Can anyone sum up what’s going on with vaccines for me?

[Cornettoninja]

I don’t understand why this has emerged as the next problem.

So the government are saying that there are problems with supply; this makes no sense to me regarding the AZ one. It’s been reported for months that this has been in manufacturing throughout trials with the understanding it would all be binned off it didn’t work. The Pfizer one... I’m not sure about the supply issues with this one if I’m honest. I’ve read reports from both companies this morning that there is no issue their end with supply.

Secondly how is it possible that despite months of vaccines being ‘imminent’ (to be clear I’m using that term loosely) now there are issues with staffing a vaccine programme? Health settings have had protocols in place for months at the behest of the government so they could be ready to go.

Lastly, what the hell is this sudden redesigning of dosing regimes about? Pfizer have publicly distanced themselves from the UK’s plan to extend time between doses. Do it properly or not at all!

I would be incredibly pleased to hear that this isn’t just the latest balls up of our incompetent government thinking they know better than experts and gambling with our best chance out of this absolute nightmare. Unfortunately I suspect that is the case given their track record throughout that leaves the majority of the country saying WTF.

@crunchycarrot, you're misinterpreting the 52%. To quote from the JCVI report, which I linked to on the previous page:

Published efficacy between dose 1 and 2 of the Pfizer vaccine was 52.4% (95% CI 29.5-68.4%). Based on the timing of cases accrued in the phase 3 study, most the vaccine failures in the period between doses occurred shortly after vaccination, the period before any immune response is expected. Using data for those cases observed between day 15 and 21, efficacy against symptomatic COVID-19 was estimated at 89% (95% CI 52-97%), suggesting that short term protection from dose 1 is very high from day 14 after vaccination. Similar findings were seen with the Moderna mRNA vaccine out to 108 days after the first dose

But even if it isn’t as effective at preventing disease altogether from one dose, the question is more whether it prevents severe disease and death.

As to preventing transmission, we aren’t really banking on that anyway.

We need to consider all these things separately.

What about the risk of this long gap leading to a vaccine-resistant mutation of the virus? I saw someone talking about that on Twitter.

@CrunchyCarrot

No-one here has mentioned that those having just received the Pfizer vaccine first dose (either 80-plus people or those working in front line health care) are now going to have a much lower % of immunity for the first 3 months, going forward (52% was mentioned by PPs), rather than what they were expecting to have, i.e. 95%, a week after their second dose.

These are either very vulnerable people, or very important health workers who really need max protection in order to help the sick or very frail. Now they will not have that increased protection for another 3 months. I find that disturbing.

I know we want to protect as many people as we can, but will we actually be achieving that for the oldest/most frail amongst us?

52% was mentioned by a PP, this is an average. The figure of over 90% from day 11 was also mentioned.

@Ilikewinter

According to the vaccine calculator im due sometime between January and July 2022.........i find that soooo depressing, suppose on the upside theyll have sorted out the dosage by then.

It might be worth hopping up thread to my post at 13:16 which explains the issues with that vaccine timing calculator. Your order in the queue will be about right but there is significant scope for inaccuracy in the timing.

Sorry, I cross posted with Motorina who put it much better than me!

@viccat

What about the risk of this long gap leading to a vaccine-resistant mutation of the virus? I saw someone talking about that on Twitter.

Viccat - I actually raised that question on the thread I linked to very early on in this thread and was told that I was basically a twit!

ObliviouslyIgnorant unfortunately "being a twit" - and that would be polite compared to some of the insults flung around on here - is often shorthand for having asked an unwelcome question

As said before, I'm convinced a lot of the angst is down to folk seeing the faith they'd placed in the vaccines draining away

@ArseInTheCoOpWindow

Us is not following U.K. they are sticking to the 2 dose schedule.

But what is causing the hold up in U.K. 3 days ago on vaccine calculator l was due to be done in May. I’ve now moved to December 2021. That’s a 7 month difference. And I’m in one of the priority groups. What about the rest of the population?😬

The vaccine calculator appears to have been updated to reflect the extended period to receive second dose. If I work back 12 weeks from the latest date on mine the first dose would still need to be given as I previously calculated.

