Vaccine rollout in the UK

[jdc]

It's not like the EU even particularly wants the AZ vaccine. Not for the age range currently being given priority anyway.

Germany have decided not to use AZ for over-65s. BJ hinting that the EMA will approve it for all adults though. Some actual numbers on over-65s here, assuming the Guardian haven't misunderstood what they were reading: https://www.theguardian.com/world/2021/ ... d-over-65s

Germany’s disease control agency, the Robert Koch Institute, said there was insufficient data to judge how effective the vaccine was for people over 65, and as a result it could only recommend using the vaccine on people aged 18 to 64.

Boris Johnson, the UK prime minister, said: “This is a local German decision and the EMA will, as I understand it, will be approving it for general use and I think that’s a very sensible of the EMA, because that is the vaccine our own MHRA has said produces an immune response in all age groups, as a good vaccine, so I’m confident about it.”

Calculations in the German authorities’ draft recommendation show only 6% of participants in the trials were over 65, with 341 of them receiving a shot of the AstraZeneca vaccine and 319 receiving a placebo.

In the trial, one infection was recorded in the treatment group and one in the placebo group, creating a high confidence interval that the German authorities described in their report as “no longer statistically significant”. They said: “Any assessment about the efficacy of the vaccination among the highest age group (≥75 years) therefore comes with a high level of uncertainty.”

ETA: I see you've all been discussing the last part in another thread while I was at work. I've got some catching up to do. viewtopic.php?p=67619#p67619

[shpalman]

It's not like the EU even particularly wants the AZ vaccine. Not for the age range currently being given priority anyway.

Germany have decided not to use AZ for over-65s. BJ hinting that the EMA will approve it for all adults though. Some actual numbers on over-65s here, assuming the Guardian haven't misunderstood what they were reading: https://www.theguardian.com/world/2021/ ... d-over-65s

Germany’s disease control agency, the Robert Koch Institute, said there was insufficient data to judge how effective the vaccine was for people over 65, and as a result it could only recommend using the vaccine on people aged 18 to 64.

Boris Johnson, the UK prime minister, said: “This is a local German decision and the EMA will, as I understand it, will be approving it for general use and I think that’s a very sensible of the EMA, because that is the vaccine our own MHRA has said produces an immune response in all age groups, as a good vaccine, so I’m confident about it.”

Calculations in the German authorities’ draft recommendation show only 6% of participants in the trials were over 65, with 341 of them receiving a shot of the AstraZeneca vaccine and 319 receiving a placebo.

In the trial, one infection was recorded in the treatment group and one in the placebo group, creating a high confidence interval that the German authorities described in their report as “no longer statistically significant”. They said: “Any assessment about the efficacy of the vaccination among the highest age group (≥75 years) therefore comes with a high level of uncertainty.”

If I were doing peer review I'd strike out "high" confidence interval and suggest they write "wide" confidence interval. Because it's a narrow interval which gives you high confidence that your number is correct.

It's an unfortunate coincidence that both the efficacy in >65's and the proportion of participants who were >65's is both about 6% because then when you quote the 6% efficacy people will say No ThaT'S noT the EfFIcaCY THAT'S THe prOPOrtIoN Of PARticIpANts as happened yesterday with the 8-10% numbers that were being batted about.

[Bird on a Fire]

Boris Johnson, the UK prime minister, said: “This is a local German decision and the EMA will, as I understand it, will be approving it for general use and I think that’s a very sensible of the EMA, because that is the vaccine our own MHRA has said produces an immune response in all age groups, as a good vaccine, so I’m confident about it.”

Is it just me who finds it depressingly easy to read Johnson in a Trump voice?

[shpalman]

https://www.theguardian.com/world/2021/ ... of-england

Good. Better than wasting it.

[lpm]

My GPs is closed today. Just offering a weekend emergency service.

It's because the entire staff, GPs and nurses, are out vaccinating all the housebound on their list in a single day. They are travelling from village to village like Amazon delivery drivers.

Time consuming and will mean a very low statistic for vaccines delivered per day - but gets the job done.

[Bird on a Fire]

My GPs is closed today. Just offering a weekend emergency service.

It's because the entire staff, GPs and nurses, are out vaccinating all the housebound on their list in a single day. They are travelling from village to village like Amazon delivery drivers.

Time consuming and will mean a very low statistic for vaccines delivered per day - but gets the job done.

There's an old folks' home on my street, and I saw the vaccine crew arriving the other day, covered head to toe in PPE. Starting with the most vulnerable definitely slows the progess in % population terms, but I think it's also the right approach for saving lives.

[raven]

https://www.theguardian.com/world/2021/ ... of-england

Good. Better than wasting it.

Yep. Particularly the place in Reading calling round local police stations and offering leftovers to them.

