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Covid-19 #34 - Alpha, Delta, It’s All Greek to Me!


Fragile Bird

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8 hours ago, Impmk2 said:

That's very interesting if the case. I can't really see how it would work. Can you cite that please? I just did a quick google, including having a skim through the phase 1-2 clinical trial paper (https://www.nejm.org/doi/full/10.1056/NEJMoa2026920) and I don't see indication that's what they're doing.

Good call.  This site is probably not the best for medical knowledge. :)   It was such a leftfield claim, that I didn't seriously consider it could be wrong.  And I don't know enough about the topic to know how leftfield it actually is!

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Novavax is slightly different, the first one is the vaccine, and the second one is a Matrix-M adjuvant, which it's not the vaccine, it just increases your immunity.

 

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The Premier of Luxemburg who attended the most recent EU summit tested positive and has mild symptoms. He had one dose of AZ in May.

It is a real great idea that politicians who are not fully vaccinated meet in person. *facepalm*

It is the year 2021 just talk in front of a screen...

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25 minutes ago, Fillyjonk Eilhart said:

of course he would have been fully vaccinated by now had he not tried to put on a show of how safe AZ is :P

Our chancellor did the same but only 3 weeks ago. Although with him being completely corrupt people assume that he had 2 Pfizer shots before and just waited for the study results regarding mixing vaccines. 

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20 hours ago, Padraig said:

My one doubt about Novavax (and this isn't mentioned in the article) is its performance against the beta variant, (Astrazeneca also had poor results against it).  Novavax previously reported that its efficiacy was just above 50% against beta.

Meant to comment on this earlier. The current wave in SA seems to be mostly Delta so it seems like it’s easily taking over the South African variant. Which is bad news for them but good news for vaccine efficacy I guess? 

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12 hours ago, Padraig said:

Good call.  This site is probably not the best for medical knowledge. :)   It was such a leftfield claim, that I didn't seriously consider it could be wrong.  And I don't know enough about the topic to know how leftfield it actually is!

 

I've been known to be wrong about vaccine related things before (while I work in the infectious disease space I'm far from a vaccine expert) but I think that could be a misread of the paper I linked above, which harps on about the benefits of including the adjuvant in the jab:

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Furthermore, neutralizing antibody responses after the second vaccination with rSARS-CoV-2 plus Matrix-M1 exceeded values seen in symptomatic Covid-19 outpatients and were of the magnitude seen in convalescent serum from hospitalized patients with Covid-19. The benefit of the Matrix-M1 adjuvant was clear in the magnitude of the antibody and the T-cell response, the induction of functional antibodies, and antigen dose sparing. The value of the second dose on day 21 for the two-dose rSARS-CoV-2 plus Matrix-M1 regimen is clearly demonstrated and warrants the use of this vaccination schedule.

From the phase 3 clinical trial press release:

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About Matrix-M™ Adjuvant

Novavax' patented saponin-based Matrix-M™ adjuvant has demonstrated a potent and well-tolerated effect by stimulating the entry of antigen-presenting cells into the injection site and enhancing antigen presentation in local lymph nodes, boosting immune response.

That fits with my understanding of adjuvants, it directs the immune cells towards the antigen you want the response to (in this case the spike protein). These cells then take up the antigen, migrate to nearby lymph nodes, and present it to your T-cells which promotes the development immune memory. So I'm not sure of any situation you'd inject one in the absence of the antigen you want the response to :)

(forgive the short basic immunology crash course)

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37 minutes ago, Impmk2 said:

That fits with my understanding of adjuvants, it directs the immune cells towards the antigen you want the response to (in this case the spike protein). These cells then take up the antigen, migrate to nearby lymph nodes, and present it to your T-cells which promotes the development immune memory. So I'm not sure of any situation you'd inject one in the absence of the antigen you want the response to :)

Out of curiosity, does it mean there's no adjuvant with MRNA vaccins then, since they basically just produce the spike?

 

On 6/26/2021 at 6:18 PM, L'oiseau français said:

Dr. Tam, the Chief Public Health Officer of Canada, said yesterday that all Covid-19 restrictions will not be lifted until we hit 75% of eligible Canadians, 12+, being fully vaccinated, and if the Delta variant picks up steam, that will be raised to 80%.

I fucking hope it means the vaccine will be mandatory from now on, becuase if I had to wait until 75% people show some sense before restrictions are lifted, I'd be pretty pissed off.

