Developing the Covid-19 vaccine

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Millennie Al
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Re: Developing the Covid-19 vaccine

Post by Millennie Al » Tue Nov 17, 2020 3:34 am

Boustrophedon wrote:
Tue Nov 17, 2020 12:44 am
Logically it should not be prioritised for those at greatest risk, but at those whose essential job brings then into contact with the most people? Those are the people who are going to make the greatest difference to the R value and bring the epidemic under control?
That depends on what kind of people you have organising it. If they are highly competent and pay very careful attention to the science, then they should prioritise those most likely to spread the disease, while if they are generally incompetent and cannot be trusted to identify the groups correctly, they should prioritise those most likely to be severely affected by the disease. The first situation applies to places like Australia and New Zealand, who have much less need for vaccination due to highly competent handling of the pandemic. The second situation applies to places like the UK where the authorities consistently keep doing the wrong thing at the wrong time.
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Re: Developing the Covid-19 vaccine

Post by Millennie Al » Tue Nov 17, 2020 3:37 am

Sciolus wrote:
Tue Nov 17, 2020 12:56 am
I will say that there is also a strong social equity argument for prioritising 11-25s. These people, as a generation, have made a huge sacrifice at a critical stage in their lives, for no benefit to themselves, and we owe it to them to make it possible for them to get back to normal as soon as possible, and if jabbing them makes that possible, we should do it.
Based on past performance, what I expect to happen in the UK is that any rollout of vaccination will be accompanied by a premature relaxation of other measures, leading to lots more infections amongst the unvaccinated. Since the younger people are, on average, much less harmed by being infected, that means they should be last to be vaccinated.
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Re: Developing the Covid-19 vaccine

Post by AMS » Tue Nov 17, 2020 7:17 am

Millennie Al wrote:
Tue Nov 17, 2020 3:29 am
lpm wrote:
Mon Nov 16, 2020 12:57 pm
The nice thing about having a huge surge of cases in the US is that it speeds up the trial. Whereas ordinary countries would need an age to get 95 cases, in the US you can reach that in five minutes by running the trial in a small town in South Dakota.
Unfortunately, it may not make much difference. If you look at the infection rate from the three vaccines that have released figures you get:
  • Pfizer/BioNTech, 43538 participants, 86 placebo infections = 0.4%
  • Moderna, 30000 participants, 89 placebo infections = 0.6%
  • Sputnik V, 16000 participants, 19 placebo infections = 0.24%
assuming 50% of participants were on placebo. This is hugely lower than the rate in the general population, suggesting that the people in the study are different in some way. I'd guess that the way they differ is that they consider the disease to be very serious and worth a lot of effort. And cases in a rise a lot in a particular area because that area contains a large proportion of people who don't take the disease seriously. So, while the latter group might have a greater chance of infecting the former, I expect that the former group will not show anything like a proportionate rise in infections as they'll just be more careful in a hotspot to keep away from all the careless people.
It may not be 50:50 active v placebo. I don't know in these cases what the ratio is, but it wouldn't be strange for the active arm to be bigger, as you also want your trial to identify rare but serious side effects of the vaccine. But I doubt it would be more than, say, 60:40 or 66:33, so your point still stands.

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Re: Developing the Covid-19 vaccine

Post by lpm » Tue Nov 17, 2020 9:54 am

The other way to look at the rollout would be to imagine if the first vaccines had arrived at the start of in March 2020.

We'd have done doctors and nurses first. Even if there were doubts about whether vaccines stop transmission, you'd still do nursing home staff very early in the hope that there was at least partial reduction in transmission. You'd then do residents of homes because that was the largest segment of the death toll.

But wouldn't you have then moved away from the elderly and onto people who contact loads of people? Bus drivers spring to mind. There are some people who are both potential superspreaders and potentially at high risk.

If you were 80 and vaccinated, but the pandemic was raging across the country, would you have left your home or continued to shield given that the jab is only 90% effective? 10% is too high to risk. An 80 year old typically has grandchildren aged 18-25. In September 2020 would you have taken a day trip to Manchester University to visit your grandson at his new halls of residence if you had a 10% risk? Assuming we discover the vaccines give at least a partial reduction in transmission - which must surely be the case - there's a strong argument for vaccinating every student in August rather than their grandparents.
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Re: Developing the Covid-19 vaccine

Post by AMS » Tue Nov 17, 2020 10:46 am

If you're approaching it in terms of minimising the risk of super spreading events, I'd say anyone involved in the education system (staff and students), and food processing plant staff are both good places to start. Anyone who commutes by public transport is another option.

