Vaccine rollout in the UK

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Millennie Al
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Re: Vaccine rollout in the UK

Post by Millennie Al » Fri Jul 09, 2021 12:36 am

Herainestold wrote:
Thu Jul 08, 2021 6:53 pm
Which works better to motivate people to get vaccinated, a positive message or fear? Or old fashioned compulsion?
It doesn't matter. In a democracy, the people should be told the truth.
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Re: Vaccine rollout in the UK

Post by Herainestold » Fri Jul 09, 2021 1:16 am

Millennie Al wrote:
Fri Jul 09, 2021 12:36 am
Herainestold wrote:
Thu Jul 08, 2021 6:53 pm
Which works better to motivate people to get vaccinated, a positive message or fear? Or old fashioned compulsion?
It doesn't matter. In a democracy, the people should be told the truth.
Which is what with respect to vaccination?
Delta changes everything.

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shpalman
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Re: Vaccine rollout in the UK

Post by shpalman » Sat Jul 10, 2021 9:38 am

NHS staff abused by people seeking second Covid jab early for holiday

Ha as if other countries are even going to let people from the UK in.

But 8 weeks is of course a lot longer than the official Pfizer protocol.
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Re: Vaccine rollout in the UK

Post by Herainestold » Sun Jul 11, 2021 12:49 am

shpalman wrote:
Sat Jul 10, 2021 9:38 am
NHS staff abused by people seeking second Covid jab early for holiday

Ha as if other countries are even going to let people from the UK in.

But 8 weeks is of course a lot longer than the official Pfizer protocol.
The official Pfizer protocol was based on expediency. They were trying to get their trials done as quickly as possible, and didn't bother testing longer intervals. In the face of Delta, it would be wise to reduce the intervals as small as possible.
Delta changes everything.

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Martin_B
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Re: Vaccine rollout in the UK

Post by Martin_B » Sun Jul 11, 2021 4:43 am

Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
Evidence?
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Re: Vaccine rollout in the UK

Post by Herainestold » Sun Jul 11, 2021 12:50 pm

Martin_B wrote:
Sun Jul 11, 2021 4:43 am
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
Evidence?
Just to get people double vaxed quicker and reduce the time they are only single dosed and more vulnerable to Delta. Three weeks as opposed to eight or twelve.
Delta changes everything.

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Re: Vaccine rollout in the UK

Post by headshot » Sun Jul 11, 2021 12:54 pm

So no evidence then?

Have your ever read this book?
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Re: Vaccine rollout in the UK

Post by sTeamTraen » Sun Jul 11, 2021 1:29 pm

Herainestold wrote:
Sun Jul 11, 2021 12:49 am
The official Pfizer protocol was based on expediency. They were trying to get their trials done as quickly as possible, and didn't bother testing longer intervals. In the face of Delta, it would be wise to reduce the intervals as small as possible.
I suspect that what actually happened is that the virologists, immunologists, pharmacologists, and physiologists who work for all of the manufacturers sat down and worked out what an optimum gap would be, and decided it was 3 weeks (Pfizer), 4 weeks (Moderna), and 8-12 weeks (AZ).

Then they went out and ran clinical trials on that basis. They didn't have the time or statistical power to run six different intervals and detect a meaningful difference, so they just tested what seemed reasonable, and they all got good results.

If they had chosen the intervals at random then you might argue that reducing (or increasing) them might improve matters. But since they were based on extensive theoretical considerations, and then produced 90%+ protection in the trials, I would say they probably did a pretty good job. If they start mucking about with those numbers, the potential upside is a lot smaller than the potential downside.

Can I ask, sincerely, what your level of scientific education is? You seem to be quite interested in how science works, and some of us would happy to try and help your understanding along, but it's not always easy to know at what level to pitch the information.
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bob sterman
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Re: Vaccine rollout in the UK

Post by bob sterman » Sun Jul 11, 2021 1:32 pm

Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
:roll: :roll: :roll:

Why not just give both doses on the same day then? That'll keep the interval really short. Or perhaps both in the same syringe?

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Re: Vaccine rollout in the UK

Post by shpalman » Sun Jul 11, 2021 1:52 pm

sTeamTraen wrote:
Sun Jul 11, 2021 1:29 pm
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
The official Pfizer protocol was based on expediency. They were trying to get their trials done as quickly as possible, and didn't bother testing longer intervals. In the face of Delta, it would be wise to reduce the intervals as small as possible.
I suspect that what actually happened is that the virologists, immunologists, pharmacologists, and physiologists who work for all of the manufacturers sat down and worked out what an optimum gap would be, and decided it was 3 weeks (Pfizer), 4 weeks (Moderna), and 8-12 weeks (AZ).

