Vaccine rollout in the UK

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Re: Vaccine rollout in the UK

Post by Gfamily » Sun Jan 17, 2021 12:34 am

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Re: Vaccine rollout in the UK

Post by Martin_B » Sun Jan 17, 2021 4:07 am

Gfamily wrote:
Sun Jan 17, 2021 12:34 am
ubik wrote:
Sat Jan 16, 2021 11:28 pm
Pfizered yesterday. Superpower unlocked.
According to Gfamson, sore-arm =8
Gfamson has 8 sore arms? These injection superpowers really do work!
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Re: Vaccine rollout in the UK

Post by headshot » Sun Jan 17, 2021 10:30 am

headshot wrote:
Fri Jan 15, 2021 2:55 pm
lpm wrote:
Fri Jan 15, 2021 2:33 pm
England now at 274,793 people vaccinated in a day (plus 4,854 getting a second dose).

That's dozens of lives saved, right there, surely?

Already heading towards the 2,000,000 a week target. The NHS is going to get this done.
My friend in NHS Emergency Planning assures me that everyone in the country will be first dosed by the end of Sept...if the Govt lets them get on with with it.
Now officially announced policy:

https://www.theguardian.com/world/live/ ... ca166f7714

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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 10:38 am

That is not an official announcement. That's some idiot, who somehow became foreign secretary, inventing stuff as he goes along.

The plan for after the 9 cohorts had not been finished and a couple of days ago Johnson very carefully stated that he would not reveal anything.

The current rollout would easily mean first doses for all adults by end September however. That's not particularly challenging.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 10:57 am

The real plan will be to complete 1st jabs by end July for all adults. And all second doses by end October. And this will be set knowing that the government can beat it comfortably - assuming the vials continue to flow out the factories.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 11:06 am

The key thing to remember is that the 2 million per week target is:

(a) for England only
(b) is on track to be exceeded
(c) not all people will choose to take up offers of the vaccine, due to the covid pandemic coinciding with the stupidity pandemic

The adult population of England is 44 million. So 2 million per week, 2 doses, is 44 weeks. Which is 1 Jan 2021 to end October.

You'd then overlay guesses for how many people will take the vaccine. Say 95% for top cohorts, falling to 70% for young and fit adults.

80% average take up is 35 million people. At 2 million a week, all second doses are done by end of August.

The vaccine rollout is not hard. The government is deliberately setting targets it can easily beat, while simultaneously claiming it will be really challenging. Dominic Cummings is not stupid - he knows delivering this will salvage the Conservative Party and make voters overlook the tens of thousands of people unnecessarily killed.

The only risk lies at the factory.
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Re: Vaccine rollout in the UK

Post by bob sterman » 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.

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Re: Vaccine rollout in the UK

Post by shpalman » Sun Jan 17, 2021 11:47 am

lpm wrote:
Sun Jan 17, 2021 11:06 am
The key thing to remember is that the 2 million per week target is:

(a) for England only
(b) is on track to be exceeded
(c) not all people will choose to take up offers of the vaccine, due to the covid pandemic coinciding with the stupidity pandemic

The adult population of England is 44 million. So 2 million per week, 2 doses, is 44 weeks. Which is 1 Jan 2021 to end October.

You'd then overlay guesses for how many people will take the vaccine. Say 95% for top cohorts, falling to 70% for young and fit adults.

80% average take up is 35 million people. At 2 million a week, all second doses are done by end of August.

The vaccine rollout is not hard. The government is deliberately setting targets it can easily beat, while simultaneously claiming it will be really challenging. Dominic Cummings is not stupid - he knows delivering this will salvage the Conservative Party and make voters overlook the tens of thousands of people unnecessarily killed.

The only risk lies at the factory.
Whether the reduced take-up allows you to get through everyone faster is a little bit dependent on whether people are invited to show up but if they can't make it (or don't want it) they're told not to waste anyone's time calling up to say so, or if people are contacted and asked to make appointments.

In the former case you'd need to "overbook" a bit and some people might go home disappointed at the end of the day.

But I must admit that the UK is managing to go properly quickly with this. Italy's target is (or at least it was 10 days ago) to double-dose 5.9 million by the end of March* while the rate the UK is going it it will have given that many first doses before the end of January.

