Vaccine Progress, Approval, and Deployment

[Domh245]

We just lose the nice bonus of massively cutting transmission through vaccination until we have new versions of the vaccine. We should probably hold of an wait to see if there are few more problems mutations before finally deciding.

Not cutting transmission doesn't matter though when we've vaccinated enough of the population that anyone who catches it will suffer little more than mild symptoms. Get the population inoculated and then let SARS-CoV-2 just circulate around (and stop looking for 'exciting' new strains that for the vast majority of the population won't have any impact at all)

 

[kez19]

Mutations have been occurring constantly; we didn't do much genomic analysis before, but we do now. Many countries don't do this, even now.

People forget that Wuhan battled a less transmissible form; China's incredibly harsh lockdown helped but it wasn't the only factor; Europe had the much more transmissible G614 variant ( see https://www.railforums.co.uk/threads/what-sage-really-think.212718/#post-4925455 ) in what is referred to as a 'D614G' mutation.

People who say we should be more like China conveniently forget that this mutation had occurred so that Europe fought a much more transmissible variant, and that a like-for-like comparison isn't possible (or maybe they are just ill-informed in which case they ought to keep their traps shut and leave it to be people who do have a clue!)

We are now seeing 'convergent evolution evolution' of mutations such as 'E484K' (The glutamate (E) to Lysine (K) substitution at position 484 (E484K) in the receptor binding domain (RBD) of the spike protein); K484 variants have occurred independently in different locations.

If a particular change is evolutionary advantageous for the virus, it will happen, and it won't just happen once.

The idea that there are an unlimited number of such mutations, and that they will likely occur somewhere else not within the UK, and that shutting the borders will keep them out, is utterly false and is peddled by people who lack understanding of how this virus is evolving. There are loads of such people spouting absolute nonsense right now, using this nonsense as justification to keep restrictions in place and falsely claim that vaccines are ineffective.

The reality is that E484 has occurred independently in Britain, South Africa, and Brazil. And potentially other places that don't carry out genomic testing.

Such changes do not affect T-cell immunity; they can impair the antibody response but they do not render vaccines ineffective. The vaccines can, and will, be tweaked to increase efficacy with these variants.

Just for me whilst I understand all this as written above it just seems a bit of a coincedence that we hear of these strains as vaccines come out, when it first hit nothing of this sort was ever spoken about in the media (from... not running names down but you get the drift), but all of a sudden the mutations have appeared and now all the same names are creating panic once more.

 

[Nicholas Lewis]

What you don't seem to understand is that there simply is, and will be, no "necessary in Autumn". There was no "necessary in March 2020". It was a sane precaution given what we knew.

We now know more.

If we go back in to lockdown in Autumn there will be riots. There'll be singular riots even if it is just me.

Lockdown crew are the ones that need their bloody "expectations managed". They've already "managed expectations" from a few weeks into _eleven months_.

If that's "negative" to you, tough tits.

I don't want it anymore than you but what i do know is this is a seasonal virus, yes a virulent one, but seasonal so it will naturally moderate across summer and thus all restrictions should be relaxed. However, we won't know how effective vaccines are until next Autumn so better to be prepared for the worse this time rather than sleepwalking into the fiasco that has got us to the current situation. Thus the NHS needs to be prepared to deal with increased patients so lockdowns aren't needed.

 

[Кряква]

I don't want it anymore than you but what i do know is this is a seasonal virus, yes a virulent one, but seasonal so it will naturally moderate across summer and thus all restrictions should be relaxed. However, we won't know how effective vaccines are until next Autumn so better to be prepared for the worse this time rather than sleepwalking into the fiasco that has got us to the current situation. Thus the NHS needs to be prepared to deal with increased patients so lockdowns aren't needed.

Completely agree with bulking up the NHS. There should be a massive recruitment drive.

I'm not sure why the Government isn't going along this route, it would be a ridiculously fantastic vote winner to increase NHS funding, even if coupled with tax increases. Absolute no brainer.

