One-jab efficacy questions

[D_W]

Whilst I would say this is true, the chances of moderate or severe covid for people under 40 appear to be very low.

I think if we're trying to stop transmission, we'd like to see a reduction in any symptomatic cases. An interesting study was posted on the "verboten topic" boards showing that a collection of different studies showed asymptomatic transmission among family members to be about 1/25th as common as transmission from a symptomatic person.

There are those of us cranks who have been grouching from the beginning about the idea that asymptomatic people would've been a large contributor to transmission because they generally don't fling droplets into the air - that's done by symptomatic people.

But mildly symptomatic people sneezing or coughing are a big problem.

 

[D_W]

'Researchers in the UK and United States have demonstrated the efficacy of one dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccine against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a real-world community setting in the UK.
...
As reported in The Lancet: Infectious Diseases, documented infection rates following a single dose of the Pfizer-BioNTech (BNT162b2) vaccine were 58% lower after 12 to 20 days, 69% lower after 21 to 44 days, and 72% lower after 45 to 59 days, compared with unvaccinated controls.

Following one dose of the Oxford-AstraZeneca (ChAdOx1) vaccine, documented infection rates were 39% lower after 12 to 20 days and 60% lower after 21 to 44 days than among unvaccinated controls.'
https://www.news-medical.net/news/2...en-better-than-clinical-trials-predicted.aspx

Ahh, those number are evidence of some cherry picking from the prior comment about "better at avoiding hospitalization".

We generally have 3week+ and two dose numbers here and what was a shortage of doses a couple of months ago has turned into locales having extra doses and opening to patients from outside of the locale (distribution was at the county level here, so if your county had more health care and nursing home residents, it became harder for the rest of us to get vaccinated).

Long story short, the two doses haven't been an issue here because of the buy rate - the elderly and front line workers got two doses almost immediately and other than some news stories about a few select locales, the pressure is off.

 

[Jonm]

Not quite the facts. Macron at first questioned the effectiveness in older people and he was proved to be wrong.
The restriction to only over 55's having it was as a result of abnormal clotting after have the AZ vaccine. This has been the same in other countries. This information was at first poo pooed in the UK but eventually figures were released and at the time (some weeks ago) they reported 79 cases with 19 deaths from clots.
Sometimes it seems like a vaccine propaganda is in progress.
Here in France we are very short of any type of vaccine and whilst there is a preference to have Pfizer the majority of people will have either.
I had my second jab in early March but my wife is still waiting for hers and hopefully she'll be having one (either type) in the next two weeks.
I think the EU is royally p*****d off with under delivery from AZ. This is the vaccine that will be most beneficial to poorer parts of the world so sincerely hope it's never regarded as second best.

Well that is a well balanced response.

I understand why the eu is unhappy with AZ and non delivery however uk placed orders and committed to buy AZ three months ahead of the EU. This allowed AZ to put manufacturing and supply chains in place to supply the uk market much earlier than for the eu.

I think the issue with Macron is that the EMA approved AZ, however as you say there was concern about the young age of the people in the trial and it’s effectiveness for the over 65’s. This was reported In uk as Macron saying "Today we think that it is quasi-ineffective for people over 65," There is a big difference between saying it’s effectiveness is “not proven” and it is ineffective. It may be in the translation or the uk media reporting.

The EU has been under a lot of criticism over vaccine ordering and supply. Putting this all together it looks like Macron was effectively saying that it does not matter that the eu did not place early orders as the AZ vaccine is not much good. And yes he had to retract but damage was done.

It is interesting to hear that people in France would have AZ if it was available. The impression we are getting is that the eu is very upset with AZ but do not want it anyway, reports of vaccine centres with vaccine but no patients because it is AZ.

 

[Jonm]

You're the same person who tried to hang me up in an earlier post about mutations. If you're obsessed with mutations, why would you think a higher case rate is OK?

J&J, moderna and pfizer all do about the same in preventing severe/hospitalizing covid here. I'd rather not get it at all, not even moderate.

you posted a false dilemma - pfizer wasn't available right away so you went with AZ. That's fine. I didn't state that to be the choice (none or pfizer), i said that if you have the choice between the two and you're trying to stop covid, then pfizer. There would be fewer cases around with it in a vaccinated population and the hospitalization rate would be lower in a society vaccinated by pfizer because there would be fewer symptomatic carriers passing covid.

I'd say exactly the same thing about J&J here. If nothing else is available, get it. If pfizer is available, get that over J&J. Hospitalization rates are similar, but you have less chance of getting sick at all with pfizer.

