Vaccines, Vit D and Variants

[LemonSwan]

I am obviously missing something here because I was just comparing Vit D deficiency of COVID patients (over 80% of hospitalisations) with efficacy of vaccines in reducing hospitalisations..

*Its hard to track down the exact figures as they are changing them all the time. But heres what I have:
Pfizer 52% (1st dose) going to 95% (2nd)
Oxford 70% going to 80-90%
Novavax 89% after two.
J&J single shot 66%

Now we have the SA variant which is messing up the efficacy.
Oxford 10%
Novavax 60%
Pfizer - 'Very modest difference' - SA variant not an issue.

If the virus keeps mutating (which it seems hell bent on doing) then would if have been more effective for everyone to just take vit D tablets and why has this not been pushed more by the Gov. Theres tonnes of papers on this and I haven't heard a peep about it from GOV/NHS - to the point where when I bring up taking Vit D I feel like a conspiracy theorist or a pseudoscientist.

It seems such an obvious solution that I am either being mad or have utterly missed the point. Some one please let me know

Meaning that younger people who get adequate sunshine would not need vitamin D as a precaution against severe covid symptoms.

That would be a reasonable assumption but in reality its actually quite difficult. I spend so much time outdoors I have the choice of SPF50 and vit d deficiency vs. adequate Vit D and Skin Cancer.

You only need 10-15 minutes of direct sun a day but it has to be face and arms unprotected by SPF. Office workers walking to and from the office might get more as not wearing as much sun protection but then unlikely to have their arms out. Lots of foundations/ primers and skin care nowadays also has SPF.

I didn't realise it had to be face and arms and the SPF wearing didn’t occur to me actually - interesting.

Ten to fifteen minutes on your face and forearms in the UK is the amount of sunshine you need not to get rickets.

Nobody knows for sure the optimum amount of sunshine you need to protect against internal cancers, MS, heart disease etc etc.

It doesnt have to be face and arms, any exposed skin will do. Lunch in the park with bare legs would do, as long as you dont get burnt.

Young people differ - junior doctors, for example, tend to be low because they work long hours.

This is actually a good place to buy a test, because you'll get a vitamin D spray as well at a price less than test plus spray (unless you have a discount code for elsewhere) betteryou.com/products/vitamin-d-test-kit

If young people get enough in summer, it doesn't protect them from deficiency in winter. I'm sort of laughing at that comment because the young people I know spend far more time indoors summer and winter than I do. 😳😃

Regarding elderly people in homes. If they weren't prescibed it, or given it by the home, they wouldn't have been able to buy it easily - even if there had been strong public messaging telling them that they need supplements all year round.

I'm not convinced that all breastfeeding mothers are getting the message either. They should be. But are they? Particularly this year when they've had less access to HCPs.

It doesn’t have to be face. Arms and legs are fine. Just expose enough skin. I’ll keep face protected always but happy to get other parts out.
You make more at midday.

cherryblossomosaka

Beware the Córdoba/Barcelona study.
They messed up their stats.
Let’s see what happens when it comes through peer review....

See this nice explanation as to why we can’t draw any conclusions from the study yet:
mobile.twitter.com/fperrywilson/status/1360944814271979523

Indeed. On a similar note:

mobile.twitter.com/GidMK/status/1361063430745022467

Yes let’s wait a few months until it’s all peer reviewed and we’ve done some more research in to this area. By then the pandemic will be over..

Thank god for the more pioneering doctors out there.

Or make your own call on it!

Delatrin I’m not saying don’t take it. I take super high doses (multiple sclerosis) and I have told everyone I know to take it. There’s very little to lose.

It’s just that that study is in preprint and questionable. I’m not saying vitD doesn’t work, I’m saying we can’t be certain of it from that study.

A couple of years ago MedRXiv and BioRXiv didn’t exist and there wasn’t a readily accessible place to put preprint/not peer reviewed data.

It is a brilliant thing and has come into its own during the pandemic but previously was read only by scientists who knew what preprint means.

There are lots of brilliant, competent, pioneering scientists.

They all work together in the process of peer review. Almost without exception everyone has to rewrite their papers, as others pick up issues. The big names are just as susceptible to this as anyone else.

I get it. We just don’t have lots of time for peer reviews and rewriting.

I also thing this is muddying the message. Something like 80% are deficient in this country in winter. There is lots of evidence that vitamin D deficiency an have a serious impact on health. Also that it improves outcomes for respiratory illnesses of which Covid is one.

It’s a bit of an easy win. Why are we constantly nit picking and criticising these studies. We don’t have time on our side.

I heard about the effectiveness of Vit-D a couple of months ago and me, DH and my DDs all take a daily supplement.

Yes, most people should be taking VitD anyway, especially in northern hemisphere countries and U.K. population have low vitD.

But they do need to run trials to figure out what to give covid patients in hospital (which is extremely important but different). You can’t just chuck anything and everything at them!

The danger with using this study, not just because it is in preprint but because it is decidedly dodgy, is that it could harm the cause if it is subsequently discredited.

With public-wide prophylactic measures, even extremely cheap things cost billions. We also need trials to understand what level of vitD the general public should be taking to either stave off or reduce severity of covid. The current recommended levels might well be insufficient.

Anyway, we can certainly agree there should have been some public information advertisements reminding people they are supposed to be taking the currently recommended dose.

