COVID-19: Vaccine and testing procedures Megathread Part 2 [Mod Warning - Post #1]

DaSilva

is_that_so wrote: »

Your posts are public and you have no say in who replies to them. Not sure why you imagine there is no official process. The vaccine groups were published back in December along with justifications for each one. There are also very logical explanations as to why some HCWs were done first.

I didn't say they shouldn't ask, I asked why they thought it was a question worth asking.

I was suggesting there is no official process for a patient to request their preferred vaccine... although some of you seem to not grasp that, perhaps because you are too eager to disagree with everything I say.

The "logical explanations" are not logical though especially in the case of new evidence, as can be seen they have already adjusted their plans for 70+ year olds.

In the next few years, almost everybody is going to become infected with sars-cov-2, it would therefore make sense, to use the most effective treatments on those most at risk of severe disease. It is the only priority schedule that really makes sense when you accept the fact the virus is going to stay around. If you look at the Ox data compared with the Pfizer/Moderna data you will see the Ox data population is heavily skewed to younger populations who more rarely encounter severe disease, and yet it still had lower overall efficacy. If the goal is really to reduce severe disease and mortality then it only makes sense to use the more efficacious on the more at risk

Apogee

seamus wrote: »

Here are the number of people in each cohort according to the CSO from 2016;
Age|Number
65-69|202,294
70-74|153,686
75-79|107,628
80-84|72,173
85+|51,503Based on 40,000 Pfizer/Moderna doses per week, you're looking at 7-10 days to cover the 85+ (though it'll take time to get up to full steam; I'd give it two weeks).

All of the newspaper reports quote a figure of ~480,000 over 70s. But I count ~380,000 from the table above?

https://www.irishtimes.com/news/ireland/irish-news/nearly-500-000-people-over-70-to-receive-covid-vaccine-from-their-gp-1.4462427
https://www.irishexaminer.com/news/arid-40210340.html

is_that_so

DaSilva wrote: »

I didn't say they shouldn't ask, I asked why they thought it was a question worth asking.

I was suggesting there is no official process for a patient to request their preferred vaccine... although some of you seem to not grasp that, perhaps because you are too eager to disagree with everything I say.

The "logical explanations" are not logical though especially in the case of new evidence, as can be seen they have already adjusted their plans for 70+ year olds.

In the next few years, almost everybody is going to become infected with sars-cov-2, it would therefore make sense, to use the most effective treatments on those most at risk of severe disease. It is the only priority schedule that really makes sense when you accept the fact the virus is going to stay around. If you look at the Ox data compared with the Pfizer/Moderna data you will see the Ox data population is heavily skewed to younger populations who more rarely encounter severe disease, and yet it still had lower overall efficacy. If the goal is really to reduce severe disease and mortality then it only makes sense to use the more efficacious on the more at risk

The answer is it's a medical call on vaccines just as medical decisions are made about our health all the time. The over 70s call is based on a LACK of participants in that group in the trial. We are on a growing list of countries who feel the same. Henry & Reid, who you seem to be completely ignoring, have more than once said that can change with real world data. My own feeling is that by the time AZ finally get their act together we'll have finished those groups anyway and while the position could change it'll be moot.

is_that_so

Apogee wrote: »

All of the newspaper reports quote a figure of ~480,000 over 70s. But I count ~380,000 from the table above?

https://www.irishtimes.com/news/ireland/irish-news/nearly-500-000-people-over-70-to-receive-covid-vaccine-from-their-gp-1.4462427
https://www.irishexaminer.com/news/arid-40210340.html

That was the 2016 census.

ixoy

DaSilva wrote: »

Why is that of any concern to you or this thread? Obviously there is no official process...

It's obviously of concern if everyone starts pushing and prodding for an exception to be made for them or their family. How it might impact the vaccination process if people refuse to take an offered vaccine because they want the perceived better one. Look at how people reacted to the vaccinations in the Coombe and how that would spiral out if there was a perception that some people were able to get theirs different vaccinations based purely on who-they-knew and not medical policy.

