The biology of coronavirus COVID-19 - including research and treatments

Title : Excess deaths from Black, Asian, and Minority Ethnic Doctors during the Covid-19 Pandemic

Link : http://www.drdavidgrimes.com/2020/11/covid-19-vitamin-d-deaths-of-doctors.html

 

Talking of which, did anyone catch the "Is Covid Racist?" programme on Channel 4 tonight? I totally forgot about it. I hope it looked at the whole spectrum and didn't just concentrate on socioeconomic/cultural aspects.

 

I thought that in previous discussions we'd thought that around 70% efficacy was a perfectly reasonable percentage to achieve, compared with other vaccines? I've been looking at those reports of 90-95% and wondering just how they could possibly be that high. Interesting that much higher efficacy can apparently be achieved by giving a half-dose first rather than a whole one, and the suggested reasons for it. But I can't help wondering whether all these statistics - and especially the "anything you can do I can do better" ones - are being trotted out more with an eye to the company's share price than anything else.

 

Are you aware of this? So they were making mistakes in the vaccine doses given to trial participants. Jeesh! Good thing it was a smaller dose and not a bigger dose, someone could have been harmed.

(from Reuters)

While skill and hard work drove development, AstraZeneca said it was a minor mistake that made the team realise how they could significantly boost the shot’s success rate, to as much as 90% from around 60%: by administering a half dose, followed by a full dose a month later.

“The reason we had the half dose is serendipity,” Mene Pangalos, head of AstraZeneca’s non-oncology research and development, told Reuters.

The plan was for trial participants in Britain to receive two full doses, but researchers were perplexed when they noticed that side effects, such as fatigue, headaches or arm aches were milder than expected, Pangalos said.

“So we went back and checked ... and we found out that they had underpredicted the dose of the vaccine by half.”

He said the team nonetheless decided to press ahead with that half dose group, and to administer the second, full dose booster shot at the scheduled time.

The results showed the vaccine was 90% effective among this group, while a larger group who had received two full doses produced an efficacy read-out of 62%, leading to an overall efficacy of 70% across both dosing patterns, Pangalos said.

“That, in essence, is how we stumbled upon doing half dose-full dose (group),” he told Reuters. “Yes, it was a mistake.”

https://www.reuters.com/article/uk-health-coronavirus-astrazeneca-oxford-idUSKBN2832NG

 

Paul Bleicher who is an MD/PhD (Immunology/Microbiology),
posted a Twitter thread regarding the AstraZeneca vaccine "accidental" dosing discovery and poses some interesting questions as to what it means and what happens next...

https://twitter.com/user/status/1331014373574385664

 

Different processes may have something to do with it . I read that Astra zeneca swab tested every week and picked up asymptomatic, the others swab tested symptomatic only

 

I agree with your latter point. If we look at the actual numbers of people infected in each group, the numbers are quite fragile - if just two more people in the vaccinated group in the AstraZeneca "accidental" dosage group got infected, then the calculated efficacy would drop from 90% to 80%. This could simply be due to random chance of exposure. I strongly urge people not to read too strongly into claims that the vaccine will have 90% efficacy with this different dosage protocol.

But I also suggest the mRNA vaccine trials so far are similarly vulnerable due to low numbers being infected.

However, not all of the trial data has been released - the trials in places where there were far more virus exposures could have very different results - and a-priori, I'd expect regression to the mean, rather than 90%+ estimates.

As for "70% is good", it is better than nothing, but it is not good. 90% would lead to huge societal benefits, that greatly outweighs the extra refrigeration required for the Moderna vaccine for example. The fact that people are saying, oh, but the AstraZeneca vaccine is cheaper and easier to distribute, therefore is the best choice for the third world just pisses me off! Such a statement is saying that third world lives aren't worth as much...

Yes, lucky it wasn't too high. But I don't buy this accident BS. Are they really that incompetent? Or perhaps they had a last minute change of heart and wanted to deviate from their established protocol for a reason.

