Forum menu
Im quite happy to have the AZ vaccine. 70% chance immune to CV,
But its not is it. The results show 62% effective if you get two full doses and 90% effective if you are under 55 and get a half dose followed by a full dose. Like I said in my previous post I have a problem with them averaging the two dosing regimes and coming to 70% because they're not comparing apples to apples.
Edit: IMHO they'll take the low risk option and licence the two whole dose regimen because they have better data and 62% effectiveness with no serious disease is still a good outcome.
I think by the time the masses get the chance to be vaccinated it’ll have nothing to do with the storage of the vaccine
the Pfizer vaccine is almost uniquely designed to be really terrible for the sorts of ways that GP surgeries need to give out vaccines to their patients (that have nothing to do with it's initial storage) so I'm expecting the 2 streams of vaccine supply to be routinely diverted to the best locations (at least that's what I'm expecting..)
Old people being vaccinated is political, as much as anything.
Thanks, I'll tell my mum when I see her next. She's been gadding about her care home all the time without a care in the world. Or more accurately confined to her room for the majority of time since the first lockdown due to cases in the home. I've seen her once from 3m away in a different tent in the care home garden since March with us both wearing masks.
Honestly, it would almost have been fairer to let her catch COVID and die then to be in solitary confinement for 9 months.
BTW, the elderly are by far and away the most at risk.
Will they reach out to those that applies to to let them know they already have some protection?
It was commented on 'how to vaccinate the world' that they were talking about 'unblinding' participants so they knew whether they needed to get jabbed but I've not seen anything that says they're doing that.
Full Oxford results published in Lancet.
Paper here and reads like a continuous adaptive design, with an added extra booster dose and an added Low dose arm found by accident due to the release assay.
Well at least I don't have to update my plots above 🙂 . Looking at asymptomatic infection, they achieved 58.9% in LD/SD and 3.8% in SD/SD in a total pf 69 cases (22/23 and 7/17). I'm not convinced of the approvability based on the lack of LD/SD data. there is a lot of "justification" for trial conduct in the paper that you don't normally see, largely around acceptable analysis. That second proper Phase 3 study can't come soon enough.
Disclaimer: I work for a competitor (not on vaccines) and these are my own opinions.
Old people being vaccinated is political, as much as anything.
nonsense. You give it to those most at risk. One way of looking at risk is incidence x severity so although incidence might be low the fact that the severity is high in this group means its utterly right they get it first. I speak as a man shitting myself that I am now working with covid positive people but I still want my 85 yr old parents to be a higher priority than me
BTW, the elderly are by far and away the most at risk.
They are.
But as has been discussed, there was some argument to vaccinate the spreaders first, France are in fact.
There’s arguments both ways.
Giving an elderly person the opportunity to live the expected 5 years that they might have left whilst avoiding peak demands on the NHS is the rationale. We may not all agree on it but it is understandable.
I asked this before and got a reply which I didn't fully understand.
If my 75 year old mum gets the az vaccine then how does the risk decrease. Is it..
A. She has 60% less chance of getting the virus, but if she does get it she'll then still be at high risk of severe illness
B. She has 60% less chance of getting the illness, but even if she does get it she'll be significantly less likely to go to develop severe illness (do we know how significantly lower)
C. Something else..
TJ in your example your personal incidence level is much higher than normal even if your severity rate is lower than an 85 year old, so as a front line worker you should be at least as high up the list as an elderly person, probably higher given your work is part of the solution and the fact you can't keep away from.
But as has been discussed, there was some argument to vaccinate the spreaders first, France are in fact.
MCTD, this plus despite the many knowledgeable opinions shared here I've not seen an overwhelming consensus one way or the other. Also by inference you're suggesting Boris and chums are doing the right thing rather than a politically expedient and populist thing, spose it could happen through blind chance.
Also this
We may not all agree on it but it is understandable.
Thanks, I’ll tell my mum when I see her next.
And maybe you could spare a moment to chat to all the people who may not have a roof over their head as a result of this. Oh and fair play to your mum for taking responsibility for keeping herself out of harms way (whether it be by choice or circumstance), shame many other older people havent sacrificed their lifestyle for others welfare as she has.
The AZ vaccine when administered at the standard dose, reduces your likelihood of developing symptoms 60%. There is data to support this in the elderly. If you have asymptomatic disease, it does nothing to reduce that, and may (or may not) also reduce transmission.
So B.
Might also be some C regarding onward transmission, but this was not tested.
you’re suggesting Boris and chums are doing the right thing rather than a politically expedient and populist thing, spose it could happen through blind chance.
