Scrutable

I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

Also, Mike Pence was giving Trump credit for this, but Pfizer took none of the Warp Speed money. Donald Junior was suggesting that Pfizer held back the announcement till after the election.

Well, they may well have done, but that's their prerogative.

Their shares got a double bump this morning. In fact, all shares did. The graphs are looking like Covid ones.

monkey wrote: Mon Nov 09, 2020 3:07 pm I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

Interesting article about the vaccine cold chain

Derek Lowe wrote: Pfizer has provided these details to the CDC about shipping and storage of their candidate: the vaccine can be shipped in “dry ice pack” boxes, but that dry ice will need to be replenished within 24 hours of receipt. The shipping carton needs to be closed within one minute of opening, and not opened more than twice per day. Vaccine vials, once removed, can be kept at refrigerator temperatures for up to 24 hours or at room temperature for no more than 2 hours after thawing.

Yes, it may be a problem as even in the developed world the cold chain is not set up for -70C distribution. However, some of the comments BTL for that article say that it is doable if the money is spent (but what isn't?)

monkey wrote: Mon Nov 09, 2020 3:07 pm I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

I assume there's constraints at various points in the manufacturing supply chain so it wouldn't just be a case of building/switching a bunch of other production lines.

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm

monkey wrote: Mon Nov 09, 2020 3:07 pm I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

Actually it would take 14 years at that rate because that's the number of doses, and you need 2 doses a few weeks apart.

jaap wrote: Mon Nov 09, 2020 4:19 pm

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm

monkey wrote: Mon Nov 09, 2020 3:07 pm I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

Actually it would take 14 years at that rate because that's the number of doses, and you need 2 doses a few weeks apart.

Good point, thanks. So not even enough for US + EU, which will be a fun fight.

stańczyk wrote: Mon Nov 09, 2020 3:31 pm

monkey wrote: Mon Nov 09, 2020 3:07 pm I've just read that the Pfizer vaccine needs to be stored at -80C. I am not a logistics person, but this'll make it incredibly difficult to get it out in the numbers needed, right? So if this'll be the first one available, it will only going to the most vulnerable in the more developed world. That's helpful, but doesn't seem like a solution, just a stop-gap while we wait for something to properly mass vaccinate with. Someone please tell me I'm wrong, I'd like this to be all over ASAP.

Interesting article about the vaccine cold chain

Derek Lowe wrote: Pfizer has provided these details to the CDC about shipping and storage of their candidate: the vaccine can be shipped in “dry ice pack” boxes, but that dry ice will need to be replenished within 24 hours of receipt. The shipping carton needs to be closed within one minute of opening, and not opened more than twice per day. Vaccine vials, once removed, can be kept at refrigerator temperatures for up to 24 hours or at room temperature for no more than 2 hours after thawing.

Yes, it may be a problem as even in the developed world the cold chain is not set up for -70C distribution. However, some of the comments BTL for that article say that it is doable if the money is spent (but what isn't?)

Ta. Interesting read. I note it's from August, so hopefully the people who need to have been thinking about how to do this. I assume they learnt how to do things during the trial too.

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

I assume there's constraints at various points in the manufacturing supply chain so it wouldn't just be a case of building/switching a bunch of other production lines.

With the protocol this one has, I'd expect there to be a huuuge amount of wastage, especially when it comes to delivering in places with limited infrastructure. I'd add on a good few more years to that estimate, at least (as well as doubling it). Plus us in The West will have to carry on caring whether others get it after we get our arms jabbed.

Woodchopper wrote: Mon Nov 09, 2020 2:13 pm

Rich Scopie wrote: Mon Nov 09, 2020 12:05 pm BBC News is reporting that Pfizer are claiming 90% efficacy for their version of an mRNA COVID-19 vaccine in preliminary results of third phase testing. Cautious good news. Safety testing data should be available in a couple of weeks.