There is a few other conclusions that many people don't seem to realise - once you have been vaccinated with an adenovirus vector vaccine, you can't have subsequent booster (past the initial 2 doses) shots of it because the immune response to the adenovirus vector will prevent efficacy. Similarly, it means ChAdOx cannot be used as a vector for any other novel virus in the future, in recipients.

 

The two AstraZeneca trials had different methodology - the UK trial had weekly swabbing, the Brazil trial had less regular sampling. The Brazil trial had poorer efficacy which is the opposite to what we'd expect - (we'd expect there to be more vaccinated individuals who are asymptomatic, thus skewing the results in favour of increased vaccine efficacy).

Also, just FYI, my back of the envelope estimates of the lower 95% confidence interval for the "1.5 dose" subgroup is in the 70% range, which is to say the confidence intervals of both arms likely overlap...

I wish they would just release the data properly as a preprint, rather than all this cherrypicking...

 

Alberta(Canada) researcher wins salt-coated mask innovation.

 

I was surprised at how well this article was written (as far as science journalism standards go), until I learned who wrote it.

An article by @Hilda Bastian
https://www.wired.com/story/the-astrazeneca-covid-vaccine-data-isnt-up-to-snuff/

 

and from NYT link
AstraZeneca Faces Difficult Questions About Its Vaccine After Admitting Mistake - The New York Times (nytimes.com)

 

I am not sure what more shocking - that they could make the wrong strength vaccine, that they could administer the wrong strength vaccine or that they think they can average two different groups to give a combined 70% efficacy when the original protocol specified vaccine only achieved ~60%.

Helen Fletcher, professor of immunology at London School of Hygiene and Tropical Medicine (LSHTM), said: “.... It’s not surprising if some manufacturing issues were still being ironed out when they started clinical trials but early stage trials are all about safety and the safety data we have seen has been very robust.”

"some manufacturing issues" - if making the wrong dose is a manufacturing issue the plant should be shut down.
It would be almost impossible for a manufacturer to make the wrong strength vaccine, due to the number of quality controls in place. So either there was no quality control at all, or they made the right strength, then the strength was changed but the wrong lots got administered.

Either way, it's a very serious issue and definitely not to be dismissed as "some manufacturing issues"

 

https://www.hematology.org/covid-19...fferent immunocompromised patient populations.

Have any of the vaccines been tested on immunocompromised patients?

 

I presume you mean non-covid vaccinations. The answer is yes, for example several types vaccines in people who are taking Rituximab.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462293/ (review article)

Live vaccines are generally contraindicated in the immunocompromised (this would include the AstraZeneca, J&J, Sputnik vaccines).

 

I was referring to immunocompromised candidates taking part in the Pfizer, Moderna and AstraZeneca Covid vaccination trials.
In my post above it says no, but that was in October.

 

As far as I know, the answer is still no.

I'll also take this opportunity to plug Hilda Bastian's regularly updated list of COVID19 vaccine related publications:
https://www.zotero.org/groups/2528572/covid-19_vaccine_results/items/7HIE73BT/library

 

https://absolutelymaybe.plos.org/20...ncy-press-release-readouts-whats-the-problem/

(by @Hilda Bastian)

She makes an excellent point of the danger of science-publishing-by-press release as well as pointing out how peer-review is overrated, particularly when time is of the essence. Press-releases should only be published alongside high quality preprints that show the data as transparently as possible.

 

Right on cue:

A year after Wuhan alarm, China seeks to change Covid origin story
Reports in state media signal an intensifying propaganda effort to place the birth of the virus in other countries
...
Chinese scientists have even submitted a paper for publication to the Lancet – although it has not yet been peer-reviewed – that claims “Wuhan is not the place where human-to-human Sars-CoV-2 transmission first happened”, suggesting instead that the first case may have been in the “Indian subcontinent”.
...
[full story]
https://www.theguardian.com/world/2...larm-china-seeks-to-change-covid-origin-story​

 

They've got to be joking. Epidemiological evidence suggests this is impossible given how fast the virus spreads...

 

Indeed, it's policy based 'evidence'.