babesiosis ( <LINK_TEXT text="https://www.webmd.com/a-to-z-guides/bab ... -infection">https://www.webmd.com/a-to-z-guides/babesiosis-blood-infection</LINK_TEXT> ) .

But I prefer gin and tonic with Schweppes which does contain quinine (the natural form of hydroxychloroquine).

timothy42b · by **timothy42b** » 2021-06-05 8:24 a.m.

[quote="patrickosmith"]That kind of dialogue must all be suppressed and whoever shares it must obviously be a lunatic. There is just no other explanation. There is the epitome of censorship.[/quote]

You posted your opinion publicly. I happen to disagree with it and I stated my reasons. I don't see that as persecution, but the normal course of discussing an issue. If you come here only for validation you will often but not always be disappointed.

On some issues the people taking part may be more evenly split, you do seem to be in the minority on this one, but that still doesn't rise to the level of censorship in my view. Certainly we are more polite here than on many forums.

patrickosmith · by **patrickosmith** » 2021-06-05 8:42 a.m.

True enough. Perhaps bordering on bullying by FB standards, but I'm not a snowflake. Thanks for your viewpoint. Now, I shared this information because I hadn't heard it before and thought it of interest (not because I expected validation). My experience here is a valuable reminder that one must continually seek the truth even in the face of adversity. I remain extremely skeptical. I am not going to "jump in" without a lot of evidence that I can verify myself from a variety of sources (this forum being one). Neither does it include repetitive news media reporting, coercion, incentives and certainly not celebrities and government.

patrickosmith · by **patrickosmith** » 2021-06-05 9:07 a.m.

[quote="brassmedic"]Your mind was already made up before you posted, and the reactions you got here have nothing to do with it. The Bell's Palsy thing is old news. It was reported last year...[/quote]
I still haven't "made up my mind" and I had not heard the "old news" that you say was discredited or debunked. That's a red flag right there. "Oh that was debunked so you don't need to look into it any further." I am very skeptical for good reason. I certainly do not trust the government with my life. There is a lot of conflicting information. Some may call it disinformation but those calling it so may have an agenda. I will continue to seek the truth (me myself and I) from all sources.

BGuttman · by **BGuttman** » 2021-06-05 9:58 a.m.

You really need to look in the overall context of things. If COVID were a minor disease that was localized, wanting to make sure the vaccine was thoroughly vetted is a reasonable quest. But that's not the case here. COVID is a virulent disease, spreads easily, has a high death rate among victims, and threatens to be similar to plagues from the past. This vaccine has been developed under emergency conditions as an attempt to control the disease and it seems to be pretty safe in comparison to allowing the plague to run its course.

If it helps, there has been a report that COVID contributes to ED. Think of it as a "reverse Viagra". ;)

Doug_Elliott · by **Doug_Elliott** » 2021-06-05 10:04 a.m.

Some people who got the Moderna shot got Bell's Palsy. That fact was not debunked. But at the same time a similar percentage of people in the world, who didn't have covid and were not in the control group, also got Bell's Palsy. The fact that none of those people happened to be in the control group is meaningless. Bell's Palsy is a rare side effect of being alive.

patrickosmith · 2021-06-05 12:19 p.m.

The missing link for me is the seemingly increased rate of occurrence. These outcomes occurred within days to months after receiving the vaccine. I haven't seen an analysis that addresses this and I haven't yet had the time to do it myself. Everyone here just assumes the experts have done so.

Doug_Elliott · by **Doug_Elliott** » 2021-06-05 1:15 p.m.

Lots of people have gotten Bells Palsy within days or months of NOT getting a vaccine, it's certainly not unique to this vaccine.

One thing to consider, that I have not seen addressed, is not about this vaccine specifically but about illness and immune response in general.

The "side effects" of any vaccine (or illness) are similar to the symptoms of the infection. So how much of those symptoms are due to the actual infection and how much are due to the immune response? ... We know that autoimmune diseases are the body reacting to immune responses in a bad way. Fever, chills, sweating, etc are not the disease, but the immune response... necessary to combat the disease. Is Bell's Palsy (in any form or timing) itself an infection, or inflammation as a result of the immune response? In general, do we "feel sick" as part of the immune response, or the disease itself? With some things like malaria, you can recover from the disease but it's the symptoms (uncontrolled shivering) that can kill you.

In any case, immune response is a necessary part of developing immunity so you can ward off or recover the next time you encounter the same pathogen. There's really nothing different about these vaccines from any others except the speed at which they were developed, which is a testament to the current state of medical knowledge. I'm not going to second-guess experts in the field due to conspiracy theories or politics.

brassmedic · by **brassmedic** » 2021-06-05 2:44 p.m.

