Oxford initial news

[tobee]

Covid-19: Oxford University vaccine shows 70% protection www.bbc.co.uk/news/health-55040635

This thread is about the Oxford vaccine. I have high hopes for the others. I apologise for daring to believe the concerns expressed by the likes of Derek Lowe and Marc Lipsitch over the experts in here. 🙄

Well we're all reading what experts have commented aren't we? Where has anyone said that we are experts?

Even if the 90% was for a grouper of younger people, taken together with the 62% the weighted average is 70% which is still highly effective and enough to bring an end to the pandemic

Their Lancet article last week said that the Oxford vaccine produces a strong immune response in older adults.

www.ox.ac.uk/news/2020-11-19-oxford-coronavirus-vaccine-produces-strong-immune-response-older-adults

I don't know the Pfizer and Moderna results across the age ranges, but I'm sure that eventually every group will get the one that will be best suited to them. We're used to that idea with flu - 65+ get fewer strains but an adjuvant to boost their response, children get the live nasal spray - so hopefully that will be easily accepted.

@ForBlueSkies also, you’ve posted several times that there were no severe cases reported in the placebo group - unless I’m misunderstanding this Bloomberg article says otherwise - that actually there were 16 severe cases reported.
www.bloomberg.com/news/articles/2020-11-23/astrazeneca-shot-data-hint-at-halting-severe-covid-slaoui-says

@ForBlueSkies

I understand what you're saying but presumably none of these eminent scientists actually have any more data that the rest of us on which to base their opinions? So at the moment any issues are hypothetical in nature. Until we have full data for all 3 vaccines any comparison is pretty much meaningless.

What we do know is that we have three vaccines, all of which appear to have a minimum efficacy level sufficient to make a significant impact on the pandemic which is great. The Oxford vaccine, even if a lower efficacy than the others, can be stored and transported more easily so will be more accessible across the world.

I do think we need to be careful that we don't let perfection become the enemy of the good.

I don’t think anyone is saying any of the vaccines are perfect. They all have pro’s and con’s surely? Hence why the U.K. Gov and likely most other Gov’s and international efforts have gone for a basketful of options rather than all eggs in one?
There are pro’s to the Oxford vaccine, storage, transportation, price for example than when balanced with low efficacy may mean it is a great vaccine for 2021 for many countries for their younger less at risk population. It means that countries do not have to be so restrictive and more people can be vaccinated than might be the case with the more expensive but better efficacy vaccines which sure lay is an amazing thing. It seems strange to overlook the logistics advantages of the Oxford vaccine as if they barely count. Anyway as others have said, the experts will look at all the vaccines and will hopefully give advice as to the most effective use of all of them.

I understand what you're saying but presumably none of these eminent scientists actually have any more data that the rest of us on which to base their opinions?

Do people really think that we can 'do our research' and know the same as the experts? That scientists involved in these trials aren't going to have access to additional data / pre-published data / supplementary information - as well as their own knowledge and experience to interpret and contextualise it all? Good grief.

No vaccine is perfect though

www.ncbi.nlm.nih.gov/pmc/articles/PMC6660876/

Is an interesting look at the meningococcal vaccination programs that currently exist to see really what we should be expecting of this one.

The unpalatable truth I think is that no matter what we do 1000-2000 deaths are going to occur from COVID every year - like flu in the same aging population. We are not going to eradicate this at all

The Oxford Vaccine is also important though for the developing world - necessary for us getting back to normal

@raviolidreaming

No, what I'm saying is that unless the experts quoted on Twitter actually have some additional information over and above what has been generally released then it's all just hypothesising. Once the peer reviewed findings for all 3 are out then we'll know a lot more.

I'm the first to accept the limits of my own knowledge, advance search me, you'll find it's a theme of mine!

Sunshinegirl82 ah, that makes more sense! Sorry for the misunderstanding in this case.

@Quartz2208

No vaccine is perfect though

www.ncbi.nlm.nih.gov/pmc/articles/PMC6660876/

Is an interesting look at the meningococcal vaccination programs that currently exist to see really what we should be expecting of this one.

