Vaccine Megathread No 2 - Read OP before posting

JTMan

https://twitter.com/DelthiaRicks/status/1425146276027543556

Good to see that Novavax have applied for EUA in certain countries. The EU have a large Novavax order.

Wolf359f

https://www.boards.ie/discussion/comment/117735326#Comment_117735326

I'm going to guess you mean western Europe has the higher case rates and Eastern Europe has lower case rates at this time. Vaccines aside (it seems western Europe has more vaccinated), for each previous wave, it was Western Europe where it started and then peaked as eastern Europe took off.

You can see the week on week % change, western Europe cases are slowing and now eastern Europe cases are taking off.

Real Donald Trump

https://www.boards.ie/discussion/comment/117731905#Comment_117731905

Just shows how easy it is to brainwash people, scary stuff

floorpie

https://www.boards.ie/discussion/comment/117735457#Comment_117735457

https://www.boards.ie/discussion/comment/117735431#Comment_117735431

Point of interest when getting down to figures like 40% efficacy: for the statistical tests in the Moderna and Pfizer trials, the alternative hypotheses was that their vaccines are 30% or more effective when compared to placebo

Lyle

https://www.boards.ie/discussion/comment/117735431#Comment_117735431

That Israeli 40% efficacy for Pfizer conclusion has been thrown into serious doubt since publication, as it had poor methodologies underpinning it and a limited sample size that wasn't broadly indicative. As it was published, other countries with high vaccination rates, like Canada, were publishing research with conclusions directly opposed to the Israeli study in regards to efficacy against Covid.

An overview thread here by an Israeli scientist:

https://twitter.com/dvir_a/status/1420059124700700677?s=20

And see Table 3 and 4 here for the Canadian assessment done in Alberta:

https://www.alberta.ca/stats/covid-19-alberta-statistics.htm#vaccine-outcomes

Not to mention, the even more important metric, which Israel does agree with, as they state that "effectiveness of the vaccine in preventing hospitalizations and severe symptoms stood at 88 percent and 91 percent, respectively." This will become the be-all and end-all for countries as Covid is endemic, as cases become largely irrelevant in the face of vaccination protection for both individuals and the health service.

Further to all this, an example here to look at; vaccination status in Israeli case loads actually show how effective the vaccine is:

You can see in the graph data the correlation of age and vaccine efficacy, as is most evident in the rise in severe cases in the vaccinated cohort as age ascends, whether this is from waning immunity or other factors determined by individual health conditions. In terms of overall case load, they are clearly seeing many more cases in unvaccinated people across all age cohorts. The combination of high vaccination uptake and high case numbers can only logically lead to there being more infections in vaccinated cohorts. We're seeing that in Ireland too with the HSE announcing 20% of our cases recently are in vaccinated individuals, but they are mostly experiencing a very mild illness, thanks to the protection of the vaccines.

You can read a good overview of the Israeli situation here, where the above graph is taken from:

https://www.haaretz.com/amp/israel-news/the-israeli-graphs-that-prove-covid-vaccines-are-working-1.10101640?

xboxdad

https://www.boards.ie/discussion/comment/117735326#Comment_117735326

One word: Boris

is_that_so

Russia’s health minister Mikhail Murashko has said the Sputnik V vaccine is “around 83%” effective against the Delta variant - less than was previously thought.

Red Silurian

https://www.boards.ie/discussion/comment/117736094#Comment_117736094

One of the reasons for variants we think is people are catching other viruses while infected with COVID19, another is the use of blood from recovered patients being used to treat infected patients and of course no virus never fully replicates itself perfectly...

If the virus were to imperfectly replicate itself from a vaccinated person as a result of the vaccine it is more likely that the variant would be less severe than the previous variant. This has probably already happened but the resulting variant(s) aren't as transmissible as Delta so gets beaten by it

L1011

https://www.boards.ie/discussion/comment/117735471#Comment_117735471

You're using a cyclic reference to your own post there. Pathetic pretence.

antimatterx

Does anyone know why all the dates/times for walk ins were removed from the hse wesbite?

I was intending on going to one tomorrow, I booked time off work, now all the centers are saying they're not doing walk in clinics at this time. My local clinic had times for today, tomorrow and Friday up yesterday.

stephenjmcd

https://www.boards.ie/discussion/comment/117736399#Comment_117736399

Because they only do walk in's on certain days and won't do them if they don't expect demand to be there.

You'd really be better off just registering on the HSE portal, there's no guarantee walk in centres will be back

Repo101

https://www.boards.ie/discussion/comment/117735929#Comment_117735929

Thanks for the link and write-up. Reading the FT today you would assume that Pfizer is nothing more than a placebo and Israel is on the cusp of more lockdowns and restrictions. A lot of really poor journalism during the pandemic has been extremely unhelpful.