Nobody else really seems to think that delaying the second Pfizer dose is a good idea though.

* - (Italy has given 1.1 million first doses since the beginning of the year)
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 12:39 pm

Somebody said Pfizer gives good protection for weeks 2 to 6, then lesser protection. The second dose at week 12 then gives strong protection for week 14 onwards.

Assuming similar for Oxford, a simple spreadsheet would show the numbers in each stage. Could then be compared to a counterfactual of second doses at 3 weeks.

What certainly isn't right is to call single dosed people "unvaccinated" or even "half vaccintated", as some twitterers like to say.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 1:22 pm

A quick spreadsheet shows it doesn't make that much difference.

Assuming a vaccine has 0% protection for two weeks, 60% for weeks 2 to 6, 40% for 6 to 12 weeks, second dose but still at 40% for 12 to 14, then 90% for 14 onwards...

Versus 0% for two weeks, 60% for week 3, second dose but still 60% for 3-5 weeks, 90% at week 5...

Gives an initial headstart for the 12-week strategy, which erodes at around 10 weeks in, and the 12-week strategy is then worse after 12 weeks.

However, that initial headstart is at the worst of the UK epidemic - Jan, Feb and mid-March - whereas the 3-week strategy becomes better in the April, May and June timeframe.

I think it pretty clearly shows that the well-run countries - Australia etc - should keep to the 3-week strategy. But the desperate countries - UK, Italy, USA etc - need that initial fast start of partial protection and won't pay the price until spring/early summer.

Fundamentally the 3-week strategy can't deliver fast enough in the plague lands of the UK - there are 15 million people in the top four cohorts of the most vulnerable - and 3-weeks actually delivers full protection at 5 weeks due to the couple of weeks for protection to build up. We let the epidemic get out of control not only before anyone had a vaccine, but well before any vaccine has time to kick in with full protection.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 1:36 pm

Also, I have a suspicion that the UK government is planning to beat the 12-week 2nd dose target.

If they achieve 2.5 million jabs a week instead of 2 million, they can easily keep doing 2 million for the cohorts, while allocating 0.5 million to doing second doses at 6 to 8 weeks for the most vulnerable (i.e. care homes, high risk and over 80s, plus healthcare workers).
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Re: Vaccine rollout in the UK

Post by shpalman » Sun Jan 17, 2021 3:37 pm

It's not even guaranteed that everyone will get a second dose.

If the first dose does well enough to reduce the impact of covid maybe people won't care too much.

Then you'll end up breeding a vaccine-resistant strain.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 4:51 pm

That's Raab. He is nothing to do with the vaccine rollout. He was on TV to talk about shutting borders and when the topic diverged he wandered off into his own inventions.

Everyone will get a second dose.
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Re: Vaccine rollout in the UK

Post by headshot » Sun Jan 17, 2021 4:56 pm

Also "not guaranteed that everyone will get a second dose WITHIN 12 WEEKS" which is different to not getting one at all.

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Re: Vaccine rollout in the UK

Post by lpm » Sun Jan 17, 2021 5:12 pm

Journalists keep screwing up. They ask the health secretary about schools. They ask the education secretary about businesses. They ask the business secretary about borders. They ask the foreign secretary about vaccinations.
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Re: Vaccine rollout in the UK

Post by Martin Y » Sun Jan 17, 2021 10:30 pm

lpm wrote:
Sun Jan 17, 2021 5:12 pm
Journalists keep screwing up. They ask the health secretary about schools. They ask the education secretary about businesses. They ask the business secretary about borders. They ask the foreign secretary about vaccinations.
It pisses me off when journalists try to gotcha ministers into saying something that contradicts whatever the minister responsible for that thing said. It's lazy and futile but they keep at it to score easy, worthless points instead of confronting them on stuff they're supposed to be on top of.

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Re: Vaccine rollout in the UK

Post by Millennie Al » Mon Jan 18, 2021 2:10 am

... delay between vaccine doses ...
lpm wrote:
Sun Jan 17, 2021 1:22 pm
A quick spreadsheet shows it doesn't make that much difference.
There may be another significant factor. If people believe that being fully vaccinated means they don't need to take precautions any more, but the first dose provides significant protection, delaying the second dose might mean that very many more people end up cautious and significantly protected instead of careless and better protected. If the fully vaccinated can still spread the disease in significant numbers, this could make a big difference.

