Promising New Coronavirus Vaccine

[Slobodan Blagojevic]

... It is, as you say, interesting to see that Serbia has high vaccination rates - never mentioned in the news...

I am equally surprised when we do something well

A picture of a vaccination site at a huge trade-fair hall. Seems well organized. They even bothered to arrange chairs for waiting in flag colors (red-blue-white).

[Manoli]

Interesting 'side-bar' to the ongoing vaccine discussion, (UK based).

The number of people suffering from flu has plunged by 95% to levels not seen in more than 130 years.

Influenza has been “almost completely wiped out”, said Simon de Lusignan, professor of primary care at the University of Oxford and director of the Royal College of GPs research and surveillance centre, which focuses on flu. In the second week of January, usually the peak of the season, the number of influenza-like illnesses reported to GPs was 1.1 per 100,000 people, compared to a five-year average rate of 27. Out of four million patients at 392 GP surgeries in England, 42 had influenza-like illness, or about 0.001%.

Flu has also disappeared in Wales, at 1.0 cases per 100,000 people, and vanished in Scotland, with 0.5.  In the second week of January, health analysts did a double take when they saw the flu positivity rate — a standard metric of community flu activity — was 0.0%. Not one of 1,894 samples tested positive and the number of hospital admissions in England for flu was zero.

There is a snag to the success, though. Scientists developing a vaccine for next year’s flu season are struggling because there are so few samples to work on. The drastically reduced flu numbers may also mean more of us are susceptible to it in future, having not acquired immunity this year. “It’s a nightmare to work out what comes next,” said McCauley. “If you have flu away for a year, then immunity will have waned. It could come back worse.”

[Paulo Bizarro]

Good news that we have more vaccines in the future.

As for "rankings", it is important to consider two aspects:

1. Number of people vaccinated in a particular country: necessary to distinguish between people who already got the two doses, or only the first dose. For the vaccines that require two doses to complete immunity.

2. A number of countries is increasing the recommended interval between the two doses from 21 days (Pfizer) to up to ~80 days. This is being done in the UK, I think. In this way, they use their initial batches of vaccines to vaccinate more people with the first dose. Pfizer already stated that their trials have used 21 days interval, and there is no guarantee that a period longer than that will have similar positive results.

[jeremyrh]

Good news that we have more vaccines in the future.

As for "rankings", it is important to consider two aspects:

1. Number of people vaccinated in a particular country: necessary to distinguish between people who already got the two doses, or only the first dose. For the vaccines that require two doses to complete immunity.

2. A number of countries is increasing the recommended interval between the two doses from 21 days (Pfizer) to up to ~80 days. This is being done in the UK, I think. In this way, they use their initial batches of vaccines to vaccinate more people with the first dose. Pfizer already stated that their trials have used 21 days interval, and there is no guarantee that a period longer than that will have similar positive results.

The rapid spread of cases here and the potential overwhelming of the health service made the benefit of more people being kept out of hospital in the short run bigger than more completely protecting a smaller number of people. We'll see if that was the correct decision in the long run.  Data on long term effects of the various vaccines is (obviously ) pretty sparse so it's not clear how big of a trade off it is.

[Paulo Bizarro]

The rapid spread of cases here and the potential overwhelming of the health service made the benefit of more people being kept out of hospital in the short run bigger than more completely protecting a smaller number of people. We'll see if that was the correct decision in the long run.  Data on long term effects of the various vaccines is (obviously ) pretty sparse so it's not clear how big of a trade off it is.

Indeed, but there is a risk of reducing the effectiveness of the vaccine, when increasing the number of days between first and second doses. Also, there is a breach of trust between authorities and people who got the first dose initially; they were expecting to get the second dose after 21 days, and now that is not going to happen. How will they feel about it? The only data we know is from the trials: the effectiveness from Pfizer is >90% when two doses are separated by 21 days.

Here in Portugal, where we are now the number 1 country in deaths per 1 million people, the pressure is increasing to take a similar approach, but thus far the health authorities are resisting the government and adhering to lab recommendations.

[Jeremy Roussak]

The only data we know is from the trials: the effectiveness from Pfizer is >90% when two doses are separated by 21 days.

That's true, but it's known from other vaccines and from understanding of immunology that it is likely that a longer interval between doses will not diminish the efficacy and may even increase it, and it's known that a single dose confers a substantial degree of immunity, albeit not as great as two doses and for a more uncertain time. We don't know how Pfizer alighted on three weeks for their trial.

The rationale is that a scarce resource should be used to greatest overall effect in the population, and those that claim to understand these things are, in the main, of the opinion that the greatest overall level of immunity will be achieved by giving more first doses and fewer second until either there is a greater supply of vaccine or the balance swings towards giving second doses. That latter doesn't require everyone to have been given a first dose, of course.

Jeremy

[Chris Kern]

The rationale is that a scarce resource should be used to greatest overall effect in the population, and those that claim to understand these things are, in the main, of the opinion that the greatest overall level of immunity will be achieved by giving more first doses and fewer second until either there is a greater supply of vaccine or the balance swings towards giving second doses. . . .

