Oxford vaccine?

[FlorentineAz]

When can we expect to hear anything about the vaccine? I know it needs to be safe and effective but it just feels like a long time since there’s been any positive news about it.

Does anyone know anything? Thanks in advance.

@Scottishgirl85

I'm not familiar with the Oxford trial in particular, but the trial is likely to be event-driven, ie it stops when a certain number have caught covid. So there isn't a predictable end date and they wouldn't share a guesstimate as media would be all over it.

It's 150 with an interim analysis at 75 for Oxford.

@MarshaBradyo

The Guardian is pathetic atm

Mostly scoring points in every direction in line with their agenda

I guess Forbes are full of it too:

“The second surprise from these protocols is how mild the requirements for contracted Covid-19 symptoms are. A careful reading reveals that the minimum qualification for a case of Covid-19 is a positive PCR test and one or two mild symptoms. These include headache, fever, cough, or mild nausea. This is far from adequate. These vaccine trials are testing to prevent common cold symptoms.

These trials certainly do not give assurance that the vaccine will protect from the serious consequences of Covid-19. Johnson & Johnson is the only trial that requires the inclusion of severe Covid-19 cases, at least 5 for the 75 participant interim analysis.

One of the more immediate questions a trial needs to answer is whether a vaccine prevents infection. If someone takes this vaccine, are they far less likely to become infected with the virus? These trials all clearly focus on eliminating symptoms of Covid-19, and not infections themselves. Asymptomatic infection is listed as a secondary objective in these trials when they should be of critical importance.”

www.forbes.com/sites/williamhaseltine/2020/09/23/covid-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed/#356e85095247

Then there’s the fact that ALL of these trials exclude those over 65, those mostly actually at risk and those least likely to be well protected by a vaccine.

“Our findings indicate that older adults are likely to be excluded from more than 50% of COVID-19 clinical trials and 100% of vaccine trials. Such exclusion will limit the ability to evaluate the efficacy, dosage, and adverse effects of the intended treatments.“

jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771091

People really need to temper their expectations of this first generation of vaccines. Scratch the surface and it’s clear they aren’t going to restore life to normality. I was pinning my hopes on them too, but not anymore.

The Oxford trial was expanded to include over 75s, so that's not accurate.

www.bbc.co.uk/news/health-52760871

Both the Guardian and Forbes articles are opinion pieces (so the opinion of the author not the publication). Article headlines are almost always written by the sub editor not by the article author.

[quote cathyandclare]The Oxford trial was expanded to include over 75s, so that's not accurate.

www.bbc.co.uk/news/health-52760871[/quote]
Pfizer trial also includes people aged 65 to 85.

@BlusteryShowers

If it stops hospitals being overrun, then that means we can all get back to normal.

The NHS being overwhelmed is the only reason for lockdown. If a covid vaccine renders it no more deadly than any other virus then it would be very successful. We should not wait for a vaccine that will wipe it out completely.

Exactly this.

As is the case with the Novavax trial
"Up to 10,000 volunteers aged between 18 and 84 will be enrolled for the study."
www.standard.co.uk/news/uk/novavax-phase-3-covid19-vaccine-trial-uk-a4555881.html

A careful reading reveals that the minimum qualification for a case of Covid-19 is a positive PCR test and one or two mild symptoms. These include headache, fever, cough, or mild nausea. This is far from adequate. These vaccine trials are testing to prevent common cold symptoms

These vaccine trials are testing for symptomatic COVID- what do you think they should be testing for?

On the Oxford trial, an event is a positive PCR test and symptoms as shown in the image:

"Ten thousand people will take part in the (Novavax) trial and at least a quarter of them will be over 65, the age-group most at risk of severe Covid-19."
www.bbc.co.uk/news/health-54296224.