I'll have 2nd dose tomorrow. By the end of August, everyone above 15 will have been able to get their 2 doses. If the bulk of restrictions aren't lifted because of utter morons, I'll be quite upset. Let the willingly unvaccinated get destroyed by Delta, these fuckers deserve a painful death to begin with. We only have to think of 2 issues: how to protect the very few that can't be vaccinated for now; how to keep the healthcare system from collapsing under the weight of covid-hit unvaccinated idiots. The latter is easy: as far as I'm concerned, I basically wish to deny them any healthcare and let them deal with their self-inflicted issue - I don't want anyone to have any delay, however short it would be, in normal healthcare just because of covidiots. The former is way trickier and may require vaccinating teens if not younger ones (voluntarily), or might require mandatory vaccines at least for adults.

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52 minutes ago, Impmk2 said:

That fits with my understanding of adjuvants, it directs the immune cells towards the antigen you want the response to (in this case the spike protein). These cells then take up the antigen, migrate to nearby lymph nodes, and present it to your T-cells which promotes the development immune memory. So I'm not sure of any situation you'd inject one in the absence of the antigen you want the response to :)

Thanks for that!  We all need to learn to learn more about immunology!

3 hours ago, Fillyjonk Eilhart said:

Meant to comment on this earlier. The current wave in SA seems to be mostly Delta so it seems like it’s easily taking over the South African variant. Which is bad news for them but good news for vaccine efficacy I guess? 

Yes.  Seeing much less of Beta could be one positive.  I'm actually feeling rather pessimistic about Delta right now but at least vaccines do ok against it.  In fact, its a big week for Spain and the US (Ireland too but that's less newsworthy).  This could be the week that Delta really hits those countries (like Russia, the UK and Portugal before it).  Even delaying any spike in cases by a few more weeks is a positive.  But I fear not.

17 minutes ago, Clueless Northman said:

Out of curiosity, does it mean there's no adjuvant with MRNA vaccins then, since they basically just produce the spike?

That is my (limited) understanding!

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14 minutes ago, Clueless Northman said:

Out of curiosity, does it mean there's no adjuvant with MRNA vaccins then, since they basically just produce the spike?

I did a bit of reading about this a while back, because that was my first throught too - someone had posted something about mRNA vaccines and adjuvants and I almost posted a response. But I believe the lipid nano-particle packaging that encapsulates & stabilises the RNA also has an adjuvant effect.

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2 hours ago, Clueless Northman said:

Out of curiosity, does it mean there's no adjuvant with MRNA vaccins then, since they basically just produce the spike?

 

I fucking hope it means the vaccine will be mandatory from now on, becuase if I had to wait until 75% people show some sense before restrictions are lifted, I'd be pretty pissed off.

I'll have 2nd dose tomorrow. By the end of August, everyone above 15 will have been able to get their 2 doses. If the bulk of restrictions aren't lifted because of utter morons, I'll be quite upset. Let the willingly unvaccinated get destroyed by Delta, these fuckers deserve a painful death to begin with. We only have to think of 2 issues: how to protect the very few that can't be vaccinated for now; how to keep the healthcare system from collapsing under the weight of covid-hit unvaccinated idiots. The latter is easy: as far as I'm concerned, I basically wish to deny them any healthcare and let them deal with their self-inflicted issue - I don't want anyone to have any delay, however short it would be, in normal healthcare just because of covidiots. The former is way trickier and may require vaccinating teens if not younger ones (voluntarily), or might require mandatory vaccines at least for adults.

As I said, we’ll hit 75% before the end of July. The provinces are the ones that control most things and a couple will soon be lifting most, if not all, restrictions. The federal government controls things to do with travel, and makes recommendations which some provinces will likely ignore. Dr. Tam was most concerned about indoor events, like eating in restaurants.

In other news,Toronto announced this was Vaccination Day and did a huge event at Scotiabank Plaza, where hockey and basketball are played. 25,000 vaccinations were administered, a world record for doses given at one location. People lined up for hours and news reports said it was a festive event. I saw interviews with lots of people saying how incredibly happy they were to take part in the event.

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What is Europe doing about mixing vaccines? I understand many countries are telling people who got a first dose of AZ that it's ok to get an mRNA vaccine for their second dose, but is any country in Europe mixing Pfizer and Moderna?

Canada made the decision to vaccinate as many people as possible with their first dose to help prevent deaths and illness. We are now leading the world in first doses (let's not include islands with a few hundred thousand people), and so our second doses are ramping up now.

