Developing the Covid-19 vaccine

Covid-19 discussion, bring your own statistics
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Herainestold
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jun 06, 2021 5:54 pm

bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Herainestold wrote:
Sun Jun 06, 2021 1:43 am
So if this is true, why are we seeing new virus surges every 2-3 months? We don't see that with influenza. Despite much greater vaccine coverage than we see with flu, we see new cases and major waves, in places like Chile and Seychelles with greater vaccine coverage than we have in UK.
It seems like a treadmill we will never get off.
Seychelles used a lot of Sinopharm and some AZ. Chile used a lot of Sinovac.

Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Yes in Canada. Province of Manitoba in lockdown, hospitals full, patients being flown to Ontario.
60% dosed with mostly Pfizer.
https://www.nytimes.com/2021/05/26/worl ... -hard.html
Double dose. Double mask. Double distance

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jun 06, 2021 5:59 pm

jdc wrote:
Sun Jun 06, 2021 3:36 pm
Re development time for tweaked vaccines:

they announced in Jan that they were working on a 'new' Moderna vaccine https://www.cnbc.com/2021/01/28/why-mrn ... iants.html

the first doses were administered to trial participants end Mar https://news.emory.edu/stories/2021/04/ ... index.html

and the trial is scheduled to complete end Aug https://clinicaltrials.gov/ct2/show/NCT04785144 with initial data mentioned here https://investors.modernatx.com/news-re ... t-sars-cov
a single 50 µg dose of mRNA-1273 or mRNA-1273.351 given as a booster to previously vaccinated individuals increased neutralizing antibody titer responses against SARS-CoV-2 and two variants of concern, B.1.351 (first identified in South Africa) and P.1 (first identified in Brazil). A booster dose of mRNA-1273.351, the Company’s strain-matched booster, achieved higher neutralizing antibody titers against the B.1.351 variant of concern than a booster dose of mRNA-1273. A manuscript describing these preliminary results has been submitted as a preprint to medRxiv and will be submitted for peer-reviewed publication upon completion of the multivalent mRNA-1273.211 booster arm.
And that medRxiv paper is here https://www.medrxiv.org/content/10.1101 ... .full-text
So thats like 9 months to test a booster for last year's variant. It still needs to be approved and manufactured. How long before we get a booster for Delta and by the time we get it, we will be looking at another strain.

It is very fast, we are so lucky to have this technology, but nature works faster.
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bob sterman
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Re: Developing the Covid-19 vaccine

Post by bob sterman » Sun Jun 06, 2021 7:00 pm

Herainestold wrote:
Sun Jun 06, 2021 5:54 pm
bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Yes in Canada. Province of Manitoba in lockdown, hospitals full, patients being flown to Ontario.
60% dosed with mostly Pfizer.
https://www.nytimes.com/2021/05/26/worl ... -hard.html
Yes but a few things worth noting about Manitoba...

- Only 12.5% of adults have had 2 doses (fully-vaccinated*).
- At the moment it's mostly B.1.1.7 - which vaccines seem to be working well against in UK.
- About 45% of 18-40 year olds haven't even had 1 dose - and a significant proportion of the serious cases are in this age group...

https://www.theglobeandmail.com/canada/ ... e-younger/

*To quote your own views on the importance of 2 doses (in various contexts) in other threads...
Herainestold wrote:
Tue May 04, 2021 3:04 am
Most people at this point have only had one dose. That means there is a huge population at risk.
Herainestold wrote:
Tue May 18, 2021 9:20 pm
You are not considered fully vaccinated until two weeks after your second dose, so act accordingly.
Herainestold wrote:
Sun May 30, 2021 3:45 am
One dose is basically unvaccinated against modi variant, so have to hold on a while longer yet.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jun 06, 2021 7:44 pm

bob sterman wrote:
Sun Jun 06, 2021 7:00 pm
Herainestold wrote:
Sun Jun 06, 2021 5:54 pm
bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Yes in Canada. Province of Manitoba in lockdown, hospitals full, patients being flown to Ontario.
60% dosed with mostly Pfizer.
https://www.nytimes.com/2021/05/26/worl ... -hard.html
Yes but a few things worth noting about Manitoba...