The idea that "you can't just train people up in a few months" doesn't really hold any more; autumn this year will be about 18 months since the original lockdown, there's no way that an accelerated training program couldn't have been put into place in that time.

I'm simply disagreeing with the idea of normalizing lockdowns. This is the last lockdown and it's ending in a few months whether they like it or not.

An environment in which society might just stop for months on end at the drop of a hat because <1% of the population are getting ill is simply not a reasonable state. It completely kills the ability for anyone to plan and will result in a death spiral of short-term decision making.

Remember "where do you see yourself in ten years time"? The last position I took, I couldn't forecast two months out because the business might have simply been arbitrarily deleted by the Government.

 

[takno]

I don't want it anymore than you but what i do know is this is a seasonal virus, yes a virulent one, but seasonal so it will naturally moderate across summer and thus all restrictions should be relaxed. However, we won't know how effective vaccines are until next Autumn so better to be prepared for the worse this time rather than sleepwalking into the fiasco that has got us to the current situation. Thus the NHS needs to be prepared to deal with increased patients so lockdowns aren't needed.

I think a lot of preparation would be appropriate, and would be useful for the next time we decide to overreact to a pandemic. We need to consider whether we have too high expectations of medicine as a country, whether we need to spend more to meet the expectations we have, what plans we have in place to separate our hospitals into plague hospitals and normal facilities, how we equip our doctors mentally and legally to make life and death decisions based on prioritising scarce resources, and when to lock the infection control specialists in a cupboard and let very sick people go home to die with the families.

What we don't need to do is prepare to lock down or impose any measures on wider society

 

[yorkie]

Hi. Yes I’ve read yours now and they make sense thanks. It’s just what I’ve read elsewhere mainly on Digital Spy. There’s a lot of discussion on there about all this and a lot are convinced that if the SA variant becomes widespread we will be back to square one.

We have much better informed people here than the average person on Digital Spy

I bet people there were claiming a 12 week interval for the Oxford vaccine gave less efficacy than a shorter interval, whereas people here knew that the 12 week interval was always likely to give better results.

 

[Bantamzen]

Hi. Yes I’ve read yours now and they make sense thanks. It’s just what I’ve read elsewhere mainly on Digital Spy. There’s a lot of discussion on there about all this and a lot are convinced that if the SA variant becomes widespread we will be back to square one.

I would strongly advise steering clear of the covid threads on Digital Spy, they are second only to MumsNet in terms of hysteria and drama....

 

[DustyBin]

I don't want it anymore than you but what i do know is this is a seasonal virus, yes a virulent one, but seasonal so it will naturally moderate across summer and thus all restrictions should be relaxed. However, we won't know how effective vaccines are until next Autumn so better to be prepared for the worse this time rather than sleepwalking into the fiasco that has got us to the current situation. Thus the NHS needs to be prepared to deal with increased patients so lockdowns aren't needed.

When you say “we won’t know how effective vaccines are until next Autumn” what do you mean exactly? I thought the vaccines had been thoroughly tested and the efficacy clearly stated, albeit the latter appears to vary slightly against some mutations? I may be missing something, but unless they’ve lied to us it shouldn’t matter what time of year it is, nobody (or next to nobody) is going to be hospitalised by Covid-19 once vaccinated, surely?

 

[nlogax]

I would strongly advise steering clear of the covid threads on Digital Spy, they are second only to MumsNet in terms of hysteria and drama....

I would advise the opposite.RF members may well be better informed but sites such as DigitalSpy and Mumsnet are far more representative of the world outside and general public sentiment. Pays to understand the prevailing wider arguments to see what you're up against.

== Doublepost prevention - post automatically merged: 12 Feb 2021 ==

When you say “we won’t know how effective vaccines are until next Autumn” what do you mean exactly? I thought the vaccines had been thoroughly tested and the efficacy clearly stated, albeit the latter appears to vary slightly against some mutations? I may be missing something, but unless they’ve lied to us it shouldn’t matter what time of year it is, nobody (or next to nobody) is going to be hospitalised by Covid-19 once vaccinated, surely?

