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Wondering whether a scientist can help clarify the vaccine trial data! Oxford and Pfizer, etc.

4 replies

chuzzlewitty · 16/01/2021 19:10

Posting here to try and catch the eyes and brains of scientists!

I have a lot of questions, so if you are only willing/able to field a few, I would be very grateful nonetheless!

So, I have been reading about the Pfizer and Oxford vaccines, and wondered whether anyone who can 'read' scientific papers can clarify.

The 'efficacy' statistic looks to be a big contrast at first glance...

However. I understand that a big difference in reported efficacy is that the Oxford trial asked all its volunteers to swab weekly, regardless of symptoms, so their data includes asymptomatic persons infected with Covid, which the Pfizer trial does not - the Pfizer trial only accounts for those presenting symptomatically. Can an estimate be made as to the updated Pfizer efficacy percentage if this data were to have been collected? (Or the Oxford percentage were the data to have been eliminated).

Are both vaccines 100% effective against severe illness and hospitalisation?

Are the much-touted efficacy statistics about preventing any symptoms, or rather, are they about preventing infection altogether, whether asymptomatic or symptomatic?

What is the data on what kind of protection a single dose confers - in terms of efficacy against severe illness and hospitalisation?

Did both studies use a good sample across groups, say, age groups etc? Are there any quibbles with how either trial was conducted or reported on?

Additionally, I understand that when the first dose was halved for the Oxford vaccine, efficacy shot to 90% - taking asymptomatic patients into account, does that now make it more effective than the mRNA vaccines? Does anyone know whether this has been implemented, and people now receiving the Oxford vaccine get an initial 'half' dose?

To add to my confusion, I found this quote on another mn thread that suggests it's not about dosage, but rather dosage intervals - does anyone know which it is? -

It turned out that the ‘half dose first’ regimen had a confounding variable; the length of time between doses. The ‘half dose’ group had gaps of between 3-26 weeks between their first and second dose. When they looked at the data they showed that a gap of 8-12 weeks gave 90% efficacy

Finally if there are any thoughts about the vaccine vectors in general, adenovirus 'vs' mRNA, more of a discussion than a 'vs'! Their historical and anticipated usages, etc.

Also whether a 12 week gap between Pfizer doses is likely to harm its efficacy.

And finally, whether vaccine efficacy re asymptomatic infection is an important piece of data to collect regarding potential spread of the virus, and whether the mRNA trials are doing this.

OP posts:
Witchend · 16/01/2021 20:01

My understanding is: I'm doing this off the top of my head, so someone will probably be able to do some proper information shortly.

I understand that a big difference in reported efficacy is that the Oxford trial asked all its volunteers to swab weekly, regardless of symptoms, so their data includes asymptomatic persons infected with Covid, which the Pfizer trial does not - the Pfizer trial only accounts for those presenting symptomatically. Can an estimate be made as to the updated Pfizer efficacy percentage if this data were to have been collected?
That's my understanding. I believe the Pfizer one is being rolled out in Israel very quickly, and the plan is that transmission will be tested there. Not sure about asymptomatic cases. I have to admit it does worry me, and even the Oxford one which tested that wasn't brilliant reduction. If it goes asymptomatic and it can be transmitted then it could be awkward.

Are both vaccines 100% effective against severe illness and hospitalisation?
You will never get a vaccine 100%. There will be a proportion of the time when it just doesn't for some reason. A bit like putting grommets in. They last on average a year, can last several years... but then you get the child who wakes the day after the operation with them on the pillow next to them.

Are the much-touted efficacy statistics about preventing any symptoms, or rather, are they about preventing infection altogether, whether asymptomatic or symptomatic?
My understanding is the Pfizer one didn't test for asymptomatic so they have no data on that. The Oxford one did. I may be misremembering but I think the control group had 40 asymptomatic, and the vaccine had 29. Which is a reduction, but I'm not sure what confidence levels.

What is the data on what kind of protection a single dose confers - in terms of efficacy against severe illness and hospitalisation?
My memory says it was around 50-65%, but I'm not certain on that. Don't quote me!

Did both studies use a good sample across groups, say, age groups etc? Are there any quibbles with how either trial was conducted or reported on?
Lots of quibbles, but there always will be, doesn't mean there was anything wrong. Scientists love to debate the right way to do things. Smile
Neither used children (under 16yo) to my knowledge. I've a feeling that one, at any rate, didn't go older (over 65yo) but again don't quote me!

Does anyone know whether this has been implemented, and people now receiving the Oxford vaccine get an initial 'half' dose?
My understanding is yes.

To add to my confusion, I found this quote on another mn thread that suggests it's not about dosage, but rather dosage intervals - does anyone know which it is?
I haven't heard that, so can't really comment. However 26 weeks is 6 months, so I think it's very unlikely anyone had it 26 weeks apart due to timing (That would mean they'd have had to have the first dose in May for any meaningful check on them) so if someone is saying that, then they probably aren't correct, simply because if they haven't queried that, they won't be a very objective reader.

Also whether a 12 week gap between Pfizer doses is likely to harm its efficacy
I think this is unknown.

And finally, whether vaccine efficacy re asymptomatic infection is an important piece of data to collect regarding potential spread of the virus, and whether the mRNA trials are doing this.
Definitely important. I haven't heard for sure that this is being checked. I would say I hope so. There will be a certain amount of becoming obvious as more people are vaccinated I suspect. Although if it doesn't prevent it, then it could have a rather unpleasant side effect.

Again: This is off the top of my head, being bugged by a dc, so don't take my word for it if someone corrects me with evidence.
Hopefully this will bump it for someone more knowledgeable to comment.

SpeciesOfSpaces · 16/01/2021 20:21

Bump. I want to know too!

chuzzlewitty · 18/01/2021 18:00

Thank you very much Witchend! Very informative.

I wondered whether anyone else had any further input!

OP posts:

Interested in this thread?

Then you might like threads about these subjects:

TurkeyTrot · 18/01/2021 18:06

I think that the 90% efficacy after one dose is backed up by the reduction in infection rates (the numbers looked robust).

But, there needs to be caution in extrapolating to older people and immune compromised people of any age. Here the response will likely be weaker, so two doses might be absolutely needed to protect, whereas the healthy volunteers got good responses with one.

Given that immune response in individuals isn't tested, it makes good sense to give everyone two doses.

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