Same again with Moderna:
"Moderna’s phase 3 trial is stratifying its 30,000 participants based on whether they are over or under 65 years of age. Between 25% and 40% of subjects will either be aged over 65 years or be younger but be at increased risk from COVID-19 due to comorbidities such as chronic lung disease. Subjects aged 65 years and older are eligible regardless of whether they are at raised risk of severe COVID-19. "
www.fiercebiotech.com/biotech/moderna-s-covid-19-vaccine-spurs-immune-response-older-adults

And looking at the protocol for the Astra Zeneca trial, patients who test positive fill-in an illness diary. They have an illness visit and are fitted with a Digital Health Device which tracks temperature, heart rate, respiratory rate, blood oxygen saturation, and physical activity. There is a specific set of parameters for patients to be categorised as severe COVID.

That JAMA article was published in late September, before the expansion of these protocols, so my bad.

But that doesn’t change the fact that the first vaccines will not be a silver bullet. People need to manage their expectations. Older people do not respond that well to vaccines. It gets harder to mount immune responses as we age.

Kate Bingham (head of our vaccine task force ) has been banging on about it not being a silver bullet:

“Kate Bingham also said a vaccine will not be "a silver bullet" that would allow life to get back to normal overnight.

And she warned that it was unlikely to protect everyone from infection.

Ms Bingham said she was optimistic that a vaccine would be found that would "protect some people from infection and can reduce the severity of symptoms".

But she said it was "very unlikely" to be a single jab and that ongoing revaccination would be needed - probably every few years.”

And:

“There's a real sense of when can we get back to normal? Of course that's what I hope will happen, but we don't have the data to be sure that that will happen and it also won't be overnight."

One worry, she said, is that work on a vaccine would have to start again from scratch if the virus was to mutate sufficiently in the future.

But she was hopeful that by 2022 there would be no need for people to wear face masks, and was more confident that we could be bringing in 2022 with family gatherings and parties.“

I agree with pp all we need vaccine to do it stop hospitals from being overwhelmed.

Even if they do half as much as we first thought if it’s enough to do this we can do away with restrictions.

We can hope that vaccinating the at risk and vulnerable, together with some immunity in student and school populations, and rapid testing in care homes/ mass gatherings/ travel settings/ hospitals we can live more normally with the virus.

But that doesn’t change the fact that the first vaccines will not be a silver bullet. People need to manage their expectations. Older people do not respond that well to vaccines. It gets harder to mount immune responses as we age.

"Silver bullet" needs to be added to the lexicon of annoying covid phrases. It appears on every single vaccine thread, without fail.

I think most people know that early vaccines will be imperfect and will take a long time to be rolled out to the general population. That doesn't mean that a safe, reasonably effective vaccine won't be a major game changer. Notice that I didn't say 'silver bullet'.

Yes, it's right up there with exponential growth.

Adding my thoughts here:

I expect that at least one of the vaccine candidates will have mature efficacy data before Christmas, and, at the moment, the Oxford vaccine seems best placed. I agree with those who say the Oxford vaccine may not be perfect and that the data from primate studies indicate that the vaccine protects against the development of COVID-19 symptoms but may not protect against spread. Vaccinated primates with no symptoms on SARs-CoV-2 challenge still tested positive for SARs-CoV-2 in the upper airways, although whether this is enough to transmit the virus to other primates or not remains largely unknown. On this point, the Moderna Vaccine looks as if it could protect against both symtpoms and transmission: www.nejm.org/doi/full/10.1056/NEJMoa2024671?query=featured_home

The reason protecting against symptoms but not transmission might be dangerous is that people who have been vaccinated will look to go back to normal as quickly as possible, but could possibly still infect those who have not been vaccinated, or in whom the vaccine isn't very effective. These could include the elderly, or children.

The main point is that there are several vaccines being tested, all of which look as if they will be at least a little bit effective. We cannot reliably say how effective these will be until more data are available, although even if they are only a little bit effective, this will still be helpful if delivered alongside the correct public health messaging.

Yes. When people say “vaccines won’t be a magic bullet” it is entirely unclear to me what they mean and what expectations they are seeking to manage with that statement.

