Vaccine Progress, Approval, and Deployment

[RomeoCharlie71]

Looks like children will be getting vaccinated from August, subject to successful trials.

Exclusive: Children in line for Covid vaccines from August

Ministers waiting for results of study to ensure jabs will be safe before making final decisions

www.telegraph.co.uk

Children will start getting the Covid vaccine as early as August under provisional government plans to push for maximum immunity from the virus, The Telegraph can reveal.

Two sources involved in preparations said that was the soonest point at which Britons under the age of 18 would be given the jabs – months earlier than expected.

Safety data on the critical child vaccine study being run by Oxford University – on which ministers are waiting before making their final decisions – is expected shortly, with its conclusions due in June or July.

Israel, the country with the highest proportion of vaccinated citizens, is already giving jabs to 16 and 17-year-olds after deeming it safe.

Supporters of the plan see the mass vaccination of children as a way to minimise the spread of infection, but critics note the relatively low risk Covid poses to youngsters and the still-emerging safety data.

If the current rate of roughly three million first doses a week is handed out in August, it is possible that most of the 11 million school-age children could be vaccinated before the autumn term.

A Department of Health and Social Care spokesman said "no decisions have been made on whether children should be offered vaccinations".

The plans are a reflection of the Government's growing acceptance that Covid will not disappear from Britain, with ministers instead deciding to focus their strategy on driving down cases.

After discussions about the issue with scientists over many months, Boris Johnson said on Tuesday: "I'm not sure that eradication makes sense in a globalised economy for one country alone."

Speaking at a press conference to mark one year since the first Covid lockdown, the Prime Minister said a permanent memorial would be constructed to those who have died from the virus.

He warned the public against booking overseas summer holidays, saying it was "too early to say" whether border rules could be eased given the third wave of virus cases in Europe.

Amid the drive for a high rate of vaccinations, The Telegraph revealed on Monday how Mr Johnson and Matt Hancock, the Health Secretary, had agreed to change the law to require care workers to have Covid jabs.

It can now be disclosed that NHS frontline workers, including nurses and doctors on wards and staff in community mental health support schemes, could be next.

They are among groups picked out by government officials for consideration for mandatory vaccinations, although agreement on including them – unlike on care home staff – has not yet been reached.

Trade unions and care groups criticised the plans on Tuesday, with the GMB union saying care workers should not be "strong-armed or bullied with threats of the law". However, Sir Keir Starmer, the Labour leader, said that although he had "reservations" about the policy he could "see powerful arguments on both sides".

Despite recent dips in vaccine supply affecting the coming weeks, the Government has exceeded its own early estimates for how quickly it is rolling out Covid vaccines. With all adults due to receive their first jab by the end of July, thinking inside Whitehall is now turning to the approach that should be taken to vaccinating children.

One source involved in the planning said "it could begin by late summer", specifically August. A government source familiar with the thinking said August was the "earliest" start.

Only children at very high risk of severe Covid can currently get a jab. Final decisions on whether to vaccinate children will be made once the results of the Oxford trial, testing the AstraZeneca jab on 300 children aged six to 17, are released.

Exemptions are expected if a rollout to children is given the final sign-off. It is also likely that parents would have to give consent – currently the position for teenagers in Israel.

Prof Adam Finn, a professor of paediatrics at the Bristol Children's Vaccine Centre and member of the Government's joint committee on vaccination and immunisation, said preparations were being made which could allow the rollout of vaccines for children.

He said: "Children constitute close to quarter of the population, so even if we could achieve 100 per cent uptake of vaccines across the adult population, it only gets you to 75 per cent coverage."

The Department of Health spokesman said: "While clinical trials are under way to test the efficacy and safety of Covid-19 vaccines in children and young adults, these trials have not concluded yet. We will be guided by the advice of our experts on these issues, including the independent joint committee on vaccines and immunisation."

 

[cuccir]

Looks like children will be getting vaccinated from August, subject to successful trials.

Exclusive: Children in line for Covid vaccines from August

Ministers waiting for results of study to ensure jabs will be safe before making final decisions

www.telegraph.co.uk

This is excellent, excellent news. I wish I could find it again but I recall seeing a few weeks ago a blog post from a modeller that inputting under-18s vaccinations from the summer was the only way he could shift his model from bringing out a a fourth wave in the autumn to there not being one. The final piece in the puzzle.

 

[HSTEd]

It can now be disclosed that NHS frontline workers, including nurses and doctors on wards and staff in community mental health support schemes, could be next.

Didn't take long for that expansion to many millions of workers forced to get it.