Bloke from the JVCI was on TV this morning and they asked him whether it would be a good idea to get school staff done over half term. He emphasised the current list is about reducing deaths and there's no evidence teachers are more at risk, but he also said there are other reasons to vaccinate.

Like protecting key workers so we can keep things running maybe? I don't know if we're at the point where that can become a priority, but I noticed the Italian priority list has essential workers built in. Ours doesn't. I wouldn't object to having to wait a couple more months so essential workers - police, teachers, utility workers, etc, etc - could be protected though. And if we're lucky, vaccinating people who deal with the public might also help slow the spread.

ETA: Our GPs has been very quiet when we've walked past this week, no queues of cars turning in for vaccination like last week. But I just checked the website, they've done virtually all the 80 pluses, working on the 70-80 yr olds & shielders now.

[MartinDurkin]

My wife (under 65 but shielding) got her invite this week and should be done next week. I'm 61 with no underlying conditions (at least none on their list, I thought my thyroid issues might bump me up the queue), and have not heard anything yet, as expected.

Meanwhile, a mate who lives on the other side of Leeds, 61 with no underlying conditions, and his brother, 58 and no underlying conditions had their first dose today. They did query it with the nurse and she said they had done everyone ahead of them on the list.

[TimW]

444k doses yesterday, that's not bad.

But they should move database programmers higher up the priority list.

[Sciolus]

Bloke from the JVCI was on TV this morning and they asked him whether it would be a good idea to get school staff done over half term. He emphasised the current list is about reducing deaths and there's no evidence teachers are more at risk, but he also said there are other reasons to vaccinate.

Like protecting key workers so we can keep things running maybe? I don't know if we're at the point where that can become a priority, but I noticed the Italian priority list has essential workers built in. Ours doesn't. I wouldn't object to having to wait a couple more months so essential workers - police, teachers, utility workers, etc, etc - could be protected though. And if we're lucky, vaccinating people who deal with the public might also help slow the spread.

Yeah, it's bizarre. I just don't understand how JCVI are calculating risk. A 30-year-old teacher spending every day in a room full of snotbags is surely at a far higher risk than 50-year-old me sitting in my back bedroom day in day out.

[shpalman]

Bloke from the JVCI was on TV this morning and they asked him whether it would be a good idea to get school staff done over half term. He emphasised the current list is about reducing deaths and there's no evidence teachers are more at risk, but he also said there are other reasons to vaccinate.

Like protecting key workers so we can keep things running maybe? I don't know if we're at the point where that can become a priority, but I noticed the Italian priority list has essential workers built in. Ours doesn't. I wouldn't object to having to wait a couple more months so essential workers - police, teachers, utility workers, etc, etc - could be protected though. And if we're lucky, vaccinating people who deal with the public might also help slow the spread.

Yeah, it's bizarre. I just don't understand how JCVI are calculating risk. A 30-year-old teacher spending every day in a room full of snotbags is surely at a far higher risk than 50-year-old me sitting in my back bedroom day in day out.

I think they're more concerned with consequences of catching teh covids, not the likelihood of catching them.

[lpm]

But it's a simple equation: Chance Death = Chance Catch x Fatality Rate for Age Group.

Sciolus and me might be 4x on the fatality rate component but the teacher 20x on the chance bit.

[KAJ]

Bloke from the JVCI was on TV this morning and they asked him whether it would be a good idea to get school staff done over half term. He emphasised the current list is about reducing deaths and there's no evidence teachers are more at risk, but he also said there are other reasons to vaccinate.

Like protecting key workers so we can keep things running maybe? I don't know if we're at the point where that can become a priority, but I noticed the Italian priority list has essential workers built in. Ours doesn't. I wouldn't object to having to wait a couple more months so essential workers - police, teachers, utility workers, etc, etc - could be protected though. And if we're lucky, vaccinating people who deal with the public might also help slow the spread.

Yeah, it's bizarre. I just don't understand how JCVI are calculating risk. A 30-year-old teacher spending every day in a room full of snotbags is surely at a far higher risk than 50-year-old me sitting in my back bedroom day in day out.

ONS Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020

[shpalman]

That can't be right or else leaving schools open in December would have been a really stupid f.cking idea.

[bolo]

Where I am, teachers are already being vaccinated, along with emergency workers and age 75+.

There's a lot of public pressure to reopen schools, and the teachers union has basically said no way, no how, we won't show up until we are vaccinated. Considering that UK unions tend to be stroppier than US ones, I'm kinda surprised they haven't taken that line over there.

[shpalman]

The less optimistic Italian plan from the beginning of the year had health workers, long-term hospital patients, and the over-80's in phase 1 (Jan-Mar). Phase 2 (Apr-Jun) would have chronic conditions, immunosuppressed, over-60's, and "high-priority" school workers in it.

