Covid-19 vaccines and vaccinations

@Hilda Bastian's latest vaccine roundup

https://absolutelymaybe.plos.org/20...aims-a-month-of-seismic-shifts-and-confusion/

 

Looks exactly the same as I expected. The primary effiacy is still 66.7%.

The difference in efficacy for LD/SD and the 12 week interval are almost certainly due to demographic differences. So the efficacy is around 80% in young healthy people and in the 60% range overall. The single dose had an alarming drop in efficacy for the group at the longest interval and had very different demographics - so in the 70% range short term for young healthy people, around 50% or lower for the whole population, longer term.

Against the SA variant, the efficacy will likely be lower still.

Hilda Bastian isn't impressed:
https://twitter.com/user/status/1356750426142507010

 

The way I look at it...they will probably have to keep modifying them anyway as new variants emerge and this will be more frequent until overall infections come down ...so it’s not an all or nothing situation ...like many things. It’s about risk management in the here and now and nothing is risk free.

I’m becoming increasingly relaxed about efficacy (after the initial concern) since it’s going to be a long game for quite a few years. First objective is to bring the numbers down across the world , then we will get more effective and longer lasting vaccines after that.

im prepared to continue restricting contact/risk managing for 2 more years (even when vaccinated) until vaccination has been optimised/rolled out wider.

when over 1000 people are dying here (U.K.) every day, the talk of efficacy as if we had a choice seems a bit “theoretical”

It feels like we are going to have to weather the higher risk this year and vaccination is a supply chain issue not an efficacy issue. At the end of the day we don’t have any real data yet ...it’s just preliminary reports. They may end up being 30%, 60% or 90% effective in real terms we don’t know yet. Hopefully we will know a bit more in 6 weeks time.

I’m not dismissing the concern. They should report facts plainly not massage the data by removing initial weeks etc. I’m also still concerned that they are over egging the vaccine effect and the press especially seems to be touting it in a very black and white way.

I think even if it is lower than initially thought, it is better than waiting months for the supply chain to catch up surely? Especially when everyone wants it at the same time. Ive prepared for this to be a rolling continuous thing, not all sorted after 2 injections and back to normal in the summer (as the press are obsessively focussed on)

Sounds like we will be able to make what we need more efficiently (U.K.) in the future too. we hopefully will bring back the glass production we need to make the vials ..the glass that was there in Sunderland since Roman times that we ditched around 10 years ago and decided to import from France instead. More manufacturing feels like the right thing to do so I thought this was encouraging talk yesterday (if it’s borne out)

 

They seem to be ignoring, or downplaying to the point of not mentioning it, the evolutionary pressure we are putting on the virus/human organism.

All they seem to be concerned about, with regards to mutations, is getting the number of 'infected' down as this 'will' reduce the number of mutations. This would only be correct if they were reducing the number of the 'infected' really quite rapidly. which they are not.

So what the vaccinations, and other measures, are doing is introducing evolutionary pressure on the virus/human system to survive and keep replicating.

There would appear to be no way around this, other than by extremely rapid vaccination, probably of strictly isolated pockets.

But they aren't mentioned that, it's just get the numbers of the 'infected' down as this will reduce the pool that the virus has to mutate in - which for an organism that, if it finds a single host, can produce billions of copies of itself, some of which will likely be mutants, is IMO nonsensical, and unrealistically simplistic, as an only approach to control.

Unless they get the speed up, vastly, or enforce strict isolation, or both, then......we may be doing this dance for a 'while'.

 

#MEAction

https://www.meaction.net/2021/02/02/uk-government-should-add-me-to-vaccine-priority-list/

 

In Australia, we have the luxury of waiting in terms of time.

If people need a second dose to protect from new variants, it won't be AZ anyway, due to immunity against the vector.

If you talk about supply chains etc, that's down to corporate licensing. The same facilities that make the AZ vaccine can also make Novavax, Sputnik etc. Most western countries can ramp up production of the best vaccines - if they are allowed.

The problem can be solved with the swipe of a few pens, but that apparently is not how things work in our countries.

As Wonko said, the goal should be elimination ASAP and that means the best vaccines as well as better social policies. People keep talking about how the lower efficacy vaccines lower hospitalisations etc. But that won't matter if a substantial proportion of the population is not immunised. The goal is to reduce transmission - and vaccines that have less symptomatic cases are better at that.

 

Would you mind explaining this for a non scientist @Snow Leopard ?

 

That would seem to be the case, but are we sure? It would be something of a major disadvantage to the AZ/ Oxford vaccine platform if it’s an intervention that can only be deployed once, in any individual.

