Alternatives to AstraZeneca vaccine for under 40s “could be considered” amid rise in blood clots 2

[Whichjab]

Just starting another thread as so much information still coming out. Interesting that Germany have just allowed AZ for all that want it.

Note, this is not an Anti-Vaccs thread. It is just a discussion about alternatives.

@MrsFezziwig

The UK has been too dependent on AZ.

Well that’s a pretty easy statement to make at this stage of the proceedings - if only we could travel back in time to take advantage of your superior knowledge.

Back end of last year, these threads were full of posters shouting about the mRNA vaccines being untested technology and no way would they be treated as guinea pigs. How times change!

Not me. I was sceptical of all of the vaccines up until late February when I decided that enough data had come out of Israel to support Pfizer being a safe and effective choice. I've always been highly sceptical of the AZ vaccine due to their trial being a complete shambles and due to previous adenoviral vector vaccines having severe unforseen side effects (e.g. a HIV vaccine making you more likely to catch HIV) and their unsuitability to be reused for boosters in people who've previously had two doses of that vector.

If I were in charge I'd have bough more of the mRNA vaccines from the outset and given the majority of the AZ to coax.

I'd like to see all this risk data broken down by BMI as well as age. That's another huge risk factor for COVID that is effectively being ignored.

Feel so cross. I had AZ on Wednesday and then this policy change happens. I was on the fence anyway and now I feel so worried. I've only just turned 40 so it feels like a very risky thing to have done

www.the-scientist.com/features/sex-differences-in-immune-responses-to-viral-infection-68466

Very interesting article and well worth a read. It explains why men seem to be more at risk from Covid and women appear to possibly be more at risk from the vaccine than men.

@QueenStromba where would you have magic'd all of these Pfizer vaccines from? How would you have navigated the logistics of the roll out with the conditions the Pfizer has to be transported and stored at? The reality is that the roll out would have been substantially slower solely with Pfizer, do you think the statistically tiny risk of AZ would be greater than the risk of a longer period of a higher prevelance of covid? Also curious that you would be quite happy with developing countries receiving AZ, but it's apparently not good enough for us. And the large scale bribery of vaccines for data which you'll take as you're desperate with Israel was fine. Interesting, but not surprising.

@PandemicPalava it wasn't a very risky thing to have done, without diminishing the fact that there is a risk, its absolutely miniscule. The reason advice keeps changing is as covid numbers are so low at the moment, of which a big part of the reason for that is the AZ vaccine.

Are you talking about the care home where a total of six residents caught the SA variant after having the AZ vaccination? And you're complaining about a study of a couple of thousand people being small? Have you got shares in AstraZeneca or something?

The study of a couple of thousand people produced results with a very broad confidence interval. It is clear that AZ efficacy against the SA variant is reduced but quoting 10% number without further context is not an "intellectually honest" representation of data.

The Lambeth care home example (where only very few residents got infected and most of them ended up with a mild to moderate disease) is consistent with all our experiences so far - real life data from the UK seems to suggest the vaccine works pretty damn well. I do not need to own shares in AZ to see that. I also chose to have my first AZ injection with eyes wide open as soon as I could even though I am really not worried about Covid at the personal level.

If I were in charge

@QueenStromba oooh you're playing with my dreams!

There's no conspiracy, just people at the top making shit decisions that effect us all.

I did some really back of envelope calculations and the risk/reward seemed to pay off around 36/37 for AZ with low circulation of covid. Im 31 and made the decision to wait until I could pick what I got (were also moving to the US when it’s allowed so I was worried about AZ not being recognised there or not being able to get a booster).

This was before they changed the rules but after the latest data in blood clots came out. Anyone 40+ shouldn’t be regretting their decision to have the vaccine and if you’ve had the vaccine under 40 then presumably there are reasons why your risk/reward calculation isn’t the average one (carer, medical conditions etc) so the risk was greater for you.

[quote Roboticcarrot]@QueenStromba where would you have magic'd all of these Pfizer vaccines from? How would you have navigated the logistics of the roll out with the conditions the Pfizer has to be transported and stored at? The reality is that the roll out would have been substantially slower solely with Pfizer, do you think the statistically tiny risk of AZ would be greater than the risk of a longer period of a higher prevelance of covid? Also curious that you would be quite happy with developing countries receiving AZ, but it's apparently not good enough for us. And the large scale bribery of vaccines for data which you'll take as you're desperate with Israel was fine. Interesting, but not surprising.

@PandemicPalava it wasn't a very risky thing to have done, without diminishing the fact that there is a risk, its absolutely miniscule. The reason advice keeps changing is as covid numbers are so low at the moment, of which a big part of the reason for that is the AZ vaccine.[/quote]
Pfizer can be kept in the fridge for five days. Israel have managed a pure Pfizer vaccination program, I don't see why we couldn't. If we'd ordered more doses in the first place then we'd have got more doses. We helped fund factories for AZ, we could have done the same for Pfizer.

