Vaccine Progress, Approval, and Deployment

[yorksrob]

I think it's positive regarding opening up vaccinations to younger people in the affected area. Certainly beats waiting around to lock it down.

 

[TravelDream]

Apparently it was a 'queue room', which doesn't surprise me given the weather.

Sorry just realised there was a typo in my original post: today onwards it is Pfizer.

That makes more sense.

It's pretty sad though. The Oxford/AZ vaccine is a fine vaccine and the risk of clots from it is far lower than a woman who takes the pill and comparable to a single long-haul flight. Constant media negativity has really hit public perception of it.

 

[peters]

It now seems anybody in Blackburn over 18 can book a Pfizer jab now. So the surge vaccination seems to be happening, which is a good sign.

A few weeks ago doctors from the North West said they hadn't received as many vaccines (in relation to the population) as other regions meaning the North West was lagging behind for vaccination rates. I wonder if that's changed now.

I also wonder whether the reason Bolton and Blackburn are being talked about when the Indian variant is mentioned, ahead of other places with an Indian population is because of the slower vaccine rollout.

Assume they cheered as it was Pfizer? If so such a shame as shows our wonderful media have managed to make another British product look like the pits and yet successive governments have been blamed for fall of certain industries. We are our own worst enemies in this country. Disgusting.

From BBC News today and the same story is on other sites:

Adults are more likely to report mild and moderate side-effects after mixing doses of the AstraZeneca and Pfizer Covid vaccines, a study indicates.
...
One in 10 volunteers given two AstraZeneca jabs four weeks apart reported feverishness - but if they received one AstraZeneca jab and one Pfizer, in any order, the proportion rose to about 34%
...
The Canadian provinces of Ontario and Quebec have both said they plan to mix vaccines in the near future, amid uncertainty over shipments of the Oxford-AstraZeneca jab and concerns about rare blood clots.

Covid vaccines: Mixing increases reports of mild side-effects

Researchers are still analysing whether injecting two different vaccines leads to better protection.

www.bbc.co.uk

So British media is saying the science says 2 doses of AZ is better than 1 AZ and 1 Pfizer, despite the Canadians deciding to mix vaccines. As it's 2021 people have easy access to foreign news stories, regardless of whether the likes of BBC, ITV and Sky choose to report them. It seems the BBC is questioning the Canadian approach, at the same time as reporting on the vaccine trials. They did similar when other countries stopped roll out of AZ to over 65s.

From past reports on vaccines I recall the science states:
- Pfizer is overall a lot more effective than AZ but AZ is a lot more effective than the Chinese produced vaccine.
- AZ is much cheaper and easier to store.
- The risk of blood clots is very low but it increases slightly for younger people, who have a lower risk of catching serious cases of COVID.
- The UK supply of AZ is being manufactured in many countries including India.
- The risk of side effects after a 1st dose of AZ is higher than with Pfizer but it's the other way round with Pfizer.

Brazil is reportedly using the Chinese produced vaccine. Instead of seeing the AZ vaccine as not the best option for Europe or North America, it could be seen as one of the best options for the less developed countries where storage and cost constraints will be greater. As the UK over ordered vaccines and seemed to have the approach, we'll use whatever arrives first and then let other countries have our surplus, I can see the AZ surplus in the UK ending up being used by countries like India.

 

[TravelDream]

From past reports on vaccines I recall the science states:
- Pfizer is overall a lot more effective than AZ but AZ is a lot more effective than the Chinese produced vaccine.
- AZ is much cheaper and easier to store.
- The risk of blood clots is very low but it increases slightly for younger people, who have a lower risk of catching serious cases of COVID.
- The UK supply of AZ is being manufactured in many countries including India.
- The risk of side effects after a 1st dose of AZ is higher than with Pfizer but it's the other way round with Pfizer.

