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Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 8:59 am
by Vertigowooyay
Millennie Al wrote:
Sat Jan 02, 2021 2:30 am
Vertigowooyay wrote:
Sat Jan 02, 2021 12:43 am
I really hope this is the NYT getting it wrong. Because mix and match vaccine rollout seems crazy.

https://www.nytimes.com/2021/01/01/heal ... itain.html
It's not quite as crazy as it looks. The Pfizer, Moderna, and Oxford/AstraZenica vaccines all work by targetting the spike proteins, so it's highly plausible that presenting the body with spikes in different ways will cause a good immune response.

However, If any vaccines are administered in a manner which deviates from the manner used in the clinical trials, we should at least record for each patient the exact details of what they got, monitor them for subsequent infection and its seriousness, and keep an ongoing analysis so that if one particular variant is exceptionally good or bad the treatment can be adapted. It wouldn't be anything like as good as a normal trial, but given the urgency of the situation could be justified.
“Highly plausible” isn’t good enough. These vaccines have gone through the rigorous process to get to this point. The government then deciding to f.ck around with dose spacing and then just mix and matching them without any idea of the efficacy is a nonsense.

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 9:28 am
by shpalman
There may be some evidence that the Oxford/AstraZeneca one works with a longer dose spacing - frankly it seems like the standard dosage and dose spacing chosen for the Phase III trials is the worst one versus accidentally giving less in the first dose or having to wait longer for the second one due to logistics - but the official line from Pfizer is do not f.ck about with our vaccine.

I don't know why MHRA rushed through their approval not based on a LD/SD protocol, for which we have suggestions that it's much more effective, but for the SD/SD one (only ~60% effective, and in this case, you cannot pool in the ~90% effective LD/SD data just to make it look better if you want to also hypothesize that there's a mechanism for why LD/SD is better than SD/SD) with a longer wait between the doses based on some graphs from an earlier phase of the trial or something, which if they were so good, why wasn't that the protocol tested in Phase III?

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 10:11 am
by Rich Scopie
So, a massive leap forward with vaccines, created by some of the finest minds in science, then a bunch of public schoolboy ex-journalists decide they can do better. Is there nothing this government can't royally f.ckup?

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 10:15 am
by lpm
Blackcountryboy wrote:
Thu Dec 31, 2020 11:26 am
I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.
How have you been, Blackcountryboy? Any side effects?

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 10:27 am
by Rich Scopie
lpm wrote:
Sat Jan 02, 2021 10:15 am
Blackcountryboy wrote:
Thu Dec 31, 2020 11:26 am
I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.
How have you been, Blackcountryboy? Any side effects?
He can draw much better than he could.
Spoiler:

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 11:46 am
by Blackcountryboy
lpm wrote:
Sat Jan 02, 2021 10:15 am
Blackcountryboy wrote:
Thu Dec 31, 2020 11:26 am
I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.
How have you been, Blackcountryboy? Any side effects?
Thanks for asking. No side effects, the arm was just a bit sore on the evening but only slightly. We were due the second dose on 20 Jan. Not feeling so sure about that now. I haven't been going to the gym since end October because of the level of infection in our and adjoining areas; I was looking forward to going back end January, we are now Tier 4 so that dream is dead.

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 4:06 pm
by Herainestold
Blackcountryboy wrote:
Sat Jan 02, 2021 11:46 am
lpm wrote:
Sat Jan 02, 2021 10:15 am
Blackcountryboy wrote:
Thu Dec 31, 2020 11:26 am
I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.
How have you been, Blackcountryboy? Any side effects?
Thanks for asking. No side effects, the arm was just a bit sore on the evening but only slightly. We were due the second dose on 20 Jan. Not feeling so sure about that now. I haven't been going to the gym since end October because of the level of infection in our and adjoining areas; I was looking forward to going back end January, we are now Tier 4 so that dream is dead.
Good to hear that. Hopefully things will resolve and you will get a chance for dose 2, before too much time passes.