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Re: Developing the Covid-19 vaccine

Post by EACLucifer » Tue Nov 17, 2020 12:24 pm

AMS wrote:
Tue Nov 17, 2020 10:46 am
If you're approaching it in terms of minimising the risk of super spreading events, I'd say anyone involved in the education system (staff and students), and food processing plant staff are both good places to start. Anyone who commutes by public transport is another option.
But please, please remember that all the early evidence we've seen suggests that the first tranche of vaccines don't stop viral shedding after exposure. So vaccinate bus driver because they are at risk of infection, but vaccinating bus drivers because they are likely to spread it is much murkier.

It's also worth remembering that the efficacy of a vaccine isn't a yes no question. If a vaccine has reduced infections detected by the trial by 95%, it doesn't necessarily mean the other 5% get completely normal Covid. In some of the animal tests of the Oxford vaccine, they gave macaques an unrealistically massive viral challenge to the respiratory system after a single dose of vaccine*. They did get infected, but did develop pneumonia, while control group macaques did develop pneumonia.

*It is now, like all the other advanced candidates, presumed to require two doses.

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Re: Developing the Covid-19 vaccine

Post by shpalman » Tue Nov 17, 2020 12:40 pm

EACLucifer wrote:
Tue Nov 17, 2020 12:24 pm
AMS wrote:
Tue Nov 17, 2020 10:46 am
If you're approaching it in terms of minimising the risk of super spreading events, I'd say anyone involved in the education system (staff and students), and food processing plant staff are both good places to start. Anyone who commutes by public transport is another option.
But please, please remember that all the early evidence we've seen suggests that the first tranche of vaccines don't stop viral shedding after exposure. So vaccinate bus driver because they are at risk of infection, but vaccinating bus drivers because they are likely to spread it is much murkier.

It's also worth remembering that the efficacy of a vaccine isn't a yes no question. If a vaccine has reduced infections detected by the trial by 95%, it doesn't necessarily mean the other 5% get completely normal Covid. In some of the animal tests of the Oxford vaccine, they gave macaques an unrealistically massive viral challenge to the respiratory system after a single dose of vaccine*. They did get infected, but did develop pneumonia, while control group macaques did develop pneumonia.

*It is now, like all the other advanced candidates, presumed to require two doses.
Certainly true that in the recent results, there were 11 cases of severe covid in the control group and none in the vaccine group. It would remain to be seen how this would scale up to an entire population, but it's reasonable to assume that any covid infections in vaccinated subjects would be less severe than otherwise.

Regarding virus shedding, though, does anyone have any links for that? I still think that PCR would likely be picking up fragments of unviable viral RNA.
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Re: Developing the Covid-19 vaccine

Post by lpm » Tue Nov 17, 2020 1:00 pm

How could there be significant viral shedding?

The RNA has to reproduce inside human cells before being breathed out to infect others. A vaccine gets the body to kill off virus quickly, before it can damage enough cells to make the human ill. Surely by definition a successful vaccine is one that prevents vast numbers of cells from being turned into RNA generators? If someone is spewing out RNA at the same pace as an unvaccinated person then a similar number of cells must have been commandeered by the virus?
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Re: Developing the Covid-19 vaccine

Post by EACLucifer » Tue Nov 17, 2020 4:00 pm

lpm wrote:
Tue Nov 17, 2020 1:00 pm
How could there be significant viral shedding?

The RNA has to reproduce inside human cells before being breathed out to infect others. A vaccine gets the body to kill off virus quickly, before it can damage enough cells to make the human ill. Surely by definition a successful vaccine is one that prevents vast numbers of cells from being turned into RNA generators? If someone is spewing out RNA at the same pace as an unvaccinated person then a similar number of cells must have been commandeered by the virus?
Because, as I understand it, the vaccines are not offering true sterilising immunity. They don't stop people getting a slight infection, just help them fight it off fast. Given much of the viral shedding is from the upper respiratory tract, and that that is the first part of the body to get exposed when infected via aerosol, one can get an infection in the upper respiratory tract, shed some virus, then fight it off before getting symptoms. It's a disease that is quite capable of being infectious before symptoms are developed, after all, and can be transmitted by people who never go on to develop symptoms.