Then they went out and ran clinical trials on that basis...
It seems the original idea in the AZ Phase III trials was for it to be a single-dose vaccine, so the first trial was started on that basis. This meant that when they decided to change to a two-dose regime there would have been a bit of a delay in getting the second doses ready; the other trials, which were designed as two-dose from the beginning, specified a shorter interval (the Brazil and South Africa trials targetted a 4 week interval). The second dose was also delayed for some of the COV002 participants due to Oxford being wrong about the doses (leading to that LD/SD thing) but it's not really explained what the schedule was or what it ended up being, only that Table 3 talks about 8 weeks or 6 weeks as a dividing line between subgroups.

Of course it's not very systematically reported in the paper; all the fuss was about the LD/SD regime being more efficacious, but it was the regulators I think who decided that it was actually the longer time between doses which caused it to work better. Then of course there were those later publications demonstrating the efficacy of the first dose up to about 10-12 weeks.

There was never anything like this justifying the UK's decision to lengthen the time between Pfizer doses, until of course the UK ran the experiment on its population. At the time this felt like pure fuckery to get as many people first-dosed as possible without worrying about maintaining a stock for second doses.
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Re: Vaccine rollout in the UK

Post by jdc » Sun Jul 11, 2021 2:21 pm

I'm not sure why Herainestold is getting such a hard time for suggesting we follow Pfizer's recommended protocol and give second doses at three weeks as opposed to eight or twelve.

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bob sterman
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Re: Vaccine rollout in the UK

Post by bob sterman » Sun Jul 11, 2021 2:24 pm

jdc wrote:
Sun Jul 11, 2021 2:21 pm
I'm not sure why Herainestold is getting such a hard time for suggesting we follow Pfizer's recommended protocol and give second doses at three weeks as opposed to eight or twelve.
Because originally there was no mention of 3 weeks - simply this...
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.

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Re: Vaccine rollout in the UK

Post by jdc » Sun Jul 11, 2021 2:29 pm

bob sterman wrote:
Sun Jul 11, 2021 2:24 pm
jdc wrote:
Sun Jul 11, 2021 2:21 pm
I'm not sure why Herainestold is getting such a hard time for suggesting we follow Pfizer's recommended protocol and give second doses at three weeks as opposed to eight or twelve.
Because originally there was no mention of 3 weeks - simply this...
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
Which was clarified by Herainestold before you all piled in on him.

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Re: Vaccine rollout in the UK

Post by Herainestold » Sun Jul 11, 2021 3:16 pm

bob sterman wrote:
Sun Jul 11, 2021 1:32 pm
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
:roll: :roll: :roll:

Why not just give both doses on the same day then? That'll keep the interval really short. Or perhaps both in the same syringe?



They were doing that in China. One in each arm.

Efficacy against Delta after one dose is 33%. After two doses roughly twice that.
If you are waiting 8 weeks between doses you have people exposed to the virus and it s only 33% better than being unvaccinated, and you are exposed for 8 weeks. If you go down to 3 weeks, you are reducing that time with lesser protection.

I don't know what the minimum time between doses for reasonable efficacy would be. I don't think they tested for that. I expect that they made it as short as they thought they could, in order to expedite the trial. I doubt that there would be any gain from going shorter.

Some of the retrospective analyses were indicating that a longer period between doses was better. I think this was in terms of antibodies rather than
looking at mortality or infections. So it is a trade off between waiting for antibody production to increase before the booster, and being exposed to the virus with lower efficacy before the second dose.
Delta changes everything.

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Re: Vaccine rollout in the UK

Post by Herainestold » Sun Jul 11, 2021 3:19 pm

I dont know which is better. I keep changing my mind as we see more data.
I figure on a forum such as this, speculation is okay. Isn't that why we are here, to toss ideas around?
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Re: Vaccine rollout in the UK

Post by jimbob » Sun Jul 11, 2021 9:39 pm

lpm wrote:
Thu Jul 08, 2021 2:04 pm
UK first doses are slowing right down due to lack of demand.

It's time to take the vaccines out of health centres, stadiums and village halls, and go on the road.

Set up in pubs, restaurants, cinemas, high streets, shopping malls. Capture 18-30s spontaneously instead of via appointments. That's where the big wins will come now, assuming we're not doing 12-18s.
My daughter and her three 20-something colleagues have all asked but the Scottish Highlands NHS system cannot get them slots as they're only temporarily resident.

Similarly, my son struggled with getting booked as he's now registered in Aberdeen. A lot of the 20 somethings are students and it looks like the system isn't too good for that.