Will the virus go “oh you’ve got a vaccine now, fair play, I’ll slope off then” as soon as a vaccine is approved, well obviously not. Will a vaccine rolled out to a large section of the population have major public health effects, yes it will. No vaccine out there is perfect but it’s harder to think of anything closer to a ‘silver bullet’ when it comes to how we deal with viruses.

I would see it more in terms of the smallpox eradication programme. Part of that was achieved with mass vaccination, but the vaccine wasn’t perfect and wasn’t rolled out to the whole world. The rest was achieved with really good public health measures and doing things like ring vaccination for confirmed cases. Same as is done for Ebola outbreaks now. Smallpox vaccine wasn’t a ‘magic bullet’ in the sense of being everywhere and perfect, but it was pretty amazing in terms of what it helped us achieve.

@defthandswarmheart

I guess Forbes are full of it too:

“The second surprise from these protocols is how mild the requirements for contracted Covid-19 symptoms are. A careful reading reveals that the minimum qualification for a case of Covid-19 is a positive PCR test and one or two mild symptoms. These include headache, fever, cough, or mild nausea. This is far from adequate. These vaccine trials are testing to prevent common cold symptoms.

These trials certainly do not give assurance that the vaccine will protect from the serious consequences of Covid-19. Johnson & Johnson is the only trial that requires the inclusion of severe Covid-19 cases, at least 5 for the 75 participant interim analysis.

One of the more immediate questions a trial needs to answer is whether a vaccine prevents infection. If someone takes this vaccine, are they far less likely to become infected with the virus? These trials all clearly focus on eliminating symptoms of Covid-19, and not infections themselves. Asymptomatic infection is listed as a secondary objective in these trials when they should be of critical importance.”

www.forbes.com/sites/williamhaseltine/2020/09/23/covid-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed/#356e85095247

Then there’s the fact that ALL of these trials exclude those over 65, those mostly actually at risk and those least likely to be well protected by a vaccine.

“Our findings indicate that older adults are likely to be excluded from more than 50% of COVID-19 clinical trials and 100% of vaccine trials. Such exclusion will limit the ability to evaluate the efficacy, dosage, and adverse effects of the intended treatments.“

jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771091

People really need to temper their expectations of this first generation of vaccines. Scratch the surface and it’s clear they aren’t going to restore life to normality. I was pinning my hopes on them too, but not anymore.

I don't know if Forbes are full of it, but the author of the article appears to have been very pessimistic regarding a vaccine (or The Oxford Vaccine at least) from the start, and prompted the Jenner Institute to write a rebuttal to his piece written in May.

www.jenner.ac.uk/about/news/the-oxford-covid-19-vaccine-works-very-well-in-monkeys

www.forbes.com/sites/williamhaseltine/2020/05/16/did-the-oxford-covid-vaccine-work-in-monkeys-not-really/#844d8f43c712

I’ve just read that one of the volunteers on the oxford trial in Brazil has died. RIP. I hope it wasn’t connected with the vaccine.

Apparently the trials continue.

@FlorentineAz

I’ve just read that one of the volunteers on the oxford trial in Brazil has died. RIP. I hope it wasn’t connected with the vaccine.

Apparently the trials continue.

It seems that the person who died did not receive the vaccine.

There are apparently no safety concerns but I admit that this news has rattled me.

@IcedPurple - is that so? Thanks for the information.

I suffer from OCD plus I have Aspergers and anxiety so tend to catastrophise about things.

Anyway RIP to that poor person and thanks for your bravery.

Apparently the person who died had the placebo not the actual vaccine?

@FlorentineAz

There are apparently no safety concerns but I admit that this news has rattled me.

It was reported so horribly by the Express. It was obviously nothing to do with the vaccine as trials have been paused previously for less. If there was any chance it was related the trial would definitely have been paused and investigated so it must have been obviously unrelated straight away.