DaSilva

is_that_so wrote: »

The answer is it's a medical call on vaccines just as medical decisions are made about our health all the time. The over 70s call is based on a LACK of participants in that group in the trial. We are on a growing list of countries who feel the same. Henry & Reid, who you seem to be completely ignoring, have more than once said that can change with real world data. My own feeling is that by the time AZ finally get their act together we'll have finished those groups anyway and while the position could change it'll be moot.

Yeah which is why I am suggesting rather than gambling high risk populations on AZ's US trial numbers being good or "getting their act together" as you say, we adjust vaccine rollout program to use vaccines where there is evidence of their efficacy. In other words, since the AZ vaccine has evidence it works on younger people, use it on younger people, and the other vaccines with their evidence, use them on them on older people. Just like this has resulted in a slowing of the rollout of vaccines for 70+ age group, we should slow the rollout of vaccines in low risk young HCW to give them the AZ vaccine so we can give the other vaccines to those in older age groups where there is evidence

DaSilva

ixoy wrote: »

It's obviously of concern if everyone starts pushing and prodding for an exception to be made for them or their family. How it might impact the vaccination process if people refuse to take an offered vaccine because they want the perceived better one. Look at how people reacted to the vaccinations in the Coombe and how that would spiral out if there was a perception that some people were able to get theirs different vaccinations based purely on who-they-knew and not medical policy.

Why are you framing this as being about "perception" when its about actual data and evidence. The Germans haven't restricted use to 65+ age group because of a perception, but because of a genuine lack of scientific data.

ACitizenErased

DaSilva wrote: »

Yeah which is why I am suggesting rather than gambling high risk populations on AZ's US trial numbers being good or "getting their act together" as you say, we adjust vaccine rollout program to use vaccines where there is evidence of their efficacy. In other words, since the AZ vaccine has evidence it works on younger people, use it on younger people, and the other vaccines with their evidence, use them on them on older people. Just like this has resulted in a slowing of the rollout of vaccines for 70+ age group, we should slow the rollout of vaccines in low risk young HCW to give them the AZ vaccine so we can give the other vaccines to those in older age groups where there is evidence

That is exactly what is happening.............................

iamwhoiam

DaSilva wrote: »

Yeah which is why I am suggesting rather than gambling high risk populations on AZ's US trial numbers being good or "getting their act together" as you say, we adjust vaccine rollout program to use vaccines where there is evidence of their efficacy. In other words, since the AZ vaccine has evidence it works on younger people, use it on younger people, and the other vaccines with their evidence, use them on them on older people. Just like this has resulted in a slowing of the rollout of vaccines for 70+ age group, we should slow the rollout of vaccines in low risk young HCW to give them the AZ vaccine so we can give the other vaccines to those in older age groups where there is evidence

I think that is exactly what the aim is .

stephenjmcd

DaSilva wrote: »

Yeah which is why I am suggesting rather than gambling high risk populations on AZ's US trial numbers being good or "getting their act together" as you say, we adjust vaccine rollout program to use vaccines where there is evidence of their efficacy. In other words, since the AZ vaccine has evidence it works on younger people, use it on younger people, and the other vaccines with their evidence, use them on them on older people. Just like this has resulted in a slowing of the rollout of vaccines for 70+ age group, we should slow the rollout of vaccines in low risk young HCW to give them the AZ vaccine so we can give the other vaccines to those in older age groups where there is evidence

But all healthcare workers getting their first jab from today are getting AZ anyway so what's your point ? It's already happening

DaSilva

They are still planning on using the Oxford vaccine on people aged 65+ with serious health conditions...

Icantthinkof1

Did the original AZ trials only include healthy, young people and the efficacy is still lower than the mRNA vaccines?
A lot of young people with no medical vulnerabilities would have a low risk of moderate/ severe illness with Covid anyways or am I missing something?

ACitizenErased

DaSilva wrote: »

They are still planning on using the Oxford vaccine on people aged 65+ with serious health conditions...

