lobo411

I read that the EU took over vaccine procurement for the member countries, but then it signed contracts with vaccine suppliers at a sluggish pace. So the EU was left waiting, while vaccines were being shipped to other countries on a first-inked, first-served basis.

https://qz.com/1968175/why-the-eu-ha...d-on-vaccines/

lobo411

The latter, most likely. Definitely welcome news, and one would hope that they've had the opportunity to tweak their vaccine for the new variants. I read today that Moderna delivered samples of its tweaked vaccine to the FDA in preparation for testing, and I know Novavax is also on the same course.

Luckily, the FDA has said that the procedure for tweaks/boosters will be the same as it is for the flu shot. Once the design of the basic vaccine has been approved, then manufacturers can tweak it and follow a scaled-down testing regime before putting it into production. No need for another massive clinical trial.

https://www.10news.com/news/coronavi...ainst-variants

GUWonder

In the UK, some GPs have patients who only want the AZ vaccine and refuse the Pfizer vaccine and yet have other patients who want the Pfizer vaccine but refuse the AZ vaccine. It has come with some people either no-showing for appointments or leaving without getting vaccinated.

lobo411

And it's the same people who are happy as clams to get flu shots that are 40-60% effective!

Anyway, Germany has 1 million AZ doses on ice because of this. Kinda interesting, how things change. First, the US was the poster child for a botched covid response. Now we're the model for how you do vaccination right in a nation of real size. The EU was the poster child for how to respond to covid in a free society. Now they're the model for how to screw yourself with a bad vaccination campaign.

GUWonder

[mod edit]

The AstraZ Covid19 vaccine in Germany is authorized for use for adults who are 65 years of age or younger. Since Germany is sitting on a big stock of AZ vaccine that people are refusing to use in Germany, some want the German Chancellor to publicly take the AZ vaccine shot in order to boost uptake of the AZ vaccine. But Germany's Chancellor is 66 years old, and so the vaccine is not approved for her use.

PanAmWT

Here is an interesting discussion of the possible resistance to repeated vector vaccines, an issue that was discussed several months ago in this thread.
https://finance.yahoo.com/news/focus...080000944.html

FOCUS-AstraZeneca, Sputnik vaccines face hurdles if COVID shots become annual affair

* Vaccines with viral vectors face longer-term challenge

* Immune system could turn on the vaccine

* Need for repeat shots seen likely as variants evolve

* UK government aware of vector immunity issue

Diplomatico

My 80 year old parents in Texas (finally) received their first vaccines this week. Thank goodness.

Question for the medical professionals, as I keep reading that the first vaccine takes 10-14 days to reach 70% efficacy (or something like that.)

Does this mean that from day 1 to day 14 (or so) they have no protection at all? Or does the body slowly build immunity due to the vaccine on a daily basis and the cumulative effect is 70% after two weeks?

stimpy

It looks like the US FDA has now approved the single-shot Johnson & Johnson vaccine, and it could be available in needles in less than a week. https://www.washingtonpost.com/natio...ve-updates-us/

I guess as an essential worker I am entitled to get a vaccine now. I hadn't spent anytime thinking about which vaccine to get up til now, but I would appreciate any advice, or better yet, a pointer to a qualified medical article going over the pros and cons of each vaccine available currently in the US.

exp

I thought you were in France.

in any event you don’t get a choice.

may not even find what a given site is injecting.

people are going for any place where they can get an appt. so they’re generally not chasing specific vaccines, more like any place which has available slots, if you are in the currently permitted categories.

corporate-wage-slave

There are quite a few studies done in this area, and the UK government has been wading through a lot of them trying to understand how this works. Rather than go through all of them, since some date to December 2020, I'll focus here on one, but mention in passing another, the Public Health Scotland / Edinburgh University study, the pre-print is here: if you look at the tables at the back you can see the data for yourself. Over a million people in this survey.
https://www.ed.ac.uk/files/atoms/fil...a_preprint.pdf

In the UK we have something called REACT-2, which is run by Imperial College (one of the top UK institutions) funded by the government. They are looking at 177,000 people here and unlike the general population, the cohort here is closely studied on a weekly basis so it's free of noise (e.g. the PHS study may have people who incorrectly recalled their date of injection). Their most recent study in this area is Round 5 and came out a few days ago, the results are here, again it's a pre-print but in both cases it's mass data so the pre-print status isn't much of a factor.
https://www.imperial.ac.uk/media/imp...5-preprint.pdf
It goes into this in some detail, and there are tables at the back, but here are the charts on page 25 that cut to the chase. The top black line is for someone who previously had Covid-19 typically fairly recently and then had the Pfizer vaccine. The lower blue line shows those who had no antibodies before vaccine, so typically have never had Covid-19. And as you can see there are variations between the two scenarios, which is what you would expect, particularly with B cell response, which is represented by checking the amount of IgG that is in the blood. T cell memory is much, much more difficult to assess or measure, but we know it has an impact here, it's just difficult to show, IgG is really easy to measure. The internal lines show week 0 (injection day) to week 7 after injection. One dose only, the grey shading gives the Confidence Interval min and max. And there are 4 age cohorts.



