Vaccine rollout in the UK

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Woodchopper
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Re: Vaccine rollout in the UK

Post by Woodchopper » Sat Sep 04, 2021 12:37 pm

shpalman wrote:
Sat Sep 04, 2021 10:39 am
Prof Sir Mark Walport told BBC Radio 4’s Today programme:
It’s uncomfortable but it’s not necessarily a particularly rare situation.

The JCVI looks through a very particular lens, which is the clinical safety of the vaccine for a given population group against the effects of the disease itself.

But what they don’t look at is the wider issues such as education and the harms to that, so the broader harms potentially to children and the knock-on effects to their families – that’s where policymakers come in.

My child and my grandchild’s health is also affected by their social environment, by their ability to go to school, by what happens in the family, and so there are broader factors as well.

All the evidence is the rate of myocarditis, the inflammation of the heart muscle, and of pericarditis is at least the same and probably significantly higher in that same population group if they get coronavirus.[/qyite]
Odd, because the statement does mention education and likelihood of wider spread of infection in the community.

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Re: Vaccine rollout in the UK

Post by lpm » Sun Sep 05, 2021 8:45 am

It's going to be a bit uncomfortable if the govt goes against the narrow JCVI advice. I don't think we should mess around this and risk childhood vaccination controversy - it could have knock on impacts on all other vaccinations. It's too marginal a decision to risk so much for.

A lot of twitter seems to be embracing argument from incredulity. Fair enough because it's so hard to remember the incredible gradient of the Covid age-risk curve. We feel instinctively that our children are at risk, no matter how much the statistics show they are not. We got incredibly lucky that our global pandemic was so inconsequential a danger to children.
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bob sterman
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Re: Vaccine rollout in the UK

Post by bob sterman » Sun Sep 05, 2021 9:34 am

lpm wrote:
Sun Sep 05, 2021 8:45 am
It's going to be a bit uncomfortable if the govt goes against the narrow JCVI advice. I don't think we should mess around this and risk childhood vaccination controversy - it could have knock on impacts on all other vaccinations. It's too marginal a decision to risk so much for.
Yes this is a significant risk - beyond current childhood vaccinations it could have knock on effects on take-up of vaccinations against future COVID or Influenza pandemic variants that ARE more of a danger to children.

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Re: Vaccine rollout in the UK

Post by Bird on a Fire » Sun Sep 05, 2021 9:52 am

I note from a quick Google that Italy, France, Germany, Denmark, Portugal, some regions of Spain and various other countries have all made the opposite decision to the UK and are vaccinating teens. Based on previous track records and current hospitalisation rates I know who I'd rather back.

Presumably teachers who are medically vulnerable would be eligible for retirement on health grounds, if it were deemed unwise for them to be exposed and risk a breakthrough infection?
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Re: Vaccine rollout in the UK

Post by lpm » Sun Sep 05, 2021 10:59 am

"Medically vulnerable" teachers exposed to what? Flu? Covid? Colds?

If someone's so vulnerable to these normal respiratory viruses that go around schools every term, teaching isn't for them.
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Re: Vaccine rollout in the UK

Post by bob sterman » Sun Sep 05, 2021 11:25 am

lpm wrote:
Sun Sep 05, 2021 10:59 am
"Medically vulnerable" teachers exposed to what? Flu? Covid? Colds?

If someone's so vulnerable to these normal respiratory viruses that go around schools every term, teaching isn't for them.
There are teachers in their late 50s and 60s - who while at negligible risk from serious outcomes from colds and influenza - are at more significant risk of serious outcomes from COVID.

In fact - with the removal of the default retirement age - there may be teachers around the age of 70 who may be at quite considerable risk (in light of the "Covid age-risk curve").

Now I'm not saying this should be a factor in the JCVI decision on COVID vaccines for 12-16 year olds. But there will be vulnerable teachers.

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Re: Vaccine rollout in the UK

Post by lpm » Sun Sep 05, 2021 11:59 am

Vaxxed-Covid isn't as bad as all that.

People often have to leave their jobs and abandon careers due to health reasons. A back injury or arthritis or hearing loss. Cancer and MS. Mental health. Or needing to care for someone else with health issues.

