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Covid-19 Vaccine - Where, How & Costs

Flyaway

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What was it like to live in a country ruled by a COVID denier. Though the new president doesn’t appear to be a COVID denier she’s done nothing to put a vaccination program in place and has instead formed a committee to look into how the pandemic was handled. Nobody knows how many have died and the gentleman they interview talks of overflowing wards and most still rely on herbal remedies to combat COVID.

 

Flyaway

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Looks like after banning the AZ vaccine Denmark are not going to use the J&J vaccine either.


Also just what is wrong with some people!!!

 

edwest2

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edwest2

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Like the flu, yes, the virus is here to stay. Science is doing its best right now to come up with viable alternatives to what will be a yearly shot, namely a pill or capsule or a nasal spray.
 

chimeric oncogene

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The path forward is clear; governments may decide to eat the third wave and screw over anyone not yet vaccinated. This is probably the sanest path - the vaccine-hesitant should take note.

Even with the weaker Chinese vaccines, COVID death rates will fall from 3% to ~0.6%, which is only a few times higher than baseline flu, assuming 100% vaccine penetrance. This is still likely to screw over the healthcare system like a bad flu season (death rate ~0.1%) does - my city's hospitals overflow yearly at peak flu season already - which I suspect is why the Chinese epidemiologist was not too happy with Coronavac performance despite it meeting general goals of reducing morbidity and mortality. If you really want to beat COVID into oblivion, as opposed to merely survive it, I suspect you really want Pfizer or Moderna.
 

DWG

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Confirmation that they do seem to expect a third smaller wave with the ending of restrictions, they also expect the NHS to cope with the uptick in cases.

It's always been expected there would be a rise in cases with each step out of lockdown compared to if they hadn't done it (which is obvious when you think about it). They've been quite open about that in the briefings from No 10. We've been in a step by step loosening of lockdown since early March, the next one is indoors hospitality opening on the 17th after opening outdoors hospitality and most shops a couple of weeks ago. All the loosening of restrictions are on a schedule, but spaced several weeks apart to let the data tell us what the effects are and whether they need to pause relaxations, or even go back a step.

Current rates are spectacularly lower than they were in January, locally we peaked at something like 850 cases per 100,000 (and well over 1000 not too far away), but that's now down to under 3 (they don't quantify it below that level, so could be zero). And there was only a single death across the entire country yesterday (which was a national holiday, so some could be delayed a few days, but we're reliably into single figures). Neil Ferguson, one of our leading epidemiologists, seems reasonably happy with the plan, confirming they're modelling things like not socially distancing.

 
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edwest2

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This is not about governments. Last Thanksgiving and Christmas, over a million people decided to fly in the US and each time the predictable spikes occurred in hospitalizations and deaths. I am seeing an increase in my state of out of state license plates.

Pfizer is still testing a pill that may replace a yearly shot. It is referred to as a protease inhibitor, meaning it prevents viral reproduction. Once symptoms appear, the pill is taken. Other attempts are being made to produce a different delivery system for the vaccine.
 

edwest2

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Flyaway

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Confirmation that they do seem to expect a third smaller wave with the ending of restrictions, they also expect the NHS to cope with the uptick in cases.

It's always been expected there would be a rise in cases with each step out of lockdown compared to if they hadn't done it (which is obvious when you think about it). They've been quite open about that in the briefings from No 10. We've been in a step by step loosening of lockdown since early March, the next one is indoors hospitality opening on the 17th after opening outdoors hospitality and most shops a couple of weeks ago. All the loosening of restrictions are on a schedule, but spaced several weeks apart to let the data tell us what the effects are and whether they need to pause relaxations, or even go back a step.

Current rates are spectacularly lower than they were in January, locally we peaked at something like 850 cases per 100,000 (and well over 1000 not too far away), but that's now down to under 3 (they don't quantify it below that level, so could be zero). And there was only a single death across the entire country yesterday (which was a national holiday, so some could be delayed a few days, but we're reliably into single figures). Neil Ferguson, one of our leading epidemiologists, seems reasonably happy with the plan, confirming they're modelling things like not socially distancing.

This is all dependent on our ability to keep new variants out of the U.K. Personally I have zero confidence in this due to multiple shortcomings in our quarantine system that actively encourages people to circumvent the system. Issues such as the lack of family rooms, the sheer price of quarantine out of the range of many people especially families. The lateness of tests being delivered to people, so late in fact that people are actually leaving quarantine as they are fed up for waiting for them. People circumventing the system by travelling to red listed countries but then using lower listed countries to come back to the U.K. Need I go on. The government is aware of many of these issues but has done little to fix them. They even talked to the head of one testing companies on the radio a couple of weeks ago, he said they can barely cope with the demand now, and has no idea how they were going to cope when international travel re-opens.
 

edwest2

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The behavior of individuals can only be controlled with strict, clearly defined rules and related enforcement. The media in the US is peddling the fiction that there is a "debate" over vaccine passports. When private companies start restricting access to those who can show a negative test or completed vaccination then the debate will be over. Of course, everyone will have access to food and other essentials.

Like a military operation, there will have to be checkpoints and surveillance to insure that unauthorized personnel do not enter. Of course, as in military operations, it is possible that a few will sneak in.
 

Flyaway

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Flyaway

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Article critical of the way vaccine trials were run and also how vaccine statistics are presented. That the lack of clarity especially for people working out their personal risk calculations is actually encouraging vaccine hesitancy. Also that the WHO was meant to run a trial pitting all the vaccines against each other but still hasn’t got around to it.