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Re: Developing the Covid-19 vaccine

Post by lpm » Tue Nov 17, 2020 4:34 pm

But wouldn't the trials have detected this?

Are the trials regularly testing their 30,000 volunteers? You want to get 95 cases, not 95 symptomatic cases. If there were 90 vaccinated people with unnoticeable infection of the upper respiratory tract, all 90 shedding RNA, then the routine testing should have detected RNA from all 90 even if only 5 of them ever noticed any symptoms.

Or is it that your cells can be churning out enough viruses to infect others but not enough to be detected by tests? That doesn't sound right. Maybe higher false negatives?

Or that the trials haven't been testing their volunteers regularly? Which would be wasteful when running a costly trial.
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Re: Developing the Covid-19 vaccine

Post by lpm » Tue Nov 17, 2020 4:56 pm

Reading about it, there doesn't seem to be any sign that Moderna routinely tests their 30,000 volunteers. They just keep diaries, are asked to notify the moment they got a temperature, have a few contacts over the phone.

Which sounds mad to me. Why the f.ck wouldn't you just test them once a week? 4,300 tests per day is a trivial number and expense. Half the battle with this virus is working out how asymptomatic cases behave. It means we have no evidence of asymptomatic cases in either the placebo group or the actual group.
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Re: Developing the Covid-19 vaccine

Post by shpalman » Tue Nov 17, 2020 5:11 pm

Well, either because it was deemed that they couldn't be bothered logistically, or that because they would have expected more equal numbers of asymptomatic cases between the vaccine and control group which would have made the vaccine look less effective. Understandable that they wanted a high number in the headlines.

So yes, it means you have to vaccinate the at-risk population first, according to some product of how likely they are to get infected times how severe their infection is likely to be, rather than the possible young healthy super-spreaders. I would still want health-care workers to be somewhere near the front of the queue, though, even the younger ones, since they are exposed to a high viral load.
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Re: Developing the Covid-19 vaccine

Post by shpalman » Tue Nov 17, 2020 10:32 pm

Pfizer’s vaccine must be shipped and stored at -70 degrees Celsius (-94°F), significantly below the standard for vaccines of two-to-eight degrees Celsius (36-46°F).
https://www.theguardian.com/world/2020/ ... -us-states

Earlier on Monday comma rival Moderna Inc said its experimental vaccine had 94 point 5 percent efficacy in preventing Covid dash 19 based on interim data from a late-stage trial comma boosting hopes that vaccines against the disease may be ready for use soon full stop
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Re: Developing the Covid-19 vaccine

Post by EACLucifer » Wed Nov 18, 2020 12:02 am

I think there's a bit more to it than that. Both vaccines are trying to create the same immune response against the same spike protein. They both result in the production of the same antibodies, as far as I can tell. The cool news from the Pfizer and Moderna trials is that having those antibodies results in a >90% reduction in symptomatic infections, so that does bode well for the Oxford/AstraZenica vaccine, although the real proof of the pudding will be in the release of their own phase III results. IIRC, the Oxford/AstraZeneca vaccine should be one of the cheapest to produce, and one of the easiest to produce in quantity early on, so it would be good if it does prove effective.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Wed Nov 18, 2020 12:43 am

Yes it appears that vaccines targeting the spike protein will be effective against the SARS-COV 2 virus.
China's Global Times and China Central Television (CCTV) posted tweets on Monday citing one the country's top COVID-19 experts, Zhong Nanshan, who said that the Chinese vaccine in question was about 90 percent effective at preventing infection with the novel coronavirus.

But the efficacy rate will not be publicly released "until the results of the first phase of trials are available," the tweets said.

The news from China comes just days after Pfizer announced that the vaccine it is developing with German biotechnology firm BioNTech SE "is more than 90 percent effective" at preventing COVID-19, according to an analysis of early data from a large Phase III trial.