And people often take jobs with a risk of death and injury. Roofing. Fishing. Railways. Farming.

For a minority vaxxed-Covid is another potential reason on the list.

We're got to end our habit of treating Covid as a magic disease, requiring different rules and special allowances. It's going to circulate in schools for the next decade. Some teachers might choose to quit accordingly.
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Re: Vaccine rollout in the UK

Post by OffTheRock » Sun Sep 05, 2021 1:42 pm

lpm wrote:
Sun Sep 05, 2021 11:59 am
Vaxxed-Covid isn't as bad as all that.

People often have to leave their jobs and abandon careers due to health reasons. A back injury or arthritis or hearing loss. Cancer and MS. Mental health. Or needing to care for someone else with health issues.

And people often take jobs with a risk of death and injury. Roofing. Fishing. Railways. Farming.

For a minority vaxxed-Covid is another potential reason on the list.

We're got to end our habit of treating Covid as a magic disease, requiring different rules and special allowances. It's going to circulate in schools for the next decade. Some teachers might choose to quit accordingly.
Some are already choosing to quit and we don't have many to spare. Recruitment and retention were already a problem and the government's inability to put any sort of mitigation into schools and just gaslight teachers isn't going to help.

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Re: Vaccine rollout in the UK

Post by shpalman » Tue Sep 07, 2021 1:36 pm

Lads I've got a great idea for vaccinating all the kids which the JCVI reckons we shouldn't vaccinate but the Guardian reckons we will... listen to this... let's vaccinate them at school! I know, right? I bet nobody thought of that.
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Re: Vaccine rollout in the UK

Post by tom p » Tue Sep 07, 2021 1:58 pm

shpalman wrote:
Wed Sep 01, 2021 5:06 pm
not a booster shot though

Well no, the British third jab is actually spelled borcestershire shot.
they'd get those in The Archers

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Re: Vaccine rollout in the UK

Post by tom p » Tue Sep 07, 2021 1:59 pm

Bird on a Fire wrote:
Sun Sep 05, 2021 9:52 am
I note from a quick Google that Italy, France, Germany, Denmark, Portugal, some regions of Spain and various other countries have all made the opposite decision to the UK and are vaccinating teens. Based on previous track records and current hospitalisation rates I know who I'd rather back.

Presumably teachers who are medically vulnerable would be eligible for retirement on health grounds, if it were deemed unwise for them to be exposed and risk a breakthrough infection?
Netherlands too. Wigglinha is double-jabbed

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Re: Vaccine rollout in the UK

Post by bagpuss » Tue Sep 07, 2021 2:37 pm

Herainestold wrote:
Mon Aug 23, 2021 8:50 pm
headshot wrote:
Mon Aug 23, 2021 8:18 pm
Herainestold wrote:
Mon Aug 23, 2021 4:48 pm


Thanks. Glad to hear that. Do people have to be masked at your events?
No. Because it’s not mandated anywhere in the UK for outdoor events so it isn’t possible to enforce, and besides audiences tend to naturally distance around 1m between groups anyway.
Okay, thank you. I realize how difficult it must be for someone to run any kind of business in these trying times.
Good luck to you.

Just catching up on this thread.

Having attended one of headshot's company's events earlier this year (on one of the very hot days), I can concur. Attendees were generally well-behaved, mostly (but by no means all) masked-up as requested when in the queue to enter the grounds and when going to the loos, although not generally at other times (people were mainly picnicking, so not really practical to do so anyway). Marshalls ensured that people were positioned well-spaced from other attendee groups, although they didn't really need to as people were pretty good at doing that themselves.

As a family, we're fairly cautious and risk-averse but felt very safe at the event. And had an excellent evening too, for which thanks headshot.

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Re: Vaccine rollout in the UK

Post by headshot » Tue Sep 07, 2021 8:19 pm

bagpuss wrote:
Tue Sep 07, 2021 2:37 pm
Herainestold wrote:
Mon Aug 23, 2021 8:50 pm
headshot wrote:
Mon Aug 23, 2021 8:18 pm


No. Because it’s not mandated anywhere in the UK for outdoor events so it isn’t possible to enforce, and besides audiences tend to naturally distance around 1m between groups anyway.
Okay, thank you. I realize how difficult it must be for someone to run any kind of business in these trying times.
Good luck to you.