@Motorina - thanks very much for the detailed reply. I think my brain was getting fried from all the figures I've read.

They didn't trial the vaccine in Kent by any chance?

@CrunchyCarrot

No-one here has mentioned that those having just received the Pfizer vaccine first dose (either 80-plus people or those working in front line health care) are now going to have a much lower % of immunity for the first 3 months, going forward (52% was mentioned by PPs), rather than what they were expecting to have, i.e. 95%, a week after their second dose.

These are either very vulnerable people, or very important health workers who really need max protection in order to help the sick or very frail. Now they will not have that increased protection for another 3 months. I find that disturbing.

I know we want to protect as many people as we can, but will we actually be achieving that for the oldest/most frail amongst us?

But nowhere near all that vulnerable group have had their first vaccine. That’s the point.

@CrunchyCarrot - my pleasure! And I share your pain.

@LemonTT

Looking at the headlines and social media posting it would be hard to understand what is going on. It’s all just jumbled assumptions and fake news.

With regards to planning, this has been going on for months. But part of the planning couldn’t be finalised until the authorisation details were complete. The MHRA and regulator have agreed use under certain arrangements and these are different for each vaccine. These were only known after authorisation.

Workforce: Assumptions could be made about the numbers and qualifications that might be needed but these don’t firm up until the last minute. With Pfizer more HCP and a lot of pharmacists were used because of the handling of the vaccine. Additional training requirements was set for vaccine handling and anaphylaxis. Additional clinical workforce had to be identified for supervised observations at the last minute due to anaphylaxis risks. With Oxford there is the potential to shift to using non HCP as vaccinators but this needs a regulatory change. It’s not quite in place yet in England. Until it is the GP and hospital sites are the best staffed.

Delivery Operations; The UK was really the first country that started to test the safety of moving the Pfizer vaccine around in refrigeration. This took a bit of time. The storage of the vaccine really limits the scope of its use. Lots of ducks need to be a row for this vaccine.

Site Operations: these were planned based on the known characteristics of the vaccines. But these changed. Most significantly in relation to observations which were originally required, then not and then reinstated but with the need for clinical observation. That all impacted on the space requirements and meant some sites couldn’t be used. The flow of patients wasn’t really known until it happened. Sites reported problems with patients turning up very early and en masse. This meant they needed more space and marshalls.

Vaccine supply to sites. Many sites are eager to do more and want to be supplied with more. But it’s important the current supply is fairly and evenly distributed. This is what is happening. The supply we have is sent out fairly not on demand. That frustrates some who run to papers. It’s also important to be aware that there is only one supplier. With flu there are multiple suppliers able to feed more sites, although this is uneven and inconsistent.

Vaccine manufacturer: the manufacturers are ramping up volume but are not at the peak. There are also notorious problems with vaccine manufacturing which will disrupt supply, see Pfizer. But discounting that factor the supply is building up worldwide along with demand. Orders are phased and we were never going to get 100m doses in one go. The UK expects peak Oxford supply in February.

Recording of information. GP and mass sites will use one system to record vaccinations which will be linked to a GP record or NHS number. The default will be GP record because most people don’t know their NHS number but do know their GP or other personal details. However some people live chaotic lives and we don’t have a national ID system. It’s likely that these people will be confused about their vaccination history and provide inconsistent personal details that can’t be matched. There aren’t many of these people but there are enough. When they present there is a risk to be mitigated. The mitigation is to vaccinate and give protection rather than sending them away.

Thank you so much for clearly breaking down your answers @LemonTT (I finally got the chance to read it properly! )

I’m still frustrated at the delays given the months of anticipation but yes, implementation never goes as smoothly as the paper planning. I reserve the right to moan about it though!

I’m also still very concerned about the increased dosage timings of the Pfizer vaccines. I’ve read all the reassurance but after the year we’ve had this is one thing I’m just not comfortable taking a gamble with. I’m bit even directly affected but every person who gets vaccinated is one step closer to resuming normal life for all of us. If it turns out those doses are rendered useless then there are wider consequences.