Well, if you throw enough shit at a wall, one piece will stick. I'm persuaded that the planned approach is the right one, I won't let my hatred of the clown of a prime minister cloud that possibility.
The logistics of 2 doses will be interesting.
My good lady is a nurse, her clinic carries out procedures that are pretty much critical to patients quality of life, that have to be given a month apart, 2 months in some cases, depending on each case.
The amount of no shows is staggering.
I won’t let my hatred of the clown of a prime minister cloud that possibility.
No but your view of the prime minister backs up my assertion that this was a politically driven decision, it might even be the right one, my uninformed opinion is it wasn't, but for Boris it will have been purely political. Boris following the science, no chance.
The amount of no shows is staggering.
One of the vaccines (the only one we’re using so far) is still effective after the first dose (see USA approval results announced today) … so no shows are still likely to benefit from the first jab… it’s just that those turning up for the second jab at the right time get twice the benefit. All is not lost for the no shows. At least for one particular vaccine.
So B.
Yey! All the vaccines are looking useful as regards reducing demand on medical care, aren’t they. Crossing all digits that they also reduce transmission to protect those not getting vaccinated (for both medically sound as well as down right stupid reasons) as well, and keep them out of hospitals, not just those getting one of the vaccines.
disagree strongly stumpyjohn. If my dad gets it his chance of surviving is very low. If i get my chance of surviving is very high
the rest of your arguement is daft as well. Whats your evidence for over 80s being more reckless in their behaviour>?
It's a purely practical decision at this point. Something like 1 in 5 over 80s who test positive for Covid require hospitalisation. Protecting hospital capacity for the 50-80 group is the priority, as mortality is likely to increase noticeably when capacity is exceeded.
One of the vaccines (the only one we’re using so far) is still effective after the first dose (see USA approval results announced today) … so no shows are still likely to benefit from the first jab… it’s just that those turning up for the second jab at the right time get twice the benefit. All is not lost for the no shows. At least for one particular vaccine.
Let's not tell the ****ers that, though. Turn up to your appointments, scumbags!
All the vaccines are looking useful as regards reducing demand on medical care, aren’t they
Exactly this. Reduction in transmission will be an upside. Expected but not the end of the world if it doesn't materialise.
Future vaccines will be adjuvented spike protein single administration with your flu jab. These will be room temp stable and fit the conventional vaccine storage and distribution chain. Where we are at the moment is wholly down to the speed of initial new agent generation. Where we will be in six months is going to be very different. They'll likely be given every year or two, and there's no reason I can see why they can't be formulated with the influenza protein-based vaccines too.
We shall see. I personally struggle with the Ox/AZ vaccine development pathway. Second doses are a downer, and it looks like a single purpose additional study is really needed to show the efficacy. I'd still use it, but really want protection from disease in the elderly and sterile protection from transmission in the young. We seem to have got that the wrong way round due to supply limitations and trial designs.
reads like a continuous adaptive design
That's polite - a little tongue in cheek I suspect!
I've worked on a few industry/academia collaborative trials - and that paper pretty much sums them up. A bit more AZ, and a bit less "Oxford" please.
And maybe you could spare a moment to chat to all the people who may not have a roof over their head as a result of this. Oh and fair play to your mum for taking responsibility for keeping herself out of harms way (whether it be by choice or circumstance), shame many other older people havent sacrificed their lifestyle for others welfare as she has.
Jesus christ, mostly I love this place for idle chat, sometimes I love it because it provides brilliant info, sometimes people also show real community and care and then on other occasions it gives me a real window on how people think and helps me understand the mess humans are making of the world.
Looking like London should be in tier 3 or stricter measures. What state we will be in by the end of the Christmas period I don't like to think about.
@stumpyjon - how old are these irresponsible, selfish people that you are referring to? 50, 60, 70, 80??
I don't see the same behaviour in the elderly (65+) people I know and/or encounter locally
disagree strongly stumpyjohn
Well then you are disagreeing with yourself, from your original post
You give it to those most at risk. One way of looking at risk is incidence x severity
Now you're saying
If my dad gets it his chance of surviving is very low.
Now you're basing it on severity alone, which is fine but not what you originally said.
ElShalimo, so you've got your anecdotal experience, I've got mine, I've seen a lot of older people out and about doing non essential things, immediately post lock down one, the local garden centres were rammed for example. Its also been commented on numerous times on this thread that people are battling with their older relatives over their behaviour.
AA you are a sanctimonious pain, not all damage to people's health from this pandemic has been physical, for people in nice secure jobs, like say teachers, the focus has been on avoiding covid, for many others whose jobs have gone, big life events disrupted or businesses collapsed it could take years for them recover if they ever do.