[quote="patrickosmith"]<QUOTE author="brassmedic" post_id="149933" time="1622837026" user_id="4102">
Your mind was already made up before you posted, and the reactions you got here have nothing to do with it. The Bell's Palsy thing is old news. It was reported last year...[/quote]
I still haven't "made up my mind" and I had not heard the "old news" that you say was discredited or debunked. That's a red flag right there. "Oh that was debunked so you don't need to look into it any further." I am very skeptical for good reason. I certainly do not trust the government with my life. There is a lot of conflicting information. Some may call it disinformation but those calling it so may have an agenda. I will continue to seek the truth (me myself and I) from all sources.
</QUOTE>
I didn't say it was debunked. I said it was reported last year, so I don't know why you're pretending this is something that's just being discovered. They looked into it and found that the rate of Bell's Palsy that occurred in the trial subjects was similar to the rate that it occurs in the general population and concluded that the vaccine is unlikely to be the cause, but continued to monitor the situation out of an abundance of caution. The rate of Bell's Palsy occurring after vaccinations is still commensurate with the rate in the general population. If you "haven't had the time" to find this out, perhaps you should make the time. A lot of people here have explained it politely and rationally, and you have petulantly dismissed every single one of them.

patrickosmith · by **patrickosmith** » 2021-06-05 5:19 p.m.

[quote="brassmedic"]... The rate of Bell's Palsy occurring after vaccinations is still commensurate with the rate in the general population. If you "haven't had the time" to find this out, perhaps you should make the time. A lot of people here have explained it politely and rationally, and you have petulantly dismissed every single one of them.[/quote]

Very well then. Keep in mind this analysis relies on a small sample of data (36,901 subjects) for a relatively rare outcome and a number of simplifying assumptions. And I am having a relaxing non-working day if you gather my meaning. So please do check the numbers. I know I will be checking it later.

Without further ado ...

Question:

What is the *relatively likelihood* of contracting Bell's Palsy for these two conditions:

(Condition A) "after receiving the (Pfizer/Moderna) mRNA injections"

(Condition B) "not receiving the mRNA injections at all."

Answer:

575

You are 575 times more likely to contract Bell's Palsy after receiving these mRNA injections than had you not been injected at all.

So what!? It's a rare thing right? That is true. You probably won't get it anyway since it is so rare. But, still, you are 575 times more likely to get it within a few months of your last injection.

Please feel free to point out any errors, omissions, mistakes, caveats or spin you care to make. I would love it if any of you can find a stupid math mistake, error in reasoning or whatever.

From Wilktone and http://www.neurocntr.com/bells-palsy.php we have 40,000 outcomes per 332,000,000 persons per year. That's an occurrence rate of 0.000120481 per person per year for (Condition B).

From the data provided in the subject report we have 7 outcomes per 36,901 in an average period of 25 days after receiving their last injection (specifically days 3, 9, 22, 28, 32, 37, 48). That's an occurrence rate of 0.000189696 per person per 25 days. (For the sake of the remainder in this group I hope this short-term rate reduces dramatically). Anyway, this translates to an occurrence rate of 0.069239316 per person per year for (Condition A).

The ratio of condition (A) to condition (B) is 575.

Doug_Elliott · by **Doug_Elliott** » 2021-06-05 6:20 p.m.

per person per year

or

per person per 25 days?

It looks like you're comparing apples with bushels of apples.

You're basing your figures with no justification, that the 25 day rate will continue for the rest of the year.

And how many people got Bells Palsy after having covid?

after getting any other vaccination?

after having a cold, flu, or other illness or immune system response?

Any of those would be more relevant than comparing the incidence in the general population.

paulyg · by **paulyg** » 2021-06-05 6:35 p.m.

I’m continually amazed at the breadth of intellects able to play trombone, go about life, and even type out grammatically coherent responses.

patrickosmith · by **patrickosmith** » 2021-06-05 7:32 p.m.

Doug,

I'll answer your question from my original statement:

"That's an occurrence rate of 0.000189696 per person per 25 days. (For the sake of the remainder in this group I hope this short-term rate reduces dramatically). Anyway, this translates to an occurrence rate of 0.069239316 per person per year for (Condition A)."

Has anyone gone back to check to see if the short-term rates have decreased, increased or remained the same? That would be useful data.

Patrick

BGuttman · by **BGuttman** » 2021-06-05 7:40 p.m.

This is an extremely rare occurrence given the amount of testing we have had time for. I'm sure that any additional reports of Bell's will be considered. Remember, we have a situation where you have a 1 in 300 chance of dying from COVID and something like 1 in 150 chance of permanent disability from COVID. Which do you want to risk? I got my 2nd Pfizer shot a couple of months ago and I'm still OK (well, there are other health issues that were present long before the outbreak of COVID ...).

Doug_Elliott · by **Doug_Elliott** » 2021-06-05 7:52 p.m.