 

edwest2

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Unfortunately, a lack of complete information is part of the contract process. "Trade secrets" was part of the contracts and waiving intellectual property rights so that others may make generic vaccines speaks to the urgency of saving lives and preventing further infections.

It was puzzling to read just prior to the Emergency Use Authorization being given in the US that a few questioned whether the vaccines would "work." What was given during trials? What worked during trials? If nothing actually worked then there would be nothing to approve. And depending on a person's age and other health problems, there's a very small risk from other vaccines as well.

The media, in an apparent attempt to keep anxiety high, is raising questions it should put to vaccine makers. As far as anyone evaluating their own risk, I have done and continue to do everything the general public was told to do. That's all anyone can do.

Anyone willing to carry a sign to protest anything did so in the past and will do so today and into the future.
 

chimeric oncogene

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Also that the WHO was meant to run a trial pitting all the vaccines against each other but still hasn’t got around to it.
That sounds super-hard to do and I doubt you'd get much useful information; the sample sizes you'd need would be massive!

Vaccine trials have huge error bars as it is when you're comparing no vaccine vs. vaccine - a large difference.
The error bars when comparing between different vaccines with relatively small differences in efficacy would be ginormous in any reasonably-sized trial. The study would need to be huge to have enough power to pick up the small differences.

Not worth it IMO to do it last year, when we needed working vaccines, any working vaccines, quick.
 

DWG

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Worth pointing out it's not a 'US proposal', it's a South African and Indian proposal that's been around for the last year, and the US only switched from opposing it to supporting it yesterday.

 

DWG

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Also that the WHO was meant to run a trial pitting all the vaccines against each other but still hasn’t got around to it.
That sounds super-hard to do and I doubt you'd get much useful information; the sample sizes you'd need would be massive!

There's plenty of precedent across multiple disciplines for meta-studies* that combine the results of multiple studies/trials into one overarching analysis across the field, and by definition all authorised vaccines have met a single set of standards in each of the authorising countries, so the data-sets presented for authorisation should be mutually compatible.

OTOH we're seeing reports of different vaccines having different strengths in different areas, for instance at least one paper has found AstraZeneca superior to Pfizer in some areas, despite most people assuming Pfizer is the one to beat, so there may be no single 'best' vaccine.

* The proper term is escaping me.
 

DWG

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DWG

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Note that it's standard UK Civil Service practise not to release anything controversial around an election (the whole Civil Service pretty much shuts down during a General Election - generally referred to as 'purdah'), so there's not really anything especially newsworthy in the data being delayed a day*, it's the data that's the story here.

* Though it's a bit of business as normal I'd question during a pandemic.
 

edwest2

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From the article above: “The most effective way to stop variants developing or spreading is to keep pushing down infection rates and transmission of the virus in our community,” he added. “All variants spread in the same way. We protect ourselves and others by following public health advice and getting vaccinated when our turn comes.”

So, no news here. The variants are spread by people.
 

TomcatViP

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Someone will have to tell the story of the vaccination across Europe since there are more victorious charges and debacles than in a Napoléon campaign !
 

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As I've stated here before, most of the decisions on AZ up to this point (even those that I'd personally have taken differently) I found adequately sensible and justifiable - but I have to admit they lost me now!

Nothing has changed about the risk which prompted the age restriction, so (even if I'm inclined to agree with EMA that the benefit is worth it) having instituted it, the restriction should remain! NOW the policy really is getting confusing and haphazard!

Part of my frustration is what drives this move: people over 60 are shunning AZ in favour of the mRNA vaccines, even though it was stated time and again that people would not have any choice about what type they'd be offered. That this is possible at all is because GPs are now contributing a significant fraction of vaccinations and the behaviour is creating a surplus of AZ and a shortage of BioNTech/Pfizer for younger age groups. Sorry, but if you're of an age eligible for AZ and there are no personal risk factors* suggesting mRNA might be preferable, you take it or leave it!

* I'm perfectly prepared to give GPs some leeway in this regard. Say there's a 62-year old (so - barely - eligible for AZ) female with some kind of pre-existing condition that exacerbates her individual risk of CVT - fine, jab her with Moderna or B/P! But generally speaking, the patient does not get to choose, as has been declared from the outset!
 

Richard N

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Why not take advantage of the human greed response and give everyone who gets vaccinated a chance in a weekly state lottery. $10-50K weekly prizes in every state and a golden ticket vaccine passport that will get the winner into any sought after concert, first class upgrade on an airliner, or E ticket to Disneyland.
 

chimeric oncogene

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should be mutually compatible.
Eh, they often aren't, for a variety of reasons.

The Phase III trials were in different countries, with different test populations, with different measurement intervals after vaccination... pulling a meta-analysis out of that would be tough. And I doubt the meta-analysis would be sufficiently powered to pick up differences since you're not actually combining more than one trial.

Now post-vaccination-drive meta-analyses might be possible, but you're comparing say, Chilie with the US here - the situations are again not comparable because of systemic differences between the two vaccinated groups. Might be good for AZ and Pfizer in the EU though, or J&J vs Pfizer in the USA.

Now, there are study designs and other tools to handle these differences, but it would get complicated fast.
so there may be no single 'best' vaccine
Nah, in pure efficacy terms, the mRNAs just beat everyone else silly.
 
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Trident

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AZ does give you somewhat better protection after the first shot though, IIRC. Which is part of the reason why it's possible to stretch the interval between first & second doses so greatly. AFAIK it was originally intended to be a one-shot vaccine like J&J actually, but they weren't quite happy with the efficacy in a such a regimen, so added the booster shot.
 

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