I didn't get my vaccination when my gp texted because I was also temporarily living in Kent rather than Derbyshire and had to wait until I got back.
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Re: Vaccine rollout in the UK

Post by Millennie Al » Mon Jul 12, 2021 12:05 am

Herainestold wrote:
Sun Jul 11, 2021 3:19 pm
I dont know which is better. I keep changing my mind as we see more data.
"Delaying second Pfizer vaccines to 12 weeks significantly increases antibody responses in older people, finds study" - https://www.birmingham.ac.uk/news/lates ... ponse.aspx

"Covid-19: New data on Oxford AstraZeneca vaccine backs 12 week dosing interval" - https://www.bmj.com/content/372/bmj.n326

And it is also known in general that increasing the interval for some vaccines produces a stronger response. One of the considerations for trials for Covid-19 was that if you add a month to the interval then you add about a month to the delay until you have an answer from the study. When millions are dying it makes sense to try the shortest interval you think is very likely to be good enough - then if your vaccine works you can start using it to save lives while running additional studies to see if there is a better dose schedule.
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Re: Vaccine rollout in the UK

Post by Martin_B » Mon Jul 12, 2021 12:22 am

Herainestold wrote:
Sun Jul 11, 2021 12:50 pm
Martin_B wrote:
Sun Jul 11, 2021 4:43 am
Herainestold wrote:
Sun Jul 11, 2021 12:49 am
In the face of Delta, it would be wise to reduce the intervals as small as possible.
Evidence?
Just to get people double vaxed quicker and reduce the time they are only single dosed and more vulnerable to Delta. Three weeks as opposed to eight or twelve.
Over here we don't have 8 or 12 weeks between vaccinations; both Pfizer and AZ are given with a minimum 3 week gap. When I was given my vaccination I was told that I absolutely must not try and book a second vaccination within 3 weeks (and not just to prevent others getting their dose) but because a longer gap between vaccinations is beneficial.
Herainestold wrote:
Sun Jul 11, 2021 3:19 pm
I dont know which is better. I keep changing my mind as we see more data.
I figure on a forum such as this, speculation is okay. Isn't that why we are here, to toss ideas around?
Changing your mind with more data is good. You don't appear to be changing your mind much, though.

Also, speculation is fine, but wild speculation with no data to base it on is unhelpful.
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Re: Vaccine rollout in the UK

Post by Herainestold » Mon Jul 12, 2021 2:52 am

Millennie Al wrote:
Mon Jul 12, 2021 12:05 am

And it is also known in general that increasing the interval for some vaccines produces a stronger response. One of the considerations for trials for Covid-19 was that if you add a month to the interval then you add about a month to the delay until you have an answer from the study. When millions are dying it makes sense to try the shortest interval you think is very likely to be good enough - then if your vaccine works you can start using it to save lives while running additional studies to see if there is a better dose schedule.
I would agree with that. My point was that adhering to the 8 week schedule, leaves people twice as vulnerable to the Delta variant, for a period of 5 or so weeks.
Delta changes everything.

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Re: Vaccine rollout in the UK

Post by OffTheRock » Mon Jul 12, 2021 6:07 am

There was never anything like this justifying the UK's decision to lengthen the time between Pfizer doses, until of course the UK ran the experiment on its population. At the time this felt like pure fuckery to get as many people first-dosed as possible without worrying about maintaining a stock for second doses.
I agree with the first part. This was an experiment to see whether getting as many people as possible partially vaccinated was better second dose availability wasn’t a worry because of the way the system is set up rather than because they didn’t care about it. Your second vaccine is essentially set aside when you receive your first. The U.K. stock is divided into 1st and 2nd dose stock so we shouldn’t get into the situation where we’ve got loads of people with 1st doses and no vaccine to give them their second.

I have 6-7 weeks between my doses because anything we received after the last week in February could only be used in 2nd doses.

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Re: Vaccine rollout in the UK

Post by Millennie Al » Mon Jul 12, 2021 11:05 pm

The other factor relevant to the dose schedule is availability of doses. If you have a vaccine which is 60% effective after one dose, then for any group of people with similar risk, you should give everyone one dose before anyone gets the second. For example, if the group is 100,000 people, unvaccinated risk of dying is 2% and doubly vaccinated is 100% effective

no dose: 2000 deaths
all get one dose: 800 deaths
half get two doses, half get none: 1000 deaths

For any vaccine which is >50% effective after the first dose, unless it can be better than 100% effective after two, it's better to spread it out as much as possible.

There are two cases to which this does not apply: when you get >100% effectiveness due to herd immumity protecting those who have not been treated, or >100% effectiveness relative to one group because you use the done in a more vulnerable group. An example of the latter would be where you have another 100,000 whose risk of dying is only 0.2%. Then you have:

All first group get two doses: 200 deaths
Both groups get one dose: 880 deaths
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Re: Vaccine rollout in the UK

Post by shpalman » Wed Jul 14, 2021 7:45 pm

“London practice staff are already receiving profanity-filled letters and text messages in response to vaccination reminders, and those making calls are getting abuse and threatened with being reported to regulators, and even with violence”
https://www.theguardian.com/society/202 ... -reminders
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Re: Vaccine rollout in the UK

Post by lpm » Mon Jul 19, 2021 4:13 pm

Johnson doing a Macron.

By end of Sept, must be double-dosed to get into nightclubs, other indoor events.

35% of 18-30s still not had the first dose, will this reverse the fizzle and get numbers heading up again?
What ever happened to that Trump guy, you know, the one who was president for a bit?

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