By the end of the month it will be everyone

 

[brad465]

DUN, DUN, DUN:

'Greed' and 'capitalism' helped UK's vaccines success, says PM

But Boris Johnson immediately retracts the comments made during a Zoom meeting with Tory MPs.

www.bbc.co.uk

Boris Johnson has told a private meeting of Tory MPs that the UK got its Covid vaccinations under way quickly thanks to "capitalism" and "greed".
But sources said the prime minister had "very insistently" withdrawn his comments straight after making them during a Zoom call with backbenchers.
The remarks were not made in connection with the current row with the EU over vaccine supplies, they added.
The PM reportedly praised work by large drug companies during the pandemic.
A Downing Street spokesman declined to comment on what had happened during the meeting of the Conservatives' 1922 Committee.

• EU tussle with UK over AstraZeneca jabs escalates
• PM to phone EU leaders to avoid vaccine export ban
• Extra £1.6bn for Covid vaccine rollout

The prime minister's remarks, first reported in the Sun newspaper, came as some 28.3 million people in the UK - more than half the adult population - have had at least a first dose of either the Oxford-AstraZeneca or Pfizer vaccines.
But the latest figures show jabs being administered across the EU at less than a third of the rate achieved so far in the UK.
Over the last few days, Mr Johnson has been speaking to European leaders in an effort to dissuade them from imposing an export ban on Oxford-AstraZeneca vaccine exports to the UK when they meet on Thursday.

He did retract these remarks, but one does have to question whether there is truth to this.

 

[VauxhallandI]

This is excellent, excellent news. I wish I could find it again but I recall seeing a few weeks ago a blog post from a modeller that inputting under-18s vaccinations from the summer was the only way he could shift his model from bringing out a a fourth wave in the autumn to there not being one. The final piece in the puzzle.

Who are these children going to spread it to?

Sta here watching another random GP on BBC breakfast handing out her view. When will this bull end?

 

[yorksrob]

DUN, DUN, DUN:

'Greed' and 'capitalism' helped UK's vaccines success, says PM

But Boris Johnson immediately retracts the comments made during a Zoom meeting with Tory MPs.

www.bbc.co.uk

He did retract these remarks, but one does have to question whether there is truth to this.

I can see the point he's making, however the vaccine drive wouldn't have been possible without a big dose of state intervention as well.

 

[notlob.divad]

Children will start getting the Covid vaccine as early as August under provisional government plans to push for maximum immunity from the virus,

How can I put this...

"capitalism" and "greed"

couldn't have put it better myself.

So much for 'global britain' helping the world, reaching out to develop good relations with all countries. Nope, instead using a resource that is scarce in the world and is a life-saving treatment for people in the older age brackets. To vaccinate a demographic against a virus that barely effects them.

 

[nedchester]

How can I put this...

couldn't have put it better myself.

So much for 'global britain' helping the world, reaching out to develop good relations with all countries. Nope, instead using a resource that is scarce in the world and is a life-saving treatment for people in the older age brackets. To vaccinate a demographic against a virus that barely effects them.

We can be all moralistic about this but if today Johnson announced that the vaccine programme was being paused to give our vaccines to other countries (and extend the restrictions as a result) there would be outrage.

Brings out the worst in us all

 

[roversfan2001]

(and extend the restrictions as a result)

That's the problem. This idea that we need restrictions until everyone has been vaccinated. In an ideal world we'd be sending vaccines off to other countries in a matter of weeks once we'd vaccinated the vulnerable, but because Johnson and co have an obsession with pandering to the lockdown fanatics we know that in order to actually get normal life back we need to vaccinate people that really don't need it.

 

[yorksrob]

How can I put this...

couldn't have put it better myself.

So much for 'global britain' helping the world, reaching out to develop good relations with all countries. Nope, instead using a resource that is scarce in the world and is a life-saving treatment for people in the older age brackets. To vaccinate a demographic against a virus that barely effects them.

That's the paradox with pharmaceuticals. Ultimately someone has to cough up for new ones (and quite rightly, that tends to be wealthier countries).

I'm quite happy to wait my turn until more vulnerable people in the world are vaccinated - just not in lockdown. And all the while the lockdown fanatics hold sway, my patience runs thin.

 

[Bikeman78]

Who are these children going to spread it to?

Good question. There will be some parents that cannot have the vaccine. There will be thousands more that choose not to have it. The latter are unlikely to force their children to have it.

 

[yorksrob]

I have doubts about these models that predict a fourth wave even once all adults have been vaccinated. 4th wave of what - some people feeling a bit peaky ?