However, since Moderna had so many bloody issues, they constantly failed to deliver vaccine in time. I know Canada asked the US if we could get those doses made up from the US supply, and the US refused. So Pfizer is the vaccine that 80% of the country has gotten. Now that the US has reached the point where Americans who wanted to get the vaccine have gotten it, Moderna has dumped massive numbers of doses on Canada, about 10 M. And, oh look, Pfizer all of a sudden has delivery issues, but that's ok, you're getting Moderna.

The Canadian government has taken the position that the two vaccines are interchangeable. Do you have a Pfizer appointment booked?  Hey, not to worry, take this Moderna dose instead! Is that being recommended in the US? Of course bloody not. No one in the US is getting mixed vaccine doses. But don't worry, Canada, we'll track your results! Isn't this fantastic, drug studies have 30,000 people in them and we're going to watch you do a drug study with 10 M people in it! How nice!

I am so fucking (pardon me, the fuck bombs are gonna roll) pissed off, I see the location where I'm supposed to have my second dose now has the Moderna warning on ("You must be over 18 to receive a vaccine here"). I check every day because I'm trying to book a second appointment for my brother, and every day it was still a Pfizer location, until now. I  am so fucking pissed off. Do I go on Thursday and walk out if it is Moderna, or do I become a forced guinea pig? Toronto is a Delta hot spot, and I do not leave my house anymore because of that.

I repeat, I am so fucking pissed off. And really, I blame the US for this shit and their refusal to be helpful. At this moment I really hate the USA.

eta:I don’t really hate the US, just for the moment. More like I am disgusted that this is where we’re now at. Experiment on Canada! They won’t mind!

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7 minutes ago, Filippa Eilhart said:

I don’t believe this was an issue anywhere in Europe. 

Personally I wouldn’t have a problem with it but I’m sorry this is stressful for you :(

And why would you not be worried about it? I just love the way we’re now a massive drug experiment like no other country in the world.

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14 minutes ago, L'oiseau français said:

And why would you not be worried about it? I just love the way we’re now a massive drug experiment like no other country in the world.

Very likely mixing these two is fine, they are very similar, much more interchangeble chemically  than with the Curevac mRNA (which failed). Doesnt mean I do not get your point , it isnt researched yet so thats bad. But there are studies mixing mRNA and vectors and thats fine (although there are more of the "normal" side effects than otherwise). If it helps: Angela Merkel got Moderna after AZ , although there aren't any studies about that  out there as well (only Biontech after AZ, since there wasnt much Moderna in Europe yet).

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49 minutes ago, L'oiseau français said:

What is Europe doing about mixing vaccines? I understand many countries are telling people who got a first dose of AZ that it's ok to get an mRNA vaccine for their second dose, but is any country in Europe mixing Pfizer and Moderna?

Canada made the decision to vaccinate as many people as possible with their first dose to help prevent deaths and illness. We are now leading the world in first doses (let's not include islands with a few hundred thousand people), and so our second doses are ramping up now.

However, since Moderna had so many bloody issues, they constantly failed to deliver vaccine in time. I know Canada asked the US if we could get those doses made up from the US supply, and the US refused. So Pfizer is the vaccine that 80% of the country has gotten. Now that the US has reached the point where Americans who wanted to get the vaccine have gotten it, Moderna has dumped massive numbers of doses on Canada, about 10 M. And, oh look, Pfizer all of a sudden has delivery issues, but that's ok, you're getting Moderna.

The Canadian government has taken the position that the two vaccines are interchangeable. Do you have a Pfizer appointment booked?  Hey, not to worry, take this Moderna dose instead! Is that being recommended in the US? Of course bloody not. No one in the US is getting mixed vaccine doses. But don't worry, Canada, we'll track your results! Isn't this fantastic, drug studies have 30,000 people in them and we're going to watch you do a drug study with 10 M people in it! How nice!

I am so fucking (pardon me, the fuck bombs are gonna roll) pissed off, I see the location where I'm supposed to have my second dose now has the Moderna warning on ("You must be over 18 to receive a vaccine here"). I check every day because I'm trying to book a second appointment for my brother, and every day it was still a Pfizer location, until now. I  am so fucking pissed off. Do I go on Thursday and walk out if it is Moderna, or do I become a forced guinea pig? Toronto is a Delta hot spot, and I do not leave my house anymore because of that.

I repeat, I am so fucking pissed off. And really, I blame the US for this shit and their refusal to be helpful. At this moment I really hate the USA.

