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A) it looks rhetorical. Not something meant to be answered. See that smiley you put in after it. B) it's unanswerable. C) Why would I want to try and answer it in the first place?Quote:
Originally Posted by GGT
Good to know that your gut is still wrong most of the time.Quote:
In the big scheme of things, I have a hunch we have so much polarization in the US --- because we have too many lawyers that can bring law suits willy-nilly.
Oxford/AZN vaccine second approved vaccine for use in the UK :)
Much, much easier to produce and distribute than the Pfizer jab, doesn't need super-frozen storage.
Hopefully we can see the back of this now by the Spring. I think the government might and should announce nationwide Tier 4 tonight given the new variant. January is a shitty month anyway, shut it down and rollout the vaccine.
I hope they publish something that clearly addresses previously raised concerns re. adenovirus vector vaccines.
I'm sure the MHRA have considered all the relevant information and everything will be published in due course. I'm sure it isn't your intention but it is concerning seeing some people (Kevin Maguire this morning on Twitter for instance) trying to spread anti-vax nonsense about this.
Aside from a letter in Nature I haven't yet seen anyone else bring up—or address—this issue, that previously scuppered two HIV vaccine trials, in the context of the AZN vaccine. Given that this vaccine is much more likely to see widespread use in HIV endemic areas compared to the mRNA vaccines, the issue needs to be addressed sooner rather than later; other countries will be looking at the MHRA for guidance.Quote:
Originally Posted by RandBlade
The MHRA have confirmed they'll be releasing a report and data today and publishing further data soon.
Interestingly they have not approved the half/full dose regimen that AZN recommended and instead recommended staggering between first and second dose.
Hopefully your concerns are addressed in the full report.
Most important thing is AFAIK is that from both the Pfizer and AZN vaccines there appear to be no hospitalisations. If we can end hospitalisations from the virus then that is critical, even if people do get the virus still.
After stern admonishments to the public to get a grip, use common sense and heed recommendations to not do unnecessary shit like visiting shopping malls, traveling, etc,
the PM visited Sthlm's most crowded shopping mall twice to run unnecessary errands
the minister of justice visited a shopping mall on Boxing Day to get a belated Christmas present
the minister of finance went on a skiing trip at a crowded resort
and the head of the civil contingencies agency went to La Palma on holiday
https://i.imgur.com/u26XLy7.gif
Someone should get your politicians an Amazon Prime subscription.
JCVI have changed the rollout scheme here. Vaccinating as many people as possible with the first dose first, getting the second dose no more than 3 months later.
My wife's second dose was not pre-scheduled. She was told she'd be called closer to the date with an appointment. My grandparents second doses were scheduled when they were given their first. No idea whether second dose vaccines prescheduled will still go ahead.
We're going into Tier 4 as of midnight tonight (as are the vast majority of the nation).
Edit:
Twitter Link
Yes, they are taking this seriously. :P /bitter sarcasm.Quote:
Originally Posted by Aimless
But when you see that kind of attitude I realise what has been wrong from the beginning.
I DID have a higher belief in our finance minister; though she would be a great replacement for the LÖF.
Some differences the around the world:
*South Africa, you can now be arrested and prosecuted for not wearing mask. Granted they probably got great problems so why not. As you bed you sleep.
*Sweden, at the same time, the recommendation in elder care homes just did a drastic change last week (now, if I remember this correctly...) from "can be used" to "can 'preferable' be used".
(For the rest of the population it is of course the same.)
So far I know I want to get rid of S, MP, M, SD, C, FP in the next election.
We will clearly never meet in an understanding. :P I might even concider going real left wing, V - since that is starting to become the only option!
...just that they are so bad at economics so it will hurt. ;((
Representatives of V have aggressively defended the laissez faire policies, repeating covidiot talking points and shifting the focus to pet political issues (while simultaneously ignoring the obligations of solidarity). The reality is that the pandemic isn't something you can use to choose a party—there's been broad support for our response, across parties/blocs, because it has largely reflected the public's wishes. The best we can hope for is that the people most responsible for the most egregious fuckups are booted out or at least severely criticized.Quote:
Originally Posted by rille
Why does Britain consistently do the dumb thing when it comes to Covid?
Not just Britain, most countries it seems. What are you referring to?Quote:
Originally Posted by Loki
Not giving people the second dose so it could give more people a first dose.