 

[Bikeman78]

I have doubts about these models that predict a fourth wave even once all adults have been vaccinated. 4th wave of what - some people feeling a bit peaky ?

Exactly. There were lots of unpleasant diseases out there before Covid. Half a million British people died every year.

 

[nlogax]

I have doubts about these models that predict a fourth wave even once all adults have been vaccinated. 4th wave of what - some people feeling a bit peaky ?

Don't know about you but I'm looking forward to getting a common cold again. I've been far too well this last twelve months.

 

[yorksrob]

Exactly. There were lots of unpleasant diseases out there before Covid. Half a million British people died every year.

Don't know about you but I'm looking forward to getting a common cold again. I've been far too well this last twelve months.

Funnily enough, I'm sure I caught a snippet somewhere that some common colds can boot the COVID 19 coronavirus out of cells, so that mightn't be a bad idea !

 

[Silver Cobra]

Funnily enough, I'm sure I caught a snippet somewhere that some common colds can boot the COVID 19 coronavirus out of cells, so that mightn't be a bad idea !

It was an article posted on the BBC News website on Monday: https://www.bbc.co.uk/news/health-56483445

The virus that causes the common cold can effectively boot the Covid virus out of the body's cells, say researchers.

Some viruses are known to compete in order to be the one that causes an infection.

And University of Glasgow scientists say it appears cold-causing rhinovirus trumps coronavirus.

The benefits might be short-lived but rhinovirus is so widespread, they add, it could still help to suppress Covid.

Think of the cells in your nose, throat and lungs as being like a row of houses. Once a virus gets inside, it can either hold the door open to let in other viruses, or it can nail the door shut and keep its new home to itself.

Influenza is one of the most selfish viruses around, and nearly always infects alone. Others, such as adenoviruses, seem to be more up for a houseshare.

There has been much speculation about how the virus that causes Covid, known as Sars-CoV-2, would fit into the mysterious world of "virus-virus interactions".

The challenge for scientists is that a year of social distancing has slowed the spread of all viruses and made it much harder to study.

 

[yorksrob]

It was an article posted on the BBC News website on Monday: https://www.bbc.co.uk/news/health-56483445

Ah, thanks for posting.

Yes, so the common cold is our friend !

 

[nlogax]

It was an article posted on the BBC News website on Monday: https://www.bbc.co.uk/news/health-56483445

Excellent! Time to get out and lick some lampposts.

 

[Domh245]

4th wave of what - some people feeling a bit peaky ?

Deaths & hospitalisations. As I've posted before, the maths is pretty easy: 95% take up of a vaccine that's 80% effective against death gives you 76% overall protection, or more aptly 24% of people still susceptible to dying from covid. Obviously the ~1% IFR means that most of them will still survive (though I would think that people who've failed to gain any benefit from the vaccine would be more likely to be strongly affected by covid) but that's still quite a large number of people (of the order of 100k)

 

[yorksrob]

Deaths & hospitalisations. As I've posted before, the maths is pretty easy: 95% take up of a vaccine that's 80% effective against death gives you 76% overall protection, or more aptly 24% of people still susceptible to dying from covid. Obviously the ~1% IFR means that most of them will still survive (though I would think that people who've failed to gain any benefit from the vaccine would be more likely to be strongly affected by covid) but that's still quite a large number of people (of the order of 100k)

No, that doesn't add up.

80% effective "against death" assumes 20% of people dieing, which clearly wasn't the case even without a vaccine, so it won't be afterwards.

The reality is that there is absolutely no chance whatsoever of everyone in that 24% of people not covered by the vaccine being hospitalised, and of the ones that are, there's absolutely no chance whatsoever of them all being hospitalised at the same time.

 

[cuccir]

Who are these children going to spread it to?

Each other and thence to the elderly and vulnerable.

I know we want to treat vaccinations as magic, but they're not. In the absence of "non-pharmaceutical interventions" (a term covering everything from very strict lockdowns through to masks in busy indoor public places only), vaccinated people will still catch covid-19 and die.

This article from the Lancet, published 18th March 2021, shows plausible outcomes with a range of optimistic and pessimistic assumptions. To quote its conclusion

Although we know that vaccines offer considerable protection against disease for the individual, at the population level we still expect a substantial proportion of deaths to be in people that have received one or two doses of the vaccine

FWIW, due to the speed of how things have moved, the article is already somewhat out of date: it was written with assumptions from January and early February, but we've seen

• The vaccination programme moving quicker than hoped (they anticipated 2.5 million a week from Feb but in fact we've achieved 3-4 million)
• Vaccination take-up at the highest anticipated levels (they model 85% for 50-79 but it's going to come out closer to 90%)
• Vaccines performing at or even slightly above 95% confidence intervals of effectiveness

These three features can all lead us to be more optimistic than the models in that paper are, but even so without vaccinations for children a wave appears, with increased deaths, at some point between April and October (unless we remain in lockdown until January 2022 but no-one* is recommending that). Vaccinating children doesn't help in the worse case scenarios because it comes too late, but in the better ones it does if we can start in August.