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 5:26 pm
by Trinucleus
Blackcountryboy wrote:
Sat Jan 02, 2021 11:46 am
lpm wrote:
Sat Jan 02, 2021 10:15 am
Blackcountryboy wrote:
Thu Dec 31, 2020 11:26 am
I had my first dose yesterday, second should be on 20 January. It was well organised, with competent helpers, both outside and inside to guide you through the booking in procedure and direct you to your booth, It was at a church with a decent sized car park, less than a mile from where I live, which was convenient; the only problem was there was quite a slope and narrow steps between the carpark and the entrance, which was a problem for some of the people, obviously all the attendees were old, but there were people to help if needed.
I was amused that it was a Spiritualist Church with a sign by the door saying "Spiritual Healing", presumably they do not do Covid-19 healing.
How have you been, Blackcountryboy? Any side effects?
Thanks for asking. No side effects, the arm was just a bit sore on the evening but only slightly. We were due the second dose on 20 Jan. Not feeling so sure about that now. I haven't been going to the gym since end October because of the level of infection in our and adjoining areas; I was looking forward to going back end January, we are now Tier 4 so that dream is dead.
So how much protection do you have after one dose? If I had two doses and 90% protection I'd be confident going out, but with only say 50% after one dose, not so much?

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 5:37 pm
by raven
Blackcountryboy wrote:
Sat Jan 02, 2021 11:46 am
lpm wrote:
Sat Jan 02, 2021 10:15 am
How have you been, Blackcountryboy? Any side effects?
Thanks for asking. No side effects, the arm was just a bit sore on the evening but only slightly. We were due the second dose on 20 Jan. Not feeling so sure about that now. I haven't been going to the gym since end October because of the level of infection in our and adjoining areas; I was looking forward to going back end January, we are now Tier 4 so that dream is dead.

To add more anecdata: two relatives in their 80s had their first doses before Christmas. Neither had any side effects.

Also, they're both in York. One got a call Sunday evening, can you come in to the bigger GP's surgery one over from yours tomorrow morning, went eagerly. T'other had to take a bus across town and work out how to get into an unfamiliar surgery, but otherwise quick and straightforward. Both booked in for a second jab early next week, but who knows whether that'll happen.

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 5:41 pm
by raven
Trinucleus wrote:
Sat Jan 02, 2021 5:26 pm
So how much protection do you have after one dose? If I had two doses and 90% protection I'd be confident going out, but with only say 50% after one dose, not so much?
I think -- but IANADr -- that the % refers to subjects en masse. So 90% protection means 90% of people vaccinated are protected.

Let's hope someone who actually knows comes along shortly...

ETA: I went looking. From here:
The Pfizer/BioNTech vaccine reports 90% efficacy, which means that – of the 94 confirmed cases of COVID-19 – their vaccine prevented COVID-19 symptoms for 90% of those who received the vaccine compared with placebo.

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 5:47 pm
by shpalman
raven wrote:
Sat Jan 02, 2021 5:41 pm
Trinucleus wrote:
Sat Jan 02, 2021 5:26 pm
So how much protection do you have after one dose? If I had two doses and 90% protection I'd be confident going out, but with only say 50% after one dose, not so much?
I think -- but IANADr -- that the % refers to subjects en masse. So 90% protection means 90% of people vaccinated are protected.

Let's hope someone who actually knows comes along shortly...
It means that in the phase III trial (assuming a similarly large number of subjects in both the vaccine and the control groups) the difference in the number of covid cases in the control group and vaccinated group, divided by the number of cases on the control group, is 0.90.

I think that means that the vaccine makes you 90% less likely to catch the symptomatic covids, (The Pfizer trial wasn't routinely swabbing the subjects so wouldn't have picked up asymptomatic covids).

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 6:08 pm
by Trinucleus
shpalman wrote:
Sat Jan 02, 2021 5:47 pm
raven wrote:
Sat Jan 02, 2021 5:41 pm
Trinucleus wrote:
Sat Jan 02, 2021 5:26 pm
So how much protection do you have after one dose? If I had two doses and 90% protection I'd be confident going out, but with only say 50% after one dose, not so much?
I think -- but IANADr -- that the % refers to subjects en masse. So 90% protection means 90% of people vaccinated are protected.

Let's hope someone who actually knows comes along shortly...
It means that in the phase III trial (assuming a similarly large number of subjects in both the vaccine and the control groups) the difference in the number of covid cases in the control group and vaccinated group, divided by the number of cases on the control group, is 0.90.

I think that means that the vaccine makes you 90% less likely to catch the symptomatic covids, (The Pfizer trial wasn't routinely swabbing the subjects so wouldn't have picked up asymptomatic covids).
Thanks, but what about after one dose, is there any data?

