Vaccine rollout in the UK

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raven
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Re: Vaccine rollout in the UK

Post by raven » Wed Jan 20, 2021 11:40 pm

headshot wrote:
Wed Jan 20, 2021 8:23 pm
From what my dad's been telling me, the people who administered his first dose were VERY clear that he should maintain social distancing, masks and other safe practices until after he's had his second dose.
Yes, we could do with better messaging on that generally. And also perhaps some public acknowledgement from the government that we won't be going back to normal in February, or at Easter. That'll have to wait until we've got enough adults vaccinated to generate some herd immunity.

But on a more optimistic note, the NHS really seems to be ramping up the jabs. Parents (late 70s) got a call on Saturday afternoon, got their first jabs on Sunday at a local health centre, April appointment booked there for the second dose.

Then they both got letters inviting them to a mass centre today. Which, tbf, did say ignore this if you've been done.

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Re: Vaccine rollout in the UK

Post by shpalman » Thu Jan 21, 2021 9:54 am

My mum (81) had the jab this morning.

(The Oxford one)
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Re: Vaccine rollout in the UK

Post by lpm » Thu Jan 21, 2021 10:03 am

And so will 350,000 other people in the UK.

It's going very nicely. Just need to bring the 2nd Pfizer doses forwards to the 6 to 8 week mark.
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Re: Vaccine rollout in the UK

Post by mediocrity511 » Thu Jan 21, 2021 11:51 am

lpm wrote:
Thu Jan 21, 2021 10:03 am
And so will 350,000 other people in the UK.

It's going very nicely. Just need to bring the 2nd Pfizer doses forwards to the 6 to 8 week mark.
Is 12 week just a maximum rather than an aim though? My Mum had her first dose of Pfizer the other day and had a follow up appointment booked in for 8 weeks time.

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Re: Vaccine rollout in the UK

Post by lpm » Thu Jan 21, 2021 1:03 pm

The govt policy is still 12 weeks. They haven't officially shortened it - but it now seems clearly wrong for Pfizer so maybe professionals are making their own decisions.

But Oxford-AZ might be better at 12 weeks than 6-8.

Such is the mess that Plague Islands get themselves into when they try desperate measures.
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Re: Vaccine rollout in the UK

Post by Gfamily » Thu Jan 21, 2021 1:56 pm

lpm wrote:
Thu Jan 21, 2021 1:03 pm
The govt policy is still 12 weeks. They haven't officially shortened it - but it now seems clearly wrong for Pfizer so maybe professionals are making their own decisions.

But Oxford-AZ might be better at 12 weeks than 6-8.

Such is the mess that Plague Islands get themselves into when they try desperate measures.
As was commented on Radio 4's World at One program today - the low level of protection reported in Israel for the first dose of the Pfizer vaccine doesn't tell much, because:
- Immunity is known to increase from day 1
- Israel is giving dose 2 at 21 days, so the window for getting infected after the first dose is small, People who fall sick between the two doses is likely to include people who were already infected when vaccinated (or very shortly afterwards).
- It is known from other 'spike' vaccines that efficacy increases over time.

So it is not necessarily 'clearly wrong for Pfizer'.
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Re: Vaccine rollout in the UK

Post by lpm » Thu Jan 21, 2021 2:03 pm

21 days obviously tells us nothing about 6-12 weeks, so why not look at the initial data on 6-12 weeks instead? That's where the worry is. There's suggestions of protection of only around 33% for this period.
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Re: Vaccine rollout in the UK

Post by Gfamily » Thu Jan 21, 2021 2:08 pm

lpm wrote:
Thu Jan 21, 2021 2:03 pm
21 days obviously tells us nothing about 6-12 weeks, so why not look at the initial data on 6-12 weeks instead? That's where the worry is. There's suggestions of protection of only around 33% for this period.
Hmmm, 'suggestions of' =! 'clearly wrong'.
anything >50% is beneficial if you have twice as many protected.
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Re: Vaccine rollout in the UK

Post by Woodchopper » Thu Jan 21, 2021 8:02 pm

Thread on the Israeli data on vaccine efficacy:
https://twitter.com/shalituri/status/13 ... 06594?s=21

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Re: Vaccine rollout in the UK

