Developing the Covid-19 vaccine

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sTeamTraen
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Re: Developing the Covid-19 vaccine

Post by sTeamTraen » Fri Jul 23, 2021 2:23 pm

shpalman wrote:
Fri Jul 23, 2021 2:11 pm
Italy made its gap between Pfizers a bit longer. It was 5 weeks for Dance Partner, for example, who had her second dose less than two weeks ago.
Here in Spain they have been scrupulous about the gaps. I've heard people complain about getting Moderna rather than Pfizer simply because it means a week longer until they are fully vaccinated. There are a few first-world problems about the vaccine rollout here, but I think we may end up with one of the highest take-up rates in Europe.
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Re: Developing the Covid-19 vaccine

Post by jaap » Fri Jul 23, 2021 2:31 pm

sTeamTraen wrote:
Fri Jul 23, 2021 2:23 pm
shpalman wrote:
Fri Jul 23, 2021 2:11 pm
Italy made its gap between Pfizers a bit longer. It was 5 weeks for Dance Partner, for example, who had her second dose less than two weeks ago.
Here in Spain they have been scrupulous about the gaps. I've heard people complain about getting Moderna rather than Pfizer simply because it means a week longer until they are fully vaccinated. There are a few first-world problems about the vaccine rollout here, but I think we may end up with one of the highest take-up rates in Europe.
Here in the Netherlands the Pfizer gap is exactly 5 weeks. I tried to get my second jab moved a few days earlier, but they wouldn't budge on that.
(I had my second two days ago, and plan to go on holiday at the end of next week so will have to get regular tests done during the first few days of the trip.)

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Fri Jul 23, 2021 7:22 pm

sTeamTraen wrote:
Fri Jul 23, 2021 2:06 pm
Woodchopper wrote:
Fri Jul 23, 2021 1:43 pm
Good point. Israel also had a three week gap between doses whereas the UK had eight weeks, which turns out to be more effective. https://www.bbc.com/news/health-57929953
Every country that respected the manufacturer's recommendations had a three-week gap with Pfizer and a four-week gap with Moderna. The only major country I know that didn't do this was the UK, when it was realised that having a bigger gap either (a) provided at least some protection for more people more quickly or (b) enabled the headline number of how many people have been vaccinated to look bigger (delete according to political position). Interestingly, the first person I saw mention that idea in public was Tony Blair, so presumably he was thinking of (a).
The link I posted summarizes research that finds that eight weeks is the ‘sweet spot’. This may explain why the Israeli data has tended to show worse results than the UK data.

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Re: Developing the Covid-19 vaccine

Post by Bird on a Fire » Fri Jul 23, 2021 7:27 pm

sTeamTraen wrote:
Fri Jul 23, 2021 2:06 pm
Woodchopper wrote:
Fri Jul 23, 2021 1:43 pm
Good point. Israel also had a three week gap between doses whereas the UK had eight weeks, which turns out to be more effective. https://www.bbc.com/news/health-57929953
Every country that respected the manufacturer's recommendations had a three-week gap with Pfizer and a four-week gap with Moderna. The only major country I know that didn't do this was the UK, when it was realised that having a bigger gap either (a) provided at least some protection for more people more quickly or (b) enabled the headline number of how many people have been vaccinated to look bigger (delete according to political position). Interestingly, the first person I saw mention that idea in public was Tony Blair, so presumably he was thinking of (a).
I got my Moderna on the 13th in Portugal, and they were hoping I'd come back in a month. However, I'm in Iceland till early September, and they've already done everyone - in a single day per dose! The joys of being a country with the same population as a town - so it seems I'll serendipitously end up with a bit of extra immunity.

Second dose dates in Portugal aren't fixed yet, so I suppose there's a chance they'll push them back a bit.
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Re: Developing the Covid-19 vaccine

Post by sTeamTraen » Sat Jul 24, 2021 11:45 am

Woodchopper wrote:
Fri Jul 23, 2021 7:22 pm
The link I posted summarizes research that finds that eight weeks is the ‘sweet spot’. This may explain why the Israeli data has tended to show worse results than the UK data.
It's an interesting problem. I assume the trials were all done with a particular interval and this was dictated by some combination of theoretical and practical factors. Then once approval was given they had to keep to those numbers, but maybe they knew that health systems would vary them and so there would be a natural experiment going on.