Because things have so far gone better than anticipated I'm mildly optimistic that real life will look better than the best case scenarios in this paper, and than in most modelling from the late winter. What I take from reading this sort of work as a non-expert is that we'll really see where we lie during April - if you look at graphs E and F that's where the more negative scenarios start to see rises in deaths again.

I don't want any of this to be seen as a call for extending lockdown. FWIW I'm personally uncertain on whether masks should continue in indoor public spaces through the summer: I think it is worth reserving judgement based on what happens through April and into May. I know people want to see the back of it, and are suspicious that a continuations in any measures means a continuation in all measures, but I can't see it in that black and white way (no measures v zero-Covid all measures). We need to be prepared for nuance and realism: we will almost definitely see hospitalizations and deaths start to rise at some point in the next few months. IMO calls for zero-Covid and elimination which see any increase in deaths as a failure are wrong, but so are calls for removal of all measures at almost any cost. Whatever your view, unless we get very very lucky, we will see 'bumps' in the road as we reopen, so it's a question of what size bumps people are willing to accept.




*OK some people but let's not listen to them!

 

[YorkshireBear]

Don't know about you but I'm looking forward to getting a common cold again. I've been far too well this last twelve months.

I have been getting out and about more as we have fully restarted maintenance at the heritage railway i volunteer at, definitely picked up more illnesses quickly having not had one for a long time!

 

[Cdd89]

So much for 'global britain' helping the world, reaching out to develop good relations with all countries. Nope, instead using a resource that is scarce in the world and is a life-saving treatment for people in the older age brackets. To vaccinate a demographic against a virus that barely effects them.

I would be happy to accept a deal whereby we stop new first doses now we’ve done the over 50’s and vulnerable, in return I would expect all restrictions removed (including test-trace-isolate) and the guarantee of no further lockdowns unless deaths exceed some high threshold.

What about you?

 

[cuccir]

I have doubts about these models that predict a fourth wave even once all adults have been vaccinated. 4th wave of what - some people feeling a bit peaky ?

This from the New York Times explains efficiency rates quite well.

For statisticians, efficacy is a measurement of how much a vaccine lowers the risk of an outcome. For example, Johnson & Johnson observed how many people who received a vaccine nevertheless got Covid-19. Then they compared that to how many people contracted Covid-19 after receiving a placebo.

The difference in risk can be calculated as a percentage. Zero percent means that vaccinated people are at as much risk as people who got the placebo. A hundred percent means that the risk was entirely eliminated by the vaccine. In the United States trial site, Johnson & Johnson determined that the efficacy is 72 percent.

So 72% efficacy doesn't mean that the vaccine stops of 72 of 100 people getting the virus. It means that the number of people in the placebo group who got the virus was 28% of the number in the vaccinated group.

 

[Yew]

I would be happy to accept a deal whereby we stop new first doses now we’ve done the over 50’s and vulnerable, in return I would expect all restrictions removed (including test-trace-isolate) and the guarantee of no further lockdowns unless deaths exceed some high threshold.

What about you?

Unfortunately, the papers have spent the last year pretending that this is some sort of super-virus, that is killing young healthy people in their droves, rather than the mild illness that it is for many (I believe Prof Woodhouse once said “For the non-vulnerable population, coronavirus carries no more risk than a "nasty flu")

 

[Domh245]

No, that doesn't add up.

80% effective "against death" assumes 20% of people dieing, which clearly wasn't the case even without a vaccine, so it won't be afterwards.

The reality is that there is absolutely no chance whatsoever of everyone in that 24% of people not covered by the vaccine being hospitalised, and of the ones that are, there's absolutely no chance whatsoever of them all being hospitalised at the same time.