Here’s some info from the company: https://investors.pfizer.com/investor-n ... fault.aspx

And some more info: https://www.statnews.com/2020/11/09/cov ... -indicate/

jaap wrote: Mon Nov 09, 2020 4:19 pm

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

Actually it would take 14 years at that rate because that's the number of doses, and you need 2 doses a few weeks apart.

The other issue is how long the immunity generated by the vaccine lasts.

To quote from 'In the Pipeline' from today

Derek Lowe wrote: Pfizer/BioNTech say that the protection looks like it should last at least a year – no numbers on that yet, but it can only be based on neutralizing antibody titers and/or T-cell levels and their change over time.

It is possible that vaccination will be required every one to two years.

stańczyk wrote: Mon Nov 09, 2020 5:31 pm

jaap wrote: Mon Nov 09, 2020 4:19 pm

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

Actually it would take 14 years at that rate because that's the number of doses, and you need 2 doses a few weeks apart.

The other issue is how long the immunity generated by the vaccine lasts.

To quote from 'In the Pipeline' from today

Derek Lowe wrote: Pfizer/BioNTech say that the protection looks like it should last at least a year – no numbers on that yet, but it can only be based on neutralizing antibody titers and/or T-cell levels and their change over time.

It is possible that vaccination will be required every one to two years.

That’s only a problem if you plan on vaccinating everyone. If you’re only going to vaccinate 10%, for example, then it’s a lot better. Plus it’s not necessarily the last word. We could easily have more vaccines in a few more months.

Any substantial vaccination percentage you manage to achieve is going to help. It will reduce R_t and make the whole test/trace thing more manageable. You can make a bigger difference to mortality by targeting the at-risk population and essential workers. You can accept that imperfect protection from being vaccination but not that recently is still better than nothing, because it should reduce both the severity of the infection in that subject and that amount of virus they shed.* You can let Russia and/or China do their own vaccine.**

* - of course if it leads to the same amount of infectivity but fewer symptoms then you'll get more asymptomatic spread.

** - assuming that they actually work.

What it won't do is mean that starting in spring next year everything is going to magically be like it was before.

The other other question is whether it stops people shedding virus. If the worst time for spreading is before symptoms start to show, that may well be before the vaccine kicks in. This matters for herd immunity. Anyone seen anything about this?

Bird on a Fire wrote: Mon Nov 09, 2020 4:28 pm

jaap wrote: Mon Nov 09, 2020 4:19 pm

Bird on a Fire wrote: Mon Nov 09, 2020 4:09 pm

The BBC article says that they reckon they can make about 1 billion vaccines by the end of 2021, which means it would take about 7 years to make enough for everyone in the whole world.

Actually it would take 14 years at that rate because that's the number of doses, and you need 2 doses a few weeks apart.

Good point, thanks. So not even enough for US + EU, which will be a fun fight.

It'll be enough for me to win my bet though.

You can donate my winnings to the food bank / environmental charity of your choice.

Well, the point about a vaccine is that the immune response to the actual virus can kick in faster and harder, right?

Is the worst time for spreading before symptoms start to show because once there are symptoms people know to isolate/avoid? Is the peak in shedding right before the immune system starts to work on the virus or are some of the symptoms part of the means the virus uses to spread?

I expect these sorts of questions have been answered in threads on here already.

I dunno. I ask because I suggested that superspreaders should be prioritised for the vaccine, and someone (EAC?) pointed out that there was reason to believe that vaccines might not suppress shedding/spreading. I don't recall much detailed discussion of the issue here, but now things are starting to firm up, vaccine-wise, there might be hard info available.

shpalman wrote: Mon Nov 09, 2020 8:31 pm Well, the point about a vaccine is that the immune response to the actual virus can kick in faster and harder, right?

Is the worst time for spreading before symptoms start to show because once there are symptoms people know to isolate/avoid? Is the peak in shedding right before the immune system starts to work on the virus or are some of the symptoms part of the means the virus uses to spread?

