Vaccine rollout in the UK

[lpm]

Week to Sat 20 Feb: 2.5m 1st doses
Week to Sat 27 Feb: 2.5m 1st doses

So the lull, partly supply and partly stockpiling for 2nd doses (Pfizer probably), has cost us 1 million vs the FT chart. Improving from 3m to 4m per week would mean we catch up this deficit in a single week, if my calculations are correct.

[lpm]

England. Deaths are halving every week - for the oldest cohorts. Only down 20% per week for <65s.

This is what it looks like when a vaccine turns a disease into a non-fatal illness.

[lpm]

Chart from today's briefing.

1) The 12-week gap to 2nd dose is a triumphant success - it works as a single dose and this has saved thousands of lives. The history books will record the 3-week decision by the EU as a deadly mistake. The EU needs to admit their blunder, u-turn and go for the 1st dose strategy.

2) The prioritisation of the rollout has been perfect. No diversion to teachers or police, despite pressure from unions and Labour. Far better than more haphazard ordering (e.g. US), thus demonstrating the value of socialised medicine under a national health service.

3) The speed of the rollout keeps beating targets. 1-4 done 3 days early, 5-9 will be a couple of weeks early, all adults offered vaccine potentially within six months of the mass rollout. Johnson, Hancock and Zahawi have hit the jackpot and their massive success will conceal their reckless manslaughter of thousands of citizens.

[shpalman]

Chart from today's briefing.

1) The 12-week gap to 2nd dose is a triumphant success - it works as a single dose and this has saved thousands of lives. The history books will record the 3-week decision by the EU as a deadly mistake. The EU needs to admit their blunder, u-turn and go for the 1st dose strategy.

I know, how reckless of them to follow the protocol defined by the manufacturer and tested in the Phase III trials.

The EU has basically only had Pfizer vaccines to give so far; we don't know how many of the UK's doses have been Pfizer ones do we?

The AstraZeneca one is a different matter, basically anything you do with that one apart from follow the officially tested protocol makes it work better.

[lpm]

That chart makes absolutely clear that having 20m people 1st dosed effortlessly beats 10m people 1st and 2nd dosed, whether Pfizer or AZ.

Due to the disastrous position the UK was in it's easily several thousand lives saved. Acting during the great peak of the pandemic counts far more than acting over the ups and downs.

And the UK has the capacity to easily start doing 3rd doses in the summer after all adults have been 2nd dosed - at a time when the EU will still have adults waiting for 1st doses.

[shpalman]

New data show vaccines reduce severe COVID-19 in older adults

preprint

[Bird on a Fire]

A decline from 61% of deaths to 49% doesn't sound that impressive, compared with the expected efficacy of the vaccine. Better than nothing, of course.

I know it equates to a lot of lives, but only because the UK was running super hot and needlessly killed even more people than they saved. It's like somebody deliberately playing sh.t football for 90 minutes, taking a penalty with their pants round their ankles and scoring a goal by pure luck.

I don't think future historians will be too impressed with the UK's handling of the pandemic, assuming they still have maths in the future.

[hakwright]

Chart from today's briefing.

1) The 12-week gap to 2nd dose is a triumphant success - it works as a single dose and this has saved thousands of lives. The history books will record the 3-week decision by the EU as a deadly mistake. The EU needs to admit their blunder, u-turn and go for the 1st dose strategy.

I know, how reckless of them to follow the protocol defined by the manufacturer and tested in the Phase III trials.

The EU has basically only had Pfizer vaccines to give so far; we don't know how many of the UK's doses have been Pfizer ones do we?

The AstraZeneca one is a different matter, basically anything you do with that one apart from follow the officially tested protocol makes it work better.

I think the bigger mistake by France, Belgium, Germany and others was to decide that the AZ jab shouldn't be given to the over 65s. France has just reversed that decision, and looks like Belgium and others are also likely to reverse that decision soon.

And EU countries *have* had plenty of doses of AZ vaccine to give, but because of their choices, they've found it very difficult to use more than a small percentage of their stocks. That's a bad outcome.

The UK strategy of delaying the 2nd dose of Pfizer jab by 10-12 weeks was not an obvious choice, but it was supported by the science (in cases where rates of infection are so high getting more people dosed with 1st dose is more useful). Sounds like some EU countries (e.g. Belgium) may also change their stance on the delay between Pfizer jabs, and follow the 10-12 weeks approach used in the UK - which, the mounting evidence shows, was a good decision.