Where?

iamwhoiam

DaSilva wrote: »

They are still planning on using the Oxford vaccine on people aged 65+ with serious health conditions...

Have you link ?

timsey tiger

stephenjmcd wrote: »

Politics has no input as to what vaccine someone will get. It's a medical decision that'll be made for you.

Someone's choice is vaccine or no vaccine

This is naive as hell.

The EMA has approved this for all age groups, we were all set to give it to all age groups.

The numbers of participiants in all age groups and associated p-values have been known for months.

All of a sudden, when Gremans raise an objection our medics change their mind.

Yet you do not see this as political, what is the alternative, incompetence?

There is nothing wrong with political actions in health, they are required to maintain confidence. The op can rest assured as his parents won't now be getting AZ at the eleventh hour and it is because of political reasons.

is_that_so

DaSilva wrote: »

They are still planning on using the Oxford vaccine on people aged 65+ with serious health conditions...

Here's what the CMO said, with a bolded bit. That is not generally the case with anyone under 70. If there is a perceived risk with people in another group this is where that medical decision comes in.

The main objective of the vaccination strategy is to prevent morbidity and mortality. International and national data indicate that those aged 70 years and older are at significantly higher risk of hospitalisation and mortality. Due to the demonstrated efficacy of mRNA vaccines in older persons and in recognition of their particular vulnerability in terms of their increased risk of death and serious disease if they contract COVID-19, it has been recommended that mRNA vaccines be administered to all those over 70 years in order to provide the highest level of protection available to this population

is_that_so

timsey tiger wrote: »

This is naive as hell.

The EMA has approved this for all age groups, we were all set to give it to all age groups.

The numbers of participants in all age groups and associated p-values have been known for months.

All of a sudden, when Germans raise an objection our medics change their mind.

Yet you do not see this as political, what is the alternative, incompetence?

There is nothing wrong with political actions in health, they are required to maintain confidence. The op can rest assured as his parents won't now be getting AZ at the eleventh hour and it is because of political reasons.

The objection was not political, it was pragmatic too in light of the limited supplies.

timsey tiger

is_that_so wrote: »

The objection was not political, it was pragmatic too in light of the limited supplies.

I never said the objection was political. I refute that it was pragmatic in light of the limited supplies. This makes no sense, as it is being used in lower age groups.

I'm talking about the Irish decision not the German one.

is_that_so

timsey tiger wrote: »

I never said the objection was political. I refute that it was pragmatic in light of the limited supplies. This makes no sense, as it is being used in lower age groups.

I'm talking about the Irish decision not the German one.

Yeah, but they won't be till much later in the year when we should have better supplies. It's limited now.

timsey tiger

is_that_so wrote: »

Yeah, but they won't be till much later in the year when we should have better supplies. It's limited now.

This is pointless and irrelevent to the op.

is_that_so

timsey tiger wrote: »

This is pointless and irrelevent to the op.

I'm refuting your refutation!

Apogee

Deathofcool wrote: »

Based on the previous article linked with the German vaccine allocation I make out our equivalent allocation below. Obviously highly caveated.

Nice table. What is row 6?

For crosscheck, Paul Reid on Newstalk (7 min mark)
Q1: 690,000 Pfizer, 110,000 Moderna, 285,000 AZ (+ possible 150/160K AZ)
"17 million committed from EU Process"
"We would be starting to see over 1 million per month from May onwards"
https://www.newstalk.com/news/ireland-could-see-over-one-million-vaccinations-a-month-from-may-paul-reid-1147100

tesla1989

timsey tiger wrote: »

This is naive as hell.

The EMA has approved this for all age groups, we were all set to give it to all age groups.

Emergency use or approval?

stephenjmcd

stephenjmcd wrote: »

But all healthcare workers getting their first jab from today are getting AZ anyway so what's your point ? It's already happening

Got my first jab today.. Health Care worker.
Got the Pfizer vaccine.