That's how I understand it too.

 

[35B]

When you say “we won’t know how effective vaccines are until next Autumn” what do you mean exactly? I thought the vaccines had been thoroughly tested and the efficacy clearly stated, albeit the latter appears to vary slightly against some mutations? I may be missing something, but unless they’ve lied to us it shouldn’t matter what time of year it is, nobody (or next to nobody) is going to be hospitalised by Covid-19 once vaccinated, surely?

I think that's an optimistic assumption, where we need to see how the vaccines perform at a population level rather than in the trials. The weakness of the urgency of the trials is that we - by definition - do not have clear information on how the immunity given by vaccines degrades, while the actual (as opposed to modelled) effect of vaccination immunity on the population as a whole is not yet clear. We also do not have a clear view of whether and if so how mutations in the Covid virus will affect those results.

I bet people there were claiming a 12 week interval for the Oxford vaccine gave less efficacy than a shorter interval, whereas people here knew that the 12 week interval was always likely to give better results.

I'm not sure who here or elsewhere knew that the extended interval would work - surely the point is that it's research done recently that has validated the government's decision.

I think a lot of preparation would be appropriate, and would be useful for the next time we decide to overreact to a pandemic. We need to consider whether we have too high expectations of medicine as a country, whether we need to spend more to meet the expectations we have, what plans we have in place to separate our hospitals into plague hospitals and normal facilities, how we equip our doctors mentally and legally to make life and death decisions based on prioritising scarce resources, and when to lock the infection control specialists in a cupboard and let very sick people go home to die with the families.

What we don't need to do is prepare to lock down or impose any measures on wider society

Part of that preparation, mid-pandemic, is considering how to relax the measures that have been imposed, and to weigh up the costs of continuing those measures against the costs of having to try to contain a further outbreak. Much as I'd like to be able to do a whole raft of things normally, for myself and for the organisations I'm involved with, I'm not going to criticise the government for taking a cautious approach of wait and see.

 

[Domh245]

I would advise the opposite.RF members may well be better informed but sites such as DigitalSpy and Mumsnet are far more representative of the world outside and general public sentiment. Pays to understand the prevailing wider arguments to see what you're up against.

I'm downbeat about covid enough as it is, I don't need uninformed hysteria on top! (especially if said hysteria has little chance of swaying the government, which I am optimistic of)

The weakness of the urgency of the trials is that we - by definition - do not have clear information on how the immunity given by vaccines degrades, while the actual (as opposed to modelled) effect of vaccination immunity on the population as a whole is not yet clear. We also do not have a clear view of whether and if so how mutations in the Covid virus will affect those results.

We do however know a lot about immunity generally, and the longevity and cross immunity conferred by SARS-CoV-1 should give cause for optimism around the longevity and breadth of immunity from SARS-CoV-2. We can't stay under restrictions 'just in case'

 

[Bantamzen]

I think that's an optimistic assumption, where we need to see how the vaccines perform at a population level rather than in the trials. The weakness of the urgency of the trials is that we - by definition - do not have clear information on how the immunity given by vaccines degrades, while the actual (as opposed to modelled) effect of vaccination immunity on the population as a whole is not yet clear. We also do not have a clear view of whether and if so how mutations in the Covid virus will affect those results.

I'm not sure who here or elsewhere knew that the extended interval would work - surely the point is that it's research done recently that has validated the government's decision.

Part of that preparation, mid-pandemic, is considering how to relax the measures that have been imposed, and to weigh up the costs of continuing those measures against the costs of having to try to contain a further outbreak. Much as I'd like to be able to do a whole raft of things normally, for myself and for the organisations I'm involved with, I'm not going to criticise the government for taking a cautious approach of wait and see.

The problem with the "wait and see" method is that it puts a lot jobs at risk, jobs we need to continue in order to claw back tax revenue to get money moving into the public services. Many sectors are now reporting that businesses are on the verge, and a prolonged wait to gather 6 or more months worth of data to ponder over really isn't an option. We know the vaccine is going to have an effect, so the time to move is now.