This is broadly right, but not 100% from what I recall.
1) The phase 3 trials showed Pfizer was more effective than AZ, but not 'a lot more'. The problem Oxford/AZ had was that mRNA vaccines were far more effective than anyone thought possible. Both vaccines are far more effective than normal seasonal flu vaccines. Real-world studies have shown than AZ is only slightly less effective than Pfizer.
2) Yes, though a new version of the Pfizer vaccine which can be stored at -20 degrees and not -70 degrees has been approved and is now being produced. A German company should have a fridge-stored mRNA vaccine approved and in use within a couple of months. The Pfizer vaccine is more expensive, but that's nothing in comparison to the cost of lockdowns.
3) The risk of clots is extremely low. The JCVI and MHRA look at a number of factors. These include risk-benefit for different age profiles. I think they are being too cautious given the effects of Covid.
4) This is partly right. UK AZ vaccines are currently mainly produced here in the UK, but are also produced in the Netherlands and India. India blocked the export of 5 million doses when their cases surged which has slowed our progress somewhat. Our Pfizer vaccines are produced in Belgium, and a new plant in Germany just started a few weeks ago. Moderna vaccines are produced in Spain and Switzerland.
5) From articles I have seen, side effects are highers with AZ after both doses. The Pfizer one is more likely to produce side-effects after the second dose in comparison to their first dose, not compared to AZ.

 

[peters]

This is broadly right, but not 100% from what I recall.
1) The phase 3 trials showed Pfizer was more effective than AZ, but not 'a lot more'. The problem Oxford/AZ had was that mRNA vaccines were far more effective than anyone thought possible. Both vaccines are far more effective than normal seasonal flu vaccines. Real-world studies have shown than AZ is only slightly less effective than Pfizer.

There's different statistics from different trials. Yes there's one showing a single dose of AZ or Pfizer can have a 70%+ chance of preventing a serious case of COVID e.g. one requiring a hospital admission and with two shots it's over 90% in both cases. However, there's also stats which show two shots of AZ have around a 70% chance of preventing COVID altogether (including mild cases), whereas Pfizer is over 90% but with mutations those figures are subject to change.

One thing to bear in mind is currently someone who tests positive for COVID has to self-isolate for 10 days (regardless of their vaccine status) so for someone who can't work from home having that extra bit of protection against less serious cases of COVID could be very useful.

3) The risk of clots is extremely low. The JCVI and MHRA look at a number of factors. These include risk-benefit for different age profiles. I think they are being too cautious given the effects of Covid.

The decision for a preference for Pfizer or Moderna for the under 40s partly relates to convincing younger people to take up the vaccine. The advice is that Pfizer or Moderna are preferred if it won't delay the vaccine roll out, so if there's no supplies of either in the local area then the under 40s won't get that option. A notification from my practice advises people not to book through online platforms if they have a severe allergy or carry an Epi-pen as those people shouldn't get the Pfizer vaccine.

UK AZ vaccines are currently mainly produced here in the UK, but are also produced in the Netherlands and India. India blocked the export of 5 million doses when their cases surged which has slowed our progress somewhat. Our Pfizer vaccines are produced in Belgium, and a new plant in Germany just started a few weeks ago. Moderna vaccines are produced in Spain and Switzerland.

It might be the Valneva vaccine produced in West Lothian gets approved in time for the 18-30 age group or possibly for teenagers or boosters, reducing reliance on vaccine imports. It sounds like @Richard Scott would be happy if that happened.

5) From articles I have seen, side effects are highers with AZ after both doses. The Pfizer one is more likely to produce side-effects after the second dose in comparison to their first dose, not compared to AZ.

What I wrote didn't really make sense. I meant if someone has AZ they are more likely to have side effects after the 1st dose than the 2nd, while the Pfizer it's the other way around. That can mean for some people they know others in their age group who've had an AZ 1st shot and didn't feel well afterwards and they also know people who have had a Pfizer 1st shot and didn't have any noticeable side effects, so they are going to think Pfizer's better.

I just got a text from a friend in London, where she had her vaccine today. Apparently yesterday was their last AZ day; today onwards if Pfizer. When it was announced, apparently many in the queue cheered!

That's interesting. Presumably everyone they've given a 1st dose of AZ to has also been offered a second dose, otherwise won't stopping AZ altogether cause issues for those people?

Just tried to book online again after being eligible for nearly 3 weeks, still won't offer me anything anywhere near and it's now offering them in the next category. I'm still not travelling for it.

Have you checked whether your local NHS trust or doctor's surgery is doing any GP led rollout in your area? If they are it might not show up on the national booking system and you'll only be able to book if they contact you directly.

 

[swt_passenger]

I understand Moderna is more likely in lower volume rural centres as does need special low temperature freezers

Sorry, but did you mean to write “does not need…”?

 

[TravelDream]

There's different statistics from different trials. Yes there's one showing a single dose of AZ or Pfizer can have a 70%+ chance of preventing a serious case of COVID e.g. one requiring a hospital admission and with two shots it's over 90% in both cases. However, there's also stats which show two shots of AZ have around a 70% chance of preventing COVID altogether (including mild cases), whereas Pfizer is over 90% but with mutations those figures are subject to change.


