Vaccine thread

[Layladylay234]

I know someone on another thread suggest someone start one of these. Considering I've just watched a video with the person leading the vaccine trial,I thought now's as good a time as any. Here's the link to the video,it's really hopeful

@nether social distancing doesn't just reduce the risk of SARS-CoV-2 infections.....its possible, if we're still social distancing then, that it might also minimize the transmission of other viruses, so it might be a relatively light flu season if we're still doing social distancing and masking then.

A slight word of caution to those expecting a vaccine: none of these trials have provided efficacy data yet. i.e. we still don't know if any of these work, and we don't know how durable any immunity is (although the minimum 56 days suggested in the trial would still be really helpful in reducing community circulation).

Sunshinegirl I remember reading a lot of your posts about the vaccine earlier in the year when I was feeling incredibly anxious and hopeless. Your positive yet factual posts were really helpful for me. Thank you.

@Mybrowneyedgal

Sunshinegirl I remember reading a lot of your posts about the vaccine earlier in the year when I was feeling incredibly anxious and hopeless. Your positive yet factual posts were really helpful for me. Thank you.

I agree; much needed during a time when so many threads were filled with "it takes 5 years to create a virus" etc etc.

Of course I mean vaccine ffs

A few comments on vaccines from the Health and Social Care Committee session this morning:

On vaccines, Professor Sir John Bell says the reality is that this pathogen is here forever. The vaccine is unlikely to have a durable effect so we will have a continual cycle of vaccinations and more disease. The idea that we will eliminate coronavirus completely is unrealistic.

Chris Witty says that we are very excited by and proud of the UK's vaccine work - but no one should be under any illusions: the chances of us getting a vaccine before Christmas are very low.

Asked about vaccination, Jonathan Van-Tam says we may get a vaccine targeted at a particular population. Vaccine effectiveness varies, targeting a relatively small proportion at the very highest risk will deal with those who have the risk loaded against them at the moment.

Professor Van-Tam says he is more optimistic about getting a vaccine this side of Christmas but we won't have data on how it can be safely staged with the flu vaccine.

mobile.twitter.com/CommonsHealth

parliamentlive.tv/Event/Index/4b2dfc60-0c0e-47fe-8b78-1db2f135a004

Clip from last night's Channel 4 news on the Oxford vaccine:

I would say that's all pretty much in line with cautiously optimistic expectations?

I have never really expected them to have a vaccine for the general, low risk population in October/November but I'm hopeful of emergency licensing and a roll out across high risk groups at around that sort of time if all goes to plan. I do think your average person can have a reasonable expectation of receiving a vaccine towards the beginning of next year if Oxford are successful.

If all high risk groups are vaccinated (and the vaccine has a reasonable level of efficacy) I would anticipate that almost all social distancing can be abandoned although I suspect testing, isolating, tracing contacts etc will continue for some time.

I'm also not surprised that it is anticipated that the virus will circulate in the population for a long time. We still have outbreaks of measles etc here and in developing countries these can be widespread and severe. CW said in one of his lectures that measles kills around 10% of children who catch it in countries where healthcare is less widely available. That is despite a safe and widely available vaccine being in existence for many years.

I'm not sure that it is necessarily a problem that the virus will continue to circulate. Combinations of vaccines, awareness and treatments should hopefully mean that in time it is no more concerning than any of the other pathogens in circulation.

I do think that there is sufficient will worldwide to get on top of coronavirus and if the human race is going to eradicate another disease (we have proved we can do it with smallpox!) Covid 19 is probably the most likely. It won't happen overnight though.

On another note I find JVT completely fascinating and he is definitely on my fantasy dinner party guest list!

[quote CoffeeandCroissant]A few comments on vaccines from the Health and Social Care Committee session this morning:

On vaccines, Professor Sir John Bell says the reality is that this pathogen is here forever. The vaccine is unlikely to have a durable effect so we will have a continual cycle of vaccinations and more disease. The idea that we will eliminate coronavirus completely is unrealistic.

Chris Witty says that we are very excited by and proud of the UK's vaccine work - but no one should be under any illusions: the chances of us getting a vaccine before Christmas are very low.

Asked about vaccination, Jonathan Van-Tam says we may get a vaccine targeted at a particular population. Vaccine effectiveness varies, targeting a relatively small proportion at the very highest risk will deal with those who have the risk loaded against them at the moment.

Professor Van-Tam says he is more optimistic about getting a vaccine this side of Christmas but we won't have data on how it can be safely staged with the flu vaccine.

mobile.twitter.com/CommonsHealth

parliamentlive.tv/Event/Index/4b2dfc60-0c0e-47fe-8b78-1db2f135a004[/quote]
Well this is where the "it's like the flu" analogy might come in. If there was no such thing as the flu vaccine then many more thousands of old and vulnerable people would die or get seriously ill every winter.

If we can develop something that becomes essentially an extra vaccine every year for old and vulnerable people then that's the main thing. So many people are still effectively shielding until they've got some protection against Covid.

Would you imagine the ones in the nhs flu jab list to be given this? Thank you

@scotlandg - the government published a strategy on this a while back. Front line health and social care workers, and then people at higher risk was what they said. Not sure if that would be identical with the flu jab list, but there would certainly be overlap.

