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Covid-19 #25: The Prisoner’s Dilemma


Fragile Bird

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3 hours ago, Fragile Bird said:

A study reported in the New England Journal of Medicine, analyzing the data already out there, says the first shot of the Pfizer vaccine has an efficacy of 92.6%, and the Moderna vaccine has a similar number. However, no one knows how long that protection will last, since people then got their second shots.

They should be getting good data from the province of Quebec, vaccinations have been given since before Christmas and no second shots have been administered yet. That's over 300,000 people.

They should have some idea from the UK with the UK adopting the policy of giving many people a single shot is better than giving half of that many 2 shots. At least in the short term (months). I suppose most people will get their second jab before immunity from a single shot starts to wane. But I imagine there will be a lot of people who don't get a second jab because they forget or can't be bothered, and these people should be followed up after 6 months, a year to see what their immunity is like.

ETA: We like to think small here, today our first 25 people got the jab.

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9 hours ago, Filippa Eilhart said:

why do we even want them to deliver it, right? 

I guess there is a political factor related to the lack of other options. Deliveries of Pfizer and Moderna will take longer than expected, J&J and Novavax hasn't applied yet (?) for approval and anyway have production problems. The alternatives are more politically unpalatable, namely vaccines from Russia and China.

Thinking about it. Probably it has a lot to do with the later. AZ is the main tool in the vaccine diplomacy, which Europe is lagging behind Russia and China (and even India using the very same vaccine). US is not even interested in that game.

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7 hours ago, Padraig said:

Exactly.  We have a lot of speculation right now.  There was the AZ test in South Africa which showed a poor response against mild COVID but the sample size was quite small, so the confidence wasn't high.  AZ is still saying that it could be reasonably effective against severe COVID, which ultimately is what really matters.

yes, but this isn't how trials are measured and how we are comparing vaccines. Despite variance, vaccine efficacy is measured against symptoms. We surely can expect protection against severe disease, but how much? We can only knew after roll out.

 

7 hours ago, Padraig said:

And now Pfizer and Moderna have said that based on lab studies, their vaccines have generated less antibodies against the South African variant.  But nobody knows what that means.  How many antibodies do you need?  (Never mind T-Cell response, which is completely unclear).  Hopefully even 66% less antibodies is enough to stop you getting severe COVID?  And lab studies aren't real life tests.

Yes and yes.  There are more aspect than antibodies.

 

7 hours ago, Padraig said:

A few of the other candidates have reported lower efficacy against COVID.  Novavax reported 86% efficacy against the UK variant but 60% against the South African one.  J&J also reported a drop.  But neither are mRNA vaccines.  Curevac (a mRNA vaccine) is doing a Phase 3 trial at the moment but I don't believe it is in South Africa.  Thus, not sure how long things will remain vague.

Right now, the South Africa variant is only dominant in southern Africa I believe.  But I don't think many countries are doing enough regular testing of this.  You really want to keep this variant out of your country.

I think it's too late and if these mutations are giving an evolutionary advantage either in transmission and/or immune escape, there are bound to appear elsewhere. 

7 hours ago, Padraig said:

I see Biden is going to make a big contribution to COVAX.  That's great.  Not sure is that linked to COVAX's announced 1bn order for Novavax's vaccine (also today).  Wow.  On the other hand, I know others have said this but COVAX is becoming a big tease.  I don't believe it has delivered anything yet.

I see. So US is also playing the game, but through COVAX which indeed afaik hasn't delivered yet.

 

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JJ actually applied for EU approval and it's expected mid-March (there was talk of mid-February but that was ages ago). But now EMA is saying mid-March. Which doesn't mean they will be able to deliver vaccines as of then, as we well know by now ;)

In Luxembourg currently 39% of samples are the British variant and 5% South African. I wonder which one of these will prevail.

I agree we mostly want AZ because other options are limited. But honestly they haven't done a very good job - efficacy aside, they botched their trials, it's still uncertain what dosage works best (half dose and full dose after which it was apparently 90%? what happened to that regimen or maybe just a single dose which seems to work better than 2 doses). Apart from which it seems to have more side effects than the other vaccines. Although maybe that's just anecdotal. I'll still obviously take it if offered but I would much prefer to be offered something else ;)

 

 

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2 hours ago, Filippa Eilhart said:

JJ actually applied for EU approval and it's expected mid-March (there was talk of mid-February but that was ages ago). But now EMA is saying mid-March. Which doesn't mean they will be able to deliver vaccines as of then, as we well know by now ;)

In Luxembourg currently 39% of samples are the British variant and 5% South African. I wonder which one of these will prevail.