The unpalatable truth I think is that no matter what we do 1000-2000 deaths are going to occur from COVID every year - like flu in the same aging population. We are not going to eradicate this at all

The Oxford Vaccine is also important though for the developing world - necessary for us getting back to normal

Indeed. The truth is the real world results for vaccines almost always fall short of trial results, for a long list of reasons.

Whatever the outcome with the Oxford vaccine I do think they’ve handled the messaging around these interim results quite badly. Reporting the 90% figure when it appears to have been derived from a mistake, from a geographically homogenous smallish sample that excludes over 55s, immediately raises suspicions of an attempt to dress up the less stellar results in the main group.

At best, it’s messy.

As for the developing world, if the 62% figure turns out to be correct I suspect this vaccine will be beaten out in the long run by the Chinese or Russian vaccines, or perhaps even J&J? Only time will tell. 🙂

[quote MarcelineMissouri]@ForBlueSkies also, you’ve posted several times that there were no severe cases reported in the placebo group - unless I’m misunderstanding this Bloomberg article says otherwise - that actually there were 16 severe cases reported.
www.bloomberg.com/news/articles/2020-11-23/astrazeneca-shot-data-hint-at-halting-severe-covid-slaoui-says[/quote]
Yes, I’ve seen that too. Quite puzzled as to how there can also be a direct quote from an Oxford person saying there were zero? We’ll have to wait for the proper data to be released.

but the results arent actually less than stellar @ForBlueSkies for a vaccine (where anything about 50 is seen as been ok) its just the expectations are so high (and made higher by the other groups).

We have unrealistic expectations as well as I said about the fact this is going to go away - we are going to have it forever. We just need things to get it under control.

Also a lot of this information is delievered in a specific way and isnt designed to be jumped upon by the public who the majority of the time have no idea what they are actually reading (and I include myself in that!)

@Quartz2208

but the results arent actually less than stellar *@ForBlueSkies* for a vaccine (where anything about 50 is seen as been ok) its just the expectations are so high (and made higher by the other groups).

We have unrealistic expectations as well as I said about the fact this is going to go away - we are going to have it forever. We just need things to get it under control.

Also a lot of this information is delievered in a specific way and isnt designed to be jumped upon by the public who the majority of the time have no idea what they are actually reading (and I include myself in that!)

I’m aware this virus is now endemic and I do not expect a vaccine to end things.

But from a comparative perspective 62 v 90-95% efficacy surely constitutes “less than stellar” interim results, especially given the Pfizer results involved 43,500 participants and the Moderna results were 30,000 plus including over 7,000 over 65s and 5000 participants with high risk chronic disease.

In truth, it’s hard to judge because Oxford has been frustratingly opaque about some of its numbers so far. I don’t think there’s anything more to be said until we get those. The severe cases in the placebo group, and a proper understanding of the “happy mistake” arm will be illuminating.

^ The trial size point above is reassuring from a safety perspective, I meant to say, not efficacy.

I think the problem is that less than stellar @ForBlueSkies implies that they did something wrong that something could have been changed. Where the truth is that the tech system Pfizer/Moderna use is better and more effective.

Would I like Oxford Vaccine to be higher - yes. Not as much as I would like the Pfizer vaccine to have a better storage temperature of the Moderna one to be easily distributed. www.wired.co.uk/article/coronavirus-vaccine-distribution-logistics

The fact is that outside of the effacy results the Oxford Vaccine has advantages that the others dont have in terms of speed of creating, transporting and giving of it is easy.

Economically/psychologically there is not that much left to give so we need solution that works even if it doesnt work as well as some of the others. This isnt perfect but IF deemed SAFE is good enough. And I will take that

I agree. As long as it’s proven to lessen severe incidence, it’s a win. I still have an instinct that there will be a better efficacy/low cost combination available in the next 12 months, however.

It’s quite remarkable that we have so many that already seem to be efficacious in reducing symptoms, but it’s inevitable that some will work better than others. There are so many unknowns still, such as how long each vaccine type protects the recipient.