I expect these sorts of questions have been answered in threads on here already.

Yes to the bold bit. But also, for the question about spreading it around - shedding virus requires lots of infected cells, which act as virus factories. The vaccines aim to provoke a T-cell response (as well as neutralising antibodies), which is an immune response recognising and shutting down infected cells, rather than free virus. So in principle, the vaccine should lead to your immune system shutting down these viral factories much quicker and more specifically, with a knock on effect on spreading it to others. This is why care home staff are in the first wave for vaccination, rather than just the residents. (Everybody focuses a bit too much on antibodies because they are better known and also easier to measure from a blood sample.)

The cold chain problems looks like it will be a biggie. This vaccine news is good news, but not the miracle so many were hoping for.

As for the number of doses needed, remember that China already has more than one vaccine in use already, hundreds of thousands have been vaccinated, with no adverse effects reported. I cant seem to find the efficacy results for the Chinese vaccines, but I am pretty skeptical of the 90% number for the Pfizer vaccine. Everyone was saying 60-70% would be good,and they come out with 90? Come on.

The Chinese vaccines are also already in use in the Middle East and Brazil.

So the potential market for the Pfizer vax is "only" a billion or so. Most of the world will be served by vaccines from China and Russia and Europe.

Leav it EACL hez not wurf it

The figures on the Pfizer website are that 94 out of 43,538 participants got the disease. This is 0.2%.

From https://www.ons.gov.uk/peoplepopulation ... ctober2020:

The percentage testing positive in the latest 14-day period (3 to 16 October 2020) was 0.88% (95% confidence interval: 0.83% to 0.94%)

so from 43538 randomly chosen people in England we would expect about 383 to have caught COVID-19 in just that fortnight. This means that merely particpating in the trial is (well) over 75% effective at preventing infection. If a vaccine was that good, it would eliminate the disease.

I suspect the explanation for this is that study particpants are highly non-representative of the general population. Not only will anti-vaxxers and general idiots not volunteer, but those who most consider the disease serious will be heavily over-represented. The participants will, therefore, be much more likely to follow good practices to avoid catching the disease. And the figures then show that what these people are doing is highly effective.

And, of course, the eligibility criteria will also skew the figures. For example, if you're a care home resident you're more likely to catch the disease (partly due to communal living, and partly due to massive incompetence in letting known cases into such places), but may be excluded from the study due to the need to make visits for administering the vaccine and various tests.

Another trial shutdown:

Covid: China's Sinovac vaccine trial halted in Brazil

The Brazilian clinical trial for a Chinese Covid-19 vaccine has been suspended after health authorities reported a "severe adverse" incident.

Brazilian health regulator Anvisa said the incident took place on 29 October, but did not give further details.

The CoronaVac vaccine, developed by the Chinese firm Sinovac Biotech, is one of several in final-stage testing globally.

On Monday Anvisa said it had "ruled to interrupt the clinical trial of the CoronaVac vaccine after a serious adverse incident".

It did not reveal what happened, nor where it took place. Late-stage trials for the Sinovac vaccine are also being conducted in Indonesia and Turkey, but neither of these countries have announced a suspension.

Indonesia's state-owned Bio Farma said on Tuesday that its own Sinovac vaccine trials were "going smoothly", according to Reuters news agency.

Dimas Covas, the head of Butantan, the medical research institute conducting the Brazilian trial, told local media that the trial's suspension was related to a death. However, he insisted that the death was not related to the vaccine, Reuters said.

Rich Scopie wrote: Mon Nov 09, 2020 12:05 pm BBC News is reporting that Pfizer are claiming 90% efficacy for their version of an mRNA COVID-19 vaccine in preliminary results of third phase testing. Cautious good news. Safety testing data should be available in a couple of weeks.

Can anyone explain in layman's terms for me what 90% efficacy actually means?