And just two days later, the Russian Gamaleya National Center of Epidemiology and Microbiology in Moscow announced that its Sputnik V coronavirus vaccine had a 92 percent efficacy rate.
https://www.msn.com/en-us/health/medica ... r-BB1b3jDl

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Re: Developing the Covid-19 vaccine

Post by shpalman » Wed Nov 18, 2020 6:08 pm

The updated Pfizer results are 162 cases in the control group and only 8 were in the vaccinated group (out of 41,000 subjects), and it works perfectly well in over-65s.

https://www.bbc.co.uk/news/health-54986208
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Re: Developing the Covid-19 vaccine

Post by Woodchopper » Wed Nov 18, 2020 9:57 pm

Immunological memory to SARS-CoV-2 assessed for greater than six months after infection
https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Fri Nov 20, 2020 12:41 pm

This is cool. Sinopharm vax been administered to over a million people and no adverse effects.
Nearly a million people have taken an experimental coronavirus vaccine developed by Chinese company Sinopharm, the firm said, although it has not yet provided any clear clinical evidence of efficacy.

China has been giving experimental Covid-19 vaccines to people including state employees, international students and essential workers heading abroad since July.

"We have not received a single report of severe adverse reaction, and only a few had some mild symptoms," Liu Jingzhen said in an interview re-published by the state-owned firm on Wednesday.
https://www.ibtimes.com/almost-million- ... rm-3085950

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Re: Developing the Covid-19 vaccine

Post by AMS » Fri Nov 20, 2020 4:36 pm

Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.

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Re: Developing the Covid-19 vaccine

Post by EACLucifer » Fri Nov 20, 2020 5:14 pm

AMS wrote:
Fri Nov 20, 2020 4:36 pm
Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.
After covering up the initial outbreak, China specifically sought to censor scientific works on the subject, while engaging in a torrent of b.llsh.t to promote the idea the coronavirus did not come from China, none of which had any evidentiary basis, while all the actual evidence pointed to China.

A misinformation that our resident apologist for Chinese fascism sought to repeat on this forum.

It's not that there aren't talented scientists in China capable of developing a vaccine, there surely are - especially with the head start they got from having access to the virus even as the Chinese state sought to deny human-human transmission and lean on the WHO and other states to block travel bans that would have limited the spread of this disease - it's that we cannot trust a damn word they say or stat they publish because they prevent all oversight.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Fri Nov 20, 2020 7:51 pm

AMS wrote:
Fri Nov 20, 2020 4:36 pm
Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.
I agree that they should be more forthcoming with their hard data. I expect that will change in coming days.

Would you rather trust profit seeking Big Pharma statistics?

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Re: Developing the Covid-19 vaccine

Post by bolo » Fri Nov 20, 2020 8:21 pm

Herainestold wrote:
Fri Nov 20, 2020 7:51 pm
AMS wrote:
Fri Nov 20, 2020 4:36 pm
Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.
Would you rather trust profit seeking Big Pharma statistics?
Yes, of course. (Dammit why do I keep reading this sh.t.)

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Re: Developing the Covid-19 vaccine

Post by EACLucifer » Fri Nov 20, 2020 8:24 pm

Herainestold wrote:
Fri Nov 20, 2020 7:51 pm
AMS wrote:
Fri Nov 20, 2020 4:36 pm
Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.
I agree that they should be more forthcoming with their hard data. I expect that will change in coming days.

Would you rather trust profit seeking Big Pharma statistics?
Yes, because there is a robust system of oversight, including a free press that can highlight violations. It's very different from the fascist sh.t you promote where the government censors anything it dislikes - even stuff as simple as the observation that its leader looks like a character from a certain children's book - and uses force to enable that censorship.

And you've outstanding questions about the regime you promote's attempts to destroy its racial, religious and cultural minorities, you pathetic coward.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Fri Nov 20, 2020 8:28 pm

bolo wrote:
Fri Nov 20, 2020 8:21 pm
Herainestold wrote:
Fri Nov 20, 2020 7:51 pm
AMS wrote:
Fri Nov 20, 2020 4:36 pm
Not saying it's wrong, but there's still a big question of trust when it comes to a Chinese state-owned firm.
Would you rather trust profit seeking Big Pharma statistics?
Yes, of course. (Dammit why do I keep reading this sh.t.)
Well okay, at least you admit it.

It will be interesting to see which vaccines ultimately prevail, but we are lucky, it looks like we will be able to make that choice.

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