- Only 12.5% of adults have had 2 doses (fully-vaccinated*).
- At the moment it's mostly B.1.1.7 - which vaccines seem to be working well against in UK.
- About 45% of 18-40 year olds haven't even had 1 dose - and a significant proportion of the serious cases are in this age group...

https://www.theglobeandmail.com/canada/ ... e-younger/

*To quote your own views on the importance of 2 doses (in various contexts) in other threads...
Herainestold wrote:
Tue May 04, 2021 3:04 am
Most people at this point have only had one dose. That means there is a huge population at risk.
Herainestold wrote:
Tue May 18, 2021 9:20 pm
You are not considered fully vaccinated until two weeks after your second dose, so act accordingly.
Herainestold wrote:
Sun May 30, 2021 3:45 am
One dose is basically unvaccinated against modi variant, so have to hold on a while longer yet.
Okay I didn't realize their second dose component was so low. If they are doing that poorly against B117 Kent alpha, imagine how much worse off they would be against Delta. it just shows you can't be complacent about these variants just because you are (partially) vaccinated. You still need the other NPI s, masking, distancing, test and trace, lockdown. Lockdown first to combat transmission, vaccin ation to prevent severe outcomes and ease the strain on the NHS. To get fully vaccinated protection with mRNA you are looking at least 5 weeks.So include that in your mitigation response plans.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Mon Jun 07, 2021 4:03 am

Only 12.5% fully vaccinated! What were they thinking? The Delta variant is going to be a major problem there.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Wed Jun 09, 2021 6:19 pm

Study on the JJJ vax, shows good T cell response, should be somewhat effective against variants.
The research was fairly straightforward. Scientists took blood from volunteers who had received the Johnson & Johnson COVID-19 vaccine and looked at the levels of neutralizing antibodies, the kind that prevent a virus from entering cells.

"What we showed is that the neutralizing antibodies are reduced about fivefold to the B.1.351 variant," says Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. Under the new nomenclature proposed by the World Health Organization, B.1.351 is now called Beta. It first appeared in South Africa.

And it's that last immune response, the T-cell response, that Barouch says is critically important. Because T cells, particularly CD8 T cells, play a crucial role in preventing illness.

"Those are the killer T cells," Barouch says. "Those are the types of T cells that can basically seek out and destroy cells that are infected and help clear infection directly."

They don't prevent infection; they help keep an infection from spreading.

"The T-cell responses actually are not reduced — at all — to the variants," Barouch says. It's not just the Beta variant, but also the Alpha and Gamma variants.
https://www.npr.org/sections/health-sho ... t-variants

If I recall correctly, JJJ was about 50% effective against Beta in SA, which isn't great but better than nothing.

Doesnt say how it would do against Delta.

I am wondering about multiple vax boosters, one AZ, one mRNA, one JJJ, one sputnik, etc. Would that give broader coverage against these new more virulent variants? Or do we need specific shots tailored to each variant?
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Re: Developing the Covid-19 vaccine

Post by jdc » Wed Jun 09, 2021 8:11 pm

https://www.statnews.com/2021/02/02/com ... n-johnson/
The J&J one-dose vaccine was shown to be 66% protective against moderate to severe Covid infections overall from 28 days after injection, though there was variability based on geographic locations. The vaccine was 72% protective in the United States, 66% protective in South America, and 57% protective in South Africa.

Not as good as Pfizer, which was 95% effective against symptomatic infection in phase 3 trials and, apparently, was 75% effective against B.1.351 infection in Qatar, giving 'near total' protection against severe disease: https://www.nature.com/articles/d41586-021-01222-5
People in Qatar who received two doses of the Pfizer–BioNTech vaccine were 75% less likely to develop a case of COVID-19 caused by B.1.351 than were unvaccinated people, and had near-total protection from severe disease caused by that strain.

The mRNA vaccines also provided good cellular immunity - two doses led to higher levels of T cells than in convalescent patients.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Wed Jun 09, 2021 10:25 pm

jdc wrote:
Wed Jun 09, 2021 8:11 pm

Not as good as Pfizer, which was 95% effective against symptomatic infection in phase 3 trials and, apparently, was 75% effective against B.1.351 infection in Qatar, giving 'near total' protection against severe disease: https://www.nature.com/articles/d41586-021-01222-5
People in Qatar who received two doses of the Pfizer–BioNTech vaccine were 75% less likely to develop a case of COVID-19 caused by B.1.351 than were unvaccinated people, and had near-total protection from severe disease caused by that strain.

The mRNA vaccines also provided good cellular immunity - two doses led to higher levels of T cells than in convalescent patients.
jdc, do the mRNA vaxes perform better than the alternatives in every category and against every variant (so far) ?

I get that impression, but the data is not all in one place, and there doesn't seem to be much info on the Chinese and Sputnik vaccines.