The risk/benefit analysis for AZ is different in countries that actually would struggle to roll out Pfizer. It's pretty selfish of us to insist on using the AZ when other countries need it and we have alternatives.

I had the vacc at 29 due to being an unpaid carer for my dad (who's had 2 doses of Pfizer)

The clot news after the second vaccine has really thrown me. Mental health is poor anyway and it just feels like the end of the line.

If I were in charge I'd have bough more of the mRNA vaccines from the outset and given the majority of the AZ to coax.

It is very, very easy to make such statements in 2021.

UK placed its first (very sizeable) order with Pfizer in July 2020, way ahead of most other countries. Back then mRNA technology was largely untested and placing full reliance on it would have been a major gamble. We hedged our bets by ordering a range of traditional vaccines (including AZ).

Pfizer is a US company which means it will always prioritise the US deliveries at the expense of everything else. What we have negotiated (e.g. 5.8m vaccines in December 2020, consistent deliveries throughout 2021) was already pretty good.

@QueenStromba Israel were heavily supported by Pfizer in their roll out in return for data. Still an epic amount of hard work on the country's part, but it couldn't be replicated in the same way elsewhere, as Pfizer only required the data from one. Its not as simple as just putting in a bigger order, you have to be realistic about the reality, many countries have had delays with Pfizer, and we have no rights to the IPR and so can't just open more factories as we can with AZ. Theres also a lot of politics and business involved, investing in more factories isn't simple or desirable. If you have read the report as well, what do you think of the heart inflammation following 2 doses of Pfizer reported in rare cases? The mass vaccination centres wouldn't have been able to do the daily numbers they have been doing with just Pfizer, and where would your money for the ridiculous amount of fridges come from? It's not selfish of us as we can produce a lot of AZ, and many millions of doses have already been distributed globally; I sense a bit of back tracking but I do feel a lot think its okay for them but not us, which is sad.

All of the vaccines are great imo, it's easy to dismiss AZ but the reality is we absolutely wouldn't be where we are now without it. I've happily had both doses.

@wintertravel1980

Are you talking about the care home where a total of six residents caught the SA variant after having the AZ vaccination? And you're complaining about a study of a couple of thousand people being small? Have you got shares in AstraZeneca or something?

The study of a couple of thousand people produced results with a very broad confidence interval. It is clear that AZ efficacy against the SA variant is reduced but quoting 10% number without further context is not an "intellectually honest" representation of data.

The Lambeth care home example (where only very few residents got infected and most of them ended up with a mild to moderate disease) is consistent with all our experiences so far - real life data from the UK seems to suggest the vaccine works pretty damn well. I do not need to own shares in AZ to see that. I also chose to have my first AZ injection with eyes wide open as soon as I could even though I am really not worried about Covid at the personal level.

So the top end of the error bars tip above 50%? In the real world if AZ had the same results against the original variant then it would have gone straight on the bin. I don't know why you're pretending otherwise.

You can't say that AZ offered any protection in that care home. The only thing we know for sure is that 60% of residents who contracted the variant had been vaccinated with AZ. The low numbers of people infected could be due to the outbreak being caught early rather than any effect from vaccination.

I'd like to see all this risk data broken down by BMI as well as age. That's another huge risk factor for COVID that is effectively being ignored.

Agree. Quoted stats are iirc 80% of ICU admissions are overweight. Therefore using the methodology presented in the risk charts anyone not overweight would presumably be justified in dividing their underlying ICU risk by 5. This makes a significant difference to the 40-50 age range under discussion within the terms presented by those advising the judgement on our behalf.

@wintertravel1980

If I were in charge I'd have bough more of the mRNA vaccines from the outset and given the majority of the AZ to coax.

It is very, very easy to make such statements in 2021.

UK placed its first (very sizeable) order with Pfizer in July 2020, way ahead of most other countries. Back then mRNA technology was largely untested and placing full reliance on it would have been a major gamble. We hedged our bets by ordering a range of traditional vaccines (including AZ).

Pfizer is a US company which means it will always prioritise the US deliveries at the expense of everything else. What we have negotiated (e.g. 5.8m vaccines in December 2020, consistent deliveries throughout 2021) was already pretty good.

AZ is not a traditional vaccine - I don't know why people think that. I'd have bought enough mRNA and enough Novavax (which is a traditional vaccine) to do everyone and probably enough AZ simply because it's cheap and was ready early. I'd have also funded factories for these vaccines to be made in the UK as countries were obviously going to stop exports.

@QueenStromba - as you were sceptical of all the vaccines until late February, I’m glad you were not in charge of procurement as you would have royally fucked that up, ordering so late.