So you will see that actually it is fairly, but not totally linear. I've seen some internal data for AZ which shows it is more linear than Pfizer, not as steep an incline as Pfizer, but goes on for longer and goes above Pfizer from week 5, and that ties in well with the PHS study referenced above. So you get a pretty impressive amound of protection from week 1 onwards (0.25 is definitely worth having), it goes up daily at a fairly linear rate, it peaks around 3 to 5 weeks. Don't worry too much about the decline in IgG towards week 7, that is fairly normal in viral diseases when looking at IgG figures alone, usually the T cells kick in at that point.

corporate-wage-slave

The PHS survey mentioned in my previous post should convince you, with the cold hard numbers in there, to get a vaccine as soon as you can. And it doesn't greatly matter which one, the difference between them is so small that waiting 2 days to get a different variety would counter the factor that matters most: speed.

I'm a Covid vaccinator, and I've now jabbed several thousand people. Once in a while I'm asked by those being vaccinated the difference between the two vaccines currently used in the UK (BioNTech-Pfizer and Oxford AstraZeneca), and trying to communicate this in a way which is both meaningful and accurate can be tricky. The way I have settled on is to say that each vaccine has different technological start points, so Pfizer is messenger RNA, AZ uses a surrogate virus structure, but in terms of how they work, these vaccines are actually quite similar: they mimic Covid's spike protein to trigger an immunity response. And that immune response aspect of vaccines is extremely traditional, it goes back to Edward Jenner in 1796 injecting cowpox, to mimic and then trigger a response to smallpox - that aspect is as old school as it gets. Cows are now immortalised as vaccines via the Latin word for them, vaccas. Now we don't give people a choice, I don't always know which vaccine I'm going to be using until I turn up for work. That doesn't matter unless you are one of the tiny minority who have an allergy to PEG (which is present in Pfizer and Moderna). What matters is you get vaccinated as soon as you can.

UKTony

A message that is echoed by JVT and one people should be listening to not delaying.

lobo411

Generally, I agree with the notion that people should take whatever vaccine they can get right now. However, at least in my county, and increasingly as vaccines become more available, people will have a choice. Here, vaccine clinics are listed by date, location, and vaccine being administered, so you do have a choice.

Perhaps it would be smart for people to rank their options in order of preference, and then if they end up having a choice, they can grab the appointment they want without second guessing.

My list:

Novavax (not yet approved, but best in breed. Produces 3-15x the antibody response of any other vaccine. Natural adjuvant that is extremely well tolerated)

​​​​​​Moderna (pretty good, booster in clinical testing)

JNJ (more recent efficacy data, but doesn't prevent illness)

Pfizer (good enough)

AstraZeneca (good enough)

Below is a graph of Phase 2 neutralizing antibody counts by vaccine.

The dark blue line is 21 days after shot 1
The light blue line is 14 days after shot 2
The red line is the count from people who recovered from natural infections

The "stringent" disclaimer is important too. Basically, some companies used "stringent" methods to assay their antibody counts, and others used moderately or least stringent methods. Obviously, the more stringent the method, the more reliable the number.

stimpy

I fly back and forth between France and New York often. And in New York you currently have a choice between Pfizer and Moderna, with Johnson & Johnson coming soon it seems. See https://vaccinefinder.nyc.gov/ and type in an NYC zip code (try 10018 for instance) and you can see for yourself. We do have a choice.

But I agree that I want the vaccine ASAP. I want it sometime in the next two weeks as one month from now I am going to have a work activity where I will spend a lot of time with a bunch of other people.

Has anyone dug into the Johnson & Johnson vaccine?

skyflyer99

Isn't it a lot more complicated than just counting the number of antibodies? We can't assume that the antibodies are the same in each case, or that they are equally effective at preventing infection and illness, and equally robust against future mutations. In the graph, you can see that they also aren't even quite measuring at the same time points. And as Lobo411 notes, they are not counting antibodies in the same way. They might have different age ranges. As an example, it looks like Moderna's vaccine produced more antibodies than Pfizer's. But then you notice that Moderna measured it 14 days after the 2nd does, vs. 7 days after for Pfizer. And the baseline from recovered patients is high for Moderna. And then also note the small'ish sample sizes (N=3 in one case). I do think it's very interesting data to think about, but I personally wouldn't weigh it much in my choice of vaccine.

Isn't the actually clinical trial data much more relevant, making the antibody data mostly obsolete? The Pfizer vaccine has been shown to be highly effective at actually preventing illness in extremely large samples, with small error bars. I don't care if it's just one tiny antibody that is really really busy.

As I recall, the clinical trial data suggests...

1st tier: Moderna = Pfizer = Novovax
2nd tier: JNJ = AZ
3rd tier: Chinese & Russian (just guessing about Russian)

https://www.statista.com/chart/23510...ne-candidates/

The JNJ and AZ vaccines seem clearly better than nothing, but not necessarily if means you go to the back of the line for getting the really effective vaccines.