An well researched piece on the Oxford data issues and the lack of scientific rigour applied, from the well regarded Hilda Bastian:

www.wired.com/story/the-astrazeneca-covid-vaccine-data-isnt-up-to-snuff/

A snippet:

“There are other problems, too. In the press release, Oxford-AstraZeneca reports that two of the dosing regimens “demonstrated efficacy.” Presumably, none of the others did, but they didn’t give specifics. Of the only two regimens they reported, one (the mistaken first half-dose, followed by a full dose at least a month later) came in at 90 percent, and the other (two standard doses at least a month apart) achieved only 62 percent efficacy. You’ll see reports that the vaccine had 70 percent efficacy, on average; but that’s un-knowable, because we only have numbers on these two regimens, as opposed to everyone in the trials—and how they arrived at those percentages isn’t explained. As far as we know, some of this analysis could hinge on data from just a few sick people. That means the findings could be a coincidence, or they could be biased by other factors. For example, it has since been revealed that the people who received an initial half-dose—and for whom the vaccine was said to have 90-percent efficacy—included no one over the age of 55. That was not the case for the standard-dosing group, however, where the reported efficacy was 62 percent. This demographic difference could be more important than the change to the size of the first dose.

That’s not the end of the problems. Overall, the Oxford-AstraZeneca trials appear to include relatively few participants over the age of 55, even though this group is especially vulnerable is Covid-19. (People over 55 were not originally eligible to join the Brazilian trial at all.) Compare that to BNT-Pfizer’s trial, where 41 percent of the volunteers were over 55.”

And more detail (including a useful timeline on the Astra/Oxford vaccine) here:

hildabastian.net/index.php/100

Plus:

“Where does this leave us? I discuss issues and red flags in detail at WIRED, but a few major issues didn’t fit there. The press release doesn’t provide the most basic level of detail to enable us to understand what they did: we don’t know how the percentages were derived, exactly what the comparisons were, or what the level of uncertainty (confidence intervals) is around the numbers they reported. We don’t know if they had enough severe Covid-19 events to draw meaningful conclusions about that critical issue.

Given the enormous difference in when second injections were given – in the Brazilian trial it could be up to 3 months – we really need to see what happened to the people in that interval. The primary analyses for efficacy are done after the second injection – but to get an idea of likely effectiveness, we also need to know what happened in between shots, and how many people didn’t get that second shot at all. That’s important for any two-shot vaccine, but it’s particularly critical for one with a high rate of adverse events.

Bottom line? When you consider the press releases from BNT/Pfizer and Moderna alongside the detail they report in their protocols and for their very large coordinated trials generally, it’s easy to be confident those vaccines work very well – even though there’s still a lot to know.
With the Oxford/AstraZeneca vaccine, though, the combination of what we know about their trials, the twists and turns of their interim analysis process, and the contents of the press release, the case for having serious doubts about those results is strong. We certainly don’t want to throw babies out with the bath water. Just because the trials and data analyses are badly flawed, doesn’t mean that the vaccine is too. It just means that the US trial – including any new dosing regimen they want to test – has to be rigorous, and it’s indispensable. What’s just happened has the hallmarks of being “Plan B” after the big US trial they talked about in July took so long to get off the ground – only to be grounded for weeks because of safety review. But “Plan A” shouldn’t all that far off.

Meanwhile, the mRNA vaccines from BNT/Pfizer and Moderna are well down the road. Results for 3 inactivated virus vaccines are just around the corner: 1 from Sinovac, and 2 from Sinopharm. And it probably won’t be all that long till we start hearing more about Johnson & Johnson’s single shot vaccine.”

It's well known that the attempt to find a vaccine has become a nationalist issue.

Looking up the latest person quoted by ForBlueSkies I'm not sure she's someone I'd listen to above all others.

or @tobee a money based one.

It is merely coincedence that the one that is being picked apart is the cheap and easy to make one?

There's limited value in having an expensive and tricky to store vaccine for worldwide distribution. We need as many people to take any of the approved vaccines as possible. I'm more bothered about anti vaxxers having more fuel then that a bad vaccine will be approved.

More data will be released, more data will be scrutinised and it will go from there.

As Prof Sarah Gilbert has said (and many others) several vaccines will be needed. Quite possibly none of the first 3 vaccines will be widely used after spring next year and others may be used for boosters. We still know so little and yet so much.

From the Wired article:

But the two trials had other substantive differences. In the UK, for example, the volunteers who did not get the experimental Covid vaccine were injected with meningococcal vaccine; in Brazil, those in the comparison group were given a saline injection as a placebo

Is this of any real significance?