80% effective means it reduces the chance of death by 80% (consider it more that it prevents 80% of deaths) - it doesn't imply 20% of people dying, only 20% of people being susceptible to death

To give you an example (and also using the correct numbers, it was 85% effective against death, it was 80% effective for hospitalisations), looking at the 80-84 age range, there are ~1,690,000 people in that group in the UK - assuming a 95% takeup that gives ~84500 people with no protection from the vaccine. For the 1.6 million who do have the vaccine, it'll be effective against death in 85% of them, giving ~241,000 who have had "no protection" from the vaccine. Apply the IFR for that age range (5.3%) to those who have no vaccine protection (84500+24100)*0.053 = 17,250 people that you'd expect to die if they caught it. Repeat across the population and it quickly adds up

Agreed that there's no chance of everyone in that 24% being hospitalised, nor happening all at the same time, but the power of big numbers strikes again. Doing the same exercise, with a hospitalisation rate 3.5x higher than IFR (based on there being about that number more hospitalisations than deaths) gives 475,000 still susceptible to hospitalisation, down from almost 2m applying the hospitalisation rates used to a population with no immunity - to date there have been 454,000 people hospitalised with covid since the start of the pandemic.

The chance of them all being hospitalised at the same time is slim, but as we've seen from this year you don't need all of them hospitalised for it to be an issue. So long as covid can spread in the population (R>1, which it will be with no restrictions) then these people will continue to catch it and cause issues. The two* options therefore to maintain R close to 1 (to prevent rapid spread and ensuring that the unprotected people turn up in hospitals and mortuaries at a slow, manageable rate) are either continued baseline restrictions for a significant length of time, or getting vaccine into as many arms as possible to bring things closer to herd immunity thresholds to limit the extent of transmission

*bonus third option of saying "sod em" is not politically viable as an option

 

[yorksrob]

This from the New York Times explains efficiency rates quite well.



So 72% efficacy doesn't mean that the vaccine stops of 72 of 100 people getting the virus. It means that the number of people in the placebo group who got the virus was 28% of the number in the vaccinated group.

But then if that 28% who catch it, also have a much lower chance of having severe symptoms, that's a much greater impact than initially suggested.

 

[notlob.divad]

So 72% efficacy doesn't mean that the vaccine stops of 72 of 100 people getting the virus. It means that the number of people in the placebo group who got the virus was 28% of the number in the vaccinated group.

You seem to be implying that if 100 people in the vaccinated group caught the virus, during the same time only 28 in the placebo group would. I would hope you meant, either if 100 in the vaccine group caught it, 128 in the placebo group caught it, or (more likely) if 100 in the placebo group caught it, only 28 in the vaccine group did, which I think is what you are saying in your first sentance but not in the 2nd.

 

[yorksrob]

80% effective means it reduces the chance of death by 80% (consider it more that it prevents 80% of deaths) - it doesn't imply 20% of people dying, only 20% of people being susceptible to death

To give you an example (and also using the correct numbers, it was 85% effective against death, it was 80% effective for hospitalisations), looking at the 80-84 age range, there are ~1,690,000 people in that group in the UK - assuming a 95% takeup that gives ~84500 people with no protection from the vaccine. For the 1.6 million who do have the vaccine, it'll be effective against death in 85% of them, giving ~241,000 who have had "no protection" from the vaccine. Apply the IFR for that age range (5.3%) to those who have no vaccine protection (84500+24100)*0.053 = 17,250 people that you'd expect to die if they caught it. Repeat across the population and it quickly adds up

Agreed that there's no chance of everyone in that 24% being hospitalised, nor happening all at the same time, but the power of big numbers strikes again. Doing the same exercise, with a hospitalisation rate 3.5x higher than IFR (based on there being about that number more hospitalisations than deaths) gives 475,000 still susceptible to hospitalisation, down from almost 2m applying the hospitalisation rates used to a population with no immunity - to date there have been 454,000 people hospitalised with covid since the start of the pandemic.

The chance of them all being hospitalised at the same time is slim, but as we've seen from this year you don't need all of them hospitalised for it to be an issue. So long as covid can spread in the population (R>1, which it will be with no restrictions) then these people will continue to catch it and cause issues. The two* options therefore to maintain R close to 1 (to prevent rapid spread and ensuring that the unprotected people turn up in hospitals and mortuaries at a slow, manageable rate) are either continued baseline restrictions for a significant length of time, or getting vaccine into as many arms as possible to bring things closer to herd immunity thresholds to limit the extent of transmission

*bonus third option of saying "sod em" is not politically viable as an option

But we are getting it into as many arms as possible, so that should considerably reduce the rate at which people present at hospital compared to the pre-vaccination scenario.

 

[Bald Rick]

But we are getting it into as many arms as possible, so that should considerably reduce the rate at which people present at hospital compared to the pre-vaccination scenario.

Indeed it does, and has. But that’s in the current lockdown scenario. When lockdown is eased, and people start mixing again, that has an opposite effect. The net effect will be to slow the rate of reduction of people landing in hospital, but hopefully not reverse it.