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 6:15 pm
by shpalman
There's an unsourced and out-of-context graph on Twitter from f.ck knows where, will that do?
EqovIVYW4AAYraR.jpg
EqovIVYW4AAYraR.jpg (60 KiB) Viewed 1816 times
It's posted by a vaccinologist - & citizen & relative of people in at-risk groups so *thumb up emoji*

Re: Vaccine rollout in the UK

Posted: Sat Jan 02, 2021 6:44 pm
by raven
shpalman wrote:
Sat Jan 02, 2021 5:47 pm
It means that in the phase III trial (assuming a similarly large number of subjects in both the vaccine and the control groups) the difference in the number of covid cases in the control group and vaccinated group, divided by the number of cases on the control group, is 0.90.

I think that means that the vaccine makes you 90% less likely to catch the symptomatic covids, (The Pfizer trial wasn't routinely swabbing the subjects so wouldn't have picked up asymptomatic covids).
I went looking for better articles on efficacy and found this one: https://scroll.in/article/979627/a-stat ... ccine-mean

Efiicacy= (1 - (cases in the vaccinated group) divided by (cases in the unvaccinated group)) x100%

So, if I've read the maths right, 90% efficacy (which everyone&his dog is calling protection) means ten times more people in the control group got infected than the number in the vaccine group.

Does that mean you're ten times less likely to get infected if you've been vaccinated? (Probability is not my strength. Give me some nice vector calculus anyday.)

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 1:49 am
by Millennie Al
Trinucleus wrote:
Sat Jan 02, 2021 5:26 pm
So how much protection do you have after one dose? If I had two doses and 90% protection I'd be confident going out, but with only say 50% after one dose, not so much?
That has not been directly measured. Note that in the various trials with tens of thousands of participants, ony about 100 people in the control group catch the disease (e.g. 0.5% of them in a group of 20,000) so the numbers are too low to give fine-grained results. However there has been analysis on how the body reacts to the doses. For example, https://www.nature.com/articles/s41591-020-01179-4 for the Oxford vaccine where single dose, dose with the same after 28 days, dose with the same after 56 days and dose with half dose after 56 days were compared. You can see the nice graphs in this paper which show the strength of the effects. Presumably this is some of the data that reassures Sandy Douglas leading him to tweet as recently reported on this forum.

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 1:52 am
by Millennie Al
raven wrote:
Sat Jan 02, 2021 6:44 pm
Efiicacy= (1 - (cases in the vaccinated group) divided by (cases in the unvaccinated group)) x100%

So, if I've read the maths right, 90% efficacy (which everyone&his dog is calling protection) means ten times more people in the control group got infected than the number in the vaccine group.

Does that mean you're ten times less likely to get infected if you've been vaccinated? (Probability is not my strength. Give me some nice vector calculus anyday.)
Yes, that's right. But in the case of the Oxford vaccine it was also reported that the few who caught the disease after vaccination also had less severe illness than those in the control group (though the absolute numbers were quite small). If the same happened for the BioNTech vaccine, it might not have been noticed as the numbers were even smaller.

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 12:44 pm
by snoozeofreason
There is a lot of comment on Twitter at the moment about the possibility of mixing and matching vaccines in the UK, i.e. giving a first dose of Pfizer and a second of Oxford, or vice versa. Some if it seems to be sparked by a New York Times article on the subject.

The PHE Green Book advice is
If the course is interrupted or delayed, it should be resumed using the same vaccine but the first dose should not be repeated. There is no evidence on the interchangeability of the COVID-19 vaccines although studies are underway. Therefore, every effort should be made to determine which vaccine the individual received and to complete with the same vaccine. For individuals who started the schedule and who attend for vaccination at a site where the same vaccine is not available, or if the first product received is unknown, it is reasonable to offer one dose of the locally available product to complete the schedule. This option is preferred if the individual is likely to be at immediate high risk or is considered unlikely to attend again. In these circumstances, as both the vaccines are based on the spike protein, it is likely the second dose will help to boost the response to the first dose. For this reason, until additional information becomes available, further doses would not then be required.

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 2:05 pm
by snoozeofreason
Vertigowooyay wrote:
Sat Jan 02, 2021 12:43 am
I really hope this is the NYT getting it wrong. Because mix and match vaccine rollout seems crazy.

https://www.nytimes.com/2021/01/01/heal ... itain.html
If I'd read the thread more carefully then the above post would have been a response to yours!