I read yesterday that 3.8 billion doses have been administered worldwide, so there ought to be some quite fine-grained data by now.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Jul 24, 2021 6:32 pm

Bird on a Fire wrote:
Fri Jul 23, 2021 7:27 pm
sTeamTraen wrote:
Fri Jul 23, 2021 2:06 pm
Woodchopper wrote:
Fri Jul 23, 2021 1:43 pm
Good point. Israel also had a three week gap between doses whereas the UK had eight weeks, which turns out to be more effective. https://www.bbc.com/news/health-57929953
Every country that respected the manufacturer's recommendations had a three-week gap with Pfizer and a four-week gap with Moderna. The only major country I know that didn't do this was the UK, when it was realised that having a bigger gap either (a) provided at least some protection for more people more quickly or (b) enabled the headline number of how many people have been vaccinated to look bigger (delete according to political position). Interestingly, the first person I saw mention that idea in public was Tony Blair, so presumably he was thinking of (a).
I got my Moderna on the 13th in Portugal, and they were hoping I'd come back in a month. However, I'm in Iceland till early September, and they've already done everyone - in a single day per dose! The joys of being a country with the same population as a town - so it seems I'll serendipitously end up with a bit of extra immunity.

Second dose dates in Portugal aren't fixed yet, so I suppose there's a chance they'll push them back a bit.
I hope you are able to get your second dose in a timely manner.
Vaccination saves lives. Lockdowns stop transmission.We need both to end this pandemic.

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Re: Developing the Covid-19 vaccine

Post by tom p » Mon Jul 26, 2021 1:36 pm

Herainestold, you'[re normally all over news articles about Sputnki.
How come you haven't posted this one?
Maybe more countries should try getting hold of some Sputnik!

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Mon Jul 26, 2021 4:16 pm

tom p wrote:
Mon Jul 26, 2021 1:36 pm
Herainestold, you'[re normally all over news articles about Sputnki.
How come you haven't posted this one?
Maybe more countries should try getting hold of some Sputnik!
Thanks tomp,I hadn't seen that.

My position on the Sputnik and Chinese vaccines is that westerners are prejudiced against them for political and racist reasons.
Sputnik appears to be very effective, but Russian incompetence in following the letter of regulation law, is keeping it from gaining approval in the west.This lies partially with the Russians.

It seems that most of the approved vaccines have run into production problems and sputnik is no exception. I hope they can get it sorted, as the world desperately needs more vaccines of all types.
Vaccination saves lives. Lockdowns stop transmission.We need both to end this pandemic.

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Re: Developing the Covid-19 vaccine

Post by tom p » Tue Jul 27, 2021 12:02 pm

The Chinese manufacturers haven't submitted any documents to EU regulators. You can't deny someone a license for racist reasons if they haven't applied for it.
My nephew is black. He doesn't have a driving license. Is that because of the undeniable systemic racism in Britain or is it because he's 12 and hasn't applied for one?
Were EU governments to order vaccines from China (assuming they even have enough to sell to make a difference to the vaccine schedules), they would be taking the pronouncements of the Chinese government on the safety and efficacy of the vaccines entirely on trust.
Just how trustworthy and open is the Chinese government?

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Wed Jul 28, 2021 9:26 am

Thread on Israel and why it appeared to have much worse vaccine efficacy data than elsewhere.
We think the reason is mostly that we got the denominator wrong.
https://twitter.com/dvir_a/status/14200 ... 83491?s=21

Isn’t a comment on waning immunity.

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Fri Jul 30, 2021 9:47 am

sTeamTraen wrote:
Sat Jul 24, 2021 11:45 am
Woodchopper wrote:
Fri Jul 23, 2021 7:22 pm
The link I posted summarizes research that finds that eight weeks is the ‘sweet spot’. This may explain why the Israeli data has tended to show worse results than the UK data.
It's an interesting problem. I assume the trials were all done with a particular interval and this was dictated by some combination of theoretical and practical factors. Then once approval was given they had to keep to those numbers, but maybe they knew that health systems would vary them and so there would be a natural experiment going on.