 

[VauxhallandI]

I think that's an optimistic assumption, where we need to see how the vaccines perform at a population level rather than in the trials. The weakness of the urgency of the trials is that we - by definition - do not have clear information on how the immunity given by vaccines degrades, while the actual (as opposed to modelled) effect of vaccination immunity on the population as a whole is not yet clear. We also do not have a clear view of whether and if so how mutations in the Covid virus will affect those results.

I'm not sure who here or elsewhere knew that the extended interval would work - surely the point is that it's research done recently that has validated the government's decision.

Part of that preparation, mid-pandemic, is considering how to relax the measures that have been imposed, and to weigh up the costs of continuing those measures against the costs of having to try to contain a further outbreak. Much as I'd like to be able to do a whole raft of things normally, for myself and for the organisations I'm involved with, I'm not going to criticise the government for taking a cautious approach of wait and see.

When the EU said they were unsure about the efficacy at such low trial exposure they were touted as crazy red tapped anti this and that.

 

[yorkie]

I think that's an optimistic assumption, where we need to see how the vaccines perform at a population level rather than in the trials. The weakness of the urgency of the trials is that we - by definition - do not have clear information on how the immunity given by vaccines degrades, while the actual (as opposed to modelled) effect of vaccination immunity on the population as a whole is not yet clear. We also do not have a clear view of whether and if so how mutations in the Covid virus will affect those results.

While we may not know the exact details at this stage, many genuine experts do know the general principles, and we do know a reasonable amount about immunity from Sars-CoV-1.

So far the results have been consistent with expectations.

As for how mutations will affect the vaccines, we know that some mutations manage to avoid some of the antibodies produced by the vaccine, but we also know that the antibody response cannot be completely evaded and we also know that it does not affect the T-cell response. While we may not have the data on exact percentages of efficacy lost with different mutations, you make it sound like there are more unknowns than there are, or that the risks are greater than they are, which I don't think is proportionate or sensible and could cause people to be unnecessarily worried that the vaccines don't work. I do not think that people should be unduly worried.

I'm not sure who here or elsewhere knew that the extended interval would work - surely the point is that it's research done recently that has validated the government's decision.

This is disingenuous. We knew it was likely to be the case that 12 week gap was better than a 3/4 week gap due to research from previous vaccines. We also knew that the trials for Sars-CoV-2 vaccines realistically had to go with the shortest viable gap because of the need to conclude the trials as soon as reasonably practicable.

Again, the results have been consistent with expectations.

Part of that preparation, mid-pandemic, is considering how to relax the measures that have been imposed, and to weigh up the costs of continuing those measures against the costs of having to try to contain a further outbreak. Much as I'd like to be able to do a whole raft of things normally, for myself and for the organisations I'm involved with, I'm not going to criticise the government for taking a cautious approach of wait and see.

I doubt you'd complain if we were all kept in this awful lockdown for many more months, but that doesn't make it right.

 

[Yew]

Reckless measures with massive harms,that nobody recommended before the Chinese Communist Party decided to give them a go, are in no way cautious.

 

[nlogax]

The vaccination program in some parts of the country is beginning to become a victim of its own success. Time to start bringing priority groups forward on a regional or local level if needs be

https://www.theguardian.com/world/2...running-out-of-priority-patients-to-vaccinate

Frustrated medics say they are beginning to run out of patients in the government’s top four priority cohorts to vaccinate and fear that lives will be lost unless they are allowed to immunise more people immediately.

Doctors at the Francis Crick Institute in London say they are providing first doses at a rate of 100 a day when they have capacity for 1,000.

 

[yorksrob]

Indeed. They should be progressing as fast as possible, or alternatively bringing second jabs forward.

 

[35B]

While we may not know the exact details at this stage, many genuine experts do know the general principles, and we do know a reasonable amount about immunity from Sars-CoV-1.

So far the results have been consistent with expectations.