AA you are a sanctimonious pain
Maybe, still better than you from what I can see. Though that is a low bar.
Define older people.... 45, 87, 103??
for many others whose jobs have gone, big life events disrupted or businesses collapsed it could take years for them recover if they ever do.
Whilst those that die due to you prioritising wealth creation over lives would recover quickly!!
for people in nice secure jobs, like say teachers
Dude, when you're in a hole, stop digging. 🙄
That’s polite – a little tongue in cheek I suspect!
It’s a public forum and I work for a competitor. Academic amateur hour would sum it up better. Normally when we have investigator-led studies, they generate a hypothesis and then we confirm it in a proper large registration study. And that’s exactly where this one is going.
mOREcASH...
I think from previous discussion, the cost and time of testing to see who needed the vaccine was more expensive than just vaccinating the whole group.
Putting aside the ethics* etc. I still struggle to see how it can be cheaper for the Pfizer vaccine unless the calculation takes into account a full capacity of NHS and beds and simply say's regardless of people needing hospitalisation we won't/can't expand capacity so they can die in care homes and at home and not be a NHS cost?
I'm no longer following this but my understanding is the Pfizer vaccine is not only expensive to buy but administer and we have a limited supply. There must be whole care homes where everyone that isn't newly arrived has been exposed and either developed it and died, recovered or for some reason not developed COVID-19.
London should be in tier 3 or stricter measures
Tier 1 doesn’t not control spread
Tier 2 may keep things stable
Tier 3 reduces spread
London is Tier 2 and “may” is doing a lot of work in that sentence. Things look flat but didn’t really fall from lockdown. I predicted a fall but now think that stable is more likely only with more measures. It has a different case kid (younger) than elsewhere.
I still struggle to see how it can be cheaper for the Pfizer vaccine
I was just trying to remember the previous discussions, but as I recall the argument was that the time and cost of testing everyone for antibodies - which may or may not suggest sufficiently high natural immunity, of course - was too high compared to the cost of just jabbing everyone.
Like a lot of things, that doesn't necessarily agree with different versions of facts we see reported - over the counter antibody tests being available in France for example.
Stumpyjon
ElShalimo, so you’ve got your anecdotal experience, I’ve got mine, I’ve seen a lot of older people out and about doing non essential things, immediately post lock down one, the local garden centres were rammed for example. Its also been commented on numerous times on this thread that people are battling with their older relatives over their behaviour.
It seems it is divisive ...perhaps even more than the general population.
Some are doing absolutely everything to avoid it whilst others are doing nothing or actively choosing to do high risk things over lower risk.
It's only an observation but there is a lot of truth... I saw busloads of pensioners (literal busloads) and a disproportionate number in garden centres etc.
On several occasions I've wanted to say "FFS I'm doing this for you" or shopkeepers have tried - some old gent at the service station/shop and the attendant telling him it was his 3rd or 4th time that day and he should wear his mask.
There must be whole care homes where everyone that isn’t newly arrived has been exposed and either developed it and died, recovered or for some reason not developed COVID-19.
Just think about the logistics involved. Staff need to attend to test all residents for the presence of antibodies. Then there is a delay while they process the test results. Then they return a week later and vaccinate those who are negative, and again 21 days later.
There is also the uncertainty over whether the presence of antibodies in itself means that person is immune. The test has both a false negative and false positive, so some people in need of vaccination will be missed.
For a vulnerable care home resident, every new clinical contact carries a small risk of transmission. Minimising the amount of traipsing in and out of care homes is the ideal plan, both for their safety and the best use of a very scarce skilled resource.
Tier 1 doesn’t not control spread
Tier 2 may keep things stable
Tier 3 reduces spread
Would you think that after winter, this might change so the T2 restrictions could be effective enough to allow regions to go to T1 - or is it just wishful thinking on my behalf?
RM.
MoreCash
I was just trying to remember the previous discussions, but as I recall the argument was that the time and cost of testing everyone for antibodies – which may or may not suggest sufficiently high natural immunity, of course – was too high compared to the cost of just jabbing everyone.
Like a lot of things, that doesn’t necessarily agree with different versions of facts we see reported – over the counter antibody tests being available in France for example.
It's two things though ...
The direct cost (which isn't just jabbing everyone like the flu jab) and the indirect cost of care for those who don't get a vaccine given to someone that probably needed it less (has antibodies).
It's not that I agree with a pure economic approach, but I that struggle to see how a pure economic approach even stacks up.
Like a lot of things, that doesn’t necessarily agree with different versions of facts we see reported – over the counter antibody tests being available in France for example.
Quite and I found out about these from my mate.... it's not like they are even publicised.