Just catching up on this thread.

Having attended one of headshot's company's events earlier this year (on one of the very hot days), I can concur. Attendees were generally well-behaved, mostly (but by no means all) masked-up as requested when in the queue to enter the grounds and when going to the loos, although not generally at other times (people were mainly picnicking, so not really practical to do so anyway). Marshalls ensured that people were positioned well-spaced from other attendee groups, although they didn't really need to as people were pretty good at doing that themselves.

As a family, we're fairly cautious and risk-averse but felt very safe at the event. And had an excellent evening too, for which thanks headshot.
Awww thanks!

Which one did you see, and where?

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Re: Vaccine rollout in the UK

Post by bagpuss » Tue Sep 07, 2021 10:10 pm

headshot wrote:
Tue Sep 07, 2021 8:19 pm

Awww thanks!

Which one did you see, and where?
HMS Pinafore, at Berkhamsted Castle. The bagkitten's drama club teacher/producer was in the cast which was how we found out about it, and then I realised it was your company. Berko isn't very far from us but it's not somewhere we tend to go to very often and don't usually pick up on what's on there so we wouldn't have known about it otherwise.

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Re: Vaccine rollout in the UK

Post by headshot » Wed Sep 08, 2021 7:21 am

Ah nice. Rachel’s lovely, a real asset to the company.

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Re: Vaccine rollout in the UK

Post by bagpuss » Wed Sep 08, 2021 8:52 am

headshot wrote:
Wed Sep 08, 2021 7:21 am
Ah nice. Rachel’s lovely, a real asset to the company.
Yes, we love her too - she's fantastic with the kids as well.

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Re: Vaccine rollout in the UK

Post by shpalman » Sat Sep 11, 2021 6:49 pm

molto tricky

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Re: Vaccine rollout in the UK

Post by shpalman » Sun Sep 12, 2021 7:35 am

So twitter had a go at Robert Peston for the original headline of that article but it really does seem like the infection rate amongst double-vaxxed people is higher in the whole 40-79 age range.

Image

Yes we know that the number of infections should be higher just because the majority of the population in that age range is vaccinated, but how about the rate per 100,000 being higher?
molto tricky

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Re: Vaccine rollout in the UK

Post by mediocrity511 » Sun Sep 12, 2021 7:56 am

shpalman wrote:
Sun Sep 12, 2021 7:35 am
So twitter had a go at Robert Peston for the original headline of that article but it really does seem like the infection rate amongst double-vaxxed people is higher in the whole 40-79 age range.

Image

Yes we know that the number of infections should be higher just because the majority of the population in that age range is vaccinated, but how about the rate per 100,000 being higher?
There's lots of reasons why that might be the case. People who aren't vaccinated in those age groups may well be less compliant with public health advice than vaccinated people and therefore less likely to test for covid when experiencing symptoms. People who are at higher occupational risk of catching covid may well be much more likely to be vaccinated. People who are vaccinated may feel protected and therefore go to more risky venues.

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Re: Vaccine rollout in the UK

Post by Brightonian » Sun Sep 12, 2021 8:41 am

mediocrity511 wrote:
Sun Sep 12, 2021 7:56 am
shpalman wrote:
Sun Sep 12, 2021 7:35 am
So twitter had a go at Robert Peston for the original headline of that article but it really does seem like the infection rate amongst double-vaxxed people is higher in the whole 40-79 age range.

Image

Yes we know that the number of infections should be higher just because the majority of the population in that age range is vaccinated, but how about the rate per 100,000 being higher?
There's lots of reasons why that might be the case. People who aren't vaccinated in those age groups may well be less compliant with public health advice than vaccinated people and therefore less likely to test for covid when experiencing symptoms. People who are at higher occupational risk of catching covid may well be much more likely to be vaccinated. People who are vaccinated may feel protected and therefore go to more risky venues.
Thanks shalpers for raising this - when people on Twitter earlier were giving Peston's tweet an eye-roll I looked again and I was puzzled, and nobody in the replies gave a sensible rebuttal, so I thought maybe column headings or figures had been mistranscribed or something and I didn't investigate further (not that I'd know how tbh).