Post by Grumble » Thu Jan 21, 2021 8:43 pm

My dad has now had 3 invites for vaccination and is expecting a 4th. Joined up care this is. The government can’t be cooking the books by offering multiple shots can it?
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Re: Vaccine rollout in the UK

Post by Woodchopper » Thu Jan 21, 2021 9:17 pm


Widespread delays of the second dose might create a pool of millions of people with enough antibodies to slow the virus and avoid getting sick, but not enough to wipe it out. That could well be the perfect recipe for creating vaccine-resistant strains, says virologist Florian Krammer of the Icahn School of Medicine at Mount Sinai: “If we end up with everybody just getting one dose with no doses available for a timely boost, that would in my opinion, be a problem.”

But others say unchecked spread of the virus poses greater risks. “It's carnage out there,” says evolutionary microbiologist Andrew Read of Pennsylvania State University, University Park. “Twice as many people with partial immunity has got to be better than full immunity in half of them.” Historically, few viruses have managed to evolve resistance to vaccines, with the notable exception of seasonal influenza, which evolves so rapidly on its own—without vaccine pressure—that it requires a newly designed vaccine every year.

If vaccine-resistant SARS-CoV-2 strains emerge, vaccines might need to be updated. Several vaccines could be easily changed to reflect the latest changes, but regulators might balk at authorizing them without seeing updated safety and efficacy data, Krause says. If new variants circulate alongside older strains, multivalent vaccines, effective against several lineages, might even be needed. “To be clear: These are downstream considerations,” Krause says. “The public should not think that this is imminent, and that new vaccines will be needed.” But Ravindra Gupta, a researcher at the University of Cambridge, says manufacturers should start to produce vaccines designed to generate immunity to mutated versions of the spike protein, because they keep cropping up. “It tells us that we should have these mutations in our vaccines, so that you shut off one of the avenues for the virus to go down.”
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Re: Vaccine rollout in the UK

Post by raven » Thu Jan 21, 2021 9:21 pm

Grumble wrote:
Thu Jan 21, 2021 8:43 pm
My dad has now had 3 invites for vaccination and is expecting a 4th. Joined up care this is. The government can’t be cooking the books by offering multiple shots can it?
Better to get multiple invites than none. The invite my mum got after she'd been jabbed said to call for an appointment, but to just ignore it if you'd already been done.

Although I'm sure some bright spark will think of having one, then making an appointment for a second one in three weeks....

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Re: Vaccine rollout in the UK

Post by lpm » Thu Jan 21, 2021 10:29 pm

lpm wrote:
Thu Jan 21, 2021 10:03 am
And so will 350,000 other people in the UK.
363,508.
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Re: Vaccine rollout in the UK

Post by Lew Dolby » Fri Jan 22, 2021 2:24 pm

https://www.theguardian.com/world/2021/ ... ne-england

but Rupert effing murdock got one !! We really have become a nasty nation !!
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Re: Vaccine rollout in the UK

Post by tom p » Fri Jan 22, 2021 3:52 pm

bob sterman wrote:
Sun Jan 17, 2021 11:15 am
Having visited a smaller vaccine delivery "hub" I think someone needs to do a serious risk vs benefit analysis for the post-vaccine observation arrangements.

To look out of anaphylaxis presumably - people who have just been vaccinated are asked to sit for 15 minutes in a room that may be quite crowded and is poorly ventilated, with other recently vaccinated people.

At a time when community prevalence of COVID-19 could be around 1 in 20 - and the vaccine is not likely to protect you against an infection picked up on the same day you receive it - this seems far from ideal.
In terms of pure risk-benefit , it's a marginally better not to to wait together in a poorly-ventilated room, but better to wait together in a well-ventilated room:
Fatality rate of COVID ~ 2k in 100k (2%)
Risk of catching COVID per microcovid project (assuming 10 people who don't know each other in the room at a time, spaced out at 2m each and nobody is wearing masks = 400 microcovids. If they all wear one, 90 microcovids. Figures based on NewYork 'cos I couldn't see any UK option.
So risk of catching it there in that 15 mins and dying from it = 1.8 in a million or 0.18 in 100k.