The flu jab list would be after specified front line workers and the exceptionally clinically vulnerable (who are a subset of those who qualify for flu jabs, but at even higher higher risk)

Then it will be the 'flu jab' vulnerable ie by age and certain other specified medical conditions - and I think that said it might be everyone over 50

And then everyone else

But of course that might change

the flu jab list doesn't include some conditions like hypertension that do seem to increase risk of covid complications. Or pre-diabetes. So I hope whatever list they come up with for the vaccine actually looks at covid-specific issues and doesn't just take a generally 'vulnerable' list like they did for shielding at first (and then revised a bit, I think, as they realised as more information came out that some of their first thoughts about what made people at higher risk weren't actually the case).

An obvious problem with using the flu jab list is there are too many old people. The vaccines might not be as effective in older people, for largely the same reasons that those aged >70 have worse COVID-19 symptoms than young people (i.e. because their immune systems aren't as robust and are less able to mount strong immune responses). It could be, for example, that older people need higher vaccine doses, or more regular injections to achieve durable immunity. It could also be that vaccines simply don't work in older people.

Another related issue to this extent is that many of the vaccine trials have an upper age limit for volunteers of 55 (i think similar criteria applies to other trials, this is usually because they don't want too many deaths from other causes during testing and they don't want people with loads of comorbidities). So we may never know if, for example, the Oxford vaccine is effective in older people. At worst, It could be that older people will need to rely on herd immunity effects in order to stay safe.

Of course, if the vaccine works in older people, I would want them to be prioritized after health-care workers and those providing other essential front-line services (including, for example, non-clinical hospital staff).

I wonder if they have some preliminary results (that they can't release for obvious reasons) on the efficacy of the vaccine. I know it's a small number of participants so far, I know it's only been a month or two for some of them, I know there isn't that much transmission here, etc etc.., loads of reasons why it won't be good data yet, but still... they must have some idea for themselves, if anyone in the vaccine group has caught it yet at all, what's happened to them, etc. Of course it might be that nobody in the entire study has got it, control or vaccine, or that they can't be sure they didn't get it in the window before they'd had a chance to make the antibodies etc, but nonetheless, I'm sure they must be wanting to know. Maybe they're not allowed to unblind the data and see how it's going yet at all, but I doubt it. There must be a way to do it without compromising the study. After all, if loads of vaccinated people had got it, they wouldn't be continuing?! I know they can't tell us. But I do wonder.

oh they must have unblinded it if they know it produces antibodies, so that point is off the list anyway.

Don't know if this has bee posted but Russia say their vaccine will be ready by August!

www.aa.com.tr/en/europe/russias-covid-19-vaccine-ready-says-official/1917666

The data they have released on the Oxford vaccine is from phase 1 which has concluded.

Phases 2 and 3 are ongoing and are double blind trials so no data from those yet.

that's still 1000 people though, which you'd think might be enough to give them some early ideas of efficacy. I don't know though, guess it depends where they were located and how front line they were. I suppose nobody getting it in that time period isn't than unexpected, and then there'd be nothing to show one way or the other.

and i guess if they are concluding that two doses might be needed to really protect people, maybe the results of who gets it or not could be too inconclusive to say at this point. But if I were a researcher, I'd sure want to know what kind of outcomes were being experienced!!

@Grumblyberries: I agree with many of your sentiments here, although i'm not sure I agree with the notion that they must have unblinded. Immunity was analyzed in a subset of patients and it's perfectly possible to retain blinding while also analyzing some samples for immunogenicity. Or to put this another way, if blinding was compromised, then the trial would also be compromised.

I was also a little dissapointed that there were not early efficacy signals reported. Nonetheless, efficacy is a primary endpoint, so the investigators feel that, in principle, they have adequate enrollment to test efficacy (not sure I agree with that point, it possibly depends on the exposure risks of the cohort). My feeling is that if they had a good efficacy signal, we would know by now.

that's what's a little worrying - that we don't know. But I'm assuming that they are just not publicising it all because so many people would just on early indications and run with it, when the researchers will be entirely aware of the limitations of those indications. I assume they're positive enough for them to keep going - if they really didn't think it would work, they'd be on to changing it by now, I hope. I wondered if their predictions of September/November/next spring were any indication of what the efficacy results were/were not!

Not a vaccine as such but another potential treatment with apparently preventative properties:
www.theguardian.com/science/2020/jul/22/antibody-mix-trialled-as-potential-coronavirus-treatment

@Grumblyberries: I just looked up the registered protocol for the ChAdOx trial....estimated completion is listed as May 2021, so they expect to have robust efficacy data by then (I assume this was a conservative estimate): clinicaltrials.gov/ct2/show/NCT04324606?term=ChAdOx1+nCoV-19&draw=2&rank=3

In the meantime, ChAdOx is also being tested in South Africa, and this study has a primary completion date of October 2020: this could explain the November timeline for rolling out vaccinations? clinicaltrials.gov/ct2/show/NCT04444674?term=ChAdOx1+nCoV-19&draw=2&rank=1

they're also running a trial in Brazil, although that's not currently registered in clinicaltrials.gov www.ovg.ox.ac.uk/news/trial-of-oxford-covid-19-vaccine-starts-in-brazil

Fingers crossed for October then...

I heard data numbers of something like 2,000 for the South Africa one, 3000 for Brazil, and more (9,000?) for US. The 1,000 here doesn't sound so small in comparison, but the level of transmission is so much lower that it probably is too small for very useful results. Although, disproving that it works if some of the strong antibody groups have contracted it might be possible! Hopefully not the case.

I think the 1,000 in the UK is the Phase 1 group - I think phase 2/3 is 10,000 people, but there is not enough infection about so they included Brazil and South Africa. And in the US they are meant to be recruiting 30,000.
Plus the challenge trials of they are allowed.