As for how mutations will affect the vaccines, we know that some mutations manage to avoid some of the antibodies produced by the vaccine, but we also know that the antibody response cannot be completely evaded and we also know that it does not affect the T-cell response. While we may not have the data on exact percentages of efficacy lost with different mutations, you make it sound like there are more unknowns than there are, or that the risks are greater than they are, which I don't think is proportionate or sensible and could cause people to be unnecessarily worried that the vaccines don't work. I do not think that people should be unduly worried.


This is disingenuous. We knew it was likely to be the case that 12 week gap was better than a 3/4 week gap due to research from previous vaccines. We also knew that the trials for Sars-CoV-2 vaccines realistically had to go with the shortest viable gap because of the need to conclude the trials as soon as reasonably practicable.

Again, the results have been consistent with expectations.


I doubt you'd complain if we were all kept in this awful lockdown for many more months, but that doesn't make it right.

We spent most of last year with government taking the most optimistic assumptions, then changing course at the last minute and finding that they were imposing stronger measures for longer, at higher cost in lives and money. I refuse to criticise a policy that errs on the side of caution, using both informed prediction and observed results, to judge how to relax restrictions.

Crossing threads, my hope is that the policy set out - whatever it is - is based on objective criteria that can be monitored and understood, rather than arbitrary timelines - Easter, summer, Christmas, whatever - which bear no relationship to real progress against the pandemic. For me, the real failing will be if we have a return to lockdown - the relaxation strategy needs to be based on creating circumstances that avoid that possibility.

 

[yorkie]

For me, the real failing will be if we have a return to lockdown - the relaxation strategy needs to be based on creating circumstances that avoid that possibility.

I will respond in the lockdown thread.

 

[DustyBin]

We spent most of last year with government taking the most optimistic assumptions, then changing course at the last minute and finding that they were imposing stronger measures for longer, at higher cost in lives and money. I refuse to criticise a policy that errs on the side of caution, using both informed prediction and observed results, to judge how to relax restrictions.

Crossing threads, my hope is that the policy set out - whatever it is - is based on objective criteria that can be monitored and understood, rather than arbitrary timelines - Easter, summer, Christmas, whatever - which bear no relationship to real progress against the pandemic. For me, the real failing will be if we have a return to lockdown - the relaxation strategy needs to be based on creating circumstances that avoid that possibility.

The circumstances have been created; we’ve vaccinated the most vulnerable. We’re well and truly into “cure worse than disease” territory at this stage, and there is no reason to retain restrictions beyond April at the very latest (to allow the vaccines to become fully effective). I’m not sure what you mean by “progress against the pandemic”? The virus isn’t going anywhere, all we can do is prevent serious illness via vaccination which we’re doing. If that doesn’t work we’ll have to revert back to “Plan A” which is natural herd immunity, in which case we should get started ASAP. For me it’s crunch time, do we want to return to normality or enter a new era of permanent restrictions on our freedoms and civil liberties? Personally I’d rather the former. This has gone on for nearly a year now, we know as much as we’re ever going to know and we’ve now done as much as we are ever going to do. Vaccines are our final role of the dice and as it happens they appear to be working. The scare mongering and shifting of goalposts has to stop, there’s simply no justification for continuing to impose misery on millions of people at this stage.

 

[ExRes]

The circumstances have been created; we’ve vaccinated the most vulnerable

I think that you'll find 'vaccinating' is the word, most certainly not 'vaccinated'

 

[DustyBin]

I think that you'll find 'vaccinating' is the word, most certainly not 'vaccinated'

We will have vaccinated them in the next couple of days so my point stands. Even if we wait until the second doses have been administered it still stands. I’ve no wish to split hairs over exact dates or timescales; restrictions will soon no longer be required.

 

[ExRes]

We will have vaccinated them in the next couple of days so my point stands. Even if we wait until the second doses have been administered it still stands. I’ve no wish to split hairs over exact dates or timescales; restrictions will soon no longer be required.