[quote="patrickosmith"]Doug,

I'll answer your question from my original statement:

"That's an occurrence rate of 0.000189696 per person per 25 days. (For the sake of the remainder in this group I hope this short-term rate reduces dramatically). Anyway, this translates to an occurrence rate of 0.069239316 per person per year for (Condition A)."

Has anyone gone back to check to see if the short-term rates have decreased, increased or remained the same? That would be useful data.

Patrick[/quote]
I know I have better things to do right now than follow this thread or do the math, but that sure doesn't look right to me. And even if it is, I think you're making a lot of assumptions with no basis.

I'm out of here for now.

patrickosmith · by **patrickosmith** » 2021-06-05 8:44 p.m.

I made no errors or omissions that I know about. I didn't quantify the statistical error bars. One often needs at least 30 outcomes for a good estimate. Alas this data set had only 7 outcomes. That would be the most likely dart thrown by "the experts."

Doug_Elliott · by **Doug_Elliott** » 2021-06-05 9:43 p.m.

Speaking of errors and omissions:

Since the vaccine trials only involved a certain age group, any comparisons to the overall incidence of Bells Palsy necessarily have to include only the same age group. Good luck finding that information.

Without it, those statistics are meaningless.

greenbean · by **greenbean** » 2021-06-06 12:10 a.m.

Whoa, it looks like an epidemiologist is needed here! I happen to be one....

Here is a quick statistical analysis. I think I have the right numbers. Let me know if not and I will fix it. This is probably what the researchers did as a first pass. Then they would have used a much more sophisticated statistical model. Or, more likely, they realized that they didn't have enough data to draw conclusions with any certainty. So, the "risk ratio" (treated / control) is 7.01. It might be tempting to interpret this as "the rate in the vaccinated group was 7 times the rate in the control group." But looked at the confidence interval (CI) for that point estimate. It is wider than any CI that I reported in my research career. Why? Not enough data! Look at the number of cases this analysis is based on. Seven cases and one case! Tiny data samples like this are subject to natural variability but are also very sensitive to data errors. So, the control group had one case. What if there was really a second case that was incorrectly reported as some other neurological condition. If you put that person back into the analysis (where they belong), it completely changes the results. The estimated rate among the control would double. And maybe the data analyst miscoded some people while working with the data (easy to do). Maybe the 7 cases in the vaccinated group is really 6. Again, that would significantly change the results. These are simple examples, but you get the idea.

<ATTACHMENT filename="Screen Shot 2021-06-05 at 8.42.21 PM.png" index="0">~~[attachment=0]~~Screen Shot 2021-06-05 at 8.42.21 PM.png</ATTACHMENT>

Epidemiological studies are subject to a laundry list of possible problems. Yes, this is a randomized trial, but trials suffer from many of the same problems. There are big challenges caused by differential drop out rates and by differences in behaviors that affect ascertainment of disease status. One thing to really watch for in a trial like this would be the fact that the control will have more severe COVID symptoms and would be more likely to end their participation in the study, after being identified as a COVID case and thus being much less likely to have other diagnosis become known. There may have been several control group participants who developed Bells Palsy but were not identified by study staff because they dropped out of the study. And on and on.

BGuttman · by **BGuttman** » 2021-06-06 1:03 a.m.

Thanks, Tom. This is what a lot of us have been trying to say. Figures don't lie, but Liars can Figure.

Posaunus · by **Posaunus** » 2021-06-06 1:13 a.m.

[quote="greenbean"]Whoa, it looks like an epidemiologist is needed here![/quote]

Fortunately, it was other professional epidemiologists, statisticians, and medical experts who reviewed the extensive clinical trial data for the "experimental" COVID-19 vaccines - and who surely saw and accounted for the Bell's Palsy outliers in that data - before they recommended releasing the vaccines to the general population. These same experts are surely also monitoring the results of the by-now very wide distribution of the vaccines (billions of doses so far), now clearly understood to be safe and effective.

It is those professionals who most of us trust, and on whose recommendations we have willingly been injected to protect ourselves - and others! They surely have more expertise than a TromboneChat member whose claim to fame seems to be that he "~~[color=#0040BF]~~enjoyed probability theory in undergraduate school" and "~~[color=#0040BF]~~used [his] knowledge over the decades in real world engineering designs (like designing satellite systems, rockets and the like)," but who has not seen the totality of the data used to make the vaccine release recommendations - nor the details or medical history of the Bell's Palsy patients. These recommendations come from sources (people) that I trust to have made their decisions in the best interest of the public - NOT from some politically-inspired arm of "government." [Quoting the O.P.: "~~[color=#0040BF]~~I am very skeptical for good reason. I certainly do not trust the government with my life."]

I have no personal knowledge to question the O.P's motives or his fears. But, for some reason, "I am very skeptical."

greenbean · by **greenbean** » 2021-06-06 1:28 a.m.