Is it that if 100 people are exposed to covid 90% of them don't get ill? Because I thought the natural asymptomatic rate was around that? Or it allowing for that of those that might have been ill 90% don't? Or is it 90% exposed don't becomes contagious? or something else altogether?

(and how do they know in most of the above circumstances because the numbers are pretty low on the trial 90k people but at 5% infection rate?)

science_fox wrote: Tue Nov 10, 2020 2:09 pm

Rich Scopie wrote: Mon Nov 09, 2020 12:05 pm BBC News is reporting that Pfizer are claiming 90% efficacy for their version of an mRNA COVID-19 vaccine in preliminary results of third phase testing. Cautious good news. Safety testing data should be available in a couple of weeks.

Can anyone explain in layman's terms for me what 90% efficacy actually means?

Is it that if 100 people are exposed to covid 90% of them don't get ill? Because I thought the natural asymptomatic rate was around that? Or it allowing for that of those that might have been ill 90% don't? Or is it 90% exposed don't becomes contagious? or something else altogether?

(and how do they know in most of the above circumstances because the numbers are pretty low on the trial 90k people but at 5% infection rate?)

I don’t know, but I’d imagine that the infection rate amongst those with the jab is running at ~10% of those in the control arm.

science_fox wrote: Tue Nov 10, 2020 2:09 pm

Rich Scopie wrote: Mon Nov 09, 2020 12:05 pm BBC News is reporting that Pfizer are claiming 90% efficacy for their version of an mRNA COVID-19 vaccine in preliminary results of third phase testing. Cautious good news. Safety testing data should be available in a couple of weeks.

Can anyone explain in layman's terms for me what 90% efficacy actually means?

Is it that if 100 people are exposed to covid 90% of them don't get ill? Because I thought the natural asymptomatic rate was around that? Or it allowing for that of those that might have been ill 90% don't? Or is it 90% exposed don't becomes contagious? or something else altogether?

(and how do they know in most of the above circumstances because the numbers are pretty low on the trial 90k people but at 5% infection rate?)

Read somewhere that it's a 90% reduction in disease occurrence, comparing the placebo to vaccine. So if 100 people on the placebo get covid, 10 on the vaccine get it.

Bird on a Fire wrote: Tue Nov 10, 2020 10:11 am Another trial shutdown:

Covid: China's Sinovac vaccine trial halted in Brazil

The Brazilian clinical trial for a Chinese Covid-19 vaccine has been suspended after health authorities reported a "severe adverse" incident.

Brazilian health regulator Anvisa said the incident took place on 29 October, but did not give further details.

The CoronaVac vaccine, developed by the Chinese firm Sinovac Biotech, is one of several in final-stage testing globally.

On Monday Anvisa said it had "ruled to interrupt the clinical trial of the CoronaVac vaccine after a serious adverse incident".

It did not reveal what happened, nor where it took place. Late-stage trials for the Sinovac vaccine are also being conducted in Indonesia and Turkey, but neither of these countries have announced a suspension.

Indonesia's state-owned Bio Farma said on Tuesday that its own Sinovac vaccine trials were "going smoothly", according to Reuters news agency.

Dimas Covas, the head of Butantan, the medical research institute conducting the Brazilian trial, told local media that the trial's suspension was related to a death. However, he insisted that the death was not related to the vaccine, Reuters said.

Not good news. However it shows the system working as intended with the halting of this trial.

After discussion with the FDA, the companies recently elected to drop the 32-case interim analysis and conduct the first interim analysis at a minimum of 62 cases. Upon the conclusion of those discussions, the evaluable case count reached 94 and the DMC performed its first analysis on all cases. The case split between vaccinated individuals and those who received the placebo indicates a vaccine efficacy rate above 90%, at 7 days after the second dose.

From https://www.pfizer.com/news/press-relea ... te-against but I might have read it first in one of Chops' links.

So afaict all we know is that 0-9 in the vaccine group got covid and the rest of the cases (85-94) were in the control group. Is that right?