I

the more transmissible mutant will always outperform the others, so likely and hopefully the British and not the south african will become the dominant one. About mutants:  IIRC there is a mutant of the British variant out there (somewhere in England, read it on BBC; they are monitoring it)  which has also the critical deletion of the South African variant, so it is very likely highly tansmissibly AND reducing the efficacy of vaccines. If this is the case than we all want the "normal" British variant to outperfom the wildtyp and not this new one.

https://www.bbc.com/news/health-56082573

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8 hours ago, The Anti-Targ said:

They should have some idea from the UK with the UK adopting the policy of giving many people a single shot is better than giving half of that many 2 shots.

There certainly is more evidence appearing about how effective Pfizer is after 1 dose.

Quote

The first dose of Pfizer Inc’s COVID-19 vaccine is 85% effective, a study of healthcare workers at an Israeli hospital has found, potentially fuellng a debate over the recommended two-dose schedule as governments try to stretch out supplies.

https://www.reuters.com/article/us-health-coronavirus-israel-vaccine/israeli-study-finds-pfizer-vaccine-85-effective-after-first-shot-idUSKBN2AJ08D

But yes, there is data from the UK on the AZ vaccine working well with just 1 shot also.

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12 hours ago, williamjm said:

Do we have any evidence the experts are wrong about that? I haven't read all the coverage about it, but in the quote I posted above the author of the study still seemed to think they would be effective.

The Pfizer vaccine efficacy is yet to be determined, I'll admit. But the Novavax vaccine had the first clinical results late January that showed efficacy against the British variants dropped to mid 80 and South African one to lower 60s.

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32 minutes ago, IheartIheartTesla said:

The Pfizer vaccine efficacy is yet to be determined, I'll admit. But the Novavax vaccine had the first clinical results late January that showed efficacy against the British variants dropped to mid 80 and South African one to lower 60s.

I thought Novavax wasn't a MRNA vaccine? 

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58 minutes ago, williamjm said:

I thought Novavax wasn't a MRNA vaccine? 

It isn’t.

eta: it’s a protein subunit vaccine. They use moth cells. I saw that the Glaxo/Sanofi vaccine that got Warp Speed funding also used an insect protein. It’s been delayed because the response in people over 65 was not strong.

The Novavax vaccine, which was trialed in the UK while the B.1.1.7 variant was sweeping across the UK, had 89.3% efficacy in the UK, so I’d be fine with it. (From the NYT article explaining how the Novavax vaccine works)

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So will hit 500,000 deaths here in the US sometime over the weekend. I recall a meme going around months ago comparing headlines when we hit 100k and 200k death tolls. The first set were shocked, the second were more like, whatever, this is happening. We're close to 10 times the deaths we had in Viet-fucking-nam, and a lot of Americans simply don't care anymore.

WTF?

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14 minutes ago, Tywin et al. said:

So will hit 500,000 deaths here in the US sometime over the weekend. I recall a meme going around months ago comparing headlines when we hit 100k and 200k death tolls. The first set were shocked, the second were more like, whatever, this is happening. We're close to 10 times the deaths we had in Viet-fucking-nam, and a lot of Americans simply don't care anymore.

WTF?

According to Worldometer the US hit that number earlier this week. BFC posted about it. John’s Hopkins is thousands of deaths behind.

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1 hour ago, Fragile Bird said:

According to Worldometer the US hit that number earlier this week. BFC posted about it. John’s Hopkins is thousands of deaths behind.

I stopped checking, but I'm not surprised. Just going off what NBC is reporting at this point in time. 

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Ladies and gentlemen, I give you ....Florida Woman:https://www.theguardian.com/world/2021/feb/19/florida-women-wear-granny-disguise-covid-vaccine

Quote

Two Florida women aged 34 and 44 dressed up as “grannies” – wearing bonnets and gloves – in a failed attempt to pass as old enough to be eligible for coronavirus jabs, according to local media reports.

We live in a universe where anti-vaxxers and people desperate to get vaccines co-exist. Also, reading the report, it looks like they already got their first shot? At this point I'd just give them the second one. Can't really fault them too much, these are weird and tough times for many, and who knows what their personal circumstances are.

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I just saw a report from Pfizer that says their vaccine is stable at -15C to -25C (5F to -13F) so they can be stored in a regular pharmacy freezer for a two week period. Long term storage at -60C to -80C (-76F to -112F) is good for 6 months.

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-submit-covid-19-vaccine-stability-data

I don't know what uptake numbers are elsewhere but in Ontario +90% of LTC residents have accepted doses, and many locations have hit 100%.

Remember I said there should be data out of Quebec where they have only administered 1 dose to 300,000 people? They are reporting efficacy of one shot of the 2 mRNA vaccines has been 80%. 