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Re: Vaccine rollout in the UK

Post by bagpuss » Mon Jan 18, 2021 10:17 am

shpalman wrote:
Sat Jan 16, 2021 10:00 pm
bagpuss wrote:
Sat Jan 16, 2021 9:56 pm
lpm wrote:
Sat Jan 16, 2021 9:52 pm
? We are getting daily stats showing the ramp up. They already look impressive.
Sorry, my failure, I've been busy this week and hadn't heard or seen any stats since mid week. Now you're going to point me to a post about 3 before mine, with all the stats, aren't you? I'll just go and hide over there and read up properly
https://coronavirus.data.gov.uk/details/healthcare now has daily stats, starting from the beginning of this week.

For a global overview there's https://ourworldindata.org/covid-vaccinations
Thanks, that's very useful :)

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Re: Vaccine rollout in the UK

Post by lpm » Mon Jan 18, 2021 10:23 am

There have been no stories of allergic reactions, that I've seen.

After 4 million jabs, at 99.99% safe, wouldn't we have expected hundreds of serious incidents and maybe some deaths?
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Re: Vaccine rollout in the UK

Post by Herainestold » Mon Jan 18, 2021 2:22 pm

lpm wrote:
Mon Jan 18, 2021 10:23 am
There have been no stories of allergic reactions, that I've seen.

After 4 million jabs, at 99.99% safe, wouldn't we have expected hundreds of serious incidents and maybe some deaths?
Is there any info about the proportion of different vaccines that have been given?

ie how many Pfizer, which seems to be the one that people are concerned about.
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Re: Vaccine rollout in the UK

Post by Bird on a Fire » Mon Jan 18, 2021 7:40 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.
OTOH, it would only take one poorly-handled adverse reaction for the usual suspects to put a big dent in uptake numbers, so I can understand being extra careful.

It shouldn't be beyond the wit of folks to hire a few industrial fans, put up screens, etc.
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Re: Vaccine rollout in the UK

Post by lpm » Tue Jan 19, 2021 9:58 am

The UK: best educated or most desperate?

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Re: Vaccine rollout in the UK

Post by bagpuss » Tue Jan 19, 2021 10:59 am

I'm going with most desperate. I thought I'd compare with levels of other vaccinations to see. I initially looked at actual levels but as everything else is in the 90s, the rankings weren't clear, so I went with just a chart of rankings. I picked DTP in 1 year olds and first dose* of measles containing vaccines in 1 year olds, both for 2019 and then, just because, I picked the measles for 2004 - the UK's lowest ebb on measles vaccine.

We're not ranked better than 11th out of the 14 for any of the other vaccinations. (Edit - although my selection of 2004 measles was inevitably going to skew us right down on that one)

Screenshot 2021-01-19 105203.png
Screenshot 2021-01-19 105203.png (39.5 KiB) Viewed 1742 times
Source for all data except the COVID which I took from lpm's chart



* Forgot to put the first dose bit on the chart but couldn't be bothered to re-do the snip.

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Re: Vaccine rollout in the UK

Post by Woodchopper » Wed Jan 20, 2021 8:07 pm

The first real-world analysis of the Pfizer/BioNTech coronavirus vaccine suggests it is matching its performance in clinical trials, but raises serious questions about the UK's decision to delay the second dose.

Scientists in Israel - which is leading the COVID-19 vaccination race - have told Sky News that they are "very hopeful" having studied preliminary data from 200,000 vaccinated people.

But crucially they say their results do not show efficacy at a level close to that used by the UK to justify delaying the second dose of the Pfizer/BioNtech jab.

Professor Ran Balicer is a physician, epidemiologist and chief innovation officer for Clalit, the largest health care provider in Israel. He is also an adviser to the World Health Organisation.

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"We compared 200,000 people above the age of 60 that were vaccinated. We took a comparison group of 200,000 people, same age, not vaccinated, that were matched to this group on various variables..." Prof Balicer said.


"Then we looked to see what is the daily positivity rate... And we saw that there was no difference between vaccinated and unvaccinated until day 14 post-vaccination.

"But on day 14 post-vaccination, a drop of 33% in positivity was witnessed in the vaccinated group and not in the unvaccinated... this is really good news."