And thanks mediocrity for some plausible explanations (though figures in the region of a quarter or a third higher for the vaxxed are still rather striking). Before the vaccines appeared I have to admit I vaguely assumed they'd be a sort of magic bullet providing 100% protection against infection and hence illness. And long after learning none of that's the case, having been double jabbed I am indulging in riskier behaviour (going to pubs/cafés, even though sitting outside, going to shops a bit more, and so on).

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Re: Vaccine rollout in the UK

Post by shpalman » Sun Sep 12, 2021 9:11 am

I still think it's the case that the vaccines protect well against severe outcomes; there never really was good evidence to suggest they protected against mild/asymptomatic illness (e.g. compare Voysey et al. with the preprint by the same authors). A person getting infected is one of those qualitative yes/no answers to a question which should be more qualitative i.e. how bad do they have it?

The preprint said, for Asymptomatic COVID-19 Cases > 14 days after second dose (COV002 only), that there were a total of 41 cases in the vax group (for all dose intervals) out of 2692 subjects; there were 42 cases in the control group out of 2751 subjects. So basically not effective at all. The preprint said "overall cases of any PCR+ were reduced by 67% (95%CI 49%, 78%) after a single SD vaccine suggesting the potential for a substantial reduction in transmission" and
A measure of overall PCR positivity is appropriate to assess whether there is a reduction in the burden of infection. Analyses presented here show that a single standard dose of the vaccine reduced PCR positivity by 67%, and that, after the second dose, the SD/SD schedule
reduced PCR positivity by 49.5% overall. These data indicate that ChAdOx1 nCoV-19, used in the authorised schedules, may have a substantial impact on transmission by reducing the number of infected individuals in the population.
... there was a lot of First dose of vaccine reduces transmission by 'about two-thirds' because of that, but you won't find that claim in the published version. Most of the efficacy making up that 67% figure was anyway in symptomatic cases.

(I'm not looking for the answer as such, I just think it's an interesting discussion to have.)

As I've said, I've pivoted away from "let's eradicate covid with vaccines and lockdowns" to "the covids are going to find you sooner or later so protect yourself and hope it goes the least bad for you as possible".
molto tricky

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Re: Vaccine rollout in the UK

Post by lpm » Sun Sep 12, 2021 9:14 am

Simple. Infection + Injection.

The table only shows vaccination status, it has no knowledge of previous infection status.

We're now crazy high at 97.7% of 40-79 year olds with antibodies. The heavy lifting to get us there was with vaccines but for those who chose not to be vaccinated it had to be via getting ill. All the table shows is that the 40-79 age group is now well mixed - you'd expect the vaccinated and unvaccinated rates to be similar, because the vaccinated might catch it with breakthroughs and the unvaccinated might not catch it due to previous infection.

The other way to look at it is to imagine the inverse of the table - numbers of people who encountered the virus and didn't get infected so were not cases in the time period.

We know that the chance of catching Covid after vaccination is something like 60% lower than if you weren't vaccinated. But this 60% effectiveness is for the very large majority of us who got our doses before ever catching the disease. In my terminology, 60% is the benefit of going from 0 protection points to 2. For the minority who had prior infection, i.e. going from 1 point to 3, the benefit is substantially less than 60%. More akin to a slight couple of percent top-up from a booster jab. You can't ignore the protective benefit of previous infection in tables like this when comparing to the protective benefit of injections.
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Re: Vaccine rollout in the UK

Post by lpm » Sun Sep 12, 2021 9:53 am

shpalman wrote:
Sun Sep 12, 2021 9:11 am
I still think it's the case that the vaccines protect well against severe outcomes; there never really was good evidence to suggest they protected against mild/asymptomatic illness (e.g. compare Voysey et al. with the preprint by the same authors). A person getting infected is one of those qualitative yes/no answers to a question which should be more qualitative i.e. how bad do they have it?