When look at that and the costs (and ethics) of not testing people told to self isolate (and the complete mess they made) my conclusion is that testing is being discouraged as iut leads to identification of cases.
Gotta shoot for now though....
for many others whose jobs have gone, big life events disrupted or businesses collapsed it could take years for them recover if they ever do.
Whilst those that die due to you prioritising wealth creation over lives would recover quickly!!
It's a nearly impossible one to reconcile.
I should be thrilled by recent news, both my parents who I've seen twice in 9 months, at a social distance, and not at all since September, will be high on the priority list. My wife's a key worker so hopefully reasonably high. I'll continue to be good until my over-50's call.
But:
I'm terrified by the long term effect. There are hundreds of thousands, men, women and a lot of kids that are already drifting into poverty and destitution as a result of the fall out (don't even mention the B word) and when / if UC top up is removed that will increase further. Report today says 2 million and more.....
https://www.independent.co.uk/news/uk/home-news/children-poverty-destitution-dwp-uk-b1767929.html
I've also been on 2 calls recently - one with CALM, another a work training on mental health awareness for line managers. Both gave the same statistic; death by suicide has not increased as a result of the pandemic, if anything it's down. But unpick why and that's where the concern comes. At times of crisis we rally round. We make changes like topping up UC for those that need it, we've furloughed those that would have been without work otherwise, and as friends and family we've made an effort to support those who we know are vulnerable. But when the vaccine comes and we all go back to 'normal' - what then? That's when the problem will come for many and will the fortunate just go back to the old ways. If suicides is a measure for the nation's survival let's not sign the scorecard just yet.
It's great to think of all of us that are going to survive the direct bombing raid, but those whose houses were destroyed are going to have to live in the burnt out shells picking among the rubble for years to come.
When look at that and the costs (and ethics) of not testing people told to self isolate (and the complete mess they made) my conclusion is that testing is being discouraged as iut leads to identification of cases.
Not really. The window for a positive test is pretty small, especially if you have no symptoms. So a negative test is meaningless for close contacts because you could still be brewing the virus rather than shedding it. It could send you back to work, and the next day you could be infecting your workmates.
Also, testing the close contacts of a positive/symptomatic person would have quickly overwhelmed laboratory capacity, which was creaking badly even with symptom-only testing. If people who had symptoms were having to wait 3-4 (or more) days for a result at one point, imagine throwing in 2 or 3x as many tests to process.
Let's say your symptomatic person was negative, but instead of getting a result in 2-3 days, (immediately releasing them and all their close contacts from self-isolation), they had to wait more than a week. At that point they would actually be in a worse position because of increased testing.
Obviously, in an ideal situation, we'd have had access to rapid, reliably accurate, testing from the word go. But that still isn't an option, regardless of all the blather about moonshots etc.
We don’t test people’s antibody status for other vaccines. This will be no different. Repeat coronavirus infections give a natural boost to antibodies. This vaccine is giving the first primer for the lifetime of infections you (but not your newborn) have not had. In ten years it will be a childhood infection (hopefully).
Cases rising in London over all, rising in 3 of 4 boroughs, worst in outer London. I looked up Croydon, my borough, a significant increase in a week in confirmed cases. London as a whole having more cases than many areas in tier 3. So I see why the mayor is worried and to me it seems tier 2 isn't anywhere near enough here at this time. I hope I'm worrying unnecessarily but I fear we won't change before Christmas and by then it could be quite a state we are in. I sense 8 weeks lock down starting in January.
allow regions to go to T1
Tier 1 is over. We won’t be going back until mass vaccination shows a response. London, SE, East of England have all risen to stable and too high levels. So after Christmas we’ll be in Tier 3 to bring things down. I’m not so sure about Lockdown3 but wouldn’t rule out a further half-term circuit breaker this time around.
Those are looking like pretty robust summaries for policy now. Expect better things ramping up from Easter. Not so long but will feel like it after a year.
Thank you!
RM.
NHS saying that anyone with severe allergies shouldn't get the pfizer vaccine apparently
So at school if kids get it no teachers need to isolate as we are not in close contact apparently, however when a teacher gets it only kids need to isolate, top work PHE.
That one's easy, teachers are notoriously shouty, spreading Covid greater distances. 🙂
Also, board rubbers can hold viruses for several days, and teachers are experts at landing them square in the face of unsuspecting pupils.
While not wanting to dismiss the long term economic effects of Covid on health and mental health, we loose (a worryingly high) 6-7000 people a year to suicide. The forecasts were up to 400,000 dead of Covid with no measures taken, we're already at 60,000+ with all these measures.
The right actions are being taken health-wise, now at least. Long term economic and health support under this government? Who knows.