In the US here when they paused the J&J, and quickly reversed course, I thought it was stupid - let's at least compare the vaccine complications to a fraction of what you'd get with the resulting increase in covid from not vaccinating. It' wasn't a situation where everyone scheduled to get it would just get pfizer instead, and the same with europe pausing or halting AZ. If there isn't another more viable option, then that choice results in unnecessary deaths.

Actually Phizer was available in uk before AZ, if you look at the Article I referenced about the Scottish data there were
650,000 doses of Pfizer and 490,000 doses AZ.

Perhaps in Pennsylvania you have the luxury of choice, here in UK though we do not in general have a choice but both vaccines are excellent. Ok Phizer appears to be a bit better at preventing disease after one dose, we do not know yet what the effect is after two doses. They prevent onward transmission by about 50% but we do not know which is better.

My concern is that The EU but particularly France and Germany appear to be throwing mud at AZ to divert criticism away from themselves due to EU slowness in placing orders and agreeing to pay for vaccines so manufacturers could get organised to supply the necessary doses. AZ and vaccines like it are needed to vaccinate the world and need to be credible.

 

[Jonm]

Ahh, those number are evidence of some cherry picking from the prior comment about "better at avoiding hospitalization".

this article is about efficacy after one dose, and both are good. The article I referenced was about hospitalisations. What is “cherry picking” about that.

 

[Chris152]

this article is about efficacy after one dose, and both are good. The article I referenced was about hospitalisations. What is “cherry picking” about that.

Yep, it's just the latest bit of what looks like reliable research on the efficacy of the first jab that I could find. No idea about cherry picking, just seemed like some useful and hopefully quite good news.

 

[francovendee]

It is interesting to hear that people in France would have AZ if it was available. The impression we are getting is that the eu is very upset with AZ but do not want it anyway, reports of vaccine centres with vaccine but no patients because it is AZ.

I'm not sure of peoples attitude to the vaccine outside of France, and even here I can only go by what I her and see locally. It's more than possible that other EU countries don't want it.
I just don't understand their reluctance to take a very small risk when set against the far,far greater one of catching this killer disease. When getting my vaccination it didn't matter a jot which type, I'd have had either without hesitation.

Slightly off topic the French are to allow a test social gathering (I think it is a music concert) of 5000 people. These are to be monitored after the event to see any upsurge in outbreaks amongst the attendees. This is similar to Spain who did a similar thing a couple of months ago. Spain are reporting no massive increase of infections and the few reported cases couldn't be attributed with certainty to the concert. I guess it's being outside that lessens the risk. This would seem to be what stopped a major outbreak from the end of the first UK lock down when thousands were crowded on beaches.

 

[D_W]

this article is about efficacy after one dose, and both are good. The article I referenced was about hospitalisations. What is “cherry picking” about that.

every other statistic favors pfizer. You responded to my comment about pfizer. The hospitalization number is small enough that it's probably the least credible statistic from the group.

Coupled with your comment in another thread about wanting to eliminate cases to avoid mutations, it's just a trail of bits suggesting that you're just picking and choosing what to say in each case to be oppositional.

When I'm in a bad mood, I do it sometimes, but I do try to be more consistent to be fair to other people in the exchange.

 

[D_W]

Yep, it's just the latest bit of what looks like reliable research on the efficacy of the first jab that I could find. No idea about cherry picking, just seemed like some useful and hopefully quite good news.

Anyone not in the back and forth may miss that subtlety, and I could be getting jonm and someone else with a similar length J name confused (not jacob!!- he's "unique"). But somewhere back through this thread I said something about severe cases, and less urgency for the young, and then working top down to the third world and the response was "we can't have variants!!!". Now, the response to preference for pfizer because the overall case load is less (which would actually lead to fewer severe cases in a population, even if it was slightly less efficient per case - I doubt it is) is that AZ has a better hospitalization rate (but the stats on other cases was conveniently omitted).

Pfizer appears to be the best of all of the vaccines so far. My comment was pretty simple - if you have a choice, that's the best so far in terms of total efficacy and side effects. If I lived somewhere that only AZ was available, I would certainly take it. Europe dropped the ball by being chicken - AZ was available and they declined to use it, and then called it "not good" or some such thing after a few clotting incidence that are a pimple on the butt compared to populations with covid (even putting the whining about not getting supply ahead of someone else who ordered before them aside).

The criticism about the cost per dose is also a little odd considering the "high priced" option is $20 per dose. I think this is probably a situation where it's money well spent.

A look to India will provide good data on what happens if you don't have vaccine supply - each situation is different. When there is an abundance of supply, what do you do? pick the best option. When there is only one option and the choice is vs. nothing, what do you do - when the option is 100 times better than nothing, you take that option.