It might be the Valneva vaccine produced in West Lothian gets approved in time for the 18-30 age group or possibly for teenagers or boosters, reducing reliance on vaccine imports. It sounds like @Richard Scott would be happy if that happened.

The Valneva vaccine is a *LONG* way off (don't listen to some of the nonsense in the media or Boris' Downing Street briefings which make these things sound imminent). Anyone who wants one will still be offered a vaccine by the end of July.
We currently use AZ, Pfizer and Moderna. The single-dose J&J (developed and produced in the EU) has been approved and will likely start being used by mid-June, but in very small numbers. It was hoped Novavax, which will be manufactured in Barnard Castle, would be ready by July, but their recent announcements are a but more cautious about that - it might be though.
So for UK produced vaccines, we are looking at AZ and possibly Novavax by the end of July.


I'm not sure what you are talking about on trials.
The phase three trials for Pfizer and AZ both looked at two doses.
Pfizer - 95% - https://www.pfizer.com/news/press-r...ntech-conclude-phase-3-study-covid-19-vaccine
AZ - 70% (up to 90%) - https://www.astrazeneca.com/media-c...analysis-results-published-in-the-lancet.html
Both were 100% effective in preventing severe disease and death.

There have been many 'real-world' studies (which aren't trials) which have looked at different things in different countries. Single-dose, medical workers, whole populations, the elderly etc.etc. which make then not totally comparable. What they all show though is both Pfizer and AZ are very effective. Many have shown they have almost the same effectiveness (the UK single-dose one. The Korean one on elderly people).
There have been a couple of 'real-world' trials too like the US Center of Disease Control one of medical workers. That only looked at Pfizer and Moderna and found them both to be incredibly effective.

 

[peters]

I'm not sure what you are talking about on trials.
The phase three trials for Pfizer and AZ both looked at two doses.
Pfizer - 95% - https://www.pfizer.com/news/press-r...ntech-conclude-phase-3-study-covid-19-vaccine
AZ - 70% (up to 90%) - https://www.astrazeneca.com/media-c...analysis-results-published-in-the-lancet.html
Both were 100% effective in preventing severe disease and death.

Well as you've found the statistics which back up what I was originally talking about, so you can't be disputing that and I only expanded on the 1st dose reports because you said what I originally said 'wasn't 100% correct.' So it sounds like you disagree that a 95% result proves it's a 'lot more effective' than a 70% result.

Look at it this way if there's 200 people in one workplace all who've had 2 doses of Pfizer and they all get exposed to the virus, then on average 10 will start showing symptoms and will need to go into self-isolation. That might be annoying for the business but probably something the remaining staff can cope with.

If they've had AZ instead then we might be talking about 60 people rather than 10. That might need an emergency meeting and functions of the business being suspended until people return.

Like I said in an earlier post, fewer people in self isolation is much better if people can't work from home. Yes I accept 140 people in work in the 2nd instance is much better than everyone self-isolating but it's significantly worse than 190 in work

 

[DelayRepay]

Look at it this way if there's 200 people in one workplace all who've had 2 doses of Pfizer and they all get exposed to the virus, then on average 10 will start showing symptoms and will need to go into self-isolation. That might be annoying for the business but probably something the remaining staff can cope with.

This isn't correct because it assumes that if there are 200 people who haven't had any vaccines, then all 200 will become ill. This clearly isn't the case because until January we had no vaccines yet I am not aware of any workplace where every single person caught Covid.

Your other assumption is that we will continue with the self-isolation rules but I don't think this will be the case. The real benefit of the vaccines is that even if a vaccinated person catches Covid, it is likely to be a much more mild infection and much less likely to lead to serious sickness or death. We can see the evidence of that in the UK hospitalisation and deaths statistics. So once most people are protected from serious illness and death, why would we treat Covid any differently to any other mild illness e.g. flu or a cold?

 

[peters]

@DelayRepay Yes it's an over simplified hypothetical example, to illustrate why I think 95 and 70 are significantly different numbers, so adding in too many variables to an example wouldn't have helped explain it. It's also unlikely in a real example that one company would only have employees who have had AZ and that there was an equivalent set of employees working for another business who had all had Pfizer.

 

[Pete_uk]

Had my text message and made my appointment yesterday!