[quote="Posaunus"]

Fortunately, it was other professional epidemiologists, statisticians, and medical experts who reviewed the extensive clinical trial data for the "experimental" COVID-19 vaccines - and who surely saw and accounted for the Bell's Palsy outliers in that data - before they recommended releasing the vaccines to the general population. These same experts are surely also monitoring the results of the by-now very wide distribution of the vaccines (billions of doses so far), now clearly understood to be safe and effective.

...[/quote]

For sure, Dave. Vaccine development is not a new field. Huge investments have been made building the research infrastructure to (relatively) quickly gets vaccines ready. The annual flu vaccine development has been a big part of it. What these companies and the NIHs have done for this Coronavirus crisis has been nothing short of astounding. Could we imagine we would be where we are today?... say, a year ago when the US President (!) was calling it a hoax?

brassmedic · by **brassmedic** » 2021-06-06 1:59 a.m.

What I don't understand is, if someone is convinced that this 7 to 1 differential conclusively proves that those two vaccines greatly increase your risk for developing Bell's Palsy, and isn't just statistical noise, then why not just get the Johnson & Johnson vaccine, which had an equal number of Bell's Palsy cases in the treated and control groups? :idk: Unless this isn't really about being concerned and is more about having certain political beliefs.

patrickosmith · 2021-06-06 7:32 a.m.

Hey guys, Tom Rice threw two darts.

1) The small data dart which is true. With only 7 outcomes there is significant statistical error which I have not yet quantified. However, I did not use the much worse method ("7 to 1") that Tom Rice implied. That would introduce much higher error for no reason. I did use the 7 reported outcomes from those who received the mRNA injections out of the 36,901 cases. I agree that is a small number over a limited time period. Nevertheless the markedly increased *rate* of occurrence is alarming when compared to the pre-pandemic rate based on 40,000 outcomes per 332,000,000 persons per year. You see, I did not use that 1 outcome from the placebo group. As many of you correctly pointed out, we have all the data in the world for that case. I used all the data I had and let the numbers speak for themselves.

Additional surveillance of those who received nRNA from the original group of 36,901 might show that the risk rate goes back to the nominal pre-pandemic rate risk.

2) Tom's other dart was that *maybe* some of the 7 who reported Bell's Palsy were *misreporting* the condition, i.e., they didn't actually have Bell's Palsy. While that may be true I assumed that the data in this (peer reviewed?) report is valid. I can't go changing the numbers. That's what people with an agenda try to do and most people correctly see right through that.

patrickosmith · by **patrickosmith** » 2021-06-06 7:41 a.m.

[quote="BGuttman"]Thanks, Tom. This is what a lot of us have been trying to say. Figures don't lie, but Liars can Figure.[/quote]

I truly hope you aren't actually calling *me* a liar for conducting my own statistical analysis. I'm practically begging anyone to throw darts at it. Until someone can throw a dart that actually sticks, the increased risk is "575 times more likely." The biggest dart is the one I already pointed out: data from only 36,901 person's with only 7 outcomes for a rare condition. One needs 30 for a credible report, 100 for a much higher level of credibility, and 1000s for indisputable reporting.

patrickosmith · by **patrickosmith** » 2021-06-06 8:02 a.m.

[quote="brassmedic"]...this 7 to 1 differential conclusively proves ...[/quote]
I didn't use the much worse statistical estimate based on 7 to 1 differential to which Tom Rice alluded. I ignored the placebo group and used the pre-pandemic rate offered by Wilktone based on the population of the USA (40,000 outcomes per 332,000,000 person's per year).

BGuttman · by **BGuttman** » 2021-06-06 8:10 a.m.

The problem is still the VERY small sample size. There are not enough instances to create statistical confidence in the outcome.

On the other hand, we have very strong statistical evidence that all of the vaccines tested (this excludes Sputnik and the Chinese) are significantly capable of preventing COVID infection and reducing the consequences of any infection found.

No, I don't call you a liar. I just think you are misinterpreting the information. In fact, you are probably equally at risk of Bell's Palsy whether you get the vaccine or not.

Wilktone · by **Wilktone** » 2021-06-06 8:34 a.m.

The article Patrick linked to in the first post in this thread states:

The FDA pointed out that the cases in the vaccine groups did not represent a frequency above that expected in the general population [1] and concluded that currently available information was insufficient to determine a causal relationship with the vaccine.

This is just an example of the scientific method working itself out in real time. The FDA is taking this seriously out of an abundance of caution, but the risk/benefit to getting vaccinated is quite clear.