I read yesterday that 3.8 billion doses have been administered worldwide, so there ought to be some quite fine-grained data by now.
Here’s the preprint on the UK data:

Higher serological responses and increased vaccine effectiveness demonstrate the value of extended vaccine schedules in combatting COVID-19 in England

https://www.medrxiv.org/content/10.1101 ... 21261140v1

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Re: Developing the Covid-19 vaccine

Post by jdc » Thu Aug 05, 2021 6:52 pm

Moderna’s Covid-19 vaccine remains 93 per cent effective six months after the second dose, the US drugmaker said, as sales of the jab helped lift the company to a record quarterly profit.
The biotech said its vaccine remained 93 per cent effective against coronavirus infection after six months and 98 per cent effective against hospitalisation.

The US drugmaker reiterated its belief that booster shots will be needed later this year, despite the high six-month efficacy of its original two-dose Covid vaccine regimen. It said phase 2 studies showed that its three booster options induced a “robust antibody response” against Covid-19 variants of concern, including Delta
Moderna is focusing its booster efforts on its original vaccine, multi-valent jabs that target multiple strains and a Delta variant-specific shot
https://www.ft.com/content/31bf0e75-f3d ... 22939303f5

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Fri Aug 06, 2021 1:20 am

jdc wrote:
Thu Aug 05, 2021 6:52 pm
Moderna’s Covid-19 vaccine remains 93 per cent effective six months after the second dose, the US drugmaker said, as sales of the jab helped lift the company to a record quarterly profit.
The biotech said its vaccine remained 93 per cent effective against coronavirus infection after six months and 98 per cent effective against hospitalisation.

The US drugmaker reiterated its belief that booster shots will be needed later this year, despite the high six-month efficacy of its original two-dose Covid vaccine regimen. It said phase 2 studies showed that its three booster options induced a “robust antibody response” against Covid-19 variants of concern, including Delta
Moderna is focusing its booster efforts on its original vaccine, multi-valent jabs that target multiple strains and a Delta variant-specific shot
https://www.ft.com/content/31bf0e75-f3d ... 22939303f5
So why do we need boosters if it is 93% efficacious against covid? I don't think that is true against Delta. Maybe 50% against Delta infection...
Still near miracle drugs against severe outcomes, but infection and transmission not so much. Be thankfull for small mercies, but do not by any stretch of the imagination, think thast the world of 2019 is going to come back. Not in our lifetimes
Vaccination saves lives. Lockdowns stop transmission.We need both to end this pandemic.

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Re: Developing the Covid-19 vaccine

Post by jdc » Fri Aug 06, 2021 4:37 pm

Herainestold wrote:
Fri Aug 06, 2021 1:20 am

So why do we need boosters if it is 93% efficacious against covid?
Despite the impressive 6-month figures they're still expecting immunity to wane further over a longer period.

Also, it looks like it should give us better protection against variants like Delta... It looks like all three booster options induced a “robust antibody response” in the phase II trial.
Herainestold wrote:
Fri Aug 06, 2021 1:20 am
I don't think that is true against Delta. Maybe 50% against Delta infection...
Still near miracle drugs against severe outcomes, but infection and transmission not so much. Be thankfull for small mercies, but do not by any stretch of the imagination, think thast the world of 2019 is going to come back. Not in our lifetimes
Pfizer is 88% effective against symptomatic infection with Delta[1] and Moderna's results tend to be marginally better than Pfizer's (I believe Moderna uses a higher dose). I did see a news article about vaccination being ~50% effective against any infection but that was for any vaccine and the non-mRNA jabs will be dragging that average down.

A return to normality depends how effective the booster shots are, the extent of vaccine coverage, and the potential for new, viable variants to arise that can escape the immune system while maintaining transmissibility. Note that we're now into testing multivalent and delta-specific boosters along with the old-school booster. It also depends on society - how willing people are to return to normal, what level of illness and death they're willing to tolerate. I don't think everyone will return to normal but it could be a majority. There were a fair few people who were prepared to return to normal before we even had a vaccine available, after all.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2108891

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Aug 07, 2021 12:34 am

Thanks jdc, you are a real asset to this discussion forum. I would happily buy you a drink when this pandemic ends. (2030?)
Israel says Pfizer Covid vaccine is just 39% effective as delta spreads, but still prevents severe illness
,
the cutting edge evidence shows that vaccines (Pfizer, AZ, Sputnik, whatever ) are losing their effectivenss w. r. t. Delta variant and transmissions therof.
It creates a wicked problem, vaccines are near miraculous in preventing death and dismemberment, but not so hot at preventing transmission. Recent evidence from America shows that vaccinated people will actually transmit infection at the same rate or more than vaccinated people. The vaccinated themselves will be protected. Kind of a Typhoid Mary problem.