Quote:
Originally Posted by Loki
It is what is recommended by the impartial JCVI scientific experts.
The evidence with AZN is that a longer gap between doses is better, from what I have read this relates to vector immunity from the vaccine. Pfizer I'm not sure how or why they've come to the conclusion to do that. Seems logical to me to do Pfizer at 3 weeks and AZN at 12.
But if it is safe and efficient to do it then it is absolutely the logical thing to do. Better to have eg 10 million with 70% efficacious immunity than 5 million with 90% and 5 million with 0% . . . so long as it is safe to do it this way. Why do you consider it to be stupid if the experts are saying it is safe and appropriate to do it this way?
All four countries Chief Medical Officer (CMO) have tonight unanimously backed the dose as many as possible with second does 12 weeks apart regime.
1 million people have had their first dose so far, which should mean about half of the most vulnerable have been done (there's 1.6 million in the top priority list and 75% are going to them, about 25% to health and care workers).
A) It's quite obvious some of your medical experts are idiots.Quote:
Originally Posted by RandBlade
B) The people missing out on their second shot are far more likely to die than people getting their first shot. It's why they were first in line.
C) It's by no means guaranteed that the people who got the first shot will come back for a postponed second shot (many of them are very old). Even getting that info to them on such short notice will be extremely cumbersome.
D) Most importantly, there isn't definitive evidence that one shot actually works. That's not what the studies ran by each company proved. Nor do we know whether a second delayed follow-up shot will be effective.
A: Maybe, maybe not. They've got some calls wrong, but some right too.
B: Which is why they have had their first shot that the data shows is highly efficacious in the first place. The second in line are still very vulnerable which is why they are second and they need it. The first in line will still be getting their second
dose well before those low down the priority list get their first.
C: No that is not an issue. The elderly and the NHS are absolutely used to interacting with each other. As is the NHS used to scheduling and rescheduling appointments at short notice. If there's anything the NHS can handle it is that.
D: AZN study did prove that. It is a reasoned assumption for Pfizer.
E: The NHS is at risk of being overwhelmed by hospitalisations and the hospitalisations have a different bell curve to the deaths.
Getting as many partially protected as possible ASAP will aid the NHS massively and protect against deaths.
For what length of time do you believe a single dose of the Pfizer vaccine is known to be "highly efficacious"?
Quote:
Originally Posted by Aimless
Unknown.
The data shows it to be highly efficacious from 10 days after injection until the second one is given so far. There seems to be little reason to believe protection will overnight drop from highly efficacious to completely ineffective in the extra 9 weeks proposed. But it will be completely ineffective for those not given a vaccine if they aren't given one.
The reality is we are talking a marginal increase in communal efficacy for half as many people - or a massive increase in communal efficacy spread across twice as many people.
The NHS and the vaccine rollout is about what is best for the community, not just the individual.
Between the first dose and the second dose—administered with a 21 day interval—the efficacy at group level was estimated at 52% compared to placebo. It's not "highly efficacious", and it's not "overnight". During this period of inadequate protection, the UK will have extremely widespread community transmission—perhaps entailing a higher baseline risk than was seen in the study. The evidence does not support delaying the second dose for an additional 9 weeks, and certainly does not seem to support doing so for the most vulnerable groups. You cannot speculate about the extent and duration of protection at the community level with the proposed strategy on the basis of this data. The modeling that has been conducted to justify the decision has not undergone external scrutiny, and might be sensitive to unforeseen developments wrt eg. the spread of the new lineage.Quote:
Originally Posted by RandBlade
Saying that something is about "the greater good" doesn't magically justify a questionable decision-making process.Quote:
The NHS and the vaccine rollout is about what is best for the community, not just the individual.
Not entirely true. The data shows that there is negligible protection on the day you get the injection or the days after it, but that is not the case from about day 10 onwards.Quote:
Originally Posted by Aimless
Yes you can get the injection and then later that day or the next day become positive - but then its entirely possible that is because you were already positive before you got the injection, it just wasn't showing up yet. Hence looking from days after the injection and the data shows extremely high efficacy from day 10 onwards - you have only got it down to 52% by including days 1-9 in the pool of days 1-21 which is distorting the data.