Getting vaccinated is much like wearing a mask if you're unvaccinated. It's not so much to protect you, but to protect those around you. If you are able to get the vaccine and there aren't any health reasons why you shouldn't, then I think you have a moral obligation to do so. If your ideological views prohibit that for some reason, then I think the moral thing to do is to continue to wear a mask (assuming that *continue* is the right description here) and socially distance yourself when out.

It is natural to feel some anxiety about a new vaccine and one that was developed and rolled out with such speed. Discussing your concerns on a trombone forum is the absolute wrong place to address this issue. If you don't trust the government, why would you trust a random group of trombonist strangers? Do you trust your doctor? Make an appointment and discuss this issue with your medical provider.

Dave

patrickosmith · 2021-06-06 8:53 a.m.

David Wilken,

You are absolutely right. No more statistical, covid or vaccine discussions with any brass instrumentals. But I reserve the right to introduce a limerick.

Patrick

p.s.

"He said that if they knew so well how things were to be done, they did not need him. He refused to help them further, and vanished."

Wizard's First Rule, Terry Goodkind

timothy42b · by **timothy42b** » 2021-06-06 9:41 a.m.

[quote="BGuttman"]The problem is still the VERY small sample size. There are not enough instances to create statistical confidence in the outcome.
[/quote]

With a small sample size, we can't assume a normal distribution, and therefore most of the standard statistical tests are not valid. You might be able to get around that using cell means and the Central Limit Theorem but I don't see a way to get that data.

patrickosmith · by **patrickosmith** » 2021-06-06 10:48 a.m.

Having had just a bit too much wine

the statistician opted to recline

head in the Frigidaire

feet out in the hot air

On the average he was feeling fine

Source: https://www.familyfriendpoems.com/poem/statistics

Kingfan · by **Kingfan** » 2021-06-06 11:25 a.m.

[quote="Wilktone"]... It is natural to feel some anxiety about a new vaccine and one that was developed and rolled out with such speed. Discussing your concerns on a trombone forum is the absolute wrong place to address this issue. If you don't trust the government, why would you trust a random group of trombonist strangers? Do you trust your doctor? Make an appointment and discuss this issue with your medical provider.

Dave[/quote]

I agree. Coming to this forum for information on COVID is like posting on an AMA epidemiologist website a question on trombone mouthpieces. You might get some good information, but...

patrickosmith · by **patrickosmith** » 2021-06-06 11:26 a.m.

[quote="robcat2075"]The people with no symptoms are the reason we have an epidemic.[/quote]

https://wwwnc.cdc.gov/eid/article/27/4/20-4576_article

Volume 27, Number 4—April 2021

Dispatch

Analysis of Asymptomatic and Presymptomatic Transmission in SARS-CoV-2 Outbreak, Germany, 2020

"In conclusion, our study suggests that asymptomatic cases are unlikely to contribute substantially to the spread of SARS-CoV-2."

brassmedic · by **brassmedic** » 2021-06-06 12:01 p.m.

[quote="patrickosmith"]<QUOTE author="brassmedic" post_id="150133" time="1622959164" user_id="4102">
...this 7 to 1 differential conclusively proves ...[/quote]
I didn't use the much worse statistical estimate based on 7 to 1 differential to which Tom Rice alluded. I ignored the placebo group and used the pre-pandemic rate offered by Wilktone based on the population of the USA (40,000 outcomes per 332,000,000 person's per year).
</QUOTE>
So what? That wasn't my question.

Dennis · 2021-06-06 1:43 p.m.

[quote="patrickosmith"]<QUOTE author="BGuttman" post_id="150127" time="1622955798" user_id="53">
Thanks, Tom. This is what a lot of us have been trying to say. Figures don't lie, but Liars can Figure.[/quote]

I truly hope you aren't actually calling *me* a liar for conducting my own statistical analysis. I'm practically begging anyone to throw darts at it. Until someone can throw a dart that actually sticks, the increased risk is "575 times more likely." The biggest dart is the one I already pointed out: data from only 36,901 person's with only 7 outcomes for a rare condition. One needs 30 for a credible report, 100 for a much higher level of credibility, and 1000s for indisputable reporting.
</QUOTE>

A number of darts have been thrown that have in fact stuck.

In terms of time-to-event data, the FDA will require sample sizes large enough to generate at least 100 events in a Phase IIb trial and more in a Phase III trial. Seven or 8 events in a randomized trial is simply insufficient to make any sort of conclusion. Consider that the trials were randomized 1:1 to the two treatments. We observed 8 events. If there is in fact no causal relationship between vaccination and Bell's palsy, a 1:7 split happens about 3.5% of the time. In terms of incidence data, the FDA will require sufficient data to provide 80% to 90% power for the alternative hypothesis.

However, there has been no adjustment made for the data snooping. That is, if we had specified before the fact that Bell's palsy was an adverse event (AE) of special concern, we might have sufficient evidence to conclude that there is an association between the vaccine and Bell's palsy. (I say might, because the exact test used here is just barely significant and any multiplicity adjustment would make the result insignificant. So, if Bell's palsy was the only AE of concern, we'd have the result you have claimed.)