Quote

“We saw that in health-care workers and in residents of long-term care facilities, the vaccine gives a protection around 80 per cent in both groups,” Dr. Gaston De Serres, epidemiologist at Quebec’s government-mandated public health institute, told reporters.

That level of protection took two weeks to develop in health-care workers and three weeks to develop in long-term care residents, who generally have weaker immune systems, he added.

Around 80 per cent of long-term care residents and 50 per cent of public sector health-care workers have received a single dose of vaccine, De Serres said, adding that since early January, the number of COVID-19 cases in long-term care homes has dropped by around 95 per cent.

Quebec has had half of all the deaths in Canada and 80% of the deaths have been in LTC facilities.

https://globalnews.ca/news/7647690/quebec-coronavirus-nursing-homes-cases-drop-vaccine/

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On 2/18/2021 at 11:39 AM, JoannaL said:

The EU should sue AZ out of business.

Just to follow up on that.  Politico has released an article on that very topic (Spoiler:  Its not going to happen).

There was a bit of attention on COVAX at the G7 summit today.  I find it puzzling that this "boast" about sharing leftover vaccines with poorer countries got any positive traction.  While obviously not a bad thing, it's the bare minimum anyone could do (with a very vague timeline).  Sometimes, it is best to say nothing at all.  The media can be very kind sometimes.

I think Oxfam's response was appropriate.  See here.

Quote

Making huge parts of Africa and Asia wait for unwanted, leftover vaccines from rich countries’ stocks is not just immoral, it is irresponsible.

Macron suggested sharing 5% of their vaccines with other countries, as it is delivered.  I suppose that is not going to go anywhere either (not like 5% is going to do a lot) but a least it was tangible.

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For months I’ve seen stories about how many African countries have handled the pandemic so much better than Western countries, because of their experience with Ebola. While some countries are lying about their cases (Tanzania) others have very few cases. Send vaccine to countries that need it, mostly in the north. Since none of the vaccines so far are very effective against the South African variant, does it make sense to send vaccine with 50% efficacy to them or should that wait until they’ve changed the vaccine?

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5 hours ago, Fragile Bird said:

For months I’ve seen stories about how many African countries have handled the pandemic so much better than Western countries, because of their experience with Ebola. While some countries are lying about their cases (Tanzania) others have very few cases. Send vaccine to countries that need it, mostly in the north. Since none of the vaccines so far are very effective against the South African variant, does it make sense to send vaccine with 50% efficacy to them or should that wait until they’ve changed the vaccine?

I tend to agree. A friend who is in Congo tells me that COVID is hardly an issue there. She is doing educational work related to health issues (mostly reproduction related) and besides people using masks in crowed settings, not much is being done. Social distancing is nearly impossible. It's possible that COVID hasn't reached there in full force or there are other reasons.

Besides I find COVAX initiative troubling in some aspects. Rich countries donate money that in turn go to buy vaccines produced by the very same countries. The Ecuador president went out and complained about that. He doesn't get a choice about what vaccines they get or when.

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The WHO/FDA/EMA all seem to have a cut off point at 50%, so if a vaccine manages to reach that target, it should be used.  Before Moderna/Pfizer managed their strong figures, people were worried that we would end up using vaccines at around 60% efficacy.

J&J is 57% against the South African variant.  If you view that as more than halving the amount of people in hospitals, that's still a big win (and probably stopping anyone from dying).

The weird thing about the Oxfam quote was that it mentioned Asia and Africa, when its Latin America that has being severely hit.   Never mind the case figures, the amount of people that have died in Peru and Mexico are very high.  There are plenty countries that need to be vaccinated, even if you ignore the fact that some countries don't have great data.

At the same time, yes, Slovakia currently has the highest fatality rate in the world.  Supply remains the issue until April.

4 hours ago, rotting sea cow said:

Rich countries donate money that in turn go to buy vaccines produced by the very same countries.

I noticed that trend.  It could make you very cynical!  But still, rather them do it than not.

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7 minutes ago, Padraig said:

The WHO/FDA/EMA all seem to have a cut off point at 50%, so if a vaccine manages to reach that target, it should be used.  Before Moderna/Pfizer managed their strong figures, people were worried that we would end up using vaccines at around 60% efficacy.

I don't think people were worried. We apparently use vaccines with efficacy around 50% all the time. I think it's just that a lot of people who've never paid any attention to the efficacy of a vaccine before in their lives (most of us I'd guess) saw the reported efficacy of the Pfizer vaccine and just started assuming that's the level we should consistently expect.

5 hours ago, rotting sea cow said:

Besides I find COVAX initiative troubling in some aspects. Rich countries donate money that in turn go to buy vaccines produced by the very same countries.

The vaccine for Covax has mostly been produced in India hasn't it?

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