Still would be interested to see real world data on Novavax, if they ever get it going. Maybe it would do better against Delta? or not.
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Re: Developing the Covid-19 vaccine

Post by jdc » Thu Jun 10, 2021 1:04 am

From what I've seen, the mRNA vaccines have been consistently better so far in terms of efficacy after a full course of vaccination. Downsides are the need to organise two doses, the need to keep it at low temperatures, and maybe the cost.

I've got novavax here https://ir.novavax.com/news-releases/ne ... inal-and-0 96.4% against the original strain, 86.3% against alpha, and 48.6% against beta (up to 55.4% for HIV-negative).

Pfizer was 94% against the original strain in their phase 3 I think, I've got 93% effective in preventing symptomatic cases of the virus caused by the Alpha variant here https://www.bhf.org.uk/informationsuppo ... t#UKpfizer (same page refers to 100% in a small study re beta, but the larger Qatar study gave 75% for beta).

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Jun 10, 2021 3:25 am

Thanks, jdc.
Would be interesting to see Novavax results against Delta. Too bad they didn't get their stuff together with respect to manufacturing, we would have another option now.
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Re: Developing the Covid-19 vaccine

Post by monkey » Thu Jun 10, 2021 3:49 am

bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Herainestold wrote:
Sun Jun 06, 2021 1:43 am
So if this is true, why are we seeing new virus surges every 2-3 months? We don't see that with influenza. Despite much greater vaccine coverage than we see with flu, we see new cases and major waves, in places like Chile and Seychelles with greater vaccine coverage than we have in UK.
It seems like a treadmill we will never get off.
Seychelles used a lot of Sinopharm and some AZ. Chile used a lot of Sinovac.

Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Maybe Bahrain. Don't know what they have predominantly vaccinated with, but someone I know out there had the Sinopharm, so they're giving it out. They've just been having a wave and gone back into lockdown.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Jun 10, 2021 4:21 am

monkey wrote:
Thu Jun 10, 2021 3:49 am
bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Herainestold wrote:
Sun Jun 06, 2021 1:43 am
So if this is true, why are we seeing new virus surges every 2-3 months? We don't see that with influenza. Despite much greater vaccine coverage than we see with flu, we see new cases and major waves, in places like Chile and Seychelles with greater vaccine coverage than we have in UK.
It seems like a treadmill we will never get off.
Seychelles used a lot of Sinopharm and some AZ. Chile used a lot of Sinovac.

Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Maybe Bahrain. Don't know what they have predominantly vaccinated with, but someone I know out there had the Sinopharm, so they're giving it out. They've just been having a wave and gone back into lockdown.
Waleed Khalifa al Manea, Bahrain’s undersecretary of health, said the vaccine manufactured by state-owned Chinese drugmaker Sinopharm, which has accounted for more than 60% of Bahrain’s inoculations so far, was providing a high degree of protection. More than 90% of people hospitalized in the current Covid-19 wave, the worst the country has faced, hadn’t been vaccinated, he said.

Still, Dr. al Manea added, Bahrain residents who are over 50, are obese or have chronic illnesses now are being urged to get another shot six months after their full Sinopharm vaccination—with the Pfizer-BioNTech vaccine. The government started offering the boosters at the end of May, he said.

Bahrain, which has made the Pfizer-BioNTech vaccine available to unvaccinated residents for months, will continue to offer the choice of Sinopharm to those who prefer the Chinese vaccine, Dr. al Manea said. The government’s BeAware app allows users to book a Sinopharm booster shot, but says that Pfizer-BioNTech is recommended for more-vulnerable population groups.
https://www.wsj.com/articles/bahrain-fa ... 1622648737
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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Fri Jun 11, 2021 6:49 am

Double dose of Pfizer kicks around the new variants (or at least psuedo creations):
BNT162b2-elicited neutralization of B.1.617 and other SARS-CoV-2 variants

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve around the world, generating new variants that are of concern based on their potential for altered transmissibility, pathogenicity, and coverage by vaccines and therapeutics1–5. Here we report that 20 human sera, drawn 2 or 4 weeks after two doses of BNT162b2, neutralize engineered SARS-CoV-2 with a USA-WA1/2020 genetic background (a virus strain isolated in January 2020) and spike glycoproteins from the newly emerged B.1.617.1, B.1.617.2, B.1.618 (all first identified in India) or B.1.525 (first identified in Nigeria) lineages. Geometric mean plaque reduction neutralization titers against the variant viruses, particularly the B.1.617.1 variant, appear lower than the titer against USA-WA1/2020 virus, but all sera tested neutralize the variant viruses at titers of at least 40. The susceptibility of these newly emerged variants to BNT162b2 vaccine-elicited neutralization supports mass immunization as a central strategy to end the coronavirus disease 2019 (COVID-19) pandemic across geographies.
https://www.nature.com/articles/s41586-021-03693-y
[without the paywall] https://pdfhost.io/v/dc0wtXvKJ_BNT162b2 ... riants.pdf