The emerging consensus here in the States seems to be for providers using two-dose vaccines (1) not to sequester second doses—i.e., they should use all the doses at their disposal for individuals who are currently eligible for vaccination under national and local guidelines* (medical staff, the elderly, etc.); (2) when administering current inventory, to give priority to those ready for second doses under the manufacturer's clinical trial protocol.

My impression is that few experts here are overly concerned about "late" administration of second doses, believing they are likely to be as effective as second doses that are given in accordance with intervals used in the respective clinical trials.

———
*The federal government provides advisory national guidelines, but each of the states currently has independent authority to interpret them and to allocate vaccine doses in accordance with its own priorities.

[Slobodan Blagojevic]

... The UK had the chance to enrol in the EU's vaccine procurement programme last year but declined, to the expressed dismay of many politicians and commentators who viewed it as a triumph of Brexit over health; few, if any, of them have yet chosen as publicly to eat their words. It's not clear whether or not that option would have been open to the UK had we not left the EU by that stage...

[Manoli]

There are still concerns about how effective a single dose of vaccine will be against the South African strain. So far Pfizer and Moderna's studies have only looked at how people given two doses react to the SA variant.

Studies into how well Oxford University/AstraZeneca's jab will work against the South African strain are still ongoing. Johnson & Johnson actually trialled its jab in South Africa while the variant was circulating and confirmed that it blocked 57 per cent of coronavirus infections in South Africa, which meets the WHO’s 50 per cent efficacy threshold.

IIRC, both the Pfizer and Moderna vaccines were said by the companies to be no more than 50% effective in single jab mode. Pfizer has developed a booster shot to counteract the SA strain and Moderna announced that one is under development. 

Furthermore there is a growing body of research indicating that antibodies in those previously seriously infected with Covid-19 are, in many cases, proving ineffective in protecting against the SA virus.  Today, SKY News broadcast that testing at Cambridge University shows the Pfizer vaccine is proving ineffective in combatting the SA virus in the over 80's - so another note of caution here. (*)
—
My personal POV, is that "vaccine nationalism" be damned. The supplies should be adequate to cope with high vaccination rates throughout the European continent within the next 8-10 weeks.  In the British case, vaccines are something of a 'Hail Mary' given the tragically high death toll. So far it's going well - long may it continue.




(*) In the chart, Sanofi-GSK are manufacturing the Pfizer/BioNTech vaccine under licence.
(*) https://www.cam.ac.uk/research/news/pfizer-biontech-vaccine-likely-to-be-effective-against-b117-strain-of-sars-cov-2

The preliminary data, which have yet to be to peer-reviewed and relate to only a small number of patients, also suggest that a significant proportion of over-eighty olds may not be sufficiently protected against infection until they have received their second dose of the vaccine.

[faberryman]

...which meets the WHO’s 50 per cent efficacy threshold.

"Heads you catch it, tails you don't" sounds like a pretty low bar to me, but every little bit helps. If we had had the vaccine last March, we might have saved 200,000+ of the 400,000+ deaths, so driving over to get your shot does make sense.

[jeremyrh]

Couple of interesting developments - 1) Sputnik vaccine reported to have high level of efficacy, and 2) AZ vaccine reported to be having good effect on reducing transmission.

[Jeremy Roussak]

Couple of interesting developments - 1) Sputnik vaccine reported to have high level of efficacy, and 2) AZ vaccine reported to be having good effect on reducing transmission.

And there's considerable interest and excitement about the possibly improved results of giving one as a first dose and the other as a second. Interesting times.

Jeremy

[rabanito]

And there's considerable interest and excitement about the possibly improved results of giving one as a first dose and the other as a second. Interesting times.

Jeremy

More interesting still is that since the first and the second dosis are exactly the same, you can use the second as first and the first as second.

[LesPalenik]

More interesting still is that since the first and the second dosis are exactly the same, you can use the second as first and the first as second.

In other words, one should wait with the first shot until he gets the second?

[rabanito]

In other words, one should wait with the first shot until he gets the second?

It seems that the covid vaccines are time-symmetric 
Alice in Wonderland II (unpublished)

[Eric Myrvaagnes]

Yes. I got my second shot a couple of weeks ago, and I'll get my first shot soon...   

[rabanito]

Yes. I got my second shot a couple of weeks ago, and I'll get my first shot soon...   

I've read that from one to two weeks after the second shot you are protected. I'd skip the first one then

[Slobodan Blagojevic]

https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/?utm_source=facebook&utm_medium=cpc&utm_campaign=content&utm_content=covidtracker2021&fbclid=IwAR0Bl9v1tmpTFLv4Fs-DDUGL76k2y5AExrjhstbqYSjV3ORt0sMmbnxXCbA

"More Than 108 Million Shots Given: Covid-19 Tracker"

[John Camp]

Does anybody have any idea at all about what's going on in Africa? It strikes me that it's possible that Africa could become a big pool of covid strains mixing with each other, then migrating to other areas, since it doesn't look like much is being done in the way of remediation.

[PeterAit]

No, I do not think you doctor information. I think that you frequently present very selective information, and that is worthwhile to look beyond it.

The main issue is that these data, even if true, mean nothing important. Or maybe nothing at all. Just putting something in a pretty chart is, in itself, meaningless.