Rate of anaphylaxis to Comirnaty ~=1 in 100k (0.001%), of which ~70% in the first 15 minutes, so 0.7 in 100k could be at risk.
According to this article Fatality rate of Anaphylaxis ~=1 in 100k too. Which should mean 1 in every 10 billion doses causes fatal anaphylaxis and 1 in every 14 billion or so would be caught by the 15 mins delay.
However, I bet the fatality rate is based on current medical practice, in which people at risk of anaphylaxis have epi-pens and people wait 15 mins after vaccination in case. I bet the fatality rate would be far higher without available treatment. Severe anaphylaxis is almost always fatal. In the first minutes of the reaction, severe and mild anaphylaxis are very similar, so all anaphylactic reactions should be treated as a medical emergency.
If 10% of anaphylactic reactions were fatal without treatment, then about 0.1 in 100k lives would be saved.

That gives, with your unventilated room, a net 0.08 extra in 100k who would die (or 8 in 10 million doses).
If a door or large window were open to the outside, then the 90 microcovids drops to 20 and your risk drops to 0.04 in 100k (4 in 10 million, net benefit 96 in 10 million from waiting). If it's outdoors, then it's 4 microcovids & it's a complete no-brainer to wait - 0.008 in 100k or 8 in 100 million chance of catching & dying from it in that 15 mins (net 99.2 in 10 million lives saved).

That's why I highlighted your "may be quite crowded and is poorly ventilated". Do you have any evidence of this being the case? Because this is a pretty easyish thing to fix. Look at the comments elsewhere about GPs installing gazeboes for the post-vax waiting area. And I don't believe for a moment that they would allow it to be that crowded. If your post-vax wait time is 15 mins, then there can't be that many people in the post-vax waiting area. I don't think I've ever had a vaccine that took less than 3 mins from entering the room to leaving it. Even when I'm prepped with my sleeve rolled-up, there's still consent & allergy questions & safety info & wiping & cotton wool & rolling down the sleeve & putting my sweater back on etc. Even with 2 vaccinators, that's 10 people in a room, and any place will plan it so that there's enough space for people to be safe.

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Re: Vaccine rollout in the UK

Post by bob sterman » Fri Jan 22, 2021 5:02 pm

tom p wrote:
Fri Jan 22, 2021 3:52 pm
That's why I highlighted your "may be quite crowded and is poorly ventilated". Do you have any evidence of this being the case? Because this is a pretty easyish thing to fix.
Tom - thanks for the comprehensive analysis.

Evidence was first hand experience of taking an elderly relative into the post-vaccination observation room. Windows might have been open slightly but it was crowded and impossible to maintain spacing > 2m.

I think they had 4 vaccinators - so could put 4 into the room at a time for their 15 minute wait. Plus these were elderly folk - and some had a carer or relative with them.

As I was not being vaccinated - my personal risk-benefit calculation had me go and wait in the car park until relative had completed 15 minutes.

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Re: Vaccine rollout in the UK

Post by shpalman » Fri Jan 22, 2021 7:02 pm

Grumble wrote:
Thu Jan 21, 2021 8:43 pm
My dad has now had 3 invites for vaccination and is expecting a 4th. Joined up care this is. The government can’t be cooking the books by offering multiple shots can it?
I doubt they'd be counting multiple invitations to get the (1st) dose as many doses given.

Is there any data apart from the official dashboard, for example, on how many of each kind of vaccine have been given or what stocks there are?

How many of the Pfizer and Oxford doses is the UK supplied with each week, for example?
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Re: Vaccine rollout in the UK

Post by sTeamTraen » Sat Jan 23, 2021 1:11 am

The scientists I interact with seem split down the middle on the general principle of the 12-week delay. But I think that people who were told they would get the second shot after three weeks should get it. There's quite an issue with consent otherwise. If it later turns out that there was an issue with the 12-week wait then maybe the health authorities will be able to hide behind the "Hail Mary" argument for people who were told it was 12 weeks when they had the first shot, but those who were told three weeks will be justifiably very angry.
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Re: Vaccine rollout in the UK

Post by sTeamTraen » Sat Jan 23, 2021 1:13 am

shpalman wrote:
Fri Jan 22, 2021 7:02 pm
How many of the Pfizer and Oxford doses is the UK supplied with each week, for example?
Spain reports every delivery, by supplier and region. I'm summarising the daily numbers, which are in a nerdy .ODS format, in a Google sheet that I try to update daily.
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Re: Vaccine rollout in the UK