As for the AZ vaccine and it being worse than nothing - the facts show otherwise, with massively lower death rates now than previously, despite most people having been given the worse-than-nothing vaccine. The fact is, all people, even those given Pfizer, will inevitably need boosters against future variants at some stage. AZ recipients may be at the front of the queue for those if they are considered more at risk, but all people will need them to be protected. And yes, of course the SA variant is of particular concern, particularly if that or similar variants gain significant traction before boosters can be offered against that and any other future variants of concern, but the study you linked didn’t record any severe disease or death, didn’t measure T-cell response, nor did it follow an appropriate vaccination window, so it was a useful warning for anyone having to rely on AZ (and other vaccines, as all have reduced efficacy against this), but severely inadequate in terms of relying on that to decide to halt AZ vaccinations. It also didn’t involve elderly people - at least the care home in Lambeth was a demonstration of the survival of 100% of the people most likely to be killed by covid pre-vaccination, again not remotely adequate to rely on as proof of anything, but frankly no less inadequate to draw final conclusions from than the SA trial.

This makes a significant difference to the 40-50 age range under discussion within the terms presented by those advising the judgement on our behalf.

@SempreSuiGeneris totally agree. It's always struck me as odd that people are happy to throw all the totals together and come up with a magic number.

[quote Walkaround]@Schulte - you see, this is what I don’t understand. When has the Government or anyone ever actually said you must have your vaccine now or we will refuse ever to vaccinate you at all, ever? All I’ve heard is calls for over 50s, etc, etc, to come forward and have their vaccine if they haven’t already, not that that window has now closed and only people under 50 are now allowed to be vaccinated. You’re perfectly free to delay til the cows come home, or you get covid, or the country runs out of vaccines.[/quote]
There are plenty over 40 who are desperate to have an alternative to AZ but they don’t know how, when, or indeed IF they will ever be able to get it. So they are feeling forced to take what’s being offered to them now.

Re dependence on AZ, of course the UK bought way more AZ doses than alternative ones to start with. How can you deny that? It’s a simple fact.

@Schulte - that applies to 100% of people, though. If there were enough alternatives for everyone to have an alternative to AZ, I don’t think you’d find many people complaining they want to be given AZ, instead. As there isn’t enough for everyone to have a choice, why do you think you in particular should have a choice, and what would you do if you sat on the internet for hours and still couldn’t get in fast enough to opt for the centres offering a different vaccine, or were not privileged enough to be able to travel and pick any time on any day to ensure you got your way? Would you just not get vaccinated? Would you feel less panicky about what to do?

To the posters constantly saying ‘but we wouldn’t be where we are now without AZ’, how is that a counter argument to what I’m saying - that all under 50s should have been given the option to access a different vaccine as soon as the link became clear in late March or early April? Covid numbers were already low at that time so the possible delay would hardly have caused a huge spike or hundreds of deaths. Nobody here is saying AZ shouldn’t have been used at all.

Re dependence on AZ, of course the UK bought way more AZ doses than alternative ones to start with. How can you deny that? It’s a simple fact.

UK bought 100 million of AZ (which was indeed more than what we needed) but it was not done at the expense of other vaccines. We also ordered:

• 40 million Pfizer (including the priority delivery of 5.8 million doses in December 2020) - the order has now been upsized to 100 million;
• 60 million Novavax
• 30 million J&J
• 17 million Moderna (that was a relatively late order with the first delivery coming in April)
• 60 million Valneva

And, of course, we have also ordered 60 million of Sanofi/GSK that, unfortunately, didn't pass stage 2 trials. How many people remember that it was considered one of the "frontrunner" vaccines with many countries (particularly, France) banking on its success? If Sanofi/GSK had come through, the vaccine situation in the EU/UK would have been very different.

@Walkaround, as I said, we’re talking about the past three weeks or so since the link has become clearer. The rollout was already on the under 50s at that point. It was simply too late for everyone else, since they had already been vaccinated. So the question whether 100 percent of the population would want a choice is irrelevant.

And if you read these threats, lots of people are still very happy to have AZ.

In Germany demand for alternatives is now managed by saying to the under 60s ‘if you want AZ, you can have it now. Otherwise wait your turn’. Seems a sensible approach.

@Schulte - you have noticed the country is coming out of lockdown, I presume, that vaccines take several weeks to become effective, and that covid is still in the community? Yet you are supremely confident that telling people in March or April they might do better waiting to get a different vaccine to the AZ vaccine would have been a good idea?

@Schulte

To the posters constantly saying ‘but we wouldn’t be where we are now without AZ’, how is that a counter argument to what I’m saying - that all under 50s should have been given the option to access a different vaccine as soon as the link became clear in late March or early April? Covid numbers were already low at that time so the possible delay would hardly have caused a huge spike or hundreds of deaths. Nobody here is saying AZ shouldn’t have been used at all.

It is a counterargument to your comment that we have been too dependent on AstraZeneca . The risk of Covid is low at the moment for you because other people have had AstraZeneca. There isn't enough other vaccines to give everyone a different vaccine at the moment so they are prioritising people under 40 because for them the risks outweigh the benefits. That isn't the case for people over 40. Nobody is forcing you to have AstraZeneca. You can wait until there are more other vaccines.