The UK’s approach to vaccination could create vaccine-resistant forms of the virus...

[Lucidas]

Are we gambling again like just the Operation Moonshot, school openings with minimal mitigation, other failed innovations of this govt?

I’ll admit this article got me a little worried. I hope we don’t fuck this up.

Paul Bieniasz of Rockefeller University is one of those who is watching the evolving situation in Britain with dread. A retrovirologist who turned from HIV research to work on SARS-2, Bieniasz is studying how the virus acquires mutations that allow it to evade the protective antibodies people develop when they have contracted Covid-19, or when they have been vaccinated against it.

“My concern, as a virologist, is that if you wanted to make a vaccine-resistant strain, what you would do is to build a cohort of partially immunized individuals in the teeth of a highly prevalent viral infection,” Bieniasz told STAT.

www.statnews.com/2021/01/04/britain-takes-a-gamble-with-covid-19-vaccines-upping-the-stakes-for-the-rest-of-us/

If that's the case we probably need to do the second vax sooner as it is meant to be given

Chris Whitty was asked this in today's press conference. I'm sorry I can't find a transcript, so can't give you word for word, but he basically said that there was a theoretical risk of that, but that it was very low. He also emphasised that - on public health grounds - the advantages of a single dose hugely outweighed the disadvantages, given that we are in a situation of limited vaccine supply and where cases are escalating fast.

This is why the obsession with the vaccine to save us worries me. We splashed it in the headlines but within weeks have decided to change the dosing schedule due to logistics problems. I hope and pray it does not turn out to be a huge mistake.

There is no data to support the cowboy approach to the off-label use of the vaccine. They are gambling with the entire worlds stability. We are complete dicks.

It's also made a mockery of the informed consent process that was undertaken. It's completely unethical to not delay the second dose to those who consented to be vaccinated and were promised on-label usage. Not one single other western nation has taken this approach.

@ProvisonalPaulina

There is no data to support the cowboy approach to the off-label use of the vaccine. They are gambling with the entire worlds stability. We are complete dicks.

It's wrong to say there is no data. There is incomplete data, which is summarized at app.box.com/s/uwwn2dv4o2d0ena726gf4403f3p2acnu

@Motorina

Chris Whitty was asked this in today's press conference. I'm sorry I can't find a transcript, so can't give you word for word, but he basically said that there was a theoretical risk of that, but that it was very low. He also emphasised that - on public health grounds - the advantages of a single dose hugely outweighed the disadvantages, given that we are in a situation of limited vaccine supply and where cases are escalating fast.

But from a public health point of view, what will the messaging look like? With the verified dosing regime, you can give them the facts around efficacy and when /how much they’re protected. But if an elderly person still hasn’t had their second dose after 2 months, what do we tell them ab

About the current efficacy of the vaccine: is it at 50%? 30%? Should they shield again for a few weeks? We have no clue.

@Motorina Incomplete data or directional data is as good as no data. There's a reason, a very good reason, we don't approve medicines and devices with "incomplete data". It violates every principle of a well controlled trial and makes evidence based decisions impossible. That "data" isn't worth the paper it's written on. Using a subset of a subset with a tiny N number to validate complete off-label use is absurd.

@ProvisonalPaulina

It's also made a mockery of the informed consent process that was undertaken. It's completely unethical to not delay the second dose to those who consented to be vaccinated and were promised on-label usage. Not one single other western nation has taken this approach.

Agreed. Public trust is one of the most crucial parts of this process if it is to be a long term success. In that context, calling up people to cancel their second appointments is an incredibly foolish and shortsighted strategy,

I do not want to risk being the country that makes a vaccine resistant strain.

Florian Krammer said something very similar on Twitter. He’s usually the opposite of alarmist, so I wondered.

twitter.com/florian_krammer/status/1345791187236646912?s=21

[quote ProvisonalPaulina]@Motorina Incomplete data or directional data is as good as no data. There's a reason, a very good reason, we don't approve medicines and devices with "incomplete data". It violates every principle of a well controlled trial and makes evidence based decisions impossible. That "data" isn't worth the paper it's written on. Using a subset of a subset with a tiny N number to validate complete off-label use is absurd. [/quote]
All data is incomplete. There is always more research to be done.

There’s been a lot of debate on this and it’s important to note that having a large proportion of the pop unvaccinated also encourages the development of resistant strains.

Many experts have spoken out to say that, on a balance on risks delaying the second dose is a better option

It’s a very risky strategy but we’re in an emergency situation. We could save everyone or generate a vaccine resistant strain that destroys the world. It’s terrifying.

I’ve been reading more about it this and it’s making me very nervous. We are basically creating the ideal conditions for a vaccine resistant strain of Covid to evolve.

@Motorina Your purposefully missing the point. We had well designed studies properly powered that were able to answe the questions set out. Saying you can just grab a random chunk of data and draw a conclusion is absurd. Or do you reckon we don't need biostats and fuck it draw whatever consclusions you fancy?

I'm buying into this new approach actually the more I look into it. Vaccine efficacy after one dose is pretty high - 85%+. Given limited resources it makes sense to have twice the number of people vaccinated at 85% protection, than half vaccinated at 90% protection. Obviously if there were no limits on resources (vaccines, phials, needles, staff, space etc) then the approved dose would be best, but until we're in that situation the priority has to be many, mostly done, rather than a few, fully done.

Think about feeding a starving population. Do you give all 5 million people 1000 calories a day for a month till the harvest, or do you give 2.5 million people their full 2000 calories a day, knowing that means the other 2.5 million will be dead in a week?

Bearing in mind Whitty and Vallance presided over the initial herd immunity plan insanity, I’m not 100% confident that they’ve backed the right option now either.

If there were no limits on resources (vaccines, phials, needles, staff, space etc) then the approved dose would be best, but until we're in that situation the priority has to be many, mostly done, rather than a few, fully done

Even if it risks the situation becoming much worse, with a virus that'll respond to nothing?

Still, I guess it would hasten the realisation that we may just have to learn to live it it ...

I think Chris Whitty used the words 'escaped mutant' in the press conference last night.. which was rather concerning to hear, I hadn't really realised this was a factor in the vaccine program, but it does seem worrying even though it's a low risk.

the priority has to be many, mostly done, rather than a few, fully done
The issue is that those who are “fully done” aren’t going to act as petri dishes to incubate the virus and allow it to mutate into a more dangerous form. Whereas those who are “mostly done” are ideal breeding grounds for vaccine resistant forms of the virus.

Vaccine efficacy after one dose is pretty high - 85%+
I don’t know where you heard that because the Pfizer vaccine is only 52% effective after one dose.

@SpikySara

the priority has to be many, mostly done, rather than a few, fully done The issue is that those who are “fully done” aren’t going to act as petri dishes to incubate the virus and allow it to mutate into a more dangerous form. Whereas those who are “mostly done” are ideal breeding grounds for vaccine resistant forms of the virus.

There's more chance that the virus will mutate in the unvaccinated population than the vaccinated once population! Virus gonna mutate - that's what they do. That why getting as many of the population vaxxed at least once is a better strategy at a population level.