Post by shpalman » Sat Jan 23, 2021 7:58 am

having that swing is a necessary but not sufficient condition for it meaning a thing
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Re: Vaccine rollout in the UK

Post by shpalman » Sat Jan 23, 2021 8:02 am

sTeamTraen wrote:
Sat Jan 23, 2021 1:11 am
The scientists I interact with seem split down the middle on the general principle of the 12-week delay.
These doctors want the 12-week delay split down the middle: https://www.bbc.com/news/uk-55777084
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Re: Vaccine rollout in the UK

Post by gosling » Sat Jan 23, 2021 9:58 am

Mrs Gos had her first dose of AZ yesterday - she's a community OT, so was arranged by the council she works for.

Interestingly, she was also contacted by our GP a couple of days ago to see if she wanted the vaccine. We can't figure out why she was offered it already. She's only early 50s and her underlying health conditions are an underactive thyroid (which is fixed with medication) and being on HRT. Not sure I've seen either of those mentioned as a factor in increased fatality rates.

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Re: Vaccine rollout in the UK

Post by lpm » Sat Jan 23, 2021 10:44 am

Maybe a quick computer program, taking all >50s on the GP's list and calculating appointments p.a.?

Instead of a time-consuming careful trawl through records for actual health vulnerabilities, simply assume if someone has visited the GP ten times a year then they must have something. Stick 'em higher up the list. If someone has zero visits, shove 'em down.

Why waste scarce resources on doing it in more detail, when all it means is shuffling people up and down the list by a few weeks?
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Re: Vaccine rollout in the UK

Post by snoozeofreason » Sat Jan 23, 2021 11:44 am

shpalman wrote:
Sat Jan 23, 2021 8:02 am
sTeamTraen wrote:
Sat Jan 23, 2021 1:11 am
The scientists I interact with seem split down the middle on the general principle of the 12-week delay.
These doctors want the 12-week delay split down the middle: https://www.bbc.com/news/uk-55777084
It's probably been suggested before on this thread, but surely the best approach would be to randomise. Given the rate of vaccination it wouldn't be hard to accumulate data. If there are strong theoretical reasons to think that a 12 week delay is going to work, but insufficient empirical evidence, then why not arrange that, of the 300,000 or so people who receive a first vaccination each day, 290,000 are told to come back in 12 weeks, and 10,000 in three weeks. It wouldn't significantly slow the rate at which first vaccinations occur, but within a week you'd have 70,000 controls against which to judge the effectiveness of the new strategy.
In six days the Lord made the heavens and the earth, the sea, and all that is in them. The human body was knocked up pretty late on the Friday afternoon, with a deadline looming. How well do you expect it to work?

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Re: Vaccine rollout in the UK

Post by shpalman » Sat Jan 23, 2021 11:56 am

snoozeofreason wrote:
Sat Jan 23, 2021 11:44 am
shpalman wrote:
Sat Jan 23, 2021 8:02 am
sTeamTraen wrote:
Sat Jan 23, 2021 1:11 am
The scientists I interact with seem split down the middle on the general principle of the 12-week delay.
These doctors want the 12-week delay split down the middle: https://www.bbc.com/news/uk-55777084
It's probably been suggested before on this thread, but surely the best approach would be to randomise. Given the rate of vaccination it wouldn't be hard to accumulate data. If there are strong theoretical reasons to think that a 12 week delay is going to work, but insufficient empirical evidence, then why not arrange that, of the 300,000 or so people who receive a first vaccination each day, 290,000 are told to come back in 12 weeks, and 10,000 in three weeks. It wouldn't significantly slow the rate at which first vaccinations occur, but within a week you'd have 70,000 controls against which to judge the effectiveness of the new strategy.
Weirdly, I think you'd need ethical approval do this, whereas just deciding as policy to leave it 12 weeks and not particularly collect any data about it is fine.

The impression I have here is that second doses are anyway being offered at any time between 3 and 12 weeks anyway, and also that the UK can't possibly be vaccinating all these people with the Pfizer vaccine (it's probably getting about half a million doses per week of that one, since that's what e.g. Germany and Italy seem to be getting, and that's enough for about one day of the UK's vaccinations let alone one week; and right now Pfizer isn't even able to produce that much).
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