Other school workers and teachers would be in Phase 3 (Jul-Sep) which would also include essential workers, prison inmates, and those with milder comorbitities. Everyone else would be done in Phase 4 before the end of the year.

Phase 1 is surely slipping because of these delays in producing vaccines, but maybe not so much, since it only corresponds to the order of 100,000 doses per day.

[Sciolus]

ONS Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020

Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex.

Surprising, but still.

[Stupidosaurus]

I had the AZ vaccine a few days ago, I was lucky enough to be bumped up the queue a bit due to my job. The Manchester mass vaccination centre was very well run (the ladies who gave me the jab were charming despite their production-line role), but it was a bit alarming to be breathing the same air as about a hundred other people, even masked up. Still, fingers crossed that I dodged the covids. One thing I didn't bargain for was my reaction to the vaccine, about 36 h of moderate fever with muscle aches and loss of appetite. It fits with the list of reactions on the leaflet but I've never experienced that kind of reaction with a flu jab. Duly Yellow-Carded, although the MHRA website is a bit counter-intuitive in places.

[raven]

ONS Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020

Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex.

Surprising, but still.

It would be interesting to look beyond age and sex to see if something else was a factor. Ethnicity, obesity, underlying conditions.... Maybe teachers are fitter? Better off and thus healthier? Or, more interestingly, have they had exposure to other coronaviruses that has confered some protection to this one...Or perhaps it's something much simpler, like teachers being more careful both inside and outside schools. The school my sister works at has been constantly reminding staff to stick to the rules outside work.

Also, I would guess that exposure is higher if you're looking after younger kids. (They only had enough data for secondary.) It's much harder to maintain social distancing when you've got a 6 yr old who's had a toilet accident and needs help changing.

[Bird on a Fire]

Don't think they're better off than average - standard teacher salaries are in the £25-35k range, and the UK median is £30k.

I'd guess that teachers are quite likely to have been semi-shielding outside of work. I mean, who'd want to go for a pint with a teacher during a pandemic?

[Millennie Al]

But it's a simple equation: Chance Death = Chance Catch x Fatality Rate for Age Group.

Sciolus and me might be 4x on the fatality rate component but the teacher 20x on the chance bit.

There's also another factor. If we assume the vaccine prevents you passing on the disease (rather than just protecting you from its effects), then some people can be more of a barrier to spreading the disease than others. These are people who meet numerous other people who otherwise would have no connection (e.g. taxi drivers). We might call these people 'bottleneck' people. Teachers meet numerous other people, but in a classroom setting preventing the teacher catching the disease does little to stop the spread as the students will pass it between them. If a teacher is in a low-risk group, it may be better for society to vaccinate either a high-risk person or a 'bottleneck' person instead.

However, I don't think that any actual rollout plans have that level of thinking behind them.

[shpalman]

But it's a simple equation: Chance Death = Chance Catch x Fatality Rate for Age Group.

Sciolus and me might be 4x on the fatality rate component but the teacher 20x on the chance bit.

There's also another factor. If we assume the vaccine prevents you passing on the disease...

People keep insisting that we have no way of knowing if this is true and that it's a ridiculous thing to assume.

It could go either way, being vaccinated might make you more likely to be an asymptomatic carrier rather than to develop symptoms and therefore know to get tested or self-isolate. Assuming that you'd have the luxury of being able to self-isolate.

[mediocrity511]

ONS Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020

Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex.

Surprising, but still.

The time period covered was from March to December. From March to July schools were closed to all but a handful of keyworker children, most staff were in very part time. From July until the start of September, they were closed totally. It isn't surprising that they weren't at increased risk when for a large part of the time period they were barely open.

[bob sterman]

It could go either way, being vaccinated might make you more likely to be an asymptomatic carrier rather than to develop symptoms and therefore know to get tested or self-isolate. Assuming that you'd have the luxury of being able to self-isolate.

Anecdote [n=1 nurse]

I was speaking to a nurse who runs a ward for elderly patients where, as you'd expect, all patients are routinely screened for COVID on admission.

She said they'd had people who'd received 2 shots of the the Pfizer nevertheless testing positive - not being ill {with COVID) but testing positive. No idea whether their viral loads would make them contagious.

Admittedly, given the timescales, they may have only just recently received the second dose. But nevertheless - could certainly go either way.

[KAJ]

Not sure if this belongs here, but not worth it's own thread...

Lot's of news fluff about "vaccine nationalism". I'm not an epidemiologist, but neither are most of the commentators, so here is a genuine question.

I don't think anyone is suggesting vaccine doses should be in long term storage.
Given that, is there any overall advantage in a dose being in an African (say) arm, rather than an English (say) arm?
Maybe equivalently (?), is there any advantage in widespread geographic uniformity in relative proportion of the population who are vaccinated?