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 10:27 pm
by raven
snoozeofreason wrote:
Sun Jan 03, 2021 12:44 pm
There is a lot of comment on Twitter at the moment about the possibility of mixing and matching vaccines in the UK, i.e. giving a first dose of Pfizer and a second of Oxford, or vice versa. Some if it seems to be sparked by a New York Times article on the subject.
According to the BBC here the editor of the BMJ has asked the NYT to correct that article.


Also Dr Mary Ramsay from PHE is quoted as saying PHE is not reccommending mix and matching, only allowing it in those rare instances when they don't know what you were given first time around or the correct vaccine isn't available. So, as a last resort kind of thing I think.

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 10:32 pm
by shpalman
raven wrote:
Sun Jan 03, 2021 10:27 pm
snoozeofreason wrote:
Sun Jan 03, 2021 12:44 pm
There is a lot of comment on Twitter at the moment about the possibility of mixing and matching vaccines in the UK, i.e. giving a first dose of Pfizer and a second of Oxford, or vice versa. Some if it seems to be sparked by a New York Times article on the subject.
According to the BBC here the editor of the BMJ has asked the NYT to correct that article.


Also Dr Mary Ramsay from PHE is quoted as saying PHE is not reccommending mix and matching, only allowing it in those rare instances when they don't know what you were given first time around or the correct vaccine isn't available. So, as a last resort kind of thing I think.
Asked to correct the misleading implication that anyone will be getting any second dose?

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 11:22 pm
by raven
shpalman wrote:
Sun Jan 03, 2021 10:32 pm
Asked to correct the misleading implication that anyone will be getting any second dose?
Good one. :D

Re: Vaccine rollout in the UK

Posted: Sun Jan 03, 2021 11:54 pm
by snoozeofreason
raven wrote:
Sun Jan 03, 2021 10:27 pm
snoozeofreason wrote:
Sun Jan 03, 2021 12:44 pm
There is a lot of comment on Twitter at the moment about the possibility of mixing and matching vaccines in the UK, i.e. giving a first dose of Pfizer and a second of Oxford, or vice versa. Some if it seems to be sparked by a New York Times article on the subject.
According to the BBC here the editor of the BMJ has asked the NYT to correct that article.


Also Dr Mary Ramsay from PHE is quoted as saying PHE is not reccommending mix and matching, only allowing it in those rare instances when they don't know what you were given first time around or the correct vaccine isn't available. So, as a last resort kind of thing I think.
Hmm, what Ramsay says (according to the Beeb) is
Dr Ramsay added that on the "extremely rare occasions" where the same vaccine is unavailable or it is unknown which jab the patient received, it is "better to give a second dose of another vaccine than not at all".
[my bolding]
What the Green Book says is
For individuals who started the schedule and who attend for vaccination at a site where the same vaccine is not available, or if the first product received is unknown, it is reasonable to offer one dose of the locally available product to complete the schedule.
[my bolding again]
The phrases "at a site" and "locally available" seem to me to make a difference.

Re: Vaccine rollout in the UK

Posted: Mon Jan 04, 2021 11:44 am
by shpalman
So the Oxford/AstraZeneca vaccine has been given to someone now.

I won't make fun of the UK rollout anymore given the Lombardy one has barely even started.

Re: Vaccine rollout in the UK

Posted: Mon Jan 04, 2021 3:24 pm
by raven
snoozeofreason wrote:
Sun Jan 03, 2021 11:54 pm
What the Green Book says is
For individuals who started the schedule and who attend for vaccination at a site where the same vaccine is not available, or if the first product received is unknown, it is reasonable to offer one dose of the locally available product to complete the schedule.
[my bolding again]
The phrases "at a site" and "locally available" seem to me to make a difference.
It might be they're trying to anticipate local shortages. Which is probably reasonable, given the logisitics of such a big roll out.

I don't know how common it is to have that sort of option - giving a different vaccine as a booster if the first isn't available -- for other vaccines. (My kids for instance probably had slightly diffent DPT vaccines as some were given in the UK, some in the US, and I think they differed slightly at the time. But those boosters are years later.) Some bod on TV yesterday said it's not unheard of to allow it and rattled off some instances, but I didn't catch what vaccines he was talking about. Fwiw, he also said as both Pfizer and AZ work via the same spike protein he wouldn't anticipate problems.

Re: Vaccine rollout in the UK

Posted: Mon Jan 04, 2021 8:39 pm
by lpm
Johnson has promised 2.25 million per week, in order to achieve his mid February target for the top 4 categories.

He has, of course, over promised and will under deliver.