Now, let's address your claimed risk-ratio of 575. The numerator of the risk ratio is suspect (because of the data snooping) and the denominator is wrong. You used the crude incidence rate in the population as the denominator, but the clinical trial was restricted to persons over 18 (or 16 for the Pfizer-BioNTech) vaccine. We know that the risk of Bell's Palsy is highest in the 15 to 45 year-old group. The crude rate is too low: an age-adjusted rate if necessary.

Of course, the real problem here is what Goldberger called micronumerosity. You are trying to reach definitive conclusions on the basis of 8 observations. Insufficient data are insufficient. What the data are sufficient for is to flag Bell's palsy for further monitoring. That is in fact what has happened: the FDA has recommended.

robcat2075 · by **robcat2075** » 2021-06-06 2:10 p.m.

[quote="patrickosmith"]<QUOTE author="robcat2075" post_id="149890" time="1622819185" user_id="3697">
The people with no symptoms are the reason we have an epidemic.[/quote]

https://wwwnc.cdc.gov/eid/article/27/4/20-4576_article

Volume 27, Number 4—April 2021

Dispatch

Analysis of Asymptomatic and Presymptomatic Transmission in SARS-CoV-2 Outbreak, Germany, 2020

"In conclusion, our study suggests that asymptomatic cases are unlikely to contribute substantially to the spread of SARS-CoV-2."
</QUOTE>

That's one. Not many others seem to agree...

~~[url]~~<LINK_TEXT text="https://www.webmd.com/lung/news/2021011 ... tic-spread">https://www.webmd.com/lung/news/20210110/59-percent-of-covid-cases-stem-from-asymptomatic-spread</LINK_TEXT>

About 59% of transmission comes from people without symptoms, according to a new study published Thursday in JAMA Network Open. This includes 35% from people who infect others before they show symptoms and 24% from people who never develop any symptoms.

~~[url]~~<LINK_TEXT text="https://www.uchealth.org/today/the-trut ... -covid-19/">https://www.uchealth.org/today/the-truth-about-asymptomatic-spread-of-covid-19/</LINK_TEXT>

“Asymptomatic spread definitely plays a role in community spread,” said Dr. David Beckham, an infectious disease specialist who studies viruses in a lab he runs at the University of Colorado School of Medicine.

~~[url]~~<LINK_TEXT text="https://jamanetwork.com/journals/jamane ... le/2774707">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707</LINK_TEXT>

Question What proportion of coronavirus disease 2019 (COVID-19) spread is associated with transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from persons with no symptoms?

Findings In this decision analytical model assessing multiple scenarios for the infectious period and the proportion of transmission from individuals who never have COVID-19 symptoms, transmission from asymptomatic individuals was estimated to account for more than half of all transmission.

Meaning The findings of this study suggest that the identification and isolation of persons with symptomatic COVID-19 alone will not control the ongoing spread of SARS-CoV-2.

<LINK_TEXT text="https://www.uchicagomedicine.org/forefr ... -of-spread">https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/asymptomatic-coronavirus-infections-contribute-to-over-50-percent-of-spread</LINK_TEXT>

Asymptomatic transmission of COVID-19 contributed significantly to community spread in New York City during the initial phase of the pandemic, according to a new paper from a team of researchers at the University of Chicago...

In the first mathematical model to incorporate data on daily changes in testing capacity, the research team found that only 14% to 20% of COVID-19 individuals showed symptoms of the disease and that more than 50% of community transmission was from asymptomatic and pre-symptomatic cases.

Doug_Elliott · by **Doug_Elliott** » 2021-06-06 2:18 p.m.

This website:

<LINK_TEXT text="https://www.medpagetoday.com/infectious ... cine/92291">https://www.medpagetoday.com/infectiousdisease/covid19vaccine/92291</LINK_TEXT>

talks about facial paralysis side effect in a much larger sample, and more importantly compares it to the incidence from other vaccines.

It looks like the covid vaccines have a very similar - or lower - risk than other vaccines.

robcat2075 · by **robcat2075** » 2021-06-06 2:52 p.m.

[quote="patrickosmith"]<QUOTE author="robcat2075" post_id="149890" time="1622819185" user_id="3697">
The people with no symptoms are the reason we have an epidemic.[/quote]

https://wwwnc.cdc.gov/eid/article/27/4/20-4576_article

Volume 27, Number 4—April 2021

Dispatch

Analysis of Asymptomatic and Presymptomatic Transmission in SARS-CoV-2 Outbreak, Germany, 2020

"In conclusion, our study suggests that asymptomatic cases are unlikely to contribute substantially to the spread of SARS-CoV-2."
</QUOTE>

a quote from that study...

A limitation of our study is that evidence was obtained from a single outbreak and might not be applicable to other settings. We used only information as recalled by the case-patients, which is imperfect and may introduce errors or bias.

It only looks at 59 cases. Do we really want to make nation policy on the mere recollections of 59 people?

And you have selectively quoted their findings. Their claim is that not "asymptomatic" but "pre-symptomatic" people are the spreaders.

Those are also people walking around with no symptoms.

greenbean · by **greenbean** » 2021-06-06 3:10 p.m.

Using those national data are a big mistake. There were not collected in a remotely similar way. Estimates like that usually come from combine registry or other reporting system data (almost always very incomplete buy useful for other things) with census data.

As for the quickie analysis I did... The extremely wide confidence interval indicate the high degree of uncertainty from random variability ONLY. This type of statistical analysis can be called "frequentist" statistics. It completely ignores the uncertainty from other sources! There are scores of selection and measurement biases that need to be considered.

[quote="Dennis"]...Of course, the real problem here is what Goldberger called micronumerosity. You are trying to reach definitive conclusions on the basis of 8 observations. Insufficient data are insufficient. What the data are sufficient for is to flag Bell's palsy for further monitoring. That is in fact what has happened: the FDA has recommended.[/quote]

Micronumerosity. I am not familiar with this terns but I like it! I totally agree with the above conclusion (emphasis added). The data have provided a suggestion that there might be an association between the vaccine and Bell's Palsy. Enough of a suggestion to justify more research.

greenbean · by **greenbean** » 2021-06-06 3:20 p.m.

Asymptomatic vs pre-symptomatic

Robert pointed out something interesting and potentially important. "Asymptomatic" is not the same as "pre-symptomatic." These groups of people may be very different. For example, it is possible that asymptomatic people are not infectious while pre-symptomatic people ARE infectious during their pre-symptomatic period.

Darts

Why are major criticisms of a data analysis being called "darts"?... To suggest they they are not important? These criticisms would be viewed as "fatally flawed" by peer reviewers if it submitted to a scientific journal for possible publication.

Dennis · by **Dennis** » 2021-06-06 4:23 p.m.

[quote="greenbean"]As for the quickie analysis I did... The extremely wide confidence interval indicate the high degree of uncertainty from random variability ONLY.[/quote]

THIS!

[quote="greenbean"]Micronumerosity. I am not familiar with this terns but I like it! I totally agree with the above conclusion (emphasis added). The data have provided a suggestion that there might be an association between the vaccine and Bell's Palsy. Enough of a suggestion to justify more research.[/quote]

Goldberger, Arthur (1991) A Course in Econometrics. It's a very tongue-in-cheek reference to proposed solutions for the collinearity problem in observational multiple regression studies, applied to the problem of small sample sizes. Econometricians are notorious for using asymptotic results with small samples. (An economist friend of mine once jokingly said, "A sample size sufficiently large to use an asymptotic results is at least one observation fewer than are available to me.")

Goldberger's tongue may have been in his cheek when he wrote that section 30 years ago, but it's a real (and ongoing) problem. I frankly never expected to encounter it in a trombone list.

BTW, greenbean: Do you make padded bags for goosenecks? How about for F-sides? I acquired a gooseneck for my Shires earlier this year, and I'd like to store it in the Bonna case I bought for it. If I could get a bag for the gooseneck and a bag for the F-side I could store it in the current configuration.

greenbean · by **greenbean** » 2021-06-06 5:42 p.m.

I think it has always been a problem. It is wishful thinking, really, that you can squeeze answers from a tiny data set. Sander Greenland has written about what he calls "sparse data bias." Data analysts will often fit regular maximum likelihood models to sparse data sets and, as they add in more covariates, some estimates start to take off. They will get very excited and think they are getting closer to the real answer. In reality they are just making more "cells" with small numbers or even zeros. (Conditional ML can give valid estimates for these data.)

*Yes, I can make the bags you need. Just email me with dimensions and photos.

patrickosmith · by **patrickosmith** » 2021-06-07 9:24 a.m.

So in retrospect, here is what I should have initially posted:

I would like to avoid any extended discussions of medical information, politics and the like.

I have just one simple question:

"Does anyone of you know of anyone who has experienced Bell's Palsy (facial muscle paralysis, usually temporary) after their mRNA injections?

Please only respond "Yes" if true. Don't bother responding "No" because that should be virtually everybody.

And please do *not* offer lengthy discussions or opinions. Just a "Yes" if true.

The FDA is tracking this issue because there were 7 reported cases within days to months of receiving their last injection in the trials leading up to emergency use authorization. 7 out of 36,901 in that time frame is a relatively high frequency of occurrence. But the sample size (only 7 outcomes) is too small to be definitive.