Deathofcool

Apogee wrote: »

Nice table. What is row 6?

For crosscheck, Paul Reid on Newstalk (7 min mark)
Q1: 690,000 Pfizer, 110,000 Moderna, 285,000 AZ (+ possible 150/160K AZ)
"17 million committed from EU Process"
"We would be starting to see over 1 million per month from May onwards"
https://www.newstalk.com/news/ireland-could-see-over-one-million-vaccinations-a-month-from-may-paul-reid-1147100

Apologies, Row 6 is Sanofi / GSK. As another user pointed out our Moderna may be well over estimated with Germany buying up additional allocation.

stephenjmcd

[Deleted User] wrote: »

Got my first jab today.. Health Care worker.
Got the Pfizer vaccine.

Must depend where you work so because according according the HSE it's AstraZeneca from today for first doses.

15,000 front line healthcare workers in hospital settings planned this week, all AstraZeneca. 5,000 GPs, Moderna & AstraZeneca.

Long term care settings, staff & residents, 8,000 dose 1, no vaccine listed beside them. Assuming LTRCF will be assigned Pfizer or Moderna based on the advice for 70 +

stephenjmcd

Two friends of mine got their 2nd Pfizer dose on Saturday night, both fairly floored yesterday with tiredness & aches & pains.

Woke up this morning and not a bother, like yesterday never happened.

Anecdotally have heard a few others similar so the 2nd dose does appear to really get your immune system to work. I know of 1 fairly large multinational that plans to give staff the day off after 2nd doses.

ACitizenErased

stephenjmcd wrote: »

Two friends of mine got their 2nd Pfizer dose on Saturday night, both fairly floored yesterday with tiredness & aches & pains.

Woke up this morning and not a bother, like yesterday never happened.

Anecdotally have heard a few others similar so the 2nd dose does appear to really get your immune system to work. I know of 1 fairly large multinational that plans to give staff the day off after 2nd doses.

My father didn't sleep for two days after the second dose and was as good as new after that. Heard similar as to what you heard.

tesla1989

Icantthinkof1 wrote: »

Did the original AZ trials only include healthy, young people and the efficacy is still lower than the mRNA vaccines?
A lot of young people with no medical vulnerabilities would have a low risk of moderate/ severe illness with Covid anyways or am I missing something?

Original trials had very little over 65 is correct and lower efficacy on certain dosage time frames, it was a messy trial with dosage intervals

Latest field study in SA was even more skewed towards younger people, 2000 people with mean age 31.I think theres 2 sets of conflicting reports for the same trial. Some sites claim the value is 10% effectiveness while others claim It’s 22% effectiveness in reducing mild to moderate cases with the variant they have there.

Probably a difference in what formula they use to calculate the efficacy, or maybe one is a midpoint estimate and the other a high/Low-end estimate. But yeah either way it’s not great.It looks like a leak. Oxford released a press statement just saying "minimal protection", but I've seen show journos screenshotting a Zoom call showing 10% efficacy against the B.1.351 SA variant (23 in placebo, 19 in vaccine).

mRNA vaccines haven't been field tested on the B.1351 South African variant to the same extent. We don't know yet how good they'll be, Novavax and J&J had a few in trials with that 484 deletion variant, but nothing close to 2000 people like AZ had.

Lab testing on mRNA ones showed a very strong immune response to 484 deletion variant's, much higher than needed to neutralize so they look promsing, but until field data/trial takes places it's all just speculation. We should know more soon.

DaSilva

Icantthinkof1 wrote: »

Did the original AZ trials only include healthy, young people and the efficacy is still lower than the mRNA vaccines?
A lot of young people with no medical vulnerabilities would have a low risk of moderate/ severe illness anyways or am I missing something?

It's not so straightforward to compare as they all described their trials differently, here is an attempt to show them all side by side, hopefully no major mistakes


Sources:
https://www.nejm.org/doi/full/10.1056/NEJMoa2035389
https://www.nejm.org/doi/full/10.1056/NEJMoa2034577
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext