Covid Vaccine. Your plans?

[Webbo]

56 minutes ago, Bijan said:

Another random thing the UK is considering is mixing and matching the two doses of two different vaccines (one Pfizer and one moderna) at least I read that in some article...

That seems to be a rumour from the US that has been denied by the authorities here in the UK (which on current form means it will be official policy by tomorrow)

[Nino]

2 hours ago, Bijan said:

Another random thing the UK is considering is mixing and matching the two doses of two different vaccines (one Pfizer and one moderna) at least I read that in some article...

 

2 hours ago, mprach024 said:

US officials are saying that’s a bad idea.  Nobody knows for certain, US also toying with half doses, we’ll see how it all shakes out in next few months.  

 

1 hour ago, Webbo said:

That seems to be a rumour from the US that has been denied by the authorities here in the UK (which on current form means it will be official policy by tomorrow)

Sems like it was meant seriously but it has not been thought out so far.

https://www.statnews.com/2021/01/04/britain-takes-a-gamble-with-covid-19-vaccines-upping-the-stakes-for-the-rest-of-us/

Britain takes a gamble with Covid-19 vaccines, upping the stakes for the rest of us

By Helen Branswell @HelenBranswell

January 4, 2021

In an extraordinary time, British health authorities are taking extraordinary measures to beat back Covid-19. But some experts say that, in doing so, they are also taking a serious gamble.

In recent days, the British have said they will stretch out the interval between the administration of the two doses required for Covid-19 vaccines already in use — potentially to as long as three months, instead of the recommended three or four weeks. And they have said they will permit the first dose and second dose for any one person to be from different vaccine manufacturers, if the matching vaccine is not available.

The moves are borne of a desire to begin vaccinating as many people as quickly as possible, particularly with Britain facing high levels of transmission of an apparently more infectious form of SARS-CoV-2, the virus that causes Covid-19.

But they are also effectively turning that country into a living laboratory. The moves are based on small slices of evidence mined from “subsets of subsets” of participants in clinical trials, as one expert described it for STAT, and on general principles of vaccinology rather than on actual research into the specific vaccines being used. If the efforts succeed, the world will have learned a great deal. If they fail, the world will also have gained important information, though some fear it could come at a high cost.

American health officials have dismissed the possibility that the U.S. would follow Britain’s lead, with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, saying the vaccines in use — one made by Moderna, the other by the Pfizer and BioNTech partnership — will be deployed here using the schedules that were tested in Phase 3 trials that generated the evidence on which the Food and Drug Administration authorized the vaccines for emergency use.

While data from both suggest the vaccines start to protect about 10 or 12 days after the first dose, it’s not known how long that initial protection lasts. In clinical trials, levels of neutralizing antibodies, which are thought to play a critical role in protecting against infection, were not substantial after the first dose of vaccine for the Pfizer vaccine.

“While we think that single shot could give protection for more than four weeks, we just don’t know that. We don’t know when it’s going to drop off,” said John Mascola, director of NIAID’s Vaccine Research Center. Mascola said Operation Warp Speed, the federal government’s project to fast-track Covid vaccines, ruled out the possibility of altering vaccination schedules before Britain decided to do so.

Paul Bieniasz of Rockefeller University is one of those who is watching the evolving situation in Britain with dread. A retrovirologist who turned from HIV research to work on SARS-2, Bieniasz is studying how the virus acquires mutations that allow it to evade the protective antibodies people develop when they have contracted Covid-19, or when they have been vaccinated against it. 

Bieniasz believes Britain is replicating in people the experiments he’s been doing in his lab — and could be fostering vaccine-resistant forms of the virus. 

On New Year’s Day he posted a short, sarcastic treatise — “Musings of an anonymous, pissed off virologist”— on Twitter outlining how one could go about rendering Covid vaccines “impotent,” if that was one’s goal. Giving millions of people who are at daily risk of contracting the disease incomplete protection by delaying the second dose of vaccine was key, he suggested. 

“My concern, as a virologist, is that if you wanted to make a vaccine-resistant strain, what you would do is to build a cohort of partially immunized individuals in the teeth of a highly prevalent viral infection,” Bieniasz told STAT. Even rolling out the vaccine at all when there is so much transmission occurring is far from ideal, he said, suggesting it would have been safer to beat down the amount of virus in circulation before beginning the vaccine deployment.

“You are essentially maximizing the opportunity for the virus to learn about the human immune system. Learn about antibodies. Learn how to evade them,” he said.

Isabella Eckerle, a coronavirus researcher at the Geneva Center for Emerging Viral Diseases, shares Bieniasz’s concern that Britain is increasing the potential for so-called escape mutants. She understands the public health imperative behind its approach, but worries about having large numbers of partially protected people for several months at a stretch. Britain is vaccinating its oldest citizens first. The immune systems of the elderly don’t function as well as those of younger adults; some will inevitably contract Covid while waiting for their second dose of vaccine, she said.

Reports of partially vaccinated people contracting Covid may also erode confidence in the vaccines, Eckerle said: “If we fail to use this vaccine in a good way, it will damage the whole field of vaccinology for many, many years, I think.”

Stephen Goldstein, a virologist at the University of Utah who specializes in coronaviruses, said that taking Britain’s approach at a time of limited supply of vaccine could create other problems. 

“If we vaccinate everybody with one dose and … six weeks later, the efficacy is now like 30% and we don’t have the doses to boost them at that point because we’ve used up their second doses on another round of first doses, it’s a disaster potentially,” he said.

Not everyone agrees there is a disaster in the making. Some believe it makes sense, given Britain’s surge in cases and the rapid spread there of the B.1.1.7 variant, which studies suggest may be 50% more transmissible than the viruses it is quickly replacing.

“At the core of my being, I really wish that we could adhere to the original schedule of vaccines, because that’s the safest thing to do,” said Akiko Iwasaki, a virologist and immunologist at Yale University who tweeted about her support for the British approach. “But seeing what’s happening in the world and just sort of looking at the situation of poor rollout and distribution, I’m feeling frustrated that we need to come up with some other options.”

(Iwasaki was dismayed, though, to realize Britain’s instructions to clinicians that they could use a non-matching second dose of vaccine if that is their only option was not going to be done in the context of a clinical trial. While there is reason to believe boosting with a different type of vaccine might actually be useful in some cases — particularly if the first dose is a vaccine like the AstraZeneca vaccine that uses a harmless virus onto which genetic material from SARS-2 has been fused — the approach has not been studied at all in clinical trials. 

“They’re kind of wasting the opportunity if they’re just sort of randomly doing it and not even following up on the effectiveness of that combination,” Iwasaki said. “So yeah, I’m a lot more comfortable if it was a trial of some sort.”)

Rajeev Venkayya, president of global vaccines for Takeda Pharmaceuticals, also believes Britain’s decision to stretch out the interval between vaccine doses is “justifiable.” 

“Of course we would all want to see vaccines used exactly as they were tested in Phase 3 efficacy trials. I don’t think there’s any debate about that. The question is: Do you have evidence to support flexibility? And here, I do think that — and this is specific to the AstraZeneca vaccine — it does appear that there is additional evidence that can support a modified recommendation,” said Venkayya, who served as special assistant to President George W. Bush and senior director for biodefense. In that role, Venkayya was the White House point person for pandemic preparedness efforts triggered by the spread of H5N1 bird flu.

While the U.S.-based trial of the AstraZeneca vaccine is testing two doses given four weeks apart, studies the company conducted elsewhere gave some participants the two doses at intervals of six to eight weeks, or nine to 11 weeks, and some received the doses at an interval greater than 12 weeks.

The Pfizer and Moderna vaccines are the first using mRNA technology, and the companies did not study those extended dosing schedules. Pfizer has objected to the proposal that the vaccine be used with a longer interval between vaccinations.

Venkayya, whose thinking is influenced by his years in the White House, said sometimes policy has to be made without perfect data. 

“I think that to take the standards that we typically apply to the body of evidence we require before reaching decisions and recommendations on how to use vaccines, that by necessity has to change in the midst of a crisis like this,” he said. “I think there is the way we do medicine and public health in peacetime … where we have the luxury of taking the time we need and investing the resources and effort to collect enough data to reach a conclusion. You just don’t have that luxury in the midst of a crisis.”

 

[Nino]

Applied online for a Covid vaccine in my state today but received an error message as so far only over 80's will get the shot first, then over 70's and then .... me ?

Hope it will be soon enough - like April/May.

[CaptainQuintero]

3 hours ago, Webbo said:

My mother had her first Pfizer jab 2 weeks ago with no problems. Her next should be in a weeks time but there is a change here in the UK where due to lack of vaccines this may be extended from 3 weeks after the first to 12 weeks. I am not happy at all about this as all the research and trials were done with 2 doses 3 weeks apart not 12. While I understand the strategy to have more with 1 dose I'm not certain that this has been modeled properly and feel this is all being made up on the hoof. Can anyone with any knowledge pass on the thoughts of the effectiveness of only 1 vaccination?

  Glad your mum got her jab ? 

  The Oxford one, the more time between doses the better the result so not particularly a huge issue there.

  With the pfizer it's simply not known but there shouldn't be an issue on paper, it's simply that it hasn't been tested. Not particularly reassuring, but a lot of places area still going ahead with the second dose with pfizer after 21 days and going extended second dose with the Oxford. It seems like the main issue could be that the pfizer may result in protection not lasting as long, if the wait didn't follow the trial, but again it's guessing at the moment. I haven't seen anything about there being an issue of safety as a result of the waiting time though.

  The vaccine mutation issue is a strange one, the possiblity is there with anything less than 100% efficacy, and none have that. One Pfizer looks to give around 90% with the second giving an extra 5%. Oxford looks like around 80% going up to the 90s with the second. I'd personally be more concerned with the Chinese and Russian jabs that are reported to be around 40%.

  As above the story about mixing vaccines was a political hack piece taking potential emergency usage as standard procedure, holds no water.

 As per usual, media and government information on this had been awful. The information should be freely available within easy access.

[Fugu]

3 hours ago, nino said:

And they have said they will permit the first dose and second dose for any one person to be from different vaccine manufacturers, if the matching vaccine is not available.

This is almost like saying, oh, gas ⛽ is out?, well then, diesel will do just fine....

3 hours ago, nino said:

but received an error message as so far only over 80's will get the shot first, then over 70's and then .... me ?

Hang in there, Nino, at least - so or so - time’s on your side.... ? ?

3 hours ago, CaptainQuintero said:

One Pfizer looks to give around 90% with the second giving an extra 5%. Oxford looks like around 80% going up to the 90s with the second. I'd personally be more concerned with the Ch

It’s not only that, the booster dose is also of significance for the longevity of the immunisation protection. 

But I heard the same been told today by the leading virologist from the Berlin Charité. At least for the mRNA vaccine, a longer interval (within limits) seems not detrimental. May (theoretically) even have pros - but hasn’t been tested so far with any of the current vaccines.

... and that is also part of the crux, as such a vaccination scheme is not part of the current approvals. So, there will also be legal aspects linked with any deviation from approved ‚standard‘ procedures. And that again could in turn cause delays again.... 

[Jimmy_jack]

4 hours ago, Bijan said:

Another random thing the UK is considering is mixing and matching the two doses of two different vaccines (one Pfizer and one moderna) at least I read that in some article...

Nothing bad here with that. I always put Honda parts in my Ford.

[La_Tigre]

On 1/6/2021 at 2:51 PM, nino said:

Applied online for a Covid vaccine in my state today but received an error message as so far only over 80's will get the shot first, then over 70's and then .... me ?

Hope it will be soon enough - like April/May.

I could’ve sworn you were 80, nino...?

[alloy]

I signed up on my counties website since I'm 65. I'm number 67,283 on the waitlist. Hoping I don't catch this crap before my vac!

[Jimmy_jack]

Wife got the Moderna shot. Sore arm for two days, chills the first night. All good after. High blood pressure since young, that’s her only health issues.

she’s an ER nurse and their hospital is over run with CV19. Overflow for the overflow is at capacity. The first time I ever heard her call it “all a shit show”.

[mprach024]

Phase 2 (1B), starts Monday in most of the States.  Anyone 65+ and Schedule 1B front line workers will be eligible to schedule their jabs.  A few weeks out (3-4) from phase 3 (1C) yet which will open it up to people with high risk conditions.  Smokers fall in this category.

[La_Tigre]

Better half was in the bed with aches and a bad headache for 24 hours or so the day after the second shot. Several coworkers reporting the same experience. It seems that it is more common in females with the Pfizer vaccination on the second dose. This is anecdotal evidence (before I get a lecture about study design, blinding, statiscal significance...yada)

While I was working at the vaccination clinic last week, I heard no complaints of this sort about the first shot from the masses we were about to give the second dose. 

