This was posted on Facebook today by Dr Tom Fardon, an NHS consultant respiratory physician working with Covid patients:
Lots of concerns going around about the data that's come out of Israel, reported in the news this week: amp.theguardian.com/world/2021/jan/19/single-covid-vaccine-dose-in-israel-less-effective-than-we-hoped?CMP=Share_iOSApp_Other&__twitter_impression=true
The first thing to say is that this data hasn't been published, so hasn't been held up to any peer review as yet. The information I have read is that the figures quoted of "less than 50% protection" are based on rates of infection at 14 days. Similar to the Pfizer data quoting 52% for the first dose, counting those first 14 days isn't a very fair comparison, as it takes anything between 10 and 21 days for any vaccine to generate an immune response. So far, then, we have the comments of the Israel COVID Tsar, and we need to see the data.
That's not to say that we shouldn't look at the real life data - we absolutely should, but it should go through the same rigorous peer review as prospective studies. So, early days.
It's worth remembering that the aim is for everyone to have 2 vaccination shots, eventually, and it's not until we have population coverage that Raes will be persistently suppressed, and we get back to normality - post vaccine, 1 shot or 2, our behaviour should stay the same: face, space, good grace.
Another thing causing worry is whether the vaccines will cover the novel, more infective strains of COVID. Here's some evidence in the pre-publish website BioRx. www.biorxiv.org/content/10.1101/2021.01.18.426984v1
The Pfizer vaccine appears to give decent coverage against the newer variants, in this study. Again, only one study, and it's in vitro, so more data required. Good news a regards variants is that both the Pfizer and AZ vaccine platforms mean that they vaccines can be modified fairly quickly to adapt to changes in the virus proteins.
Other news in the last couple of weeks has been the results of the studies into convalescent plasma use for acute COVID. The theory goes that people who have had COVID will have high levels of anti-COVID antibodies circulating in the plasma - if we take that from patients, by plasma donation, and transfuse it into patients with acute, severe COVID, they would get better more quickly.
This trial carried out in Argentina with 300+ patients showed no benefit in 30 day outcomes: www.nejm.org/doi/full/10.1056/NEJMoa2031304
The this trial, also from Argentina, with 160 patients showed some benefits, if the plasma was given within the first 72 hours, to older people. www.nejm.org/doi/full/10.1056/NEJMoa2033700
Thousands of units of plasma have been given, in America particularly, on a compassionate basis, mostly based on early pre-trial data.
RECOVERY - the very large randomised prospective study carried out in the UK - had a convalescent plasma arm. It reported last week that they have stopped that arm of the study due to futility. www.recoverytrial.net/news/statement-from-the-recovery-trial-chief-investigators-15-january-2021-recovery-trial-closes-recruitment-to-convalescent-plasma-treatment-for-patients-hospitalised-with-covid-19 . This study had > 10,000 patients receive convalescent plasma, and showed no benefit.
This shows how early studies can be misleading, particularly if they have small numbers of patients, and large datasets, large studies, are worth waiting for.
The vaccination program is progressing very quickly now - amazing feat of organisation by NHS Boards across Scotland. The Louisa Jordan Hospital vaccinated 5,000 people in one day last week! twitter.com/NHSLouisaJordan/status/1350420938718916610
Stay safe everyone.