Relax brah

Vaccine roll out going well, 90-92% effectiveness with MRNA jabs is a remarkably positive result.

For the lurkers reading, ignore the naysayers, check there post count. They spend there life’s on this forum and clearly have too much time on there hands reading misinformation and Alex Jones YouTube videos.

The Irish people are incredible people, it’s been a difficult journey with many challenges still ahead but we will get through this together.

🙏🏼

antimatterx

https://www.boards.ie/discussion/comment/117736497#Comment_117736497

They actually put them back up on the website in the last few minutes. Sorted.

noplacehere

https://www.boards.ie/discussion/comment/117736650#Comment_117736650

Is there anything more recent on AstraZeneca and delta? I got it as I was very high risk just before the pause under a certain age

Hmmzis

https://www.boards.ie/discussion/comment/117736650#Comment_117736650

In addition, if you look at our data in OWID it looks like the CFR for Ireland has been below 0.1% for a while now (seasonal influenza range).

Charles Babbage

https://www.boards.ie/discussion/comment/117736745#Comment_117736745

the CFR for influenza is not as high as 0.1%. The level of testing for flu means that many low end cases of flu are never identified as such.

That said, the vaccines have reduced the fatalities substantially, which is why were are able to tolerate 10,000 cases per week.

Pete_Cavan

https://www.boards.ie/discussion/comment/117736094#Comment_117736094

Thats party why we are not trying to reach herd immunity while in uncontrolled transmission among the rest of the population, there are still restrictions to control transmission among the rest of the population. Clearly getting everyone vaccinated as quickly as possible is the best option, the alternativeis ongoing control measures which, ironically, those opposed to vaccines are also opposed to. If that article is concerning to you, you should play your part in reaching herd immunity through controlled vaccination in the shortest time possible.

akelly02

my mrs is in a really bad way after her 2nd pfizer.

she has crohns and epilepsy, im quite worried.

is there any medication i can give bar the usual?

she has fever, sore throat, migraine.

is_that_so

https://www.boards.ie/discussion/comment/117737191#Comment_117737191

Contact HSE Live or GP ASAP I would suggest.

everlast75

https://www.boards.ie/discussion/comment/117737191#Comment_117737191

Are you really looking for medical advice on Boards?

Call her GP. Get advice from an expert with such a serious concern.

airy fairy

https://www.boards.ie/discussion/comment/117737191#Comment_117737191

Eh, ring her GP?

Go to A&E?

But don't ask on boards Ffs.

Hmmzis

https://www.boards.ie/discussion/comment/117737137#Comment_117737137

That's an excellent point, as there would be significantly more testing for Covid-19 than there has ever been for influenza. Then again, there can be some gruesome years for influenza - https://www.cdc.gov/flu/about/burden/2017-2018.htm

I fully take the point that the CDC report is mainly based on estimates and for symptomatic illness only as there is a significant fraction of flu cases that would be asymptomatic (it would be an IFR estimate then).

When it comes to mortality I don't think we're all that far off now, the vaccines are doing their jobs at priming peoples immune systems (and they're pretty good at it).

floorpie

On what basis has the narrative shifted regarding vaccination, wherein people are saying things like "vaccines were never meant to prevent infection, they are meant to reduce your chance of severe symptoms such that you're not hospitalised, and to reduce your chance of dying".

In every trial the way in which efficacy is assessed is by comparing rates of infection between the placebo group and the vaccinated groups. Secondary endpoints in each trial include severe symptoms of infection, such as shock or blood oxygen that mandates ventilation, but again it's assessed based on positive COVID-19 tests. Enough participants were infected by COVID-19 during the trials that they found statistical evidence that vaccination reduced rates of infection. Fine.

On the other hand, so few people had severe outcomes (incl. death) in the trials that the statistical power to assess each vaccine's ability to prevent severe outcomes was limited (e.g. the alternative hypothesis was that the vaccine had a 30% efficacy for severe outcomes).

I understand that statistical power for an evaluation can change as more data is collected in the real world, but this is outside the context of a trial with strict protocols (e.g. the level of seropositivity and immunity in the population are unknown in the general population, compared to cohorts in the trial).

So how are people now saying that the vaccines were only meant to prevent severe symptoms or death, but not infection, when the vaccines were approved based on the opposite finding from all trials?