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Fri Jun 11, 2021 6:52 am

Community-level evidence for SARS-CoV-2 vaccine protection of unvaccinated individuals

Mass vaccination has the potential to curb the current COVID-19 pandemic by protecting individuals who have been vaccinated against the disease and possibly lowering the likelihood of transmission to individuals who have not been vaccinated. The high effectiveness of the widely administered BNT162b vaccine from Pfizer–BioNTech in preventing not only the disease but also infection with SARS-CoV-2 suggests a potential for a population-level effect, which is critical for disease eradication. However, this putative effect is difficult to observe, especially in light of highly fluctuating spatiotemporal epidemic dynamics. Here, by analyzing vaccination records and test results collected during the rapid vaccine rollout in a large population from 177 geographically defined communities, we find that the rates of vaccination in each community are associated with a substantial later decline in infections among a cohort of individuals aged under 16 years, who are unvaccinated. On average, for each 20 percentage points of individuals who are vaccinated in a given population, the positive test fraction for the unvaccinated population decreased approximately twofold. These results provide observational evidence that vaccination not only protects individuals who have been vaccinated but also provides cross-protection to unvaccinated individuals in the community.
https://www.nature.com/articles/s41591-021-01407-5

Though I assume they didn't deal with new more infectious variants.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sat Jun 12, 2021 3:16 am

Mixing vaccines , specifically AZ/Pfizer might give a superior result.
“Two different vaccines may be more potent than either vaccine alone,” says Dan Barouch of Beth Israel Deaconess Medical Center, who helped develop the one-dose COVID-19 vaccine made by Johnson & Johnson. It and the two-dose AstraZeneca vaccine use a nonreplicating adenovirus as a “vector” to introduce DNA coding for the spike protein of SARS-CoV-2 into the recipient's cells. Vaccines from Pfizer-BioNTech and Moderna instead use messenger RNA (mRNA) coding for spike, which cells take up and use to make the protein.

Mixing the two types of vaccine may give the immune system multiple ways to recognize a pathogen. “The mRNA vaccines are really, really good at inducing antibody responses, and the vector-based vaccines are better at triggering T cell responses,” Sander says. Matthew Snape, a vaccine expert at the University of Oxford, agrees the combination vaccine results so far are promising but cautions they don't resolve whether any improvement in T cell response results from longer dose intervals rather than the mixing.
please note.
The recent studies are imperfect because they are not designed to assess actual protection against COVID-19. That would require following large groups receiving different vaccine combinations to see who gets infected and sick over many months. The antibody and T cell measurements the studies rely on are thought to correspond to real-life protection, but studies are ongoing to determine exactly how reliable these correlates are.
https://science.sciencemag.org/content/372/6547/1138
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Re: Developing the Covid-19 vaccine

Post by shpalman » Sat Jun 12, 2021 5:54 am

Well, Italy has now decided that even if the first AZ dose didn't cause any problems, people under 60 will get Pfizer as a second dose.
molto tricky

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Re: Developing the Covid-19 vaccine

Post by raven » Sun Jun 13, 2021 2:20 pm

bob sterman wrote:
Sun Jun 06, 2021 7:00 pm
Herainestold wrote:
Sun Jun 06, 2021 5:54 pm
bob sterman wrote:
Sun Jun 06, 2021 7:10 am
Are there any major new waves in populations widely vaccinated with mRNA alternatives?
Yes in Canada. Province of Manitoba in lockdown, hospitals full, patients being flown to Ontario.
60% dosed with mostly Pfizer.
https://www.nytimes.com/2021/05/26/worl ... -hard.html
Yes but a few things worth noting about Manitoba...

- Only 12.5% of adults have had 2 doses (fully-vaccinated*).
- At the moment it's mostly B.1.1.7 - which vaccines seem to be working well against in UK.
- About 45% of 18-40 year olds haven't even had 1 dose - and a significant proportion of the serious cases are in this age group...
Further to this, I couldn't remember which Middle Eastern country had stormed ahead with vaccination early on - UAE or Bahrain I think - and in looking that up on ourworldindata I was quite surprised to see Bahrain has delivered enough doses for over 90 per 100 people (not sure how many twice dosed) but has just had a big outbreak. They're now talking about offering a third shot booster- maybe Pfizer for those who've had two lots of Sinopharm. (And Sinopharm is more effective than Sinovac, right?)

This article blames third waves despite high levels of vaccination in Chile & Bahrain on loosening restrictions: https://www.thenationalnews.com/uae/sci ... -1.1232565

Which is a bit depressing. Hopefully it's more that they hadn't done enough second doses and/or used less effective vaccines.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jun 13, 2021 3:14 pm

Experience is proving that the only way forward is a combination of lockdown and vaccination.
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Re: Developing the Covid-19 vaccine

Post by bob sterman » Sun Jun 13, 2021 5:35 pm

Herainestold wrote:
Sun Jun 13, 2021 3:14 pm
Experience is proving that the only way forward is a combination of lockdown and vaccination.
Or have 60% of your population fully vaccinated with the Pfizer?
israel.jpg
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Herainestold
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Sun Jun 13, 2021 6:54 pm

bob sterman wrote:
Sun Jun 13, 2021 5:35 pm
Herainestold wrote:
Sun Jun 13, 2021 3:14 pm
Experience is proving that the only way forward is a combination of lockdown and vaccination.
Or have 60% of your population fully vaccinated with the Pfizer?

israel.jpg
Yup. Fully vaccinate with mRNA before the variants get a grip. Keep a firm lock on the borders.
Israel's 60% is 80% of adults as they have a young population.

Bit too late to do that anywhere else. Maybe OZ, NZ, China.

The rest of us are screwed.
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Re: Developing the Covid-19 vaccine

Post by bolo » Sun Jun 13, 2021 10:13 pm

Parts of the US are approaching that, with the expected results. My county (pop. 1.1 million) has vaccinated 60% of residents, including more than 72% of adults. Reported cases over the past week are negative, i.e. fewer new cases than previously reported cases reclassified as not Covid after all. We peaked at 300+ per day over the winter.

Obviously not everywhere in the country is doing so well.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Mon Jun 14, 2021 3:58 am

bolo wrote:
Sun Jun 13, 2021 10:13 pm
Parts of the US are approaching that, with the expected results. My county (pop. 1.1 million) has vaccinated 60% of residents, including more than 72% of adults. Reported cases over the past week are negative, i.e. fewer new cases than previously reported cases reclassified as not Covid after all. We peaked at 300+ per day over the winter.

Obviously not everywhere in the country is doing so well.
Some places in the NE of America have as much as 85% vaccinated. Unfortunately you can't seal off those states and most have dropped mask mandates and gathering restrictions. Delta is gooing to get in and wreak havoc.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Mon Jun 14, 2021 1:23 pm

Novavax reports result from North American trial
The vaccine was 91% protective in people deemed to be at high risk of a bad outcome from a Covid-19 infection, including people over the age of 65, people with health conditions that increased their risk of severe Covid infection, and those in circumstances with frequent Covid exposure, the company reported.

Among the nearly 30,000 participants in the trial, which was conducted in the United States and Mexico, there were 77 confirmed cases of Covid — 63 in the placebo group and 14 in the vaccine arm. All of the cases in the vaccine group were mild. There were 10 moderate and four severe infections among placebo recipients. In a call with investors on Monday, the company revealed there were an additional six people who required hospitalization — one of whom died — in the placebo group. But they were not included in the efficacy analysis because the test results were not evaluated in the trial’s central laboratory.

The vaccine was tested in adults aged 18 and older. A placebo-controlled arm of the trial involving 2,248 adolescents and teens aged 12 to 17 is still underway.
Unfortunately it was not tested against the deadly Delta variant. Still..good news.

https://www.statnews.com/2021/06/14/nov ... age-trial/
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Re: Developing the Covid-19 vaccine

Post by headshot » Mon Jun 14, 2021 7:26 pm

Some good updated news from PHE about vaccine effectiveness against Delta:

https://www.gov.uk/government/news/vacc ... ta-variant
The analysis suggests:

the Pfizer-BioNTech vaccine is 96% effective against hospitalisation after 2 doses
the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after 2 doses
These are comparable with vaccine effectiveness against hospitalisation from the Alpha variant.

Further work remains underway to establish the level of protection against mortality from the Delta variant. However, as with other variants, this is expected to be high.

The analysis included 14,019 cases of the Delta variant – 166 of whom were hospitalised – between 12 April and 4 June, looking at emergency hospital admissions in England.

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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Thu Jun 17, 2021 4:11 am

The CureVac vaccine looks like a dud

CureVac’s vaccine only 47 percent effective at preventing COVID
German firm carried out study of 40,000 people in 10 countries in Europe and Latin America with at least 13 coronavirus variants.
https://www.politico.eu/article/curevac ... ing-covid/

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