[Grumble]

The EMA said it should be given to older folk. The individual regulators are the ones looking daft.

[tom p]

The EMA said it should be given to older folk. The individual regulators are the ones looking daft.

Governments, not regulators. It's the National equivalents of Public Health England, not the equivalents of the MHRA

[Grumble]

The EMA said it should be given to older folk. The individual regulators are the ones looking daft.

Governments, not regulators. It's the National equivalents of Public Health England, not the equivalents of the MHRA

Ah, thanks for that. Clarifies things somewhat.

[shpalman]

In Italy's case it's a technical-scientific committee of the Italian Medicines Agency, AIFA, which has suggested that the mRNA vaccines be preferentially given to older or high-risk subjects, while the AstraZeneca one be preferentially given to subjects in good health between 18 and 55 at least until more data become available.

(I'm not sure how to map the Istituto Superiore di Sanità and Protezione Civile to "Public Health England")

[raven]

Chart from today's briefing.

3) The speed of the rollout keeps beating targets. 1-4 done 3 days early, 5-9 will be a couple of weeks early, all adults offered vaccine potentially within six months of the mass rollout. Johnson, Hancock and Zahawi have hit the jackpot and their massive success will conceal their reckless manslaughter of thousands of citizens.

So.... About this doing groups 1-4 on time. Is it actually confirmed we did that, or is it only sort-of confirmed in a 'well, we've done enough jabs for 1-4, so obviously we've done it' way?

Because I checked our GP's website last week and their update on the 22nd Feb says they'd made 'great progress' in doing the most vulnerable and were moving onto groups 5 & 6. Which, if they'd only just finished 1-4, is about a week late by my reckoning.

Of course it may be that they were just late in posting the update because they're too busy jabbing everybody.

(Latest update says group5 is being called to the nearest mass vaccination centre because group 6 is so large. 6 is getting done at the GPs, but they reckon it'll take 3-4 weeks to get through. Which is not a bad way of doing it I think; keep the clinically vulnerable folks local. They're keeping us all well informed too.)

[lpm]

Of course no cohort will ever be done, there will still be refusers to entice. The UK did the numbers to cover 100% of 1-4 early, plus invited everyone outstanding to get a vaccine on demand. The official targets are to "offer" by the target dates.

Your area/GP is well behind. Or at least their news is. My area is now making appointments for group 7 - 60 to 65 - implying they are close to finishing 5 and 6. All group 7 are invited to the mass centre, but can wait a few days longer for appointments at local centre or GPs.

There appears to be more geographical variation than there should be.

[headshot]

Well...my 44 year old friend and his wife, who live in South London and have no underlying health issues, have both just been vaccinated. So some areas clearly aren't sticking to the cohorts strictly.

Meanwhile, my 46 year old wife with severe asthma is still waiting...after being unceremoniously kicked out of Tier 6.

[Grumble]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

[jdc]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

We approved Moderna 8th Jan: https://www.gov.uk/government/news/mode ... -regulator

As for delivery... From 4 days ago on BBC: https://www.bbc.co.uk/news/health-55274833

Supplies of a third vaccine to be approved, made by US company Moderna, will come from Europe but are not expected to be available until later next month.

Which, four days later, is now 'later this month'.

[Martin_B]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

[ancedote] My father and BIL are doing duty as stewards (at different vaccine centres), and they reckon that (after a few teething troubles) the jabbers are working about as efficiently as they can. The mixing and preparation of the vaccines now seems to be well co-ordinated and the only major issue is at the end of the day when, for the Pfizer, using up prepared vaccine doses which won't keep overnight.

One of the centres may be capable of including more jabbers, but the bottleneck for that centre is probably the 15-minute recovery location where everyone has to remain socially distanced; there's no point having extra injection capacity there if there's nowhere for the post-jabbed to wait.[/ancedote]

[Grumble]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

[ancedote] My father and BIL are doing duty as stewards (at different vaccine centres), and they reckon that (after a few teething troubles) the jabbers are working about as efficiently as they can. The mixing and preparation of the vaccines now seems to be well co-ordinated and the only major issue is at the end of the day when, for the Pfizer, using up prepared vaccine doses which won't keep overnight.