Hmmzis

https://www.boards.ie/discussion/comment/117737731#Comment_117737731

The primary endpoint of every trial was symptomatic disease with a positive PCR. There were no means to assess the differences in asymptomatic infections between the groups. That part was assessed after deployment and it showed that the vaccines did in fact reduce transmission on a population level.

floorpie

https://www.boards.ie/discussion/comment/117737791#Comment_117737791

You seem to be agreeing with my interpretation. The primary endpoint was a positive test for COVID-19 via PCR (and symptoms were also assessed) and they found statistical evidence that they significantly reduce rates of infection.

To my understanding, they were able to assess differences in asymptomatic infection between cohorts because in every trial the participants were assessed for infection before each injection, and at set points for 24 months after their last injection via PCR, and immunogenicity via blood sample. Like I say, there was evidence that the vaccines reduced infection.

So my question remains, why are people now saying that vaccination doesn't reduce infection but rather just reduces symptoms? This isn't what the trials assessed as far as I can see, looking through the protocols and data.

I'm talking about the Moderna and Pfizer trials, not other random studies.

Hmmzis

https://www.boards.ie/discussion/comment/117737824#Comment_117737824

First of all, infection does not equal symptomatic disease. PCR was only performed when people registered symptoms, there was no regular PCR testing schedule. In phase 3 only a very small subset of people would have had their blood sampled, you might be mixing up phase 1/2 with phase 3 protocols.

They did PCR tests on the day of injection for all participants. Moderna did notice less PCR positivity on the day of the 2nd dose in the vaccine group (in those who had no symptoms) though the counts were low overall in both groups. If Pfizer did the same they did not include any analysis of that in any of their reports. Both trial results documents are available on the FDA website if you'd like to dive deeper into how they assessed efficacy. Later post deployment observations largely confirmed the findings in both trials and added statistical significance for severe outcomes and mortality, and transmission reduction.

floorpie

https://www.boards.ie/discussion/comment/117738045#Comment_117738045

"Both trial results documents are available on the FDA website if you'd like to dive deeper into how they assessed efficacy"

I've already read the papers, protocols, and data, which is why I'm asking these questions.

"In phase 3 only a very small subset of people would have had their blood sampled, you might be mixing up phase 1/2 with phase 3 protocols."

No I'm talking about phase 3 (e.g. protocol for Moderna is at bottom of the page here: Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine | NEJM), all 30K participants had their blood drawn at set points up to 759 days, so immunity and asymptomatic infection can be assessed in the whole cohort.

"First of all, infection does not equal symptomatic disease. PCR was only performed when people registered symptoms"

I understand that but I don't think it's relevant. It is true in phase 3 that all participants were asked weekly for their symptoms, and that PCR tests were taken in the case that symptoms existed (therefore people with symptoms but who don't have COVID-19 are also PCR tested). A requirement (in phase 3) to denote a case of COVID-19 was symptoms AND a positive PCR test. A statistical test is performed between the placebo and vaccine groups for this primary efficacy endpoint, and statistical evidence is found for efficacy.

Here's the hypothesis from the phase 3 trial "Statistical Hypotheses: For the primary efficacy objective, the null hypothesis of this study is that the VE of mRNA-1273 to prevent first occurrence of COVID-19 is ≤ 30% (ie, H0 efficacy: VE ≤ 0.3) .... Vaccine efficacy is defined as the percent reduction in the hazard of the primary endpoint (mRNA-1273 vs placebo)."

The primary efficacy endpoint includes a PCR test. So people who were asymptomatic, or lied about symptoms, or were vaccinated or unvaccinated, and therefore were never PCR tested, are irrelevant for the assessment of primary efficacy in phase 3, am I interpreting this statistical test correctly?

Hmmzis

https://www.boards.ie/discussion/comment/117738375#Comment_117738375

Thanks for the note of the blood tests, missed that until now. Fair play to them! I wonder what are they going to use the samples for, that's a HUGE amount of samples to analyze.

What you're highlighting is the statistical null hypothesis that they are setting out to confirm or reject. If the interim analysis would be pointing at confirming the null hypothesis it would basically invoke the trial futility clause and they'd bin the whole thing, luckily for us all the signal was for a way higher efficacy than the null hypothesis they set out to verify. It also helps to establish at what case counts to do efficacy analysis to have a chance of a statistically significant signal as early as possible. They could have set it at 40% or 60% or 80% but in those cases it would have taken longer to get to the first interim analysis as you'd need more cases to be able to tell for certain that VE allows them to reject the null hypothesis.

franciscanpunk

was wondering would we hit up to 90% of adults when mass rollout completed, looks like we are with maybe even a few more percentage points on top.

Hope it starts to make a big difference restrictions wise soon