Oxford and AstraZeneca will make a new Covid vaccine by AUTUMN
https://www.dailymail.co.uk/news/ar...AUTUMN.html?ito=native_share_article-masthead

 

Yes thank goodness. ... and I suppose the practicalities of border control is something that is also variable from country to country (land borders/import profile etc)

regarding supply chains I don’t think the commissioning thing is the main issue. as I understand it, the main issue is total capacity/throughput with key parts of the supply chain being bottlenecks. Production capacity increases of the magnitude we are talking are significant. I think I read that to build and commission a new furnace to make the sintered glass (known bottleneck) will take 18 months or so...so some things aren’t overnight, some take weeks, others take months and throughput is not infinite. They will get there in time I’m sure but it seems unrealistic to expect this to be seamless and super speedy especially when that industry isn’t particularly geared to do speedy launches and have supply chain flexibility in the first place.

in food (which is very flexible and used to fast turnaround etc) we have had to divert a lot of production and adjust lines etc to meet the changes in demand but despite this, some parts of the supply chain (foodservice) were not practical to redeploy. Sometimes there is just a limitation you can’t overcome quickly and often it is a highly technical one that is difficult to predict (e.g shortage of flour because you can’t pack it into the retail size bags even though you have enough flour). Kit Kat changed their 4 finger machine to 2 finger though very quickly ..so the devil is in the detail and how quickly demand is changing/ramping up.

 

Sure, but availability of sintered glass has little to do with the decision to make a lower efficacy vaccine in favour of a higher example. That glass can be shipped from overseas where there is higher capacity too.

 

Yes agreed it’s a bottleneck no matter where you get it from or what you put in it

I admit I have no idea as to all the hidden complexities of the supply chain or the production pros and cons for each vaccine type (perhaps some are quicker to produce/pack who knows..perhaps some have a limit on the availability of raw material for the production or packing operations)? Warehousing and distribution probably plays a part given the storage requirements for some? All these come to bear on the supply quantities and timings independent of spec or price.

Almost certainly there will be differences and these supply and demand factors will drive decision making beyond efficacy to project manage supply to a timing ...uk have clearly taken a “not all their eggs in one basket” approach from the beginning and placed orders early ahead of product approval. However orders are just that ..they rarely underwrite all of the risk and I doubt any of the various manufacturing plants had the capacity to deliver all the demand to all their potential customers just in case we had many vaccines approved all at once. They are commercial companies in the main so will be managing commercial risk and producing to contract. They probably have at least a two month lead time from approval to order fulfilment possibly more...moderna seems longer?

my feeling is that there are almost certainly factors that are not apparent driving some of the decisions and timing (there always are with these things).

it will be interesting to see what the real life results show in a few weeks time.

 

I declined an invitation yesterday to make a vaccine appointment because the only option currently available at my local surgery is Oxford/AstraZeneca. I’m hoping they might get more Pfizer in at some point and that I might be able to have that one instead. I have no idea if that will be possible (I will investigate) but for now I’m prepared to risk postponing it.

I live on my own, I stopped having carers or anyone else come into my home and have no need to go for doctor or hospital visits. So I’m able keep myself well isolated. If that were not the case then I probably would’ve gone ahead with the Oxford/AstraZeneca vaccine.

 

https://www.theguardian.com/society...cacy-of-mix-of-covid-vaccines-for-individuals

A trial to test if covid vaccines can be mixed and retain or improve efficacy. This would help with supply issues.

I have a vague recollection ( but brain is at its foggiest today so this may be entirely wrong) that a discussion on here earlier explained that a particular vaccine could not be given following an earlier different one. I may have dreamt this- I have been having vivid dreams.

 

Various bits of info about the various vaccines, including the known aftereffects:

https://www.msn.com/en-gb/health/me...-full-list/ar-BB1dm0DU?ocid=ASUDHP&li=AAnZ9Ug

 

The Guardian science journalists not understanding what they are reporting on, once again.

The study is a phase 2 study to test for safety. The sample size is not large enough for any conclusions of efficacy.

 

Charities urge clarity over who qualifies for next UK vaccine wave

https://www.theguardian.com/society...y-over-who-qualifies-for-next-uk-vaccine-wave

 

ME should be on the list because many people are bedbound and rely on a series of careers coming in so are at high risk not just because of fatigue. They really don't equate with people with mild asthma. There is asthma in my family and I hope they get vaccinated soon but they have a choice and can avoid infection as much as possible whereas someone dependent on a carer cannot avoid risk.

I am glad she mentioned that ME worsens with infection in a way that the likes of MS do not. The framing of ME as psychological and behavioural is putting us at high risk again.

I am 66 now so I am in a higher category now but when I was milder and had young children it would have been a nightmare situation and there must be people going through that now. Dreadful.

 

This article was posted today on the Guardian front page and continued on page 6. ME was the first example given on the front page of an illness left out (of group 6) i.e. vulnerable people not included in the JCVI priority groups.

Also on page 6 was an article headed "Not a priority? If I get long covid on top of ME, I might as well give up", accompanied by a large photo of a young woman with ME, as well as photos of others with different vulnerabilities. ( Article by Frances Ryan)

Interesting - ME was mentioned first on the front page, was the second case study inside and had the biggest photo, and the headline had long covid written in very large type alongside ME. Another example of times changing at the Guardian?

Front page article was by Sarah Marsh, Frances Ryan and Dan Sabbagh. Am not familiar with 2 of these names.

( I am currently struggling to form thoughts and write - this has taken ages- and am sure that there are other inferences to be drawn if anyone has time. very pleased to see Guardian continuing its change of course).

eta: prominence would have been an appropriate word to include here