 

[DelayRepay]

Delay in giving second jabs of Pfizer vaccine improves immunity

Study finds antibodies against Sars-CoV-2 three-and-a-half times higher in people vaccinated again after 12 weeks rather than three

www.theguardian.com

The UK’s decision to delay second doses of coronavirus vaccines has received fresh support from research on the over-80s which found that giving the Pfizer/BioNTech booster after 12 weeks rather than three produced a much stronger antibody response.

A study led by the University of Birmingham in collaboration with Public Health England found that antibodies against the virus were three-and-a-half times higher in those who had the second shot after 12 weeks compared with those who had it after a three-week interval.

Most people who have both shots of the vaccine will be well protected regardless of the timing, but the stronger response from the extra delay might prolong protection because antibody levels naturally wane over time.

I am posting this because it's great news. I remember back at the start of the year, when the UK extended the interval from 3 to 12 weeks for both vaccine types, there was a lot of alarm in some circles. But the decision has been vindicated by this (and other) research.

I think when we look back on this pandemic, we'll see what a game-changer this decision was. It wasn't without risk (nothing is) but it was clearly a risk that the medical authorities were correct to take.

 

[liam456]

In much better news internationally, the CDC has issued new guidance saying those who are vaccinated fully no longer need to wear masks in most settings:

The exceptions are as following: "Even vaccinated individuals must cover their faces and physically distance when going to doctors, hospitals or long-term care facilities like nursing homes; when traveling by bus, plane, train or other modes of public transportation, or while in transportation hubs like airports and bus stations; and in congregate settings such as homeless shelters, as well as prisons or jails."

‘We have all longed for this moment’: Federal guidance says vaccinated Americans may go without masks.

Fully vaccinated people only need to wear masks in health care settings, on mass transit and in transportation hubs, and in prisons and homeless shelters.

www.nytimes.com

 

[Yew]

In much better news internationally, the CDC has issued new guidance saying those who are vaccinated fully no longer need to wear masks in most settings:

The exceptions are as following: "Even vaccinated individuals must cover their faces and physically distance when going to doctors, hospitals or long-term care facilities like nursing homes; when traveling by bus, plane, train or other modes of public transportation, or while in transportation hubs like airports and bus stations; and in congregate settings such as homeless shelters, as well as prisons or jails."

‘We have all longed for this moment’: Federal guidance says vaccinated Americans may go without masks.

Fully vaccinated people only need to wear masks in health care settings, on mass transit and in transportation hubs, and in prisons and homeless shelters.

www.nytimes.com

Still rather a poor precedent for those of us who like to travel. It's about time they showed some hard evidence behind these decisions.

 

[DustyBin]

Still rather a poor precedent for those of us who like to travel. It's about time they showed some hard evidence behind these decisions.

Even more worryingly it looks like an ultimatum!

 

[takno]

In much better news internationally, the CDC has issued new guidance saying those who are vaccinated fully no longer need to wear masks in most settings:

The exceptions are as following: "Even vaccinated individuals must cover their faces and physically distance when going to doctors, hospitals or long-term care facilities like nursing homes; when traveling by bus, plane, train or other modes of public transportation, or while in transportation hubs like airports and bus stations; and in congregate settings such as homeless shelters, as well as prisons or jails."

‘We have all longed for this moment’: Federal guidance says vaccinated Americans may go without masks.

Fully vaccinated people only need to wear masks in health care settings, on mass transit and in transportation hubs, and in prisons and homeless shelters.

www.nytimes.com

So the exceptions are more or less the only places people in less panicky countries would ever consider wearing a mask anyway

 

[Yew]

So the exceptions are more or less the only places people in less panicky countries would ever consider wearing a mask anyway

Indeed, but America has converted to Maskianity. "All hail the mighty snot-rag, invincible protecter from the evil virus"

 

[liam456]

Indeed, but America has converted to Maskianity. "All hail the mighty snot-rag, invincible protecter from the evil virus"

Exactly, its a start, and one made from one of the most extreme (both ways) mask cultures.

 

[LAX54]

This isn't correct because it assumes that if there are 200 people who haven't had any vaccines, then all 200 will become ill. This clearly isn't the case because until January we had no vaccines yet I am not aware of any workplace where every single person caught Covid.