All I know is that my wife, who is 'highly vulnerable' for two separate reasons, is still waiting for a date for her vaccination, therefore 'vaccinated' or 'in the next couple of days' is far from factual

 

[DustyBin]

All I know is that my wife, who is 'highly vulnerable' for two separate reasons, is still waiting for a date for her vaccination, therefore 'vaccinated' or 'in the next couple of days' is far from factual

Is she classed as vulnerable under the government’s grouping system?

Either way I’d try calling your GP; my Aunt was actually told to do this at work (she works for the NHS) as she is currently taking an immunosuppressant drug which makes her vulnerable. Sure enough she managed to book an appointment within a few days. When something is rolled out on this scale there are always going to be people who fall through the cracks for various reasons.

 

[Domh245]

The vaccination program in some parts of the country is beginning to become a victim of its own success. Time to start bringing priority groups forward on a regional or local level if needs be

https://www.theguardian.com/world/2...running-out-of-priority-patients-to-vaccinate

That's a surprising story, my mum (51, mild asthma) is going for her first jab later today having received her invitation yesterday. Came as a bit of a surprise that she's eligible and that they've reached group 6 (the only way she'd qualify) already here. I'm not sure if FCI is just being overly cautious and sticking to what they've been told or if the place doing the vaccines here is being run by renegades!

 

[Nicholas Lewis]

When you say “we won’t know how effective vaccines are until next Autumn” what do you mean exactly? I thought the vaccines had been thoroughly tested and the efficacy clearly stated, albeit the latter appears to vary slightly against some mutations? I may be missing something, but unless they’ve lied to us it shouldn’t matter what time of year it is, nobody (or next to nobody) is going to be hospitalised by Covid-19 once vaccinated, surely?

what im advocating is a return to normality based on what the trials have told us but to have the necessary surveillance measures in place as we go into autumn to monitor its efficacy across the population. My rationale for this is respiratory viruses naturally moderate across the summer months in the Northern Hemisphere so we could be lulled into a false sense of security a to whether its the vaccine driving declining cases or a natural response. Furthermore a contingency plan with rapid response needs to be in place and this is no more than directors of public health seek to manage on a local basis all year long but given the transmissibility of this one they need to have the resources on standby to deal with it and contain it.

As the old saying goes Plan for the Worst Hope for the Best and this is what the govt should use the next six months to do. Had the govt followed this mantra (and it wasn't the only ones who haven't done so) over the last 12mths we could have avoided the more draconian restrictions it was forced to impose.

 

[MikeWM]

The local rag is reporting that 100% (!) of 75 to 79 year olds in Cambridgeshire have been vaccinated.

https://www.cambridge-news.co.uk/ne...geshire-covid-vaccine-figures-latest-19821101

• Under 70: 71,853 (12%)
• 70-74: 37,038 (83%)
• 75-79: 30,346 (100%)
• 80+: 41,153 (92%)

Somehow I feel this is a bit unlikely, and somewhere along the line 'offered a vaccination' is being conflated with 'having a vaccination'.

I wonder if this is just the awful editoral standards of the local paper, or is this sort of misleading statistic about 'delivered' vaccinations a more widespread phenomenon?

 

[Spamcan81]

Just had my first jab. Piece of cake, didn't even feel the needle go in. Local health centre running a superb system that was running like clockwork. No wonder we're achieving such high daily rates.

 

[30907]

That's a surprising story, my mum (51, mild asthma) is going for her first jab later today having received her invitation yesterday. Came as a bit of a surprise that she's eligible and that they've reached group 6 (the only way she'd qualify) already here. I'm not sure if FCI is just being overly cautious and sticking to what they've been told or if the place doing the vaccines here is being run by renegades!ot

Appears to refer to big test centres - online booking set up for groups 1-4 ATM so 5-6 cannot book in (till next week?). GPs (some) are going ahead with 5 already and have been for a couple of weeks.

 

[kristiang85]

Local health centre running a superb system that was running like clockwork. No wonder we're achieving such high daily rates.
Just had my first jab. Piece of cake, didn't even feel the needle go in.

Yes I'm hearing from others this is unusually painless. Which is great, as I'm a complete needlephobe