The Pfizer vaccine from day 10 onwards gives close to 90% efficacy with just a single dose, not two doses. From Day 14 to Day 21 is virtually a flat line.
https://wp.technologyreview.com/wp-c...NEW.png?w=1800
https://wp.technologyreview.com/wp-content/uploads/2020/12/PFIZER_CHART_NEW.png?w=1800
This is not how immunology or clinical trials work. Immunology is fiendishly complex and the exact mechanism and extent of immunity can be greatly affected by route of dosing, dosage, vector, and dosing frequency/timing.Quote:
Originally Posted by RandBlade
Is it possible that a single dose of a given vaccine will give long lasting and effective protection? Sure! But without a clinical trial to prove it, you're essentially gambling based on very incomplete information. Several pharma companies have specifically started additional trials to prove just this; they start with a 2-dose regimen because it's most likely to succeed, but follow on with a single dose trial to see if they can reduce cost/complexity. Without that data, however, you're just guessing.
I sincerely hope that it works out for the UK, but do realize that if it does this will not be a 'vindication' of their strategy. It will just be that they got lucky. This is not how evidence based medicine works.
On a broader note, I don't think that people outside of the medical or biotech world understands that these vaccines are not in fact 'approved'. We don't have adequate data to really know the full safety and efficacy of these vaccines. These are being authorized for use on patients under an 'emergency use authorization', which is essentially the FDA saying 'it looks like it's probably okay and the risks are lowish, so go ahead and start using it because the need is so pressing'. But everyone who's getting this vaccine (at least in the US) is essentially being enrolled in a Phase IV trial to track the outcomes and make sure the EUA wasn't mistaken. This whole process has been at breakneck speed, and while few corners have been cut (outside of the badly botched AstraZeneca trial), there are still lots of unknowns. This doesn't mean we should refrain from taking the vaccine - it is precisely the people who understand the ramifications of the EUA and this technology who are lining up to get it first, and I will gladly get vaccinated when it is my turn - but it definitely means that going off half-cocked on the basis of very thin to nonexistent data is just asking for trouble.
I'm not sure if you wrote that before seeing the chart I posted in my subsequent reply wiggin but absolutely it is a gamble. But that is part of the point, this isn't a licensed medicine yet (and even if it was then off-licence use of medicines do exist) it is an off-licence emergency authorisation using pre-existing emergency authorisation procedures. And we are indubitably in an emergency right now.
That chart is one of the most compelling pieces of evidence I have ever seen. My background is economics and business rather than epidemiology and medicine but that is a very clear chart to read.
Yes it is a gamble. But it is literally a gamble that could and probably will literally save tens of thousands of lives. The JCVI, MHRA and all four countries CMOs unanimously all think it is a gamble worth taking and I agree.
RB, I have seen every public scrap of data on these trials. 10 days of a reduced incidence of events doesn't tell you shit.
I wish the UK luck.
It does tell you something. It tells you that efficacy was over 90% for those 10 days.Quote:
Originally Posted by wiggin
It doesn't tell you that the efficacy will remain over 90% from day 22 to day 84, of course it does not, but it is an educated guess and gamble that it will remain high.
There are two separate concerns here:Quote:
Originally Posted by RandBlade
1. We have no data on the duration and extent of efficacy between the first and second doses if the second dose is given late. The data is extremely thin in the brief period between the first two doses on a normal schedule (only a handful of events and no ability for long term followup), and nonexistent otherwise. They are using a booster dose for a reason.
2. We have no data on the duration and extent of efficacy of a second dose after an extended delay outside the scope of the original trial. Immunization boosters are not well understood and their timing can be critical depending on e.g. vector design.
So, not only might the people be vulnerable until their second dose is administered, they might be vulnerable after the second dose is administered. They might be fine, too, but we simply don't know. Without data it's speculation.
(double posting but totally different topic)
There was an amazing article about my town in Slate a couple weeks ago. I have fortunately avoided this drama because our daughter is not attending the local schools, but I've seen the trend in local elections for some time - there's a clear fault line in the community on the issue of schooling (which drives most of the town's budget), with a traditional labor-supporting progressive wing at odds with a more technocratic leftism. At the higher levels of power in the town, the more dogmatic lefty candidates have not fared all that well, despite the overwhelming blue lean of the town.Quote:
Originally Posted by wiggin
Seeing this tension play out on the context of Covid is fascinating. And it's also a mildly hilarious profile of the super weird place that I live.