Government should encourage vaccination to the greatest extent possible, but do everything to stop transmission, recognizing that the vaccinated are transmissing . Not an easy problem to solve.

https://www.cnbc.com/2021/07/23/delta-v ... lness.html
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Re: Developing the Covid-19 vaccine

Post by bob sterman » Sat Aug 07, 2021 8:22 am

Herainestold wrote:
Sat Aug 07, 2021 12:34 am
...vaccines are near miraculous in preventing death and dismemberment
Dismemberment?? That really would be carnage. :shock:

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Re: Developing the Covid-19 vaccine

Post by headshot » Sat Aug 07, 2021 12:26 pm

bob sterman wrote:
Sat Aug 07, 2021 8:22 am
Herainestold wrote:
Sat Aug 07, 2021 12:34 am
...vaccines are near miraculous in preventing death and dismemberment
Dismemberment?? That really would be carnage. :shock:
Image

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Aug 07, 2021 1:52 pm

bob sterman wrote:
Sat Aug 07, 2021 8:22 am
Herainestold wrote:
Sat Aug 07, 2021 12:34 am
...vaccines are near miraculous in preventing death and dismemberment
Dismemberment?? That really would be carnage. :shock:
It were a joke.
Vaccination saves lives. Lockdowns stop transmission.We need both to end this pandemic.

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Sat Aug 07, 2021 3:41 pm

Israeli data on waning immunity has been published:

Elapsed time since BNT162b2 vaccine and risk of SARS-CoV-2 infection in a large cohort

Abstract

Importance
Israel was among the first countries to launch a large-scale COVID-19 vaccination campaign, and quickly vaccinated its population, achieving early control over the spread of the virus. However, the number of COVID-19 cases is now rapidly increasing, which may indicate that vaccine protection decreases over time.

Objective
To determine whether time elapsed since the second BNT162b2 messenger RNA (mRNA) vaccine (Pfizer-BioNTech) injection is significantly associated with the risk of post-vaccination COVID-19 infection.

Design
This is a retrospective cohort study performed in a large state-mandated health care organization in Israel.

Participants
All fully vaccinated adults who have received a RT-PCR test between May 15, 2021 and July 26, 2021, at least two weeks after their second vaccine injection were included. Patients with a history of past COVID-19 infection were excluded.

Main Outcome and Measure
Positive result for the RT-PCR test.

Results
The cohort included 33,993 fully vaccinated adults, 49% women, with a mean age of 47 years (SD, 17 years), who received an RT-PCR test for SARS-CoV-2 during the study period. The median time between the second dose of the vaccine and the RT-PCR test was 146 days, interquartile range [121-167] days. 608 (1.8%) patients had positive test results. There was a significantly higher rate of positive results among patients who received their second vaccine dose at least 146 days before the RT-PCR test compared to patients who have received their vaccine less than 146 days before: odds ratio for infection was 3.00 for patients aged over 60 (95% CI 1.86-5.11); 2.29 for patients aged between 40 and 59 (95% CI 1.67-3.17); and 1.74 for patients aged between 18 and 39 (95% CI 1.27-2.37); P<0.001 in each age group.

Conclusions and Relevance
In this large population study of patients tested for SARS-CoV-2 by RT-PCR following two doses of mRNA BNT162b2 vaccine, we observe a significant increase of the risk of infection in individuals who received their last vaccine dose since at least 146 days ago, particularly among patients older than 60.
https://www.medrxiv.org/content/10.1101 ... 21261496v1

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Sun Aug 08, 2021 9:04 am

Thread on Iceland, where 93% of over 16s are vaccinated and its experiencing a dramatic delta wave.
https://twitter.com/eliaseythorsson/sta ... 23878?s=21

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Re: Developing the Covid-19 vaccine

Post by jdc » Sun Aug 08, 2021 3:45 pm

Woodchopper wrote:
Sun Aug 08, 2021 9:04 am
Thread on Iceland, where 93% of over 16s are vaccinated and its experiencing a dramatic delta wave.
https://twitter.com/eliaseythorsson/sta ... 23878?s=21
At this point, I think it is unreasonable to assume that increased vaccine coverage will result in herd immunity
The herd immunity threshold for delta is about 80-90% and the VE for current vaccines (any vaccine) against infection with delta (any infection) is probably no more than 50% so I think he's on safe ground here.