We'll see how this goes in the US - the J&J vaccine appears to be less ideal as far as preventing cases, but similar in preventing hospitalizations. I got pfizer (you could vaccine shop here if you wanted to, but my first public option said "we're giving pfizer today, you're auto scheduled for your second dose in 3 weeks. Go to that room and see you then in 3 weeks after that". Lucky. My own health system was advertising that they would have a supply of J&J in a couple of weeks (meaning I could've gone to my own doc's office). No thanks - i'll go to the public stadium clinic - it's less convenient, but they're offering the version I want and sooner - I'm not looking to get mild or moderate covid, either. I've had bronchitis about 75 times in my life and done my fair share on the "shortness of breath" shift.

 

[Rorschach]

I just don't understand their reluctance to take a very small risk when set against the far,far greater one of catching this killer disease.

Depends if you really think it's that dangerous. It might be for a small section of society but for most it's nothing to fear, the IFR is well under 99% for most of the population and of course that's assuming you catch it, which isn't a certainty.

 

[Jake]

It looks like JCVI is going to recommend that the de facto policy of not using AZ for (healthy) under-30s is extended to (healthy) under-40s, on the basis the ratio of clotting deaths to COVID deaths saved in that cohort will be only in the region of 1:2.

 

[Rorschach]

It looks like JCVI is going to recommend that the de facto policy of not using AZ for (healthy) under-30s is extended to (healthy) under-40s, on the basis the ratio of clotting deaths to COVID deaths saved in that cohort will be only in the region of 1:2.

That's a good start. Personally I would say (healthy) under 40's don't need vaccinating at all and doses should be used to boost the vulnerable ready for the winter. Some people are almost 6 months since their first jab now and could need a top up.

 

[RobinBHM]

Whilst I would say this is true, the chances of moderate or severe covid for people under 40 appear to be very low.

being vaccinated reduces transmission by about 50%, so that would help reduce community transmission.

It would seem the govt are continuing to roll out the vaccine until they reach everybody over 18.

Given the vaccine programme is giving the govt a boost in popularity, I wonder if it's being led by politics rather than science.

 

[Rorschach]

It's being led by money, lots of money in vaccines even if a few people do die of rare blood clots or who knows what else we might find.

Same reason there is no treatments being looked at or being hushed up in the case of Ivermectin. I have no idea if IVM works but it is definitely being blocked on social media, or attempted anyway. Treatments aren't good because if you can cure it you won't need to vaccine the entire world every year.

 

[Terry - Somerset]

Even if those below (say) 40 are relatively unaffected by the virus with very low probability of hospitalisation or death, they are part of the herd.

If vaccinated they will:

• reduce R0 and limit the spread of a more virulent strain,
• allow for degradation over time of the vaccines effectiveness,
• help deal with mutations against which the vaccine is less effective.

 

[Jonm]

Coupled with your comment in another thread about wanting to eliminate cases to avoid mutations, it's just a trail of bits suggesting that you're just picking and choosing what to say in each case to be oppositional.

I do not have a clue what you are talking about, I have looked back through my threads and cannot find a discussion with you about mutations. And from your comment below you cannot either.

I had a discussion with Jacob about mutations coming from slums being a real danger. His response was

Not really. They are the ones who find it hardest to get here and are least likely to be visited by freewheeling travellers.
It's the well off world travellers, whether for business or pleasure, who will spread it fastest.

Needless to say I disagreed with this statement.

I think you are getting me muddled with someone else. I suggest you either find the statement which is so upsetting you or stop accusing me of inconsistencies.

 

[Jonm]

Anyone not in the back and forth may miss that subtlety, and I could be getting jonm and someone else with a similar length J name confused (

I have been polite to you, I have not cast aspersions on your integrity.

You on the other hand have accused me of
“cherry picking“, “You're the same person who tried to hang me up“, “you posted a false dilemma“, “it's the inconsistency that strikes me“ “First it matters that we have no covid cases, then ......it doesn't matter“, “it's just a trail of bits suggesting that you're just picking and choosing what to say in each case to be oppositional“

I suggest you look at your conversation on this thread with JAKE on and about 22 April which talked about mutations. Then perhaps you may wish to review your detrimental comments about me.

 

[Jonm]

Depends if you really think it's that dangerous. It might be for a small section of society but for most it's nothing to fear, the IFR is well under 99% for most of the population and of course that's assuming you catch it, which isn't a certainty.

I do hope that the infection to fatality rate is ”well under 99%“. a long way under like nearly 99% under 99%.

 

[Jake]

I suggest you look at your conversation on this thread with JAKE on and about 22 April which talked about mutations. Then perhaps you may wish to review your detrimental comments about me.

Apologies for accidentally getting you in trouble with this argumentative chap.

 

[D_W]

Ahh, jonm - it was jake. My apologies for getting you confused with him.