[Winoheel]

My wife and I get the first shot 1/24 and the second 2/11, Charlotte Motor Speedway drive through


Sent from my iPhone using Tapatalk

[Kaptain Karl]

I’ll be getting it as soon as possible! I’m a mortgage lender and somehow I’m ‘essential’ and high on the list ??‍♂️. Although I’m surprised and also not surprised that California are vaccinating the homeless and incarcerated in round 3, ahead of most of the population. 

[Fuzz]

58 minutes ago, Winoheel said:

My wife and I get the first shot 1/24 and the second 2/11, Charlotte Motor Speedway drive through


Sent from my iPhone using Tapatalk

Is it hard to keep up with the pace car while they give you the shot?

[Fosgate]

Nino have you heard if the German Govt is going to follow through with this yet? https://www.the-sun.com/news/2159382/germany-covid-rule-breakers-refugee-camps-mutant-virus/

[GWG]

So As my belief in anything the experts are saying is particularly low. What I am hearing from the people administering it is that you can still catch it after taking the vaccine and your symptoms are not effected if you take it either so my question is why take it?

 It is really troubling with so many agendas out there and all of them with their own ....truths.

[Bijan]

5 minutes ago, GWG said:

So As my belief in anything the experts are saying is particularly low. What I am hearing from the people administering it is that you can still catch it after taking the vaccine and your symptoms are not effected if you take it either so my question is why take it?

 It is really troubling with so many agendas out there and all of them with their own ....truths.

I think you're either 90 or 95% less likely to get it.

To me the equivalent logic is not wearing a bulletproof vest in a shootout because you can still die of a shot to the chest even with the vest on.

Or not wearing a helmet on a motorcycle because you can still die of head trauma.

[GWG]

6 hours ago, Kaptain Karl said:

I’ll be getting it as soon as possible! I’m a mortgage lender and somehow I’m ‘essential’ and high on the list ??‍♂️. Although I’m surprised and also not surprised that California are vaccinating the homeless and incarcerated in round 3, ahead of most of the population. 

Oh its much worse than that they are throwing vaccine away because people are missing their appts instead of having an on call list. There is a reason many people don't want the government running healthcare or anything else for that matter.

[Nino]

Germany - From the NYT :

Separately, some German states are planning guarded mandatory quarantine centers for the very few who repeatedly disobey quarantine rules, according to an investigation by Die Welt am Sonntag, a national Sunday paper.

States like Schleswig-Holstein in the north, Brandenburg around Berlin and Baden–Württemberg in the southwest are preparing such mandatory quarantine sites in hospitals, refugee centers and a youth detention center.

However, since there are very few known cases of people who repeatedly flout quarantine and isolation rules and fines — which are imposed because someone either has Covid, has had close and prolonged contact with an infected person, or has come back from a high-risk foreign country — the states are only planning for a few sites.

[Yellot00tr]

US is already mixing the two vaccines. Depends on availability. Hospital people I know had the Pfizer vac as the first shot in Dec and then received the Moderna shot in Jan. NYC is running low on vaccines. I was scheduled for 1/22, but they just pushed me to 1/29 due to vaccine shortages.

[Bijan]

4 hours ago, Yellot00tr said:

US is already mixing the two vaccines.

On same patient first dose vs second? Or different patients? US was always going to use both vaccines.

[DanWil84]

Not debating the use of it and side effects, i’m normally not against vacines, myself kids and wife have the complete cocktail which is offered. But the rush of developing this vacine, a completly new technique and 0 knowledge on long term side effects im not convinced. Ill just have to see what the restrictions will be and make my judgement based on that.

Not vacine related, but we are getting a curfew from saturday.... im always traveling to or from work during this curfew, sure I have a letter that my work is essential but im curious how many times ill be checked.

[Xavier_Dredo]

So As my belief in anything the experts are saying is particularly low. What I am hearing from the people administering it is that you can still catch it after taking the vaccine and your symptoms are not effected if you take it either so my question is why take it?
 It is really troubling with so many agendas out there and all of them with their own ....truths.

Huh?

[Xavier_Dredo]

Got my first shot today. Couldn’t be more proud working for Pfizer or more confident in this vaccine. After being inoculated and the nurse signed off on my immunization card she told me to have it laminated after receiving my second dose because it may be needed in the future when traveling. No prob...

[iGrizz]

I see a black market for vaccine cards in the near future. They fake every form of identification in the world, guarantee this will be next.