One of the centres may be capable of including more jabbers, but the bottleneck for that centre is probably the 15-minute recovery location where everyone has to remain socially distanced; there's no point having extra injection capacity there if there's nowhere for the post-jabbed to wait.[/ancedote]

There must be some slack somewhere or the numbers vaccinated wouldn’t vary by so much each day, but maybe that’s because each day isn’t the same. Obviously if you’re visiting patients rather than everyone coming to a vaccination centre it will be less efficient. Also there have been reports that Pfizer are relaxing the temperature requirements so hopefully they won’t have to throw away as many any more, or struggle to use them up.

[tom p]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

[ancedote] My father and BIL are doing duty as stewards (at different vaccine centres), and they reckon that (after a few teething troubles) the jabbers are working about as efficiently as they can. The mixing and preparation of the vaccines now seems to be well co-ordinated and the only major issue is at the end of the day when, for the Pfizer, using up prepared vaccine doses which won't keep overnight.

One of the centres may be capable of including more jabbers, but the bottleneck for that centre is probably the 15-minute recovery location where everyone has to remain socially distanced; there's no point having extra injection capacity there if there's nowhere for the post-jabbed to wait.[/ancedote]

There must be some slack somewhere or the numbers vaccinated wouldn’t vary by so much each day, but maybe that’s because each day isn’t the same. Obviously if you’re visiting patients rather than everyone coming to a vaccination centre it will be less efficient. Also there have been reports that Pfizer are relaxing the temperature requirements so hopefully they won’t have to throw away as many any more, or struggle to use them up.

WHAT?
Please provide more details.

[Grumble]

[ancedote] My father and BIL are doing duty as stewards (at different vaccine centres), and they reckon that (after a few teething troubles) the jabbers are working about as efficiently as they can. The mixing and preparation of the vaccines now seems to be well co-ordinated and the only major issue is at the end of the day when, for the Pfizer, using up prepared vaccine doses which won't keep overnight.

One of the centres may be capable of including more jabbers, but the bottleneck for that centre is probably the 15-minute recovery location where everyone has to remain socially distanced; there's no point having extra injection capacity there if there's nowhere for the post-jabbed to wait.[/ancedote]

There must be some slack somewhere or the numbers vaccinated wouldn’t vary by so much each day, but maybe that’s because each day isn’t the same. Obviously if you’re visiting patients rather than everyone coming to a vaccination centre it will be less efficient. Also there have been reports that Pfizer are relaxing the temperature requirements so hopefully they won’t have to throw away as many any more, or struggle to use them up.

WHAT?
Please provide more details.

https://www.pfizer.com/news/press-relea ... ility-data

[gosling]

Have we still only got 2 vaccines approved? We only seem to be giving Pfizer and Astra Zeneca. Could we go even more quickly if we had another 1 or 2 or are the jabbers fully utilised?

Novavax is confident they will get approval before the end of March. No idea what their stock levels are like though.

[tom p]

There must be some slack somewhere or the numbers vaccinated wouldn’t vary by so much each day, but maybe that’s because each day isn’t the same. Obviously if you’re visiting patients rather than everyone coming to a vaccination centre it will be less efficient. Also there have been reports that Pfizer are relaxing the temperature requirements so hopefully they won’t have to throw away as many any more, or struggle to use them up.

WHAT?
Please provide more details.

https://www.pfizer.com/news/press-relea ... ility-data

Thanks. So Pfizer aren't relaxing anything unilaterally, they are requesting permission from the appropriate regulators to so do.
That's ok then - I trust the FDA to make a sensible decision, and I'm not surprised that Pfizer/BioNTech are only just getting more information on long term stability at different temperatures

[Grumble]

WHAT?
Please provide more details.

https://www.pfizer.com/news/press-relea ... ility-data

Thanks. So Pfizer aren't relaxing anything unilaterally, they are requesting permission from the appropriate regulators to so do.
That's ok then - I trust the FDA to make a sensible decision, and I'm not surprised that Pfizer/BioNTech are only just getting more information on long term stability at different temperatures

Clumsy layman wording from me there

In more personal news my eldest brother has been invited for his first jab. He’s 49 but has diabetes, albeit diet controlled.

[shpalman]

Coronavirus and vaccine attitudes and behaviours in England: over 80s population, 15 February to 20 February 2021:

Nearly half of over-80s who had received both doses of the COVID-19 vaccine had met someone other than a household member, support bubble or a personal carer, indoors, since being vaccinated

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