Your other assumption is that we will continue with the self-isolation rules but I don't think this will be the case. The real benefit of the vaccines is that even if a vaccinated person catches Covid, it is likely to be a much more mild infection and much less likely to lead to serious sickness or death. We can see the evidence of that in the UK hospitalisation and deaths statistics. So once most people are protected from serious illness and death, why would we treat Covid any differently to any other mild illness e.g. flu or a cold?

At our place, we have about 60 workers or so, (and quite a few daily visitors to repair and maintain things) in the past 18 months, we have had about 3 confirmed cases, and 10 "I think I might so I am staying off work" (with pay !)

 

[WelshBluebird]

and 10 "I think I might so I am staying off work" (with pay !)

Which has been the government advice right? If you have symptoms then stay home.

 

[35B]

Which has been the government advice right? If you have symptoms then stay home.

Not to mention that swinging the lead is not a new phenomenon.

 

[DustyBin]

Which has been the government advice right? If you have symptoms then stay home.

With the emphasis on if you have symptoms, and staying at home doesn’t include going round your friend’s house or walking the dog. Anecdotal but this has certainly been an issue at my GFs company! Fortunately the offenders are too addicted to social media to get away with it….

 

[peters]

I am posting this because it's great news. I remember back at the start of the year, when the UK extended the interval from 3 to 12 weeks for both vaccine types, there was a lot of alarm in some circles. But the decision has been vindicated by this (and other) research.

I think when we look back on this pandemic, we'll see what a game-changer this decision was. It wasn't without risk (nothing is) but it was clearly a risk that the medical authorities were correct to take.

I think the alarm was because it was something Tony Blair suggested in an interview and then something the government adopted, even though Pfizer didn't recommend it but Pfizer did later change their advice to something along the lines of the 2nd dose should be no less than 3 weeks after the 1st and no more than 12. I think generally most practices and NHS trusts are aiming for a 2nd dose 11 weeks after the first and then bringing it forward if there's availability sooner and also allowing for someone who has to cancel and rebook for the following week to still get the 2nd within 12 weeks.

10 "I think I might so I am staying off work" (with pay !)

If this was in the early days the advice was to self-isolate for 14 days even if you just had a persistent cough and not even arrange a test.

If it's now the employer could be recommending regular lateral flow tests and anyone who gets a positive on one of those can get a more reliable PCR test, even if they have no symptoms.

Of course an employer would already know which employees are most likely to try it on.

 

[TravelDream]

With the emphasis on if you have symptoms, and staying at home doesn’t include going round your friend’s house or walking the dog. Anecdotal but this has certainly been an issue at my GFs company! Fortunately the offenders are too addicted to social media to get away with it….

It's always been that way though.

People always have and always will try it on for an extra day off or two.

I'll never forget someone at work calling in sick two days before we started our Christmas holidays and later that afternoon being caught by two colleagues including senior manager at the airport...
I don't know what happened, but somehow she didn't get fired.

 

[ainsworth74]

I'll never forget someone at work calling in sick two days before we started our Christmas holidays and later that afternoon being caught by two colleagues including senior manager at the airport...
I don't know what happened, but somehow she didn't get fired.

She was going for specialist treatment overseas!

 

[kristiang85]

It's always been that way though.

People always have and always will try it on for an extra day off or two.

I'll never forget someone at work calling in sick two days before we started our Christmas holidays and later that afternoon being caught by two colleagues including senior manager at the airport...
I don't know what happened, but somehow she didn't get fired.

There was that guy who went to support his team in a big final (Liverpool I think?) and obviously pulled a sickie to go to the match, only for his cheering picture to be put on the front page of a national newspaper as part of the 'joyous fans' shot. I think he was fired.

 

[LAX54]

Which has been the government advice right? If you have symptoms then stay home.

Yes, although that was in the 'early' days...... well most of 2020 ! if they call in 'sick' now, they are sent for a test, so their time off is reduced a lot !

 

[matt]

The NHS app (not the track and trace one) has now been updated to show if you have had the vaccine or not.

 

[davews]

I was a little surprised today when I went to the local vaccine centre for my second one that the nurse reminded me I had had my flu vaccination in November. They certainly seem to know everything about you.
I wonder how many people use the app rather than the various other web based system. I use patient access on my desktop.

 

[DelayRepay]

I'll never forget someone at work calling in sick two days before we started our Christmas holidays and later that afternoon being caught by two colleagues including senior manager at the airport...
I don't know what happened, but somehow she didn't get fired.

I knew a guy who called in sick. The boss was quite surprised when he put the snooker on TV and saw our colleague sat in the audience.