I cleaned up my diet a few years ago and I also take a range of supplements and vitamin D is one of the many supplements I take. I'm now about 3 years down this path. I'm doing it all with the main aim of improving oral/dental and bone health. I had a bad diet in my youth and I have acid erosion on my teeth. I had an 'aha moment' thinking my body was probably lynching minerals from anywhere in my body just to keep going. I had a high carb and high sugar diet.

I changed all that with my health in my mind. I never got a cold last winter 2019/2020. Before covid a lot of the people in my life came down with colds. I never got a cold. All I have a lot of energy now that I never had before. I uses to need a nap in the middle of the day for so long even though that's not entirely possible.

Forgot to say delatron, it’s not nit picking, read those links that coffeesandcrossaints and I posted.

That paper is a real clanger.

It does happen from time to time and it’s extremely unfortunate in this case.

Mass media's coverage of scientific analysis is very interesting.
15 experienced doctors work for months at the frontline - full of covid 19 life or death situations.

Just quickly checking their CVs, the first three doctors have 226+110+110= 346 peer reviewed publication and decades of experience.

Spanish news media have been covering their studies for weeks.

The team published a proven published and fully peer reviewed pilot RCT last year using the vit d analogue calcifediol in Cordoba. It was so successful that the governing body in Andalucía used this protocol of deficiency testing and high bolus doses on 1000s of care home and hospitalised vulnerable elderly folks. Guess what, the death rate has plummeted in Andalucia- and Boris Johnson has said in parliament that PHE are looking closely at these protocols.

Mumsnet users have posted links to two random tweeters who have never treated a covid 19 patient in their lives. They have been posting criticism of the spanish trial without having access to the full dataset and have no idea about the ethical nuances of the trial. These two twitter posters have been requested to post their critiques on the Lancet peer review server - but they have not (presumably because they haven't got the relevant qualifications or they are just refusing).So these are just some random blokes on twitter too scared to peer review formally themselves.

If you know anything about scientific papers, peer reviewers peer review, they don't spend all day tweeting.

Yes the Spanish team will have to reword, tweak and amend, this is normal for peer review - especially in a second language. Even if they have to eventually halve the odds ratio, calcifediol's large causal effect will still be undeniable.

It's just one more smoking gun from the 48 studies completed around the world.

I've read and understood most them:
vdmeta.com/

Peer review could throw out the trial results, but my money is on the 15 Spanish doctors and scientists, not the 2 random blokes from twitter.

446 publications between the first three scientists!

The people tweeting are not nit picking about the paper - but neither is it a "real clanger" or "decidedly dodgy". To demonstrate that you would need to show there was something unusual about the allocation of patients to wards.

You can argue about the statistical techniques used to analyse the data but that is unlikely to change the conclusion when the differences are as great as observed. And when you are looking at mass deaths and a cheap intervention that has an established safety record the standard statistical confidence levels are not necessarily the best measure to judge beneficial interventions.

What the government should have done after the first small controlled trial was to establish a randomised trial using different dosage regimes in all patients where there was no reason to exclude.

We’ve all been taking the recommended dose for a few months now. Will feel much happier when we’ve had our vaccines too.

I’ve been taking vitamin D since august. I’m also asthmatic.

It’s not going to make things worse so why not, even if it doesn’t help the chance it might if worth taking them I think

I am confused about what Perry Wilson is saying about that study. Yes I get that the data is weird because they didnt randomise and 'clustered wards' instead. But his point is that when he looks at the cluster data the difference is the baseline Vit D was lower in the 'untreated wards'.

Surely that is still saying what we are saying. On average it seems those with low baseline Vit D before COVID (who in this study also happen dont take Vit D during COVID) makes them have worse outcomes.

To me it seems obvious from Vit D studies on previous respiratory illnesses that most of the gain seems to come from having the right level to begin with and that dosing during illness has a miniscule effect in comparison.

I think what he is saying that the control arm started unfairly from a lower average serum level compared to the intervention arm. In reality if you randomly assign wards or patients, this disparity is inevitable and could go either way.

Anyway, we can certainly agree there should have been some public information advertisements reminding people they are supposed to be taking the currently recommended dose.

Thats exactly what I think should have happened and wish to happen. I agree it seems insufficient amount but at least it gives people a heads up to go and research and take more if they wish.

I am starting to worry that its too late. That this will never be researched properly & resolved because admitting it politically at this stage might mean we have spent billions more than we need to, lost thousands more people unnecessarily and fucked this whole thing up.

Yes its expense when you have to supply it but people will buy it. Comparatively its less than the price of a 5 pack of disposable masks which I still see a lot of people wearing.

CherryBlossomOsaka
Thank you Cherry - that is what I thought he was saying. This thread is mainly talking about raising Vit D levels of the general population before COVID infection not as a hospital intervention after. So to me it still shows what we are trying to say.

By the way, I've found out F. Perry Wilson, MD, MSCE isn't just some random guy.

And I've found out why he isn't peer - reviewing the vitamin D trial. It's because he's leading his own supplementation covid 19 trial:

medicine.yale.edu/ycci/trial/7944/?tab=volunteer

''This study is a multicenter randomized trial to evaluate the efficacy of resistant potato starch in reducing rates of hospitalization and improving time to clinical recovery in currently non-hospitalized COVID-19 positive patients''

This guy must be very irate that the vit D3 trial has completely blown out his potato trial