However, UK scientists said in December that trial data had suggested it would be 89% effective after one dose.

A document issued by the UK government's vaccine advisers, the Joint Committee on Vaccination and Immunisation, to justify delaying the second dose for up to 12 weeks said: "Using data for those cases observed between day 15 and 21, efficacy against symptomatic COVID-19 was estimated at 89%, suggesting that short term protection from dose 1 is very high from day 14 after vaccination."

This is much more optimistic than the new real-world Israeli data suggests.

Responding to the UK government strategy, Prof Balicer said: "The data and estimates I gave are what we have.

"We could not see 89% reduction in the data we reported. Further data and analyses will be released in peer reviewer scientific format."

He added: "The practice in Israel is to provide the second vaccine at three weeks.

"And so it is impossible for us to tell what would be the impact of not providing the second dose..."

Israel is following Pfizer/BioNtech protocol in giving the second dose of the coronavirus vaccine three weeks after the first.

It has a smaller population and a regular supply from Pfizer/BioNtech. In return it's providing detailed data to Pfizer.

In contrast, the UK with a much larger population is prioritising the first jab - arguing that one dose given to as many people as possible is better than two to fewer people.

"We have already covered some 25% of our population and over 75% above the age of 60 in the last four and a half weeks.

"And so we are one of the first countries to be able to witness the sheer impact in big numbers of vaccinating such a large proportion of the population," prof Balicer said.

"By being able to manipulate this data in real time, to clean it and to use proper epidemiological methodology, we are able to provide answers to the most pertinent questions right now."

The Israeli scientists believe their 33% figure will rise when data is compiled from younger age groups and the fact that the data is real-life adds to their confidence.

"This is not the ideal setting of a randomised controlled trial where everything from coaching maintenance to selection of the population of interest is done in a very meticulous way.

"This is the real-world. And so by seeing the real world impact so early on in the same direction and in the same timing as we've seen in the clinical trials is something that makes us very hopeful."

Tel Aviv's Sourasky hospital, one of hundreds of vaccination centres, is inoculating hundreds of people an hour.

Ronni Gamzu is the hospital director. He served as the government "corona tsar" - a rotating advisory role - until last month.

"I believe, truly believe, this is the beginning of the end because the vaccine creates the immune response.

"We see that clearly and we see a change in the people that are becoming severely ill with coronavirus and moderately ill. People that have got the vaccine are more protected," Professor Gamzu said.

Asked about the UK strategy of delaying the second dose, he said the 89% figure seemed "very optimistic" but understood why compromises needed to be made.

"If you are short of vaccines, this is a good idea... We believe that if you take the booster shot, even after six weeks, then you will have an effect, the effect is coming and growing gradually.

"We do not know that for sure because the studies were done for 21 days for Pfizer and 28 days for Moderna. But there is a clear logic behind postponing it when you are short on vaccines."

In a previous statement on the decision, the JCVI said: "With most vaccines an extended interval between the prime and booster doses leads to a better immune response to the booster dose.

"There is evidence that a longer interval between the first and second doses promotes a stronger immune response with the AstraZeneca vaccine.

"There is currently no strong evidence to expect that the immune response from the Pfizer-BioNTech and AstraZeneca vaccines differ substantially from each other.

"The committee advises initially prioritising delivery of the first vaccine dose as this is highly likely to have a greater public health impact in the short term and reduce the number of preventable deaths from COVID-19."

Sky News has contacted the Medicines and Healthcare products Regulatory Agency for comment.
https://news.sky.com/story/covid-19-rea ... y-12192751

That said, a single dose might still make sense as an a act of desperation as 1800 deaths were reported on one day.

But if it’s down to 33% for older people so there needs to be clear messaging that they’re only partially protected after getting the first dose.

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Re: Vaccine rollout in the UK

Post by headshot » Wed Jan 20, 2021 8:23 pm

Woodchopper wrote:
Wed Jan 20, 2021 8:07 pm
https://news.sky.com/story/covid-19-rea ... y-12192751

That said, a single dose might still make sense as an a act of desperation as 1800 deaths were reported on one day.

But if it’s down to 33% for older people so there needs to be clear messaging that they’re only partially protected after getting the first dose.
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.

He pays attention to people though, I suspect many people will just not listen/not believe what they're being told.

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