Might be lower than 50% if waning immunity is becoming an issue. I think Herainestold had a figure of 39% for Israel.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Aug 08, 2021 7:31 pm

jdc wrote:
Sun Aug 08, 2021 3:45 pm
Woodchopper wrote:
Sun Aug 08, 2021 9:04 am
Thread on Iceland, where 93% of over 16s are vaccinated and its experiencing a dramatic delta wave.
https://twitter.com/eliaseythorsson/sta ... 23878?s=21
At this point, I think it is unreasonable to assume that increased vaccine coverage will result in herd immunity
The herd immunity threshold for delta is about 80-90% and the VE for current vaccines (any vaccine) against infection with delta (any infection) is probably no more than 50% so I think he's on safe ground here.

Might be lower than 50% if waning immunity is becoming an issue. I think Herainestold had a figure of 39% for Israel.
We would be better off if we assumed vaccines have a negligible effect on transmission and a large effect on severe outcomes and planned our public health interventions accordingly.
Vaccination saves lives. Lockdowns stop transmission.We need both to end this pandemic.

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Mon Aug 09, 2021 3:25 am

Herainestold wrote:
Sun Aug 08, 2021 7:31 pm
jdc wrote:
Sun Aug 08, 2021 3:45 pm
Woodchopper wrote:
Sun Aug 08, 2021 9:04 am
Thread on Iceland, where 93% of over 16s are vaccinated and its experiencing a dramatic delta wave.
https://twitter.com/eliaseythorsson/sta ... 23878?s=21
At this point, I think it is unreasonable to assume that increased vaccine coverage will result in herd immunity
The herd immunity threshold for delta is about 80-90% and the VE for current vaccines (any vaccine) against infection with delta (any infection) is probably no more than 50% so I think he's on safe ground here.

Might be lower than 50% if waning immunity is becoming an issue. I think Herainestold had a figure of 39% for Israel.
We would be better off if we assumed vaccines have a negligible effect on transmission and a large effect on severe outcomes and planned our public health interventions accordingly.
Vaccination does appear to have a significant effect on transmission:

https://www.medrxiv.org/content/10.1101 ... 21255913v1

https://www.gov.uk/government/news/one- ... up-to-half

https://www.eurosurveillance.org/conten ... 31.2100640

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Re: Developing the Covid-19 vaccine

Post by Chris Preston » Mon Aug 09, 2021 4:18 am

jdc wrote:
Sun Aug 08, 2021 3:45 pm
I think Herainestold had a figure of 39% for Israel.
That was for people protected by one dose of Pfizer vaccine. It was 64% protection against infection for 2 doses.
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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Mon Aug 09, 2021 4:32 am

Woodchopper wrote:
Mon Aug 09, 2021 3:25 am
Herainestold wrote:
Sun Aug 08, 2021 7:31 pm
jdc wrote:
Sun Aug 08, 2021 3:45 pm


The herd immunity threshold for delta is about 80-90% and the VE for current vaccines (any vaccine) against infection with delta (any infection) is probably no more than 50% so I think he's on safe ground here.

Might be lower than 50% if waning immunity is becoming an issue. I think Herainestold had a figure of 39% for Israel.
We would be better off if we assumed vaccines have a negligible effect on transmission and a large effect on severe outcomes and planned our public health interventions accordingly.
Vaccination does appear to have a significant effect on transmission:

https://www.medrxiv.org/content/10.1101 ... 21255913v1

https://www.gov.uk/government/news/one- ... up-to-half

https://www.eurosurveillance.org/conten ... 31.2100640
See also here: https://spiral.imperial.ac.uk/handle/10044/1/90800

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