Novavax and the lack of Vaccine Choice

The answers pretty simple, there wasn't the supply to allow choices, it was delivered publicly and NIAC drove the requirements and who could get which vaccine, the AV vaccines were being delivered to keep the rollout on track not to allow choice, Ireland stopped ordering them past June as all second shots were done and then most of the J&J allocation was used up, the NIAC advice is still only to use AZ/J&J if there are no other choices for those below 50. Novavax has been in rolling review since February and still isn't approved anywhere, apparently they hit manufacturing issues. (mRNA vaccine production while new and more complex was able to scale very rapidly and wasn't effected by yields as the AV vaccines were, where the "starters" failed quite often). Valneva is further away than Novavax.

If you wanted an AV vaccine, you missed the boat at the pharmacies, had a few people I know who got J&J that way in the younger cohorts.

I was a staunch defender of the AV vaccines and would have had 0 problems taking it myself as even though I'm in a younger cohort than yourself, the risk is still ridiculously low and lower than the already low risk of COVID for me. Most of the issues with AV can be levelled at AstraZeneca, sloppily run trials with the wrong age cohorts, not admitting to manufacturing issues till the last moment and then missing the CVST issue because of Brexit (really, the UK data wasn't being shared with the EU and while the clots were occurring, they weren't being scrutinised whereas they were found in the EU very quickly).

Similarly, J&J/Janssen has been awesome, trials well run, pulled the vaccine themselves when CVST issues occurred and then worked to find the cause, how to identify and how to treat the problem if it did occur, reducing the risk even further. However, it doesn't look like they'll be going further with AV vaccines.

On top of all that, you had South Africa rejecting it, various reports of bad efficacy (eventually proven not true) and then being wrongly seen as a second rate vaccine, it is very hard to recover from that in the medicines business.

I also think you're overplaying the side effects from mRNA, but probably won't change your mind there (the post vaccination data doesn't really show much difference between AV and mRNA). I also don't think a booster will really be needed for any vaccine till end of '22 unless you've got a weakened immune system (more likely with age) or you're being exposed to high viral loads (healthcare settings), that's for all the vaccines (the antibodies produced from the mRNA vaccines is ridiculously high, so the rapid waning is kind of expected, I'd expect it to level out as time goes on and match AV), J&J seem to have found a good dosing balance, less effective against mild to moderate symptoms, but just as effective against severe and death.

edit: forgot to mention, current vaccines will probably reduce transmission by 50-80% but will really depend on nasal delivery of the vaccine for sterilising immunity to occur and break transmission entirely, still, current vaccines should get R0 below 1 once the delta wave passes, then its just a waiting game.

In that cohort myself, reason was that Pfizer was being offered so under NIAC guidelines that is all that was allowed, the younger groups had the option to "skip" the queue if they went via pharmacy and got J&J or AZ (and even then, most pharmacies were doing Pfizer anyway), the system isn't setup for choice and won't be until vaccines are bought and supplied privately. From NIAC perspective, the mRNA vaccines are suitable for all so no choice is needed, you can go and disagree with them, but they definitely have the expertise that you and I don't.

Novavax is also targeting the spike protein, the Sinovac/pharm vaccines use whole deactivated virus as you talk about above, but effectiveness and efficacy is lower than the mRNA vaccines. With mRNA (and potentially AdenoVector) the vaccines can be updated very quickly to target new proteins (weeks rather than months/years to get to production), Pfizer and Moderna are already trialing updated proteins but updates haven't been deemed necessary yet as the spike protein hasn't mutated much in any of the variants (and they can target multiple variants at once in the future if they wish to).

Novavax are working on a combined flu/COVID jab that may handle the annual booster requirement.

It's very hard to know right now if the pace of development and "choices" will remain post pandemic, vaccines are generally low margin high volume business that hasn't been interesting for pharma companies, for most other vaccines there isn't any choices at all (and really, you just need 1 to work and then mass produce it as has happened with Pfizer/Moderna, most of the reason for having multiple vaccines at all was due to hedging bets and a lot of vaccines have already failed their phase 1/2/3 trials and will never see the light of day).

J&J vaccine was not advised for the over 40s due to the (very low) risk of blood clots. This was very well publicised at the time and it's on the HSE website;

Janssen COVID-19 vaccine

So it's a less effective vaccine that has more adverse effects.

The durability of immunity remains to be seen but in terms of a way out of lockdowns in 2021, Pfizer was the only game in town.

As for AZ, I'm not being a dick, but are you serious? Do you honestly not remember the rows about supply in February, March and April? They delivered a tiny fraction of what they were supposed to. Maybe they were the cheapest vaccine per dose but they were absolutely not cost-effective.

Ummm, J&J was not recommended for people between the ages of 40 and 49. Such people would indeed be over 40, would they not? I was responding to the question about why J&J was not available for the 35-49 group. By the time the J&J vaccine was rolled out to pharmacies, every over-50 in the country had been offered an AZ or mRNA vaccine through the HSE. I never said anything about young people so I've no idea why you think you've scored a point with the reference to the 19-year old.

I'm assuming a basic flow to the discussion, not that I need to start from zero with every post.

As for your repeated references to the efficacy of J&J in South Africa. I don't know how to counter your arguments because I haven't seen any results published yet (only media reporting of same), if you have a link please send it on, I would genuinely be interested.

However, your assertion that J&J has fewer side effects than mRNA vaccines based on the 'side effects' thread on boards.ie is a bit unreliable, because we have given out 22 times as many mRNA shots as J&J. However, I do know that in Ireland, we felt strongly enough about J&J to restrict its use, in the USA the FDA paused its use and now have a specific warning about clotting for women under-50s. So, there's that.

@Wibbs , I'd appreciate if you could PM me the name of that pharmacy too, in the same age bracket & have been denied the Janssen vaccine, no interest in getting an mRNA jab.

Because with the NIAC guidance, they can't continue to use AZ/J&J on the younger cohorts, AZ is almost completely off the table as there is no guarantee of second dose supply, J&J is probably still viable as it's 1 shot only and they don't need to worry about repeats.

And when I say steady supply, I mean of Pfizer and Moderna, AZ/J&J supply is still way behind schedule with Australia another country who've been hit by over promise and under delivery most recently:

Australian production of AstraZeneca vaccine in early July just one-tenth of what government promised | Health | The Guardian

lol, thanks for the article is proves my point even further. This so called choice and over buying of vaccines are being binned likely. The cause is greed and pure self interest. Their is little wrong with those vaccines and would have many people from death. If Wibbs and Danno had your way the irish government would be buying more vaccines it doesn’t need. Novavak etc… get real and look at the global picture.

We need high global vaccination rates and we not going get their following our own self interested ways. We’re not Americans :)

It is an example of yet another group thinking they know how to run a programme better than the HSE. One would assume that the HSE have plans for them. Even if it is the bin and that's not at all ideal, there are limited options to use those vaccines because we have all but finished assigning vaccines.