The preprint said, for Asymptomatic COVID-19 Cases > 14 days after second dose (COV002 only), that there were a total of 41 cases in the vax group (for all dose intervals) out of 2692 subjects; there were 42 cases in the control group out of 2751 subjects. So basically not effective at all. The preprint said "overall cases of any PCR+ were reduced by 67% (95%CI 49%, 78%) after a single SD vaccine suggesting the potential for a substantial reduction in transmission" and
A measure of overall PCR positivity is appropriate to assess whether there is a reduction in the burden of infection. Analyses presented here show that a single standard dose of the vaccine reduced PCR positivity by 67%, and that, after the second dose, the SD/SD schedule
reduced PCR positivity by 49.5% overall. These data indicate that ChAdOx1 nCoV-19, used in the authorised schedules, may have a substantial impact on transmission by reducing the number of infected individuals in the population.
... there was a lot of First dose of vaccine reduces transmission by 'about two-thirds' because of that, but you won't find that claim in the published version. Most of the efficacy making up that 67% figure was anyway in symptomatic cases.

(I'm not looking for the answer as such, I just think it's an interesting discussion to have.)

As I've said, I've pivoted away from "let's eradicate covid with vaccines and lockdowns" to "the covids are going to find you sooner or later so protect yourself and hope it goes the least bad for you as possible".
I wrote my thing before seeing this.

We basically know that the vaccine protection descends along the scale of death-ICU-hospital-symptomatic-asymptomatic-transmission. But all the comparisons are vaccinated vs unprotected rather than vaccinated vs previous infection.

There were people with second infections, e.g March 2020 then a repeat Jan 2021, but they seemed pretty rare. Were they rarer than breakthrough infections now? What we need is the equivalent of the above Lancet stuff for these people. Weren't there suggestions that vaccines give longer lasting protection than infection, rather than better immediate protection? If so we're still in quite a "young" period, with unvaccinated-but-previous-infection people mostly having relatively recent antibodies.
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Re: Vaccine rollout in the UK

Post by shpalman » Sun Sep 12, 2021 10:36 am

It's Table 4 of COVID-19 vaccine surveillance report - Week 36 on page 14. Deaths are in Table 5, showing that vaccines reduce the death (within 28 days) rate by a factor of about 5-10 across the various age groups. Table 6 shows similar results for those needing to emergently go to hospital.

If you look at Figs. 3 and 4 you can see that they try to distinguish between antibodies from infection and from vaccination (in blood donors).
Nucleoprotein (Roche N) assays only detect post-infection antibodies, whereas spike (Roche S) assays will detect both post-infection antibodies and vaccine-induced antibodies. Thus, changes in the proportion of samples testing positive on the Roche N assay will reflect the effect of natural infection and spread of COVID-19 in the population.
Roche N is now detected in about 20% of younger (up to ~59) people so that's an idea of the fraction who got their antibodies by infection rather than (just) vaccination. I don't know if this means that you can assume that ~20% of people who haven't even had a single vaccine dose have antibodies anyway because of infection.
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Re: Vaccine rollout in the UK

Post by shpalman » Sun Sep 12, 2021 11:06 am

Page 13 says
... In individuals aged 40 to 79, the rate of a positive COVID-19 test is higher in vaccinated individuals compared to unvaccinated. This is likely to be due to a variety of reasons, including differences in the population of vaccinated and unvaccinated people as well as differences in testing patterns.

Interpretation of the data

These data should be considered in the context of vaccination status of the population groups shown in the rest of this report. The vaccination status of cases, inpatients and deaths is not the most appropriate method to assess vaccine effectiveness and there is a high risk of misinterpretation. Vaccine effectiveness has been formally estimated from a number of different sources and is described earlier in this report.

In the context of very high vaccine coverage in the population, even with a highly effective vaccine, it is expected that a large proportion of cases, hospitalisations and deaths would occur in vaccinated individuals, simply because a larger proportion of the population are vaccinated than unvaccinated and no vaccine is 100% effective. This is especially true because vaccination has been prioritised in individuals who are more susceptible or more at risk of severe disease. Individuals in risk groups may also be more at risk of hospitalisation or death due to non-COVID-19 causes, and thus may be hospitalised or die with COVID-19 rather than because of COVID-19.
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