My expectation is crickets. I expect no replies of "Yes."

Burgerbob · by **Burgerbob** » 2021-06-07 1:56 p.m.

Feel free to read all of the replies you've received here at any time.

mwpfoot · by **mwpfoot** » 2021-06-08 1:11 p.m.

I've known three trombone players over the years who've gotten Bell's Palsy, or some temporary facial paralysis like it, and they each had to work hard to get back into playing shape. I've only met, what, a hundred trombone players? And THREE of them had it?

Playing trombone MUST increases the risk, so PLEASE consider this before you teach children trombone.

It's a cursed instrument, I tells ya.

:twisted:

Doug_Elliott · by **Doug_Elliott** » 2021-06-08 1:14 p.m.

[quote="mwpfoot"]Playing trombone MUST increases the risk, so PLEASE consider this before you teach children trombone.[/quote]

I don't care, they're not MY children.

Thrawn22 · by **Thrawn22** » 2021-06-11 10:15 p.m.

This thread is so telling of certain people and how they choose to interact with those they disagree with.

Rodris · by **Rodris** » 2021-07-01 6:29 p.m.

I got eh first Pfizer shot on June 16th. Won't have to take the second shot since I got Covid a few months ago.

I just developed Bell's palsy (today it's completing 4 days) and I have all the left part of my face paralyzed.

I had a concert on July the 3rd but, unfortunately, I don't see any sign of improvement. :-| :-| :-| :-|

Hope I'll get better.

BGuttman · by **BGuttman** » 2021-07-01 6:38 p.m.

I am truly sorry to hear of this. You can get Bell's from a lot of things, not necessarily the Pfizer vaccine. It may be a coincidence or it may be causal. You should notify the group doing the vaccinations about this. Also, I hope you are having your Doctor work on the Bell's with you.

brassmedic · by **brassmedic** » 2021-07-01 7:16 p.m.

[quote="Rodris"]I got eh first Pfizer shot on June 16th. Won't have to take the second shot since I got Covid a few months ago.

I just developed Bell's palsy (today it's completing 4 days) and I have all the left part of my face paralyzed.

I had a concert on July the 3rd but, unfortunately, I don't see any sign of improvement. :-| :-| :-| :-|

Hope I'll get better.[/quote]

I don't understand. You had Covid several months before you got the vaccine, and because of that you decided to get the first vaccine shot and skip the second shot? That doesn't make sense.

Posaunus · by **Posaunus** » 2021-07-01 7:47 p.m.

[quote="brassmedic"]<QUOTE author="Rodris" post_id="152103" time="1625178578" user_id="3839">
I got eh first Pfizer shot on June 16th. Won't have to take the second shot since I got Covid a few months ago.

I just developed Bell's palsy (today it's completing 4 days) and I have all the left part of my face paralyzed.

I had a concert on July the 3rd but, unfortunately, I don't see any sign of improvement. :-| :-| :-| :-|

Hope I'll get better.[/quote]

I don't understand. You had Covid several months before you got the vaccine, and because of that you decided to get the first vaccine shot and skip the second shot? That doesn't make sense.
</QUOTE>

Rodris appears to be in Brasil. Vaccine availability and protocols may be different there.

Here in the U.S.A. it is recommended to get both vaccine injections even if you've had COVID. But even post-COVID first-dosers may get strong and uncomfortable immune reactions for a day or two. (Sort of like what some of us got after our second injection.)

Best wishes with your Bell's Palsy, Rodris. Hope your medical team can provide some relief.

robcat2075 · by **robcat2075** » 2021-07-01 9:07 p.m.

Four days is probably too soon to look for improvement.

~~[url=https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet]~~

Bell's Palsy

What is the prognosis?

The prognosis for individuals with Bell's palsy is generally very good. Clinical evidence of improvement occurs spontaneously within three weeks in 85 percent of cases, and most individuals eventually recover normal facial function. Some individuals may be left with mild residual facial weakness or show moderate to severe deficits.

"Some" could be a very low number.

brassmedic · by **brassmedic** » 2021-07-01 9:53 p.m.

[quote="Posaunus"]<QUOTE author="brassmedic" post_id="152106" time="1625181412" user_id="4102">

I don't understand. You had Covid several months before you got the vaccine, and because of that you decided to get the first vaccine shot and skip the second shot? That doesn't make sense.[/quote]

Rodris appears to be in Brasil. Vaccine availability and protocols may be different there.

Here in the U.S.A. it is recommended to get both vaccine injections even if you've had COVID. But even post-COVID first-dosers may get strong and uncomfortable immune reactions for a day or two. (Sort of like what some of us got after our second injection.)

Best wishes with your Bell's Palsy, Rodris. Hope your medical team can provide some relief.
</QUOTE>

OK, that makes sense. Thanks.

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