The US government has been very conservative with administration of the vaccines, generally sticking to the dosing regimen used in the clinical trials, since technically any deviation from the tested protocol is untested, even if there was very good reason to believe that the deviation would not adversely affect efficacy.  As a result, we stuck to the 3/4 week dosing regimen, rather than delaying the second dose as was done in other countries, and we are recommending to not use vaccines interchangeably, unless there are exceptional circumstances (i.e., first dose unknown, long term supply issue which should be rare here).  We've had this luxury because our government has hoarded it's vaccine supply, and vaccine supply here hasn't been an issue for months now.

The scientific rationale behind both the delayed dosing schedule and interchangeability of some of the vaccines, such as the Pfizer and Moderna vaccines, makes sense.  Theoretically, any vaccine that delivers the same antigen, in this case the spike protein from the same coronavirus variant, should be largely interchangeable, assuming both vaccines have a functional delivery system.  You wouldn't want to mix vaccines where the target antigens were different, like a whole virus vaccine and one that just targeted the spike, or worse, another surface protein and the spike.  Generally when you use the same antigen for both shots, after the first shot, you develop moderate levels of antibody with moderate specificity to the antigen, and then after the second shot, you develop high levels of antibody with high affinity to the antigen.  If you use different antigens for the two shots, you just end up with moderate levels of antibody with moderate specificity to two different antigens, which is probably going to perform worse.  Since Pfizer and Moderna (and AZ and J&J) both target the same version of the spike protein (with potentially some minor differences to enhance stability), the two vaccines should be interchangeable and result in the high levels of antibody with high specificity to the spike protein.

That said, if I were in your shoes, I'd prefer to get the same vaccine for both shots too.  All sorts of things should work in theory but don't.  The risk is likely very low, but why take that risk if it can be avoided.  How long do you think you'll have to wait for the Pfizer vaccine?  If the delay is just a week or two, depending on how prevalent covid is in your area, it's probably not a big deal to just wait the extra week or two for Pfizer, if you can effectively keep yourself safe (i.e., socially distance, wear mask).  If I had to wait months for Pfizer, I'd seriously consider taking Moderna unless virus levels were very low.  Single shot efficacy against Delta isn't great, so if Delta is pretty high in your area, and you mention it's a hot spot for it, I wouldn't want to delay things too long.

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1 hour ago, L'oiseau français said:

I am so fucking (pardon me, the fuck bombs are gonna roll) pissed off, I see the location where I'm supposed to have my second dose now has the Moderna warning on ("You must be over 18 to receive a vaccine here"). I check every day because I'm trying to book a second appointment for my brother, and every day it was still a Pfizer location, until now. I  am so fucking pissed off. Do I go on Thursday and walk out if it is Moderna, or do I become a forced guinea pig? Toronto is a Delta hot spot, and I do not leave my house anymore because of that.

Frustrating I agree if you are keen to avoid the mix 'n' match. It's 100% your right to walk away if you don't get the vacc you want on the day. 

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2 hours ago, L'oiseau français said:

And why would you not be worried about it? I just love the way we’re now a massive drug experiment like no other country in the world.

I love the way the US has been and will continue to be a massive viral and healthcare experiment/failure. After last year's death toll, top 10 worst in the world per capita and overall, we seem to diligently working to eclipse it due to moronic state and local governments and our thickheaded ass-backwards populace. Wanna trade? (1,800 death per million/620k deaths vs 600 deaths per million/26k total deaths)

-- I'll also note that pretty much every country is a drug experiment right now.

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8 minutes ago, Week said:

I love the way the US has been and will continue to be a massive viral and healthcare experiment/failure. After last year's death toll, top 10 worst in the world per capita and overall, we seem to diligently working to eclipse it due to moronic state and local governments and our thickheaded ass-backwards populace. Wanna trade? (1,800 death per million/620k deaths vs 600 deaths per million/26k total deaths)

-- I'll also note that pretty much every country is a drug experiment right now.

Honestly, it makes my head hurt to think the US isn’t 70% fully vaccinated already.  :(

I see that a study out of Oxford shows boosted immunity from AZ + Pfizer, but that Pfizer + AZ boosted the T-cell response more than the other way around. 
 

I also heard during my early morning listen to CNBC today that apparently some study shows immunity may be stronger and last longer than initially thought, that booster shots may not be required? Was